How supervisors leverage stress to facilitate trainee learning in clinical settings: A six-element model

Area of Science:

• Medical Education
• Psychology
• Clinical Supervision

Background:

• Moderate stress can enhance motivation, memory, and cognitive processing, thereby aiding learning.
• Supervisors play a key role in how stress influences trainee learning in clinical environments.
• The specific strategies supervisors use to leverage stress for learning are not well understood.

Purpose of the Study:

• To explore how supervisors in clinical settings utilize stress to enhance trainee learning.
• To identify specific methods supervisors employ to manage stress for optimal learning outcomes.

Main Methods:

• A constructivist grounded theory approach was used.
• Semi-structured interviews were conducted with 23 supervisors (senior residents and attending physicians) identified by paediatric residents as effective in leveraging stress.
• Constant comparative techniques were employed for iterative analysis of interview data.

Main Results:

• Supervisors viewed stress as a dynamic, individualised factor that can promote learning and readiness for practice.
• Supervisors actively introduced and modulated stressors during challenging patient care situations.
• A six-element model was developed: setting the stage, assessing baseline stress, introducing/modulating stressors, re-assessing, and debriefing.

Conclusions:

• Supervisors can effectively leverage stress to enhance learning in inpatient clinical settings.
• A proactive and cautious approach is necessary to ensure stress supports, rather than hinders, learning.
• Individualised learning experiences are created by managing stressors, preparing trainees for independent practice.