Table 2.

Questions for Collaborative Inquiry

Trainee roles

➢ To what extent does this site rely on trainees for its functioning, and (particularly for consortiums) how consistent is this across rotation sites?

➢ How does this site decide whether interns are essential personnel?

➢ How do the rights, benefits, and obligations of interns reflect their status as trainees, versus their status as workers, in our system?

➢ How do the rights, benefits, and obligations of interns differ from those of clinical faculty and/or trainees from other disciplines at our site (e.g., medical residents)?

Requirements

➢ Are there hours-based requirements currently in place in this training setting? If so: (a) What provisions exist to balance quality of hours with quantity of hours? (b) Are there any trainees at a disadvantage for meeting these requirements?

➢ To what extent do we prioritize competency-based training?

➢ What are we doing to ensure that our definitions and measurement of competency are unbiased and support the growth of all trainees?

Aims

➢ Who determines the training aims for this internship (or its rotations?)

➢ How are changes in training aims decided upon, and how much input do trainees have in these changes?

➢ When trainees’ training aims change, what process do we have for evaluating how these changes may impact their future career aims?

Locality

➢ To what extent is locality mandated by the training program, and what are the reasons for these mandates?

➢ How are these reasons balanced with the priorities of ensuring quality care delivery for patients, the safety and wellbeing of trainees, and the quality of training?

➢ Are there different policies for hybrid/remote work for trainees and clinicians at this site? If so, why?

➢ What does our program do to support trainees who have relocated from out of state and have few local connections?

Telehealth

➢ What is the culture around telework in this internship environment? What are implicit or explicit biases surrounding remote telework?

➢ How does this site make use of competencies focused on telehealth provision for trainees, and on telesupervision for supervisors?

➢ Are trainees with different personal circumstances afforded equivalent opportunities for participating in telehealth and, if not, what barriers do they experience?

Economic Security

➢ How do trainee salaries compare to the median income for the internship site’s location?

➢ What kind of safety net is available to trainees who experience sudden life disruptions (e.g., illness, disability, death of a loved one)?

➢ Are interns treated as employees, entitled to workers’ compensation and leave benefits? Why or why not?

Supporting Diverse Trainees

➢ What opportunities exist for trainees from under privileged backgrounds to voice concerns about inequities in a way that is heard and responded to by the training program?

➢ In what ways does our training program model a commitment to equity, beyond statements and advertisement? What concrete actions are being taken to increase equity in the program?

➢ What resources, supportive spaces, systems, and staff facilitate antiracist action within the organizational culture and policies, and among interns and faculty?

Collaborative Decision-Making

➢ In the culture of the internship training program, what are the norms and expectations about trainees’ inclusion, valuation, and involvement in decision-making?

➢ What are the barriers to including interns as collaborators in making decisions that have impacts on training or clinical care?

➢ How does the internship ensure that it is receiving and integrating feedback from interns about topics that matter for interns?