Patient Care Ownership in Radiology Residency: Insights from Structured Interviews of Residents and Faculty

Abstract

Introduction/Background: In radiology residency and education globally, fostering a sense of ownership can be an undervalued metric of program success. Ownership drives individual achievement, enhances organizational outcomes, and contributes to improved patient care in medicine. Objective: To explore radiology residents' perceptions of ownership at the start of their postgraduate training, alongside faculty members’ perspectives, identify barriers and facilitators, and use these insights to develop targeted professional development activities. Methods: First-year radiology residents and faculty from the same department participated in 45-minute, semi-structured interviews focusing on participants' views of roles, ownership, and conflict responses. Five residents and five faculty were interviewed. Interviews were transcribed and coded using software. Analysis included three phases: open coding for initial perspectives, axial coding to condense codes into themes, and selective coding to identify theme frequency. Results: Residents' main conception of ownership was taking responsibility. Key factors promoting ownership included: 1) intrinsic motivation, 2) responsibility for patient outcomes, 3) integrity, and 4) patient relationships. Barriers included: 1) others assuming responsibility, 2) report criticism, 3) lack of program support, and 4) lack of confidence. Faculty viewed residents as primarily trainees, with a secondary role in supporting the service, while their own primary responsibility was managing the list and patient care. Faculty noted that residents develop ownership most significantly when challenged and uncomfortable, with a supportive environment enhancing this process. Faculty emphasized the importance of culture and attitudes in fostering the willingness to grow through discomfort. Conclusions: Residents shared similar definitions of ownership but varied in its role during training. External environment was their most significant barrier to ownership. Faculty agreed that the best way to develop ownership is to form a culture that normalizes discomfort and emphasizes its importance. These perspectives offer opportunities for programs to improve professional development and foster ownership.