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      An evaluation of the current patterns and practices of educational supervision in postgraduate medical education in the UK

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          Abstract

          Introduction

          Globally, clinical supervision has been widely adopted and studied. But in the UK, another variant of supervision has developed in the form of educational supervision. The quality of supervision remains highly variable and inadequate time, investment and guidance hinders its ability to actually benefit trainees. Therefore, undertaking a detailed study of the patterns and practices in educational supervision to inform developments in supervisory practice would be extremely beneficial.

          Methods

          In this mixed methods study, educational supervisors and trainees working within a large London Trust were surveyed online about their experiences of educational supervision. In addition, observations of supervision sessions with a small group of supervisor and trainee pairs followed-up by semi-structured interviews were conducted. The quantitative data were analyzed using statistical software via descriptive statistics. The qualitative data underwent thematic framework analysis.

          Results

          Both the qualitative and quantitative data revealed that whilst most junior doctors and supervisors value the ideal of educational supervision as a process for engaging in mentoring dialogues, it can become a tick box exercise, devaluing its usefulness and purpose. Trainees highlighted the need for more frequent formal meeting along with better preparation by supervisors. Supervisors would appreciate more support from trusts to help them enhance supervision for trainees.

          Conclusion

          The effectiveness of educational supervision can be improved with trainees and supervisors engaging in meaningful preparation and proactive communication before meetings. During these formal meetings, improving the quality of feedback and ensuring that regular mentoring dialogues occurred would be highly valuable.

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          Most cited references30

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          Qualitative data analysis for applied policy research

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            Five Misunderstandings About Case-Study Research

            (2013)
            This article examines five common misunderstandings about case-study research: (1) Theoretical knowledge is more valuable than practical knowledge; (2) One cannot generalize from a single case, therefore the single case study cannot contribute to scientific development; (3) The case study is most useful for generating hypotheses, while other methods are more suitable for hypotheses testing and theory building; (4) The case study contains a bias toward verification; and (5) It is often difficult to summarize specific case studies. The article explains and corrects these misunderstandings one by one and concludes with the Kuhnian insight that a scientific discipline without a large number of thoroughly executed case studies is a discipline without systematic production of exemplars, and that a discipline without exemplars is an ineffective one. Social science may be strengthened by the execution of more good case studies.
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              Guidelines: the do’s, don’ts and don’t knows of feedback for clinical education

              Introduction The guidelines offered in this paper aim to amalgamate the literature on formative feedback into practical Do’s, Don’ts and Don’t Knows for individual clinical supervisors and for the institutions that support clinical learning. Methods The authors built consensus by an iterative process. Do’s and Don’ts were proposed based on authors’ individual teaching experience and awareness of the literature, and the amalgamated set of guidelines were then refined by all authors and the evidence was summarized for each guideline. Don’t Knows were identified as being important questions to this international group of educators which if answered would change practice. The criteria for inclusion of evidence for these guidelines were not those of a systematic review, so indicators of strength of these recommendations were developed which combine the evidence with the authors’ consensus. Results A set of 32 Do and Don’t guidelines with the important Don’t Knows was compiled along with a summary of the evidence for each. These are divided into guidelines for the individual clinical supervisor giving feedback to their trainee (recommendations about both the process and the content of feedback) and guidelines for the learning culture (what elements of learning culture support the exchange of meaningful feedback, and what elements constrain it?) Conclusion Feedback is not easy to get right, but it is essential to learning in medicine, and there is a wealth of evidence supporting the Do’s and warning against the Don’ts. Further research into the critical Don’t Knows of feedback is required. A new definition is offered: Helpful feedback is a supportive conversation that clarifies the trainee’s awareness of their developing competencies, enhances their self-efficacy for making progress, challenges them to set objectives for improvement, and facilitates their development of strategies to enable that improvement to occur. Electronic supplementary material The online version of this article (doi: 10.1007/s40037-015-0231-7) contains supplementary material, which is available to authorized users.
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                Author and article information

                Contributors
                priyankmpatel@hotmail.com
                Journal
                Perspect Med Educ
                Perspect Med Educ
                Perspectives on Medical Education
                Bohn Stafleu van Loghum (Houten )
                2212-2761
                2212-277X
                3 August 2016
                3 August 2016
                August 2016
                : 5
                : 4
                : 205-214
                Affiliations
                Centre for Medical Education, Barts and the London, School of Medicine and Dentistry, London, UK
                Article
                280
                10.1007/s40037-016-0280-6
                4978634
                27488852
                db8a3212-f23f-4ce4-b332-67ca9acd1182
                © The Author(s) 2016

                Open Access This article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made.

                History
                : 19 February 2016
                : 26 May 2016
                Categories
                Original Article
                Custom metadata
                © The Author(s) 2016

                Education
                educational supervision,postgraduate medical education,trainees,supervisors,clinical context,trainee development,clinical assessment,e‑portfolio

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