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How clinical supervisors develop trust in their trainees: a qualitative study.

Karen E Hauer1, Sandra K Oza2, Jennifer R Kogan2

  • 1Department of Medicine, University of California San Francisco, San Francisco, California, USA.

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Summary

Supervisors build trust in medical residents through observation, inference, and team input. This trust influences resident autonomy and team dynamics, preparing trainees for independent practice.

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Area of Science:

  • Medical Education
  • Clinical Supervision
  • Healthcare Professional Development

Background:

  • Clinical supervisors assess trainee performance and autonomy.
  • Factors influencing supervisor trust in trainees are known, but trust development is unclear.

Purpose of the Study:

  • To explore how supervisors develop and experience trust in resident trainees.
  • To understand the process of trust formation in clinical workplaces.

Main Methods:

  • Phenomenographic analysis of interviews with internal medicine supervisors.
  • Exploration of supervisors' perspectives on trust development in residents (postgraduate years 2 and 3).

Main Results:

  • Trust was viewed through trainee competence/leadership and supervisor's need for oversight.
  • Supervisors used inference, comparisons, direct observation, and stakeholder input to build trust.
  • Barriers and accelerators to trust formation involved resident, supervisor, relationship, context, and task.

Conclusions:

  • Supervisor trust in residents develops via observation, inference, and multi-source information.
  • Trust judgments impact supervisor roles, resident independence, and team functioning.
  • Findings inform training environments for graded autonomy and readiness for unsupervised practice.