文章基本信息

标题：How preceptors develop trust in continuity clinic residents and how trust influences supervision: A qualitative study
本地全文：下载
作者：John C. Penner ; Karen E. Hauer ; Katherine A. Julian 等
期刊名称：Perspectives on Medical Education
印刷版ISSN：2212-2761
电子版ISSN：2212-277X
出版年度：2021
卷号：11
期号：2
页码：73-79
DOI：10.1007/s40037-021-00694-5
语种：English
出版社：Springer Verlag
摘要：AbstractIntroductionTo advance in their clinical roles, residents must earn supervisors’ trust. Research on supervisor trust in the inpatient setting has identified learner, supervisor, relationship, context, and task factors that influence trust. However, trust in the continuity clinic setting, where resident roles, relationships, and context differ, is not well understood. We aimed to explore how preceptors in the continuity clinic setting develop trust in internal medicine residents and how trust influences supervision.MethodsIn this qualitative study, we conducted semi-structured interviews with faculty preceptors from two continuity clinic sites in an internal medicine residency program at an urban academic medical center in the United States from August 2018–June 2020. We analyzed transcripts using thematic analysis with sensitizing concepts related to the theoretical framework of the five factors of trust.ResultsSixteen preceptors participated. We identified four key drivers of trust and supervision in the continuity clinic setting: 1) longitudinal resident-preceptor-patient relationships, 2) direct observations of continuity clinic skills, 3) resident attitude towards their primary care physician role, and 4) challenging context and task factors influencing supervision. Preceptors shared challenges to determining trust stemming from incomplete knowledge about patients and limited opportunities to directly observe and supervise between-visit care.DiscussionThe continuity clinic setting offers unique supports and challenges to trust development and trust-supervision alignment. Maximizing resident-preceptor-patient continuity, promoting direct observation, and improving preceptor supervision of residents’ provision of between-visit care may improve resident continuity clinic learning and patient care.
关键词：Trust;Supervision;Continuity clinic;Graduate medical education