Medical School, University of Birmingham, Birmingham, UK.
School of Education, University of Birmingham, Birmingham, UK.
Med Educ. 2019 Sep;53(9):874-885. doi: 10.1111/medu.13897. Epub 2019 May 10.
The educational alliance is argued to be at the heart of supervision in medical education. This review aims to map the research field and develop a conceptualisation of the nature of such educational alliances within postgraduate supervision for general practitioners.
An integrative review of the international literature on supervision from 2011 to 2018 was undertaken, and papers assessed for relevance and quality. Data analysis incorporated framework analysis techniques. Bordin's working alliance-based model of supervision was used as a springboard for synthesis, as well as allowing for the emergence of new ideas, theories and concepts from the literature.
A total of 49 full texts were included for analysis. There was evidence of the importance of trust, agreement and bond in accordance with Bordin's model. The results also highlighted the importance of greater clarity on supervisory goals, and the tasks to support these goals, to effectively address competing priorities and roles within supervision. Non-hierarchical relationships were advocated, although supervisors must remain impartial in their assessment and monitoring roles. The influence of the wider practice community and situated learning through legitimate peripheral participation are documented. A model of General practice (GP) supervision is proposed that integrates the findings.
GP supervision requires a greater emphasis than is suggested by the working alliance model, both on the clarity of expectations and the appreciation of the multiple roles and competing priorities of both trainee and supervisor. Furthermore, as GP supervision develops within the rising workload of contemporary general practice, the role of the wider community of practice may become more prominent. We have adapted the working alliance model for postgraduate General practice (GP) supervision, emphasising the explicit sharing of expectations relating to goals, tasks and roles to facilitate negotiation and agreement.
教育联盟被认为是医学教育监督的核心。本综述旨在描绘研究生全科医生监督领域的研究现状，并对这种教育联盟的本质进行概念化。
对 2011 年至 2018 年期间国际监督文献进行综合回顾，并对相关文献进行评估。数据分析采用框架分析技术。博丁的监督工作联盟模型被用作综合的起点，同时也允许从文献中涌现出新的想法、理论和概念。
共纳入 49 篇全文进行分析。有证据表明，按照博丁的模式，信任、协议和联系非常重要。结果还强调了更明确的监督目标以及支持这些目标的任务的重要性，以有效地解决监督中相互竞争的优先事项和角色。提倡非层级关系，但监管者必须在其评估和监督角色中保持公正。记录了更广泛的实践社区的影响以及通过合法边缘参与进行的情境学习。提出了一个整合研究结果的全科医生监督模型。
全科医生监督需要比工作联盟模型所建议的更强调期望的明确性，以及对学员和监督者的多重角色和相互竞争的优先事项的理解。此外，随着当代全科医学工作量的增加，实践社区的作用可能会更加突出。我们已经为研究生全科医生监督改编了工作联盟模型，强调明确分享与目标、任务和角色相关的期望，以促进协商和协议。
