ArticleAcademic medicine : journal of the Association of American Medical Colleges2015
Thresholds of Principle and Preference: Exploring Procedural Variation in Postgraduate Surgical Education.
Article in Academic medicine : journal of the Association of American Medical Colleges, 2015. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 15 papers, 1 of them a synthesis that pooled it.
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Who cites it
15 citing papers in PubMed, 1 synthesis or guideline pooled it.
- The Sequence of Steps: A Key Concept Missing in Surgical Training-A Systematic Review and Recommendations to Include It.International journal of environmental research and public health · 2023Pooled it
- Effects of (de)motivating supervision styles on junior doctors' intrinsic motivation through basic psychological need frustration and satisfaction: an experimental vignette study.Advances in health sciences education : theory and practice · 2025Article
- Ready, or not? A qualitative study of emergency medicine senior residents' perspectives on preparing for practice.AEM education and training · 2025Article
- "It's Always There, Right?" Exploring Internal Medicine Teams' Use of Basic Science Knowledge on Inpatient Rounds.Perspectives on medical education · 2025Article
- Evaluation of veterinary students' suture performance according to three different instructional modalities.Open veterinary journal · 2024Article
- Adult Gastroenterology Trainees' Experience of Receiving Feedback on Their Performance of Endoscopy in the Workplace.Journal of the Canadian Association of Gastroenterology · 2022Article
- Surgical residents' challenges with the acquisition of surgical skills in operating rooms: A qualitative study.Journal of advances in medical education & professionalism · 2021Article
- Unearthing Faculty and Trainee Perspectives of Feedback in Internal Medicine: the Oral Case Presentation as a Model.Journal of general internal medicine · 2019Article
- Navigating Cognitive Dissonance: A Qualitative Content Analysis Exploring Medical Students' Experiences of Moral Distress in the Emergency Department.AEM education and training · 2019Article
- Perceptions on Competence by Design in urology.Canadian Urological Association journal = Journal de l'Association des urologues du Canada · 2019Article
- How Do Thresholds of Principle and Preference Influence Surgeon Assessments of Learner Performance?Annals of surgery · 2018Article
- Cut-scores revisited: feasibility of a new method for group standard setting.BMC medical education · 2018Article
- "Staying in the Game": How Procedural Variation Shapes Competence Judgments in Surgical Education.Academic medicine : journal of the Association of American Medical Colleges · 2016Article
- "They Have to Adapt to Learn": Surgeons' Perspectives on the Role of Procedural Variation in Surgical Education.Journal of surgical educationArticle
- Active Learning in Medical Education: Application to the Training of Surgeons.Journal of medical education and curricular developmentReview
Corrections and comments
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Authors and funding
5 authors.
Funding
Abstract
backgroundExpert physicians develop their own ways of doing things. The influence of such practice variation in clinical learning is insufficiently understood. Our grounded theory study explored how residents make sense of, and behave in relation to, the procedural variations of faculty surgeons.
methodWe sampled senior postgraduate surgical residents to construct a theoretical framework for how residents make sense of procedural variations. Using a constructivist grounded theory approach, we used marginal participant observation in the operating room across 56 surgical cases (146 hours), field interviews (38), and formal interviews (6) to develop a theoretical framework for residents' ways of dealing with procedural variations. Data analysis used constant comparison to iteratively refine the framework and data collection until theoretical saturation was reached.
resultsThe core category of the constructed theory was called thresholds of principle and preference and it captured how faculty members position some procedural variations as negotiable and others not. The term thresholding was coined to describe residents' daily experiences of spotting, mapping, and negotiating their faculty members' thresholds and defending their own emerging thresholds.
conclusionsThresholds of principle and preference play a key role in workplace-based medical education. Postgraduate medical learners are occupied on a day-to-day level with thresholding and attempting to make sense of the procedural variations of faculty. Workplace-based teaching and assessment should include an understanding of the integral role of thresholding in shaping learners' development. Future research should explore the nature and impact of thresholding in workplace-based learning beyond the surgical context.
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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.