Emergency Department, University Hospital Geelong, Geelong, Victoria, Australia.
Barwon Centre for Orthopaedic Research and Education (B-CORE), School of Medicine, Deakin University, Geelong, Victoria, Australia.
Emerg Med Australas. 2020 Jun;32(3):446-456. doi: 10.1111/1742-6723.13440. Epub 2020 Feb 10.
Clinical supervision is an essential part of post-graduate medical training. The current study investigated emergency medicine trainees' experiences and preferences regarding distant supervision via information and communication technology (ICT).
Four emergency medicine trainees completed a 6-month placement, one at a time, at a rural urgent care centre. Trainees were remotely supervised by emergency physicians located at another ED using ICT. Trainees recorded the frequency and content of their distant supervision experiences. Trainees also completed semi-structured interviews before and after the placement to describe their experiences and preferences regarding distant supervision. Quantitative data were analysed descriptively using counts and proportions. Qualitative data were analysed using the principles of thematic analysis.
Trainees provided care to 1458 patients and communicated with a supervisor for 126 (8.6%) patients. Phone or audio-visual ICT was used for 111 (88.1%) and 12 (9.5%) patients, respectively. Trainees described the placement as a unique learning experience that demanded independent practice, enhanced their communication and leadership skills and increased their confidence. The trainees also described disadvantages to the placement such as reduced quality and quantity of communication with supervisors, ICT failure and the supervisor's inability to provide hands-on assistance. Trainees provided their perspectives on the essential requirements of a successful remote placement that involved distant supervision.
According to trainees, distant supervision had positive and negative effects on their supervision experiences, professional development and on patient management. Trainees used ICT infrequently. The trainee's perspectives on the ideal components of a remote placement programme are presented.
临床监督是研究生医学培训的重要组成部分。本研究调查了远程使用信息和通信技术（ICT）进行监督的急诊医学受训者的经验和偏好。
四名急诊医学受训者一次一人在农村急救中心完成了为期 6 个月的实习。受训者通过 ICT 由另一家 ED 的急诊医生进行远程监督。受训者记录了他们远程监督经验的频率和内容。受训者还在实习前后完成了半结构化访谈，以描述他们对远程监督的经验和偏好。使用计数和比例对定量数据进行描述性分析。使用主题分析的原则对定性数据进行分析。
受训者为 1458 名患者提供了护理，并与一名监督者就 126 名（8.6%）患者进行了沟通。分别使用电话或视听 ICT 对 111 名（88.1%）和 12 名（9.5%）患者进行了沟通。受训者将实习描述为一种独特的学习体验，需要独立实践，提高沟通和领导能力，并增强信心。受训者还描述了实习的不利之处，例如与监督者的沟通质量和数量减少、ICT 故障以及监督者无法提供实际帮助。受训者提供了他们对成功远程实习的基本要求的看法，包括远程监督。
根据受训者的说法，远程监督对他们的监督经验、专业发展和患者管理都有积极和消极的影响。受训者很少使用 ICT。提出了受训者对远程实习计划理想组成部分的看法。
