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. 2024 Dec 18;24(1):1434.
doi: 10.1186/s12909-024-06431-w.

Rotational training structures and national employment in public health education: an organizational perspective

Nadieh J L M Taks  1 , Tiuri R van Rossum  2 , Lidewij T Warris  3 , Ellen C Reurslag  3 , Sheda Sadrzadeh  3
Affiliations

Rotational training structures and national employment in public health education: an organizational perspective

Nadieh J L M Taks et al. BMC Med Educ. .

Abstract

Introduction: Postgraduate medical education (PGME) relies on structured training rotations and workplace-based learning (WBL) to provide comprehensive clinical training and professional development. Emphasizing WBL, PGME integrates theoretical knowledge with practical skills through direct patient care involvement, underscoring the pivotal role of training institutes in supporting these initiatives. While curricular changes in PGME have been extensively studied in clinical teaching hospitals, PGME programs in public health (PGME-PH) remain underexplored, yet their multidisciplinary nature post-COVID-19 underscores the urgency for effective curricular reforms. This study explores how training institutions offering PGME-PH navigate the adoption of structured training rotations and a transition to a national employer by examining organizational perspectives to enhance sustainability and integration of educational innovations in this unique context.

Methods: Semistructured interviews were conducted with 14 participants from 8 training institutions offering PGME-PH in the Netherlands between October and November 2022 to explore their experiences with the implementation of a rotational training structure. The interviews were guided by the Consolidated Framework for Implementation Research (CFIR).

Results: The analysis identified three pivotal themes influencing sustainable implementation and ownership: influence, communication, and motivation. Participants expressed concerns about reduced influence in organizing PGME-PH and noted significant communication challenges, such as ambiguity in roles, program frameworks, and financial aspects. Despite these obstacles, participants showed strong motivation for education and underscored the importance of collaboration and shared responsibility.

Conclusion: The successful implementation of structured training rotations was negatively impacted by training institutions' experience of limited influence and communication challenges. This led to diminished ownership of the new PGME-PH curriculum, potentially affecting its long-term sustainability. Despite these challenges, participants maintain high motivation for educational delivery. Enhancing sustainable implementation requires fostering ownership, promoting collective responsibility, establishing clear communication channels, and nurturing motivation. These factors are crucial for ensuring the success and longevity of educational programs such as PGME-PH.

Keywords: CFIR; Postgraduate medical education; Public Health; Rotational training structure.

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Conflict of interest statement

Declarations. Ethical approval and consent to participate: The ethical approval for the study was acquired from the Netherlands Association for Medical Education (NVMO-ERB; file number 2022.1.11). All methods were carried out in accordance with relevant guidelines and regulations, including the Declaration of Helsinki. Participants were thoroughly informed about the study’s objectives before the interviews, and their signed informed consent was obtained prior to recording. We ensured the anonymity of participants by using aliases or codes in quotations. Participation was entirely voluntary and participants had the option to withdraw at any time. Both interview and encoding data were encrypted before being saved to a the hard drive of NSPOH for long-term storage. We also assured participants that they could view the collective findings if they wished. Consent for publication: Not applicable. Competing interests: The authors declare no competing interests.

Figures

Fig. 1
Fig. 1
Overview of new curriculum and transfer of employer
Fig. 2
Fig. 2
Overview of the used domains and constructs in relation to the research context
See this image and copyright information in PMC

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