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With a grain of salt? Supervisor credibility and other factors influencing trainee decisions to seek in-consultation assistance: a focus group study of Australian general practice trainees.
- Source :
- BMC Family Practice; 2/7/2020, Vol. 21 Issue 1, p1-11, 11p, 6 Charts
- Publication Year :
- 2020
-
Abstract
- Background: 'Ad hoc' help-seeking by trainees from their supervisors during trainee consultations is important for patient safety, and trainee professional development. We explored trainee objectives and activities in seeking supervisor assistance, and trainee perceptions of the outcomes of this help-seeking (including the utility of supervisor responses). Methods: Focus groups with Australian general practice trainees were undertaken. All data was audio-recorded and transcribed, coded using in-vivo and descriptive codes, and analysed by the constant comparison of provisional interpretations and themes with the data. Findings are reported under the over-arching categories of help-seeking objectives, activities and outcomes. Results: Early in their general practice placements trainees needed information about practice facilities, and the "complex maze" of local patient resources and referral preferences: some clinical presentations were also unfamiliar, and many trainees were unaccustomed to making patient management decisions. Subsequent help-seeking was often characterised informally as "having a chat" or "getting a second opinion" so as not to "miss anything" when trainees were "not 100% sure". Trainees emphasised the importance of being (and demonstrating that they were) clinically safe. Workflow constraints, and supervisory and doctor-patient relationships, had a powerful influence on trainee help-seeking activities. An etiquette for providing help in front of patients was described. Trainees assessed the credibility of supervisors based on their approach to risk and their clinical expertise in the relevant area. Several trainees reported reservations about their supervisor's advice on occasions. Conclusion: A trainee's subsequent help-seeking is strongly influenced by how their supervisor responds when their help is sought. Trainees prefer to seek help from credible supervisors who respond promptly and maintain trainee 'face' in front of patients. Trainees learn through help-seeking to make their own clinical decisions but may remain uncertain about professional and societal expectations, and curious about how other general practitioners practise. Trainees value opportunities throughout their training to observe expert general practice. [ABSTRACT FROM AUTHOR]
- Subjects :
- FAMILY medicine
FOCUS groups
HELP-seeking behavior
HOSPITAL medical staff
INTERNSHIP programs
LEARNING
MEDICAL referrals
PATIENT safety
PHYSICIAN-patient relations
PROFESSIONAL employee training
WORKFLOW
DECISION making in clinical medicine
THEMATIC analysis
CLINICAL supervision
DESCRIPTIVE statistics
Subjects
Details
- Language :
- English
- ISSN :
- 14712296
- Volume :
- 21
- Issue :
- 1
- Database :
- Complementary Index
- Journal :
- BMC Family Practice
- Publication Type :
- Academic Journal
- Accession number :
- 141596711
- Full Text :
- https://doi.org/10.1186/s12875-020-1084-7