Developing Confidence in Uncertainty: Conflicting Roles of Trainees as They Become Educators in Veterinary and Human Medicine.

The important role of medical trainees (interns and residents) as teachers is increasingly recognized in veterinary and human medicine, but often is not supported through adult learning programs or other preparatory training methods. To develop appropriate teaching programs focused on effective clinical teaching, more understanding is needed about the support required for the trainee's teaching role. Following discussion among faculty members from education and veterinary and pediatric medicine, an experienced external observer and expert in higher education observed 28 incoming and outgoing veterinary and pediatric trainees in multiple clinical teaching settings over 10 weeks. Using an interpretative approach to analyze the data, we identified five dynamics that could serve as the foundation for a new program to support clinical teaching: (1) Novice-Expert, recognizing transitions between roles; (2) Collaboration-Individuality, recognizing the power of peer learning; (3) Confidence-Uncertainty, regarding the confidence to act; (4) Role-Interdisciplinarity, recognizing the ability to maintain a discrete role and yet synthesize knowledge and cope with complexity; and (5) Socialization-Identity, taking on different selves. Trainees in veterinary and human medicine appeared to have similar needs for support in teaching and would benefit from a variety of strategies: faculty should provide written guidelines and practical teaching tips; set clear expectations; establish sustained support strategies, including contact with an impartial educator; identify physical spaces in which to discuss teaching; provide continuous feedback; and facilitate peer observation across medical and veterinary clinical environments.