Characterizing Residents’ Clinical Experiences—A Step Toward Precision Education

Experiential learning from patient care activities is the primary means by which residents develop the skills that shape their future practice.However, these clinical learning opportunities are typically not well characterized, limiting educators' ability to precisely tailor the experiential curriculum.Elsewhere in JAMA Network Open, Lam and colleagues 1 provide a detailed characterization of internal medicine residents' experiences admitting patients overnight within a single Canadian residency program's 5 teaching hospitals over a 10-year period.The authors developed a bespoke clinical-educational database that captures rich data from the electronic health record (EHR) for each included clinical encounter and subsequently attributes each to a specific admitting resident.Leveraging this database, they identified significant resident, hospital, and temporal variation across 6 domains, including both admission volumes and multiple patient and encounter characteristics.This work contributes in important ways to better understanding the considerable variability that exists in residency training, including unpacking what might be warranted or unwarranted variability.The authors' findings 1 are consistent with those of recent publications also using EHR data to characterize the wide variations in clinical content exposure that exist at both the program and individual resident levels. 2,3Their research 1 also adds new dimensions to our understanding of such variation by evaluating additional factors, including patient acuity, complexity, and social determinants of health.