Clinical Supervision in General Practice Training: The Interweaving of Supervisor, Trainee and Patient Entrustment with Clinical Oversight, Patient Safety and Trainee Learning

Autor/inn/en	Sturman, Nancy; Parker, Malcolm; Jorm, Christine
Titel	Clinical Supervision in General Practice Training: The Interweaving of Supervisor, Trainee and Patient Entrustment with Clinical Oversight, Patient Safety and Trainee Learning
Quelle	In: Advances in Health Sciences Education, 26 (2021) 1, S.297-311 (15 Seiten)Infoseite zur Zeitschrift PDF als Volltext Verfügbarkeit
Zusatzinformation	ORCID (Sturman, Nancy)
Sprache	englisch
Dokumenttyp	gedruckt; online; Zeitschriftenaufsatz
ISSN	1382-4996
DOI	10.1007/s10459-020-09986-7
Schlagwörter	Foreign Countries; Medical Students; Trainees; Help Seeking; Supervision; Supervisory Methods; Supervisor Supervisee Relationship; Patients; Trust (Psychology); Clinical Experience; Australia + Suchen Sie Ihr Suchwort? Ausland; Auszubildender; Weibliche Auszubildende; Help-seeking behavior; Help-seeking behaviour; Hilfe suchendes Verhalten; Patient; Australien
Abstract	Australian general practice trainees typically consult with patients from their first week of training, seeking in-consultation supervisory assistance only when not sufficiently confident to complete patient consultations independently. Trainee help-seeking plays a key role in supervisor oversight of trainee consultations. This study used focus groups and interviews with general practice supervisors to explore their approaches to trainee help-seeking and in-consultation supervision. Supervisor approaches are discussed under three themes: establishing a help-seeking culture; perceptions of in-consultation assistance required; and scripts for help provision. Within these themes, three interwoven entrustment processes were identified: supervisor entrustment; trainee self-entrustment; and 'patient entrustment' (patient confidence in the trainee's clinical management). Entrustment appears to develop rapidly, holistically and informally in general practice training, partly in response to workflow pressure and time constraints. Typical supervisor scripts and etiquette for help-provision involve indirect, soft correction strategies to build trainee self-entrustment. These scripts appear to be difficult to adapt appropriately to under-performing trainees. Importantly, supervisor scripts also promote patient entrustment, increasing the likelihood of patients returning to the trainee and training practice for subsequent review, which is a major mechanism for ensuring patient safety in general practice. Theories of entrustment in general practice training must account for the interplay between supervisor, trainee and patient entrustment processes, and work-related constraints. Gaps between entrustment as espoused in theory, and entrustment as enacted, may suggest limitations of entrustment theory when extended to the general practice context, and/or room for improvement in the oversight of trainee consultations in general practice training. (As Provided).
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Erfasst von	ERIC (Education Resources Information Center), Washington, DC
Update	2024/1/01