The nature of the beast called clinical supervision : needs assessment of clinical supervision in Postgraduate Medical Education (PGME), Aga Khan University

Date of Award

2013

Document Type

Thesis

Degree Name

Master of Health Professions Education (MPHE)

Department

Educational Development

Abstract

Objective: To identify resident needs of clinical supervision and to develop a model of clinical supervision based on residents' needs and literature. Introduction: Clinical Supervision is a vital and fundamental part of clinical professional residency training. There is a dearth of literature on residents' perspectives regarding the roles of a clinical supervisor. This study was carried out at the Aga Khan University (AKU), Karachi, Pakistan, to explore the residents' perspectives regarding their needs for the different roles of clinical supervision, to help develop a model of clinical supervision for residency supervisors. Methods: All residents registered with the Post Graduate Medical Education (PGME) office, AKU, Karachi, were surveyed. A mixed method approach was used; a quantitative cross-sectional survey and a qualitative focus group discussion, which were analysed descriptively and thematically coded, respectively. Exploratory factor analysis was used to identify whether clinical supervision role(s) was made up of a single or multiple factors. supervision functions; process of supervision; supervisor's attributes; and impact on residents. There was convergence of data between the first two themes and Factor! "specialist skills', and between the last two themes and Factor2 "role modeling- factor. Conclusion: Clinical Supervisory Roles identified in literature were supported by the questionnaire and FGD findings. Convergence of clinical supervisor roles was found between resident responses in the Questionnaire and thematic codes identified in the FGD. The expected supervisor roles from the residents' perspective, aligned to roles identified in the literature, led to the development of the Socio-Cognitive and Skill Based Model of clinical supervision (SCSM- CS). Key words: Clinical supervision, postgraduate medical education, resident, supervisor, supervisee Results: There was an overall response rate of 72.1% (n=329/456). The residents rated the clinical supervisor roles very highly (Mean=4.43-5.85, SD=1.21-1,86). Exploratory factor analysis yielded two factors; Factor I related to specialist skills (clinical expert) and Factor2 related to role modeling. Four themes emerged after thematic FGD coding:

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