An Offer You Can't Refuse: Opportunities for Intraprofessional Collaboration Learning in the Workplace.

Introduction: Intraprofessional collaboration (IntraPC) competencies are invaluable in the care for older adults with complex care needs, but these competencies are not acquired automatically. IntraPC learning requires explicit attention in postgraduate training, where learning usually occurs in the workplace. However, both residents and supervisors struggle with how to incorporate IntraPC learning into daily practice. This study explored how and to what extent current resident-supervisor dialogues (RSDs) provide opportunities for IntraPC learning and explored barriers to IntraPC workplace learning. Methods: In this focused ethnography, we observed RSDs in the geriatric medicine department of a Dutch university medical center, focusing on opportunities for learning about IntraPC in the workplace. After each observation, both the resident and supervisor participated in in-depth interviews to reflect on the observed behavior. Data were then analyzed through inductive coding followed by thematic analysis. Subsequently, themes were discussed during two focus groups to enable collective reflection with research participants. Results: Although ample IntraPC learning opportunities were observed in the current RSDs, they remained underutilized. Participants reported dynamics between residents and supervisors that could obstruct IntraPC learning, including perceived time constraints, feedback misalignment between resident and supervisor, monitoring-focus, and the struggle for entrustment. Discussion: IntraPC learning opportunities in RSDs often remain implicit, even though addressing IntraPC learning does not necessarily require additional supervision time. This implicit learning limits reflection on current collaborative practices. Moreover, dynamics between residents and supervisors may hinder the explicit development of IntraPC competencies. To support improvements in IntraPC learning, supervisors and residents are encouraged to regard IntraPC practices as an important learning topic within RSDs.