V.N.B. Nguyen is a research fellow, Monash Nursing and Midwifery, Faculty of Medicine, Nursing and Health Sciences, Monash University, Clayton, VIC, Australia; ORCID: https://orcid.org/0000-0002-0982-2532 .
C.E. Rees is head of school, School of Health Sciences, College of Health, Medicine and Wellbeing, The University of Newcastle, Callaghan, NSW, Australia, and adjunct professor, Monash Centre for Scholarship in Health Education, Faculty of Medicine, Nursing and Health Sciences, Monash University, Clayton, VIC, Australia; ORCID: https://orcid.org/0000-0003-4828-1422 .
Acad Med. 2022 Aug 1;97(8):1203-1212. doi: 10.1097/ACM.0000000000004686. Epub 2022 Jul 21.
Supervision training supports health care supervisors to perform their essential functions. Realist evaluations are increasingly popular for evaluating complex educational interventions, but no such evaluations exist appraising supervision workshops. Building on an earlier realist synthesis of supervision training, the authors evaluated whether supervision workshops work, for whom and under what circumstances, and why.
The authors conducted a 2-stage realist evaluation during 2018-2019 to refine and develop program theory. The intervention involved half-day, face-to-face supervision workshops as part of an Australian state-wide government-funded program for health care and human services supervisors. Data collection involved realist interviews with 10 workshop developers (stage 1) and 43 supervisors (stage 2). The authors employed team-based data analysis using realist logic to refine and develop program theory by identifying contexts, mechanisms, outcomes, and context-mechanism-outcome configurations.
Despite their brevity, the supervision workshops had many reported benefits for supervisors (e.g., improved satisfaction) through various perceived mechanisms pertaining to pedagogy (e.g., mixed pedagogies), workshops (e.g., optimal duration), and individuals (e.g., supervisor engagement). However, they also yielded negative reported outcomes (e.g., suboptimal knowledge gains) brought about by assorted perceived mechanisms related to pedagogy (e.g., suboptimal peer learning), workshops (e.g., content irrelevance), and individuals (e.g., suboptimal facilitator competence). Such mechanisms were thought to be triggered by diverse contexts including supervisors' levels of experience, sector, and workplace supervision cultures.
While the findings partly support the realist synthesis of supervision training and previous realist evaluations of faculty development, this realist evaluation extends this literature considerably. Health care educators should employ mixed pedagogies (e.g., didactic teaching, peer learning), relevant content, optimal workshop duration, and competent/engaging facilitators. Educators also need to tailor workshops according to supervisors' contexts including the sectors and supervision cultures in which supervision is practiced, and supervisors' levels of experience (e.g., experienced supervisors appreciated workshop brevity).
监督培训支持医疗保健监督者履行其基本职能。现实主义评价越来越多地用于评估复杂的教育干预措施,但没有针对监督研讨会的此类评估。基于早期对监督培训的现实主义综合评价,作者评估了监督研讨会是否有效,针对谁以及在什么情况下有效,以及为什么有效。
作者在 2018-2019 年期间进行了 2 阶段的现实主义评估,以完善和发展项目理论。干预措施包括为期半天的面对面监督研讨会,作为澳大利亚全州政府资助的医疗保健和人类服务监督者计划的一部分。数据收集包括对 10 名研讨会开发者(第 1 阶段)和 43 名监督者(第 2 阶段)的现实主义访谈。作者采用基于团队的数据分析方法,运用现实主义逻辑,通过识别背景、机制、结果和背景-机制-结果配置,来完善和发展项目理论。
尽管监督研讨会时间很短,但通过各种与教育学相关的感知机制(例如,混合教育学)、研讨会(例如,最佳时长)和个人(例如,监督者参与度),监督者报告了许多益处(例如,满意度提高)。然而,它们也带来了各种与教育学相关的感知机制(例如,同伴学习效果不佳)、研讨会(例如,内容不相关)和个人(例如,促进者能力不佳)带来的负面报告结果(例如,知识增益不理想)。这些机制被认为是由各种背景触发的,包括监督者的经验水平、部门和工作场所监督文化。
虽然研究结果在一定程度上支持了监督培训的现实主义综合评价和之前对教师发展的现实主义评价,但本次现实主义评价大大扩展了这一文献。医疗保健教育者应该采用混合教育学方法(例如,讲授教学、同伴学习)、相关内容、最佳研讨会时长和有能力/有参与度的促进者。教育者还需要根据监督者的背景,包括监督实施的部门和监督文化,以及监督者的经验水平(例如,有经验的监督者欣赏研讨会的简洁性),来定制研讨会。