Jackson Dawn, Davison Ian, Brady Josephine
a University of Birmingham , Birmingham , UK.
b School of Education , University of Birmingham , Birmingham , UK.
Educ Prim Care. 2018 Sep;29(5):278-285. doi: 10.1080/14739879.2018.1501769. Epub 2018 Aug 24.
A key aspect of support in UK General Practice training is the trainee-trainer supervisory relationship. A small but significant number of trainees struggle in training, and relationship 'breakdown' can result. This study aims to better understand the nature of the supervisory interaction when a trainee faces difficulty. Using Bordin's 'Supervisory Working Alliance' and Egan's 'Skilled Helper Model' as a conceptual framework, four semi-structured interviews were undertaken with GP educators all experienced with trainees in difficulty, purposively sampled based on geography and gender. Interviews were transcribed verbatim, and content and coding analysis were undertaken to identify key themes. Trainee factors (insight, engagement, GP as 'best fit' career and difficulties in training) and trainer factors (failure to fail, tensions in role) were perceived as contributing to relationship breakdown. A lack of agreement in the goals and tasks of supervision was described when relationships broke down. Relating to Bordin's model, the trainee and trainer may hold differing expectations, particularly relating to the goals and tasks of supervision. Making expectations more explicit could be part of the solution to an improved supervisory working alliance. Further study on the influence of structure and agency is required to better understand the relationship in context.
英国全科医生培训支持的一个关键方面是学员与培训师的督导关系。一小部分但数量可观的学员在培训中遇到困难，可能导致关系“破裂”。本研究旨在更好地理解学员遇到困难时督导互动的本质。以博尔丁的“督导工作联盟”和伊根的“熟练帮助者模型”为概念框架，对所有有指导困难学员经验的全科医生教育工作者进行了四次半结构化访谈，根据地理位置和性别进行了有目的的抽样。访谈逐字记录，并进行了内容和编码分析以确定关键主题。学员因素（洞察力、参与度、全科医生作为“最适合”的职业以及培训中的困难）和培训师因素（未能严格要求、角色紧张）被认为是导致关系破裂的原因。关系破裂时，在督导的目标和任务方面缺乏共识。与博尔丁的模型相关，学员和培训师可能有不同的期望，特别是在督导的目标和任务方面。使期望更加明确可能是改善督导工作联盟的部分解决方案。需要进一步研究结构和能动性的影响，以更好地理解背景下的关系。
