Model of interactive clinical supervision in acute care environments. Balancing patient care and teaching

Annals of the American Thoracic Society
Dominique PiquetteVicki R LeBlanc

Abstract

Progressive trainee autonomy is considered essential for clinical learning, but potentially harmful for patients. How clinical supervisors and medical trainees establish progressive levels of autonomy in acute care environments without compromising patient safety is largely unknown. To explore how bedside interactions among supervisors and trainees relate to trainee involvement in patient care and to clinical oversight. We conducted a qualitative study based on constructivist grounded theory methodology. We used participant observation for our data collection. We observed the overt teaching interactions among trainees and staff physicians in the critical care units of two university-affiliated hospitals during 74 acute care episodes. Our analysis led to the elaboration of a theoretical model of clinical supervision. A model of interactive clinical supervision is proposed on the basis of three themes: engaging without enactment, sharing care with support, and caring independently with feedback. Each theme regroups different teaching interactions. Engaging in monologues and dialogues about patient care and facilitating hands-off care provision involved progressive levels of trainee involvement without risk for patients. Facilitat...Continue Reading

References

Sep 30, 2000·Medical Education·S M Kilminster, B C Jolly
Oct 4, 2005·Academic Medicine : Journal of the Association of American Medical Colleges·Tara J T KennedyLorelei A Lingard
Jun 1, 2007·Medical Teacher·Sue KilminsterBrian Jolly
Jun 9, 2007·Journal of General Internal Medicine·Tara J T KennedyGlenn Regehr
Aug 28, 2010·Australian Health Review : a Publication of the Australian Hospital Association·Rick IedemaJane Street
Mar 1, 2012·Academic Medicine : Journal of the Association of American Medical Colleges·Jeanne M FarnanVineet M Arora
Aug 22, 2013·Critical Care Medicine·Dominique PiquetteVicki R LeBlanc
Jul 22, 2014·Medical Education·Dominique PiquetteVicki R LeBlanc

❮ Previous
Next ❯

Citations

Apr 25, 2017·Medical Education·Francisco M Olmos-VegaRenée E Stalmeijer
Jun 8, 2018·Medical Education·Francisco M Olmos-VegaPim W Teunissen
Oct 20, 2018·Academic Medicine : Journal of the Association of American Medical Colleges·Alina SmirnovaCees P M van der Vleuten
Apr 5, 2019·Canadian Journal of Anaesthesia = Journal Canadien D'anesthésie·Sissi CaoDominique Piquette
Nov 12, 2020·Canadian Journal of Anaesthesia = Journal Canadien D'anesthésie·Dominique PiquetteChris Parshuram

❮ Previous
Next ❯

Related Concepts

Related Feeds

American Thoracic Association Journals

Discover the latest respiratory research published by the journals from the American Thoracic Society.

© 2022 Meta ULC. All rights reserved