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Supervisor Continuity or Co-Location: Which Matters in Residency Education? Findings From a Qualitative Study of Remote Supervisor Family Physicians in Australia and Canada

Wearne, Susan, Dornan, Tim, Teunissen, Pim and Skinner, Timothy (2015). Supervisor Continuity or Co-Location: Which Matters in Residency Education? Findings From a Qualitative Study of Remote Supervisor Family Physicians in Australia and Canada. Academic Medicine,90(4):525-531.

Document type: Journal Article
Citation counts: Altmetric Score Altmetric Score is 2
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IRMA ID 75039815xPUB698
Title Supervisor Continuity or Co-Location: Which Matters in Residency Education? Findings From a Qualitative Study of Remote Supervisor Family Physicians in Australia and Canada
Author Wearne, Susan
Dornan, Tim
Teunissen, Pim
Skinner, Timothy
Journal Name Academic Medicine
Publication Date 2015
Volume Number 90
Issue Number 4
ISSN 1040-2446   (check CDU catalogue open catalogue search in new window)
Scopus ID 2-s2.0-84930346128
Start Page 525
End Page 531
Total Pages 7
Place of Publication United States
Publisher Lippincott Williams & Wilkins
Field of Research 1117 - Public Health and Health Services
HERDC Category C1 - Journal Article (DIISR)
Abstract Purpose: Changes to health care systems and working hours have fragmented residents' clinical experiences with potentially negative effects on their development as professionals. Investigation of off-site supervision, which has been implemented in isolated rural practice, could reveal important but less overt components of residency education.

Method:
Insights from sociocultural learning theory and work-based learning provided a theoretical framework. In 2011-2012, 16 family physicians in Australia and Canada were asked in-depth how they remotely supervised residents' work and learning, and for their reflections on this experience. The verbatim interview transcripts and researchers' memos formed the data set. Template analysis produced a description and interpretation of remote supervision.

Results: Thirteen Australian family physicians from five states and one territory, and three Canadians from one province, participated. The main themes were how remoteness changed the dynamics of care and supervision; the importance of ongoing, holistic, nonhierarchical, supportive supervisory relationships; and that residents learned "clinical courage" through responsibility for patients' care over time. Distance required supervisors to articulate and pass on their expertise to residents but made monitoring difficult. Supervisory continuity encouraged residents to build on past experiences and confront deficiencies.

Conclusions: Remote supervision enabled residents to develop as clinicians and professionals. This questions the supremacy of co-location as an organizing principle for residency education. Future specialists may benefit from programs that give them ongoing and increasing responsibility for a group of patients and supportive continuity of supervision as residents
DOI http://dx.doi.org/10.1097/ACM.0000000000000587   (check subscription with CDU E-Gateway service for CDU Staff and Students  check subscription with CDU E-Gateway in new window)
 
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