Trainee Identification of the Self-efficacy Domains Needed to Succeed in Undergraduate and Graduate Medical Education.

Self-efficacy is defined as a person's belief in their ability to perform context-specific tasks in a defined domain to accomplish a goal. There is a substantial body of evidence showing that the level of academic self-efficacy predicts achievement in a range of educational contexts, including medical training. The goals of this study were to identify (1) what domains of self-efficacy are most important for success from the perspective of learners at different stages of training and (2) what experiences during training most promote self-efficacy. The nominal group technique was applied to generate top 5 rank-ordered lists for each research question. One group of trainees was sampled from each year of the 4 years of medical school and from each year of the 3 years of post-graduate residency training in internal medicine. The most prevalent domains of self-efficacy identified were skills needed for patient interactions, multitasking while balancing personal wellness, independent studying, professional communication, and interprofessional work. Activities that most promoted self-efficacy related to experiences of mastery in the above domains, especially successful patient care encounters, multitasking, and self-care. Formative feedback and faculty mentorship were also important. We discuss possible interventions in the formal training programs that could better align with these trainee needs for self-efficacy.