Trainees' perceptions of being allowed to fail in clinical training: A sense‐making model

Abstract

Introduction Clinical supervisors allow trainees to fail during clinical situations when trainee learning outweighs concerns for patient safety. Trainees perceive failure as both educationally valuable and emotionally draining; however, the nuance of supervised failures has not been researched from the trainee perspective. This study explored trainees' awareness and their experience of failure and allowed failure to understand those events in‐depth. Methods We interviewed 15 postgraduate trainees from nine teaching sites in Europe and Canada. Participants were a purposive sample, representing 1–10 years of clinical training in various specialties. Consistent with constructivist grounded theory, data collection and analysis were iterative, supporting theoretical sampling to explore themes. Results Trainees reported that failure was a common, valuable, and emotional experience. They perceived that supervisors allowed failure, but they reported never having it explicitly confirmed or discussed. Therefore, trainees tried to make sense of these events on their own. If they interpreted a failure as allowed by the supervisor, trainees sought to ascertain supervisory intentions. They described situations where they judged supervisor's intentions to be constructive or destructive. Discussion Our results confirm that trainees perceive their failures as valuable learning opportunities. In the absence of explicit conversations with supervisors, trainees tried to make sense of failures themselves. When trainees judge that they have been allowed to fail, their interpretation of the event is coloured by their attribution of supervisor intentions. Perceived intentions might impact the educational benefit of the experience. In order to support trainees' sense‐making, we suggest that supervisory conversations during and after failure events should use more explicit language to discuss failures and explain supervisory intentions.

Developing and pilot testing competence cards in clinical rotations: medical students’ and supervisors’ perception

“…Other studies have focused on patient safety, as one of the major problems is medication management, knowledge of e.g. incident reporting, being able to manage distractions and interruptions as well as di culties in talking about mistakes (10)(11)(12).…”

The role of feedback in supporting trainees who underperform in clinical environments

“…We use the term trainee to represent learners at all stages of their journey: from pre-service students undertaking clinical placements to clinicians completing specialised training. We primarily focus here on sustained underperformance, although sometimes failure might occur at a micro-level, e.g., where trainees are allowed to fail without compromising patient safety ( 18 ), or as a self-assessment where performance was below personal expectation ( 2 ).…”