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

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.

Keywords: Clinical assessment; Clinical context; Educational supervision; E‑portfolio; Postgraduate medical education; Supervisors; Trainee development; Trainees.

Fig. 1

Flow chart illustrating study procedures

Fig. 2

Educational supervision provided is tailored to the level of trainee’s experience and training

Fig. 3

The number of times formal supervision sessions occurred according to trainees and supervisors

Fig. 4

Aspects of educational supervision that need to be improved to make the process more effective based on trainees and supervisors experience of supervision to date

Fig. 5

Framework for improving the effectiveness of educational supervision based on findings from this study and is applicable to both trainees and educational supervisors