Perceptions of Clinical Supervision in Ambulatory Settings: Do Supervisee and Supervisors See Eye to Eye?

Abstract

Introduction: Given the shortage of primary care physicians, faculties of medicine have been seeking ways to encourage medical students to opt for family medicine as their career choice. The Faculty of Medicine in Geneva decided to incorporate a mandatory one-month rotation during clerkship in a primary care physician’s private office. Such a learning environment offers a privileged opportunity for the student but represents a considerable challenge for clinical teachers. With the goal of identifying training priorities, we sought to investigate the differences in perception of clinical supervision held by clinical teachers and by students. Methods: Cognitive apprenticeship is a well-established theoretical framework for studies on clinical supervision. The Maastricht Clinical Teaching Questionnaire, based on this theory, measures five dimensions of clinical supervision. We used this validated questionnaire to compare student assessment and supervisor self-assessment of the clinical supervision. A total of 275 students over two years assessed their clinical supervision experience provided by a group of 128 clinical supervisors. This hierarchical configuration of the collected data (students were grouped according to the supervisor they had assessed) implied using a linear mixed-effects model approach to assess the significance of observed scores. Results: The results clearly show that students consistently scored their supervisor higher on all five dimensions than the supervisors did themselves. Although it appears that students and supervisors do not focus on the same issues pertaining to clinical supervision, and student expectations might not coincide with supervisors’, the fact remains that they both experience the tasks described in each of the five dimensions together. Conclusion: The results of our study point to some improvements to the training of clinical supervisors.