Sliding off or Supervising for real? Supervision of Junior Doctors in Medical Hospital Departments: a Qualitative Study

Abstract

Abstract OBJECTIVE Supervision is an essential part of the postgraduate medical training of junior doctors but can be a challenge in real-life clinical settings. This qualitative study explores factors affecting supervision in medical departments and the attempt to implement of a simple supervision (S-light) method. METHODS This qualitative study used a constructivist grounded theory approach. Data was collected at four different medical departments in Danish hospitals, where the “S-light” method was introduced. We enrolled eight junior doctors and eight senior doctors. Informants were interviewed about how they act in a supervised situation, what they believed to be both difficult and successful in supervision, and about their use of the “S-light” method. RESULTS We found four essential factors affecting supervision: 1) an organization structured pro supervision; 2) a culture of supervision; 3) the individual’s stress resilience and 4) the individual’s idealistic mindset. None of the informants had implement the s-light method. We found that lack of the four resources very often lead to a social pattern we named ‘sliding’, describing doctors' evasion of potential supervisory events. CONCLUSION We suggest a conceptual framework towards understanding supervision involving four factors important to maintaining healthy supervision and we describe the social pattern ‘sliding’ away from supervision. Strong implementation procedures seem necessary to implement new supervision methods.