Clinical supervision in general practice training: the interweaving of supervisor, trainee and patient entrustment with clinical oversight, patient safety and trainee learning

Sturman, Nancy; Jorm, Christine

doi:10.1007/s10459-020-09986-7

Cited by 18 publications

(25 citation statements)

References 29 publications

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“…Supervisor observers may offer similar affordances in some respects, although with ad hoc observation the supervisor typically joins and exits mid‐consultation, 23,24 leaving no opportunity for timely pre‐ or post‐consultation conversation. Scheduled sessions of supervisory observation, on the other hand, would allow observation of diverse, entire consultations, and timely conversation between consultations.…”

Section: Discussionmentioning

confidence: 99%

The educational affordances of external clinician observation of GP trainee consultations

Sturman

Fitzmaurice

Waters³

et al. 2022

Medical Education

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Aim There is widespread agreement about the importance of direct observation of trainee practice by clinical supervisors. Less is known about observation by observers external to the supervisory team. We explored the educational affordances of external observation of GP trainee consultations for educational and assessment purposes, from the perspectives of both observers and trainees. Method GP medical educators, who were scheduled to observe sessions of GP trainee consultations, were recruited as participant observers. They completed field notes, reflective memos and a focus group discussion, and conducted post‐observation interviews with trainees, focused on trainee experiences of accessing educational input from supervisors and observers during the sessions. Thematic analysis was guided by constructivist realism and socio‐cultural theory. Results A total of 23 observation sessions (131 observed patient consultations), 33 trainee interviews and 23 observer reflections were completed. External observers embraced teaching, coaching and pastoral opportunities, rather than being ‘flies on the wall’, despite also having research and assessment roles. They gained useful insights into the challenges of obtaining and providing in‐consultation supervisory assistance and provided some in‐consultation guidance themselves. Both trainees and observers experienced the sessions as valuable and collegial. Trainees appreciated post‐consultation feedback conversations: topics included consultation challenges, managing uncertainty and variation in clinical practice. Patient expectations and pre‐existing relationships influenced the distinctive interpersonal dynamic of the externally observed consultation. Conclusions The educational affordances and interpersonal dynamics of external observation differ from supervisor observation. We recommend wider use in clinical training of observers who cross between educator and clinician communities.

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Section: Discussionmentioning

confidence: 99%

The educational affordances of external clinician observation of GP trainee consultations

Sturman

Fitzmaurice

Waters³

et al. 2022

Medical Education

Self Cite

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“…In the practice community, the identity of the learner is continuously reproduced, and the learner moves from being a bystander to a participant and, finally, to a demonstrator of mature practice. In other words, they change from being a legitimate marginal participant as a novice to being a core member of the community as an expert step by step ( 20 , 21 ).…”

Section: Methodsmentioning

confidence: 99%

Real Workload-Situated Training in COVID-19 Prevention of General Practice Residents in China: A Situated Cognition Study

Rao

Luo

et al. 2021

Front. Public Health

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Objective: The participation of general practice (GP) residents in COVID-19 prevention and control tasks touched workload participation in public health and disease prevention and control and was also a rare, valuable training experience for the residents and research material for medical education. This experience contributed to the understanding of three key points: First, was the content of the COVID-19 prevention task suited to them, or did it overload them in the present? Second, their competence in the COVID-19 prevention task reflected whether the early medical school training was sufficient or not. Third, what can be drawn from this study to promote public health training in the future? This study aimed to explore these issues by conducting a real epidemic situated training (REST) program.Methods: A situated cognition study was designed that included situational context design, legitimate peripheral participation, and the construction of a community of practice. The Task Cognitive Load Scale (NASA-TLX Scale) and self-developed questionnaires were adopted to conduct a questionnaire survey of resident doctors in a GP training program from West China Hospital of Sichuan University, and 183 questionnaires were collected. SPSS 23.0 statistical software was used for the statistical analysis of data.Results: The NASA scale showed that the intensity of field epidemic prevention and control (training) was tolerable. In particular, there was statistical difference in the cognitive load intensity of training before and after the epidemic occurred at different time points (P < 0.05). This shows that they were early trained and well-prepared before sudden outbreak of the COVID-19. Before the outbreak of the epidemic, the public health knowledge and training received came from undergraduate education (83.16%), early residents program training (69.47%), online self-study (49.16%), and continuing education (20.53%).Conclusion: Former medical school education and training at the regulatory training stage have a good effect and enable residents to master the skills required for epidemic prevention and control and to physically and mentally prepare for the task. After this stage, epidemic prevention and control training in real situations will make important contributions to the self-assessment and performance improvement of public health training.

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“…In other words, they change from being a legitimate marginal participant as a novice to being a core member of the community as an expert step by step. [21,22] As it is described above , the real situational design of REST program is drawn in Table 1 Participant Resident doctors in a GP training program from West China Hospital of Sichuan University, and 183 questionnaires were collected. The participants were described in Table 2.…”

Section: Construction Of a Community Of Practicementioning

confidence: 99%

Real Workload-Situated Training in COVID-19 Prevention of General Practice Residents in China: A Situated Cognition Study

Rao

et al. 2021

Preprint

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Objective:The participation of general practice (GP) residents in COVID-19 prevention and control tasks touched workload participation in public health and disease prevention and control and was also a rare, valuable training experience for the residents and research material for medical education . This experience contributed to the understanding of three key points: First, was the content of the COVID-19 prevention task suited to them, or did it overload them in the present? Second, their competence in the COVID-19 prevention task reflected whether the early medical school training was sufficient or not .Third, what can be drawn from this study to promote public health training in the future? This study aimed to explore these issues by conducting a real epidemic situated training (REST) program.Methods: A situated cognition study was designed that included situational context design, legitimate peripheral participation, and the construction of a community of practice. The Task Cognitive Load Scale (NASA-TLX Scale) and self-developed questionnaires were adopted to conduct a questionnaire survey of resident doctors in a GP training program from West China Hospital of Sichuan University, and 183 questionnaires were collected. SPSS 23.0 statistical software was used for the statistical analysis of data.Results: The NASA scale showed that the intensity of field epidemic prevention and control (training) was tolerable. In particular, there was no statistical difference in the cognitive load intensity of training before and after the epidemic occurred at different time points (P<0.05). This shows that they were early trained and well prepared before sudden outbreak of the COVID-19.Before the outbreak of the epidemic, the public health knowledge and training received came from undergraduate education (83.16%), early residents program training (69.47%), online self-study (49.16%), and continuing education (20.53%). Conclusion:Former medical school education and training at the regulatory training stage have a good effect and enable residents to master the skills required for epidemic prevention and control and to physically and mentally prepare for the task. After this stage, epidemic prevention and control training in real situations will make important contributions to the self-assessment and performance improvement of public health training,and make participants more competent to face the epidemic task.

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Clinical supervision in general practice training: the interweaving of supervisor, trainee and patient entrustment with clinical oversight, patient safety and trainee learning

Cited by 18 publications

References 29 publications

The educational affordances of external clinician observation of GP trainee consultations

The educational affordances of external clinician observation of GP trainee consultations

Real Workload-Situated Training in COVID-19 Prevention of General Practice Residents in China: A Situated Cognition Study

Real Workload-Situated Training in COVID-19 Prevention of General Practice Residents in China: A Situated Cognition Study

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