When supervision works: Analysis of supervisors' and residents' perceptions of 'good supervision' using...

To examine how supervisors and residents perceive real-time instances of good intraoperative supervision and where their perceptions align or differ. By exploring how supervisors guide residents toward operative competence, we aim to align their perceptions to support effective learning.

Twenty surgical procedures were video recorded in six Dutch teaching hospitals. After each procedure, supervisors and residents independently selected three instances of good supervision. These clips were reviewed in separate video-stimulated interviews. Transcripts were thematically analyzed using a constructivist approach to explore alignment/misalignment in perceptions.

Supervisors emphasized explicitly contributing to residents' learning according to a self-set standard, whereas residents highlighted supervision that fulfilled their learning needs and was communicated professionally. Substantial agreement on the instance of good supervision did not necessarily imply agreement on the underlying rationale. Residents often recognized their supervisor's intentions but did not always interpret the same behaviors similarly. Differences primarily concerned the timing and nature of supervision actions.

Although perspectives differ by role, learner versus teacher, making them explicit can improve alignment and foster more effective, co-regulated learning in the operating room.