Kilroy D A
Department of Emergency Medicine, Stockport NHS Foundation Trust, Poplar Grove, Stockport, SK2 7JE, UK.
Emerg Med J. 2006 Feb;23(2):105-8. doi: 10.1136/emj.2004.022913.
To identify the key features of effective clinical supervision in the emergency department (ED) from the perspectives of enthusiastic consultants and specialist registrars. To highlight the importance of clinical supervision within emergency medicine, and identify obstructions to its occurrence in everyday practice.
A critical incident study was undertaken consisting of structured interviews, conducted by telephone or in person, with 18 consultants and higher level trainees selected for their interest in supervision.
Direct clinical supervision of key practical skills and patient management steps was considered to be of paramount importance in providing quality patient care and significantly enhancing professional confidence. The adequacy of supervision varied depending upon patient presentation. Trainees were concerned with the competence and skills of their supervisor; consultants were concerned with wider systemic constraints upon the provision of adequate supervision to juniors.
The value of supervision extends to all patient presentations in the ED. The study raised questions concerning the appropriate attitudes and qualifications for supervisors. Protected supervisory time for those with trainees is mandatory, and must be incorporated within ED consultant job planning.
从热情的顾问医师和专科住院医师的角度，确定急诊科有效临床督导的关键特征。强调临床督导在急诊医学中的重要性，并确定日常实践中其实施的障碍。
开展一项关键事件研究，通过电话或面对面进行结构化访谈，对象为18名因对督导感兴趣而挑选出的顾问医师和高级学员。
对关键实践技能和患者管理步骤进行直接临床督导，被认为对于提供高质量患者护理和显著增强专业信心至关重要。督导的充分性因患者表现而异。学员关注其督导者的能力和技能；顾问医师关注对初级人员提供充分督导方面更广泛的系统限制。
督导的价值适用于急诊科的所有患者表现。该研究提出了有关督导者适当态度和资质的问题。为带学员的人员提供受保护的督导时间是强制性的，且必须纳入急诊科顾问医师的工作计划中。
