Looking back and forward after your SHE defence by Luis Dominguez and Laurents Stassen

On February 23, Luis Dominguez received his doctorate, supervised by Laurents Stassen, Willem de Grave and Diana Dolmans. He has conducted research into the job-crafting skills of residents and the role that supervisors or leaders can play. What can educators do in the clinic to prevent residents from dropping out, very topical subject and good work. Reason enough for first supervisor Laurents Stassen to interview Luis on his research and the impact it can have.

Laurents: Why this topic?

Luis: The aim of this dissertation is to contribute to a better understanding of residents’ persistence in surgical training, considering that almost 20% of residents leave the training programs at a global level. Leaving programs has a negative impact for the sustainability of the surgical workforce, for the normal operation of educational and health institutions and, of course, for the residents who feel demoralized and frustrated.

Laurents: What were the most important findings/conclusions?

Luis: Central in our research is the idea that persistence strongly depends on residents’ work engagement. That is a state of positive wellbeing at work which main characteristics are dedication, vigour and absorption. We explored how residents can enhance their work-engagement in order to persist. How can they gain control and optimize their working conditions in a daily basis? This capacity is known as job-crafting. Additionally, we explored the paramount role of surgeons in charge of training: how they could, strengthen this capacity in the resident, through their leadership.

We found that job-crafting appears to be well developed in residents without serious intentions to leave training. It also diminishes such intentions, which is mediated by their work engagement. In other words, residents persist in training by crafting their jobs, enhancing their work engagement in the process. They do so through several mechanisms aimed to establish satisfactory interactions with surgeons and peers, to look for opportunities to strengthen their autonomy and competence in decision-making and surgical operations, and to diminish the negative impact of frustrations and errors of training.

We also found that surgeons with a transformational leadership style have an important role in strengthening residents’ job-crafting capacity. This can be attributed to specific actions that surgeons undertake in the workplace, such as modelling, connecting, offering support, and coaching.

Laurents: What impact has it or can it have?

Luis: This dissertation is relevant for society because we gained a better understanding in how residents craft their jobs in the benefit of their wellbeing and persistence in training. This in turn is in the benefit of the organization and, therefore, in the benefit of the sustainability of the surgical workforce. We also gained better insight in how surgeons can help residents to do so. Surgeons should offer a supportive environment to strengthen the capacity of residents to optimize their jobs to enhance their work-engagement. As members of the training programs, surgeons must be aware of their responsibility to support residents to self-regulate their job at the workplace. These benefits are critical considering the challenges faced by healthcare systems around the world in terms of global surgery, such as the shortage of the surgical workforce, the raising of the global burden of surgical disease and its costs, and the negative consequences of unsafe surgical care. Therefore, all efforts aimed to overcome these challenges are of relevance to society.

Congratulations Luis