Clinical supervision is an essential component of postgraduate medical training and professional development. Which of the following factors is considered MOST important for effective supervision?
- A.) Availability of the supervisor
- B.) Quality of the relationship between supervisor and trainee
- C.) Structure and content of the supervision
- D.) Training and skills of the supervisor
B.): Quality of the relationship between supervisor and trainee
Clinical supervision in medicine plays a vital role in graduate medical education; it has been defined as a formal process of professional support and learning which enables individual practitioners to develop knowledge and competence, and is acknowledged to be a life-long process.1 Kilminster and Jolly described clinical supervision in medicine as “the provision of monitoring, guidance and feedback on matters of personal, professional and educational development in the context of the doctor's care of patients”.2
Supervision is a complex activity that occurs in a variety of settings. There is sufficient evidence that supervision has a positive effect on patient outcome; conversely, lack of supervision is harmful to patients. Because it involves an interpersonal exchange, measurement of the supervisory process, and especially the outcomes, is difficult to achieve.
There is wide variation in frequency and amount of clinical supervision among institutions and between medical specialties. It is important to note that supervision is different from mentoring or coaching, because it includes an evaluative component. The learning environment, as well as good communication and feedback, are important features of effective supervision. Most authors agree that supervision should be structured; supervision contracts have been postulated to be useful, with delineation of frequency, duration and content. However, there is little research to date as to the quality and content of effective supervision.
Empirical studies have demonstrated that quality of the supervisory relationship is the single most important factor for effective supervision. A good relationship should be positive, supportive and non-judgmental, trustworthy and built on mutual respect.
Training in clinical supervision for both the supervisee and the supervisor may provide a better understanding of the clinical supervision process from the other’s viewpoint, and possibly to become aware of best practice guidelines. Trainee behavior and attitudes toward supervision have not been studied very well; these can be detrimental to the learning process, and therefore are worthy of further investigation.
- Martin P, Copley J, Tyack Z. Twelve tips for effective clinical supervision based on a narrative literature review and expert opinion. Med Teach. 2014 Mar;36(3):201-7.
- Kilminster SM, Jolly BC. Effective supervision in clinical practice settings: a literature review. Med Educ. 2000 Oct;34(10):827-40.
Swapna Chaudhuri, MD, PhD
Professor & Vice-Chair for Administration
Associate Program Director – Curriculum & Assessment
Department of Anesthesiology
Texas Tech University Health Sciences Center