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How Supervisor Experience Influences Trust, Supervision, and Trainee Learning: A Qualitative Study.

Leslie Sheu1, Jennifer R Kogan, Karen E Hauer

  • 1L. Sheu is assistant professor of medicine, Department of Medicine, University of California, San Francisco, School of Medicine, San Francisco, California. J.R. Kogan is professor of medicine, Department of Medicine, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, Pennsylvania. K.E. Hauer is professor of medicine, Department of Medicine, University of California, San Francisco, School of Medicine, San Francisco, California.

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Supervisor experience significantly shapes trust and supervision dynamics, impacting trainee learning. Tailoring supervision approaches to evolving trainee needs is crucial for effective professional development.

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Area of Science:

  • Medical Education
  • Professional Development
  • Qualitative Research

Background:

  • Effective supervision and trust are vital for medical trainees' progression to independent practice.
  • Understanding the nuances of supervisor experience is key to optimizing learning environments.

Purpose of the Study:

  • To investigate how supervisor experience influences trust and supervision dynamics.
  • To explore the subsequent impact on trainee learning and development.

Main Methods:

  • A two-phase qualitative inductive content analysis was employed.
  • Phase one involved analyzing 44 interviews with residents and attending supervisors.
  • Phase two utilized focus groups with 23 trainees to validate supervisor exemplars and discuss learning impacts.

Main Results:

  • Four domains of trust and supervision (data, approach, perspective, clinical) varied with supervisor experience.
  • Early supervisors focused on task completion and rules, while experienced supervisors adopted a holistic and selective approach.
  • Trainees recognized these differences and emphasized the need for flexible supervision aligned with their learning needs.

Conclusions:

  • Supervisor experience fundamentally alters approaches to trust and supervision.
  • Self-trust is a prerequisite for supervisors to effectively trust and guide trainees.
  • Trainees actively seek supervision styles that match their developmental stage and learning requirements.