Alina Smirnova's PhD Defense


On April 4th Alina Smirnova has successfully defended her thesis entitled “Unpacking quality in residency training and health care delivery”, also receiving the high distinction cum laude.

In her thesis she focused on the relationship between quality of post-graduate medical training and quality of care in clinical teaching departments responsible for post-graduate medical (residency) training in the Netherlands.

She tested the long-held assumption that what’s good for residents and residency training (for example, a supportive learning climate and high quality clinical teaching) automatically translates to better care for patients and better patient outcomes in the clinical teaching departments. Using clinical and patient experience data as well as validated resident questionnaires, she investigated this assumption across a range of specialties, quality indicators and patient outcomes.

Her findings showed that good residency training does not always go hand in hand with good patient care or patient outcomes, in some instances showing negative associations with patient outcomes. While much more research is needed in order to understand the reasons for the associations, the results of the research presented in this thesis point to the existence of complex and not yet understood interactions between residency training, health care delivery and patient outcomes in the studied clinical teaching departments.

The key recommendation is that a better understanding of the complex relationships between residency training and health care quality and a closer collaboration between key stakeholders in educational and healthcare is needed in order to optimize residency training and patient care in clinical teaching departments.

We congratulate Alina with her outstanding achievement.

Promotores: Prof.dr. C.P.M. van der Vleuten, Prof.dr. M.J.M.H. Lombarts
Co-promotores: Prof.dr. O.A. Arah, Dr. R.E. Stalmeijer

Alina Smirnova obtained a bachelor (physiology and health sciences) at the University of Toronto in Canada in 2008, followed by a medical training in 2012. The combination of research, policy and patient care has always had her interest.