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Institutional influences on the supervision of GP trainees: a documentary analysis
Dawn Jackson1, Ian Davison2, Josephine Brady3
1College of Medical and Dental Sciences, Medical School, University of Birmingham, Birmingham, UK.
Summary
Institutional influences shape General Practice (GP) supervision for UK trainees. Analysis reveals hierarchical messages prioritizing evidence collection over quality, potentially hindering trainees from raising concerns.
Area of Science:
- Medical Education
- Healthcare Management
Background:
- The supervisory relationship is crucial for postgraduate GP trainees in the UK.
- Institutional factors significantly influence the dynamics of GP supervision.
Purpose of the Study:
- To analyze institutional influences on GP supervision by examining training documentation.
- To understand how institutional expectations shape the supervisory relationship.
Main Methods:
- Content analysis of 60 training documents from key institutions (GMC, RCGP, Health Education West Midlands, university).
- Documents were evaluated based on audience, context, language, and purpose.
Main Results:
- Identified institutional expectations for trainees and supervisors, embedded within practice, profession, and political contexts.
- Prominent messages focused on evidence collation, quality assurance, and patient safety, reinforcing an institutional hierarchy.
- Trainees' ability to raise concerns was structured within this hierarchy, with message emphasis shifting down the chain.
Conclusions:
- The hierarchical system, while aiming for patient safety and high-quality training, may inadvertently devalue quality over evidence collection.
- Conflicting messages from various institutions create tensions and complexities in GP supervision.
- Inconsistencies can lead to divergent perspectives and expectations between trainees and supervisors.
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