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理解住院医师和导师对通过研究生牙科培训中的监督方法来发展支持自主平衡的观点:一项定性研究。

Understanding Residents' and Supervisors' Views on Developing Support-Autonomy Balance Through Supervision Methods in Postgraduate Dental Training: A Qualitative Study.

机构信息

Hamdan Bin Mohammed College of Dental Medicine, Mohammed Bin Rashid University of Medicine and Health Sciences, Dubai, UAE.

Centre for Public Health, School of Medicine, Dentistry and Biomedical Sciences, Queen's University Belfast, Belfast, UK.

出版信息

Eur J Dent Educ. 2024 Nov;28(4):1016-1024. doi: 10.1111/eje.13036. Epub 2024 Sep 3.

DOI:10.1111/eje.13036
PMID:39224981
Abstract

BACKGROUND

Supervisors continuously need to decide when to provide clinical opportunities for unsupervised patient care to facilitate residents' development in the complex clinical learning context. The aim of this study is to explore residents' and supervisors' views and understanding of the influence of clinical supervision on affording a balanced support-autonomy from the cognitive apprenticeship (CA) theoretical lens.

METHODS

Residents and supervisors, representing all disciplines, participated in five focus groups and four semi-structured individual interviews. Purposive and convenience sampling methods were used for recruiting participants. The reflexive thematic analysis approach was used for inductive data analysis.

RESULTS

A total of 15 residents and 8 supervisors participated in this study. All agreed that CA teaching methods can be applied across all levels. Participants experienced changes in their supervision methods and supervisor-resident interactions at different levels of training. They related the selection of supervision to task-, resident- and supervisor-related factors. Learning facilitating factors in clinical learning environment were identified and suggestions to enrich residents' learning experiences were also reported.

CONCLUSION

The current study found that a one-size-fits-all paradigm may not be effective for clinical supervision. It contributes to our understanding of how the CA model may be used to guide supervisor behaviour and how such practices can be modified to residents' level of development and competencies.

摘要

背景

在复杂的临床学习环境中,为了促进住院医师的发展,上级医师需要不断决定何时为其提供无人监督的患者护理临床机会。本研究旨在从认知学徒制(CA)的理论视角探讨住院医师和上级医师对临床监督对提供平衡支持-自主性的影响的看法和理解。

方法

本研究纳入了所有专业的住院医师和上级医师,共 15 名住院医师和 8 名上级医师参加了 5 个焦点小组和 4 个半结构化的个人访谈。采用目的抽样和便利抽样方法招募参与者。采用反思性主题分析方法进行归纳数据分析。

结果

共有 15 名住院医师和 8 名上级医师参加了本研究。所有人都认为 CA 教学方法可以应用于所有级别。参与者在不同的培训级别上经历了监督方法和上级-住院医师互动的变化。他们将监督的选择与任务、住院医师和上级相关因素联系起来。确定了临床学习环境中的学习促进因素,并提出了丰富住院医师学习体验的建议。

结论

本研究发现,一刀切的方法可能对临床监督无效。它有助于我们理解如何使用 CA 模型来指导上级的行为,以及如何根据住院医师的发展水平和能力来修改这些实践。

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