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Balancing closure and discovery: adaptive expertise in the workplace
Maria Louise Gamborg1,2,3, Rune Dall Jensen4,5, Peter Musaeus6
1Centre for Educational Development (CED), Aarhus University, Trøjborgvej 82-84, 8000, Aarhus C., Denmark. gamborg@clin.au.dk.
Advances in Health Sciences Education : Theory and Practice
|November 23, 2022
Summary
Clinical supervision can foster adaptive expertise in residents by supporting both discovery and closure. Aligning expectations is key for effective workplace learning in healthcare professions education.
Area of Science:
- Medical Education
- Health Professions Education
- Clinical Practice
Background:
- Adaptive expertise is crucial for navigating complex clinical environments.
- Workplace learning's role in developing adaptive expertise requires further investigation.
- Clinical supervision is a key component of resident education.
Purpose of the Study:
- To explore how clinical supervision supports the development of adaptive expertise in residents.
- To identify supervisory practices that promote adaptive expertise.
- To understand the relationship between supervision and adaptive expertise in emergency departments.
Main Methods:
- Focused ethnography conducted in two emergency departments.
- Observation of 75 supervising situations involving 27 residents.
- Analysis of 116 pages of field notes from observed interactions.
Main Results:
- Supervision served dual purposes: closure (ensuring safety) and discovery (promoting learning).
- Discovery-oriented supervision included practices like 'productive struggle'.
- Closure-oriented supervision involved practices like information verification.
Conclusions:
- Supervision is a shared responsibility requiring aligned expectations.
- Supervision is a dynamic process, shifting between discovery and closure.
- Discovery-oriented supervision is valuable, even in high-pressure clinical settings.
Keywords:
Adaptive expertiseClinical supervisionEmergency medicineEthnographyGeriatric medicineMedical educationQualitative researchResidency trainingMore Related Videos
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