Primary Care Clinical Unit, Faculty of Medicine, University of Queensland, Brisbane, Australia.
General Practice Training Queensland (GPTQ), Queensland, Australia.
Educ Prim Care. 2021 Mar;32(2):118-122. doi: 10.1080/14739879.2020.1864781. Epub 2021 Feb 11.
Timely supervisor input to the care of their trainees' patients plays a key role in ensuring the safety of patients under the care of general practice trainees. Supervisor responses to trainee calls for assistance are also important for trainee learning and professional identity formation. The in-consultation supervisory encounter in general practice training is, however, a complex social space with multiple trainee, supervisor and patient agendas. Trainee requests for assistance during their consultations are known to present general practitioner supervisors with a number of challenges. From the trainee's perspective, a safe learning environment is essential during these supervisory interactions. A number of factors may act as barriers to, or reduce the usefulness of, in-consultation assistance in particular, resulting in trainees being less likely to seek such assistance on future occasions. It is therefore important to improve both trainee and supervisor skills in safe, effective and efficient in-consultation supervision. Making time for trainee and supervisor conversations about their help-seeking and help provision may uncover opportunities for improving skills, aligning agendas and enhancing outcomes. Finding time for debriefing, reflection and effective feedback conversations may be challenging, however, and opportunities for trainees to provide feedback to their supervisors are known to be particularly limited. We introduce a Debriefing, Reflection and Feedback Guide which is designed to prompt reflection, and structure effective and efficient debriefing and reciprocal feedback conversations. We outline the evidence which informed the development of the Guides, and present some preliminary findings from a pilot in Australian general practice training.
及时的主管对其受训者患者护理的指导对于确保一般实践培训生所照顾患者的安全起着关键作用。主管对培训生求助的回应对于培训生的学习和专业身份的形成也很重要。然而，在一般实践培训中的咨询监督互动是一个复杂的社会空间，涉及多个培训生、主管和患者的议程。众所周知，培训生在咨询过程中寻求帮助会给全科医生主管带来许多挑战。从培训生的角度来看，在这些监督互动中，安全的学习环境至关重要。有许多因素可能会成为咨询协助的障碍或降低其有效性，特别是导致培训生不太可能在未来寻求此类协助。因此，提高培训生和主管在安全、有效和高效的咨询监督方面的技能非常重要。为培训生和主管就他们的求助和提供帮助进行对话留出时间，可能会为提高技能、协调议程和改善结果创造机会。然而，为总结、反思和提供有效的反馈对话留出时间可能具有挑战性，而且培训生向主管提供反馈的机会也知之甚少。我们引入了一个“总结、反思和反馈指南”，旨在促进反思，并构建有效和高效的总结、反思和相互反馈对话。我们概述了指导方针制定所依据的证据，并介绍了澳大利亚一般实践培训中试点研究的初步发现。
