Contributions to social and material resources in the community | Many participants emphasized the value of the involvement of the residents in the community
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Residents participate in clubs, coach sports teams, and engage in community fundraising, all of which directly benefit the community -
“We all live here and work here; those we meet in other ways, we impact their lives and we spend our salaries here …. And now Nanaimo is investing a lot of money here as well … the facilities, like the new simulator lab that is being built, probably wouldn’t be here otherwise” (Resident) -
The program provides a small but consistent economic gain for the community through contributions to the general economy
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Expanded knowledge and perspective brought to practice settings | Participants across all groups described the variety of experience, knowledge, background, and interests brought to Nanaimo by the residents
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There is value in having young physicians in the community. In practice, there are advantages to having fresh perspectives and “multiple sets of eyes” working with patients -
Nurses noted an increase in interdisciplinary practice facilitated by the presence of residents
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Relationships and attitudes in the hospital and community clinical settings | The nurses and physicians agreed that the residents recruited to the program had excellent attitudes and had a willingness to learn and be part of a team. This contributed to a very collegial environment in the hospital
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Although several nurses suggested that having the residents in the hospital added another layer of complexity to working relationships, the benefits of having young, energetic, respectful doctors with positive attitudes were appreciated -
Participants were in agreement that community members outside of the hospital appeared to be very accepting of the residents
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Communication and teamwork | Participants, particularly nurses, believed that residents improved communication among care providers by introducing new knowledge to discussions and by facilitating interaction among practitioners
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Nurses gave examples of residents informing the team of new developments in health care, contributing to journal clubs, assisting with examination preparation for immigrant doctors, and facilitating referrals to specialists -
The approach of the leadership was instrumental to creating a team atmosphere at the hospital in Nanaimo. “[The leadership’s] commitment to meeting with the nurses on a quarterly basis is the best possible thing they could have done for a smooth transition …. They are very good at listening, explaining, and following up [on concerns] if something is out of line” (Nurse) -
Residents are available to spend time with patients, to listen, and to thoroughly explain things to them. “[Involving residents] has worked really well in terms of increased communication [between home care and the chronic pain management clinic] …. In the past we didn’t always get medication changes in a timely fashion …. Residents have helped to address that gap” (Nurse)
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Accessibility and understanding of health care and the health care system | According to participants, the most considerable effect of the residency program was the increased accessibility of health services and health information
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All participants emphasized the greater amount of time that residents had to interact with patients -
Nurses said that having residents available gave them easier access to physicians, allowing them to triage patients and to get referrals and new admissions to the hospital moving faster -
Having residents on call at night was acknowledged as key in alleviating pressure for physicians and nurses -
Residents on-site provide educational opportunities for patients. “As the doctor is explaining and teaching the resident, the patient is also having things clarified for them” (Nurse) -
The age and sex of the residents might also increase accessibility. “In my clinic it’s all male doctors except for when we [the 2 female residents] are there. So I see a lot of teenage girls who are more comfortable seeing one of us and [they tell us things] they might not tell their male physician ....” (Resident)
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Excellence in care | There was consensus among the groups that having residents in the hospital had a positive effect on the quality of care
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Physicians teaching residents must maintain high standards and stay up to date; teaching encourages physicians to view their practices with a more critical eye -
Residents are able to interact with patients for a longer period of time, leading patients to perceive that the quality of care has increased -
The designation as a teaching hospital has improved the reputation of the hospital, particularly in the academic community, and patients now assume that things are “cutting edge” -
Wait times in clinics have decreased as a result of having residents on staff; in the hospital, residents are able to do consultations that might otherwise be put off until the next day -
Some residents are able to follow up with their patients and this might increase continuity and quality of care -
Nurses described residents’ influence on practice as positive and negative, as there was now another layer of complexity in the management of care and a new group of learners that might decrease the learning opportunities of nursing students -
Nurses did have concerns about the quality of care at night, particularly in the maternity ward when obstetricians had residents doing things that might have been outside of their scope of practice (by not coming in when they were called and leaving residents in charge)
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Physicians returning to the community to practise | There was a strong sense among service providers that having a residency training site in Nanaimo might facilitate the recruitment of physicians to the area
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