How core competencies are taught during clinical supervision: participatory action research in family medicine
Article first published online: 21 NOV 2012
© Blackwell Publishing Ltd 2012
Volume 46, Issue 12, pages 1194–1205, December 2012
How to Cite
Saucier, D., Paré, L., Côté, L. and Baillargeon, L. (2012), How core competencies are taught during clinical supervision: participatory action research in family medicine. Medical Education, 46: 1194–1205. doi: 10.1111/medu.12017
- Issue published online: 21 NOV 2012
- Article first published online: 21 NOV 2012
- Received 1 March 2012; editorial comments to authors 8 May 2012; accepted for publication 23 July 2012
Medical Education 2012: 46: 1194–1205
Objectives The development of professional competence is the main goal of residency training. Clinical supervision is the most commonly used teaching and learning method for the development of core competencies (CCs). The literature provides little information on how to encourage the learning of CCs through supervision. We undertook an exploratory study to describe if and how CCs were addressed during supervision in a family medicine residency programme.
Methods We selected a participatory action research design to engage participants in exploring their precepting practices. Eleven volunteer faculty staff and six residents from a large family medicine residency programme took part in a 9-month process which included three focus group encounters alternating with data gathering during supervision. We used mostly qualitative methods for data collection and analysis, with thematic content analysis, triangulation of sources and of researchers, and member checking.
Results Participants realised that they addressed all CCs listed as programme outcomes during clinical supervision, albeit implicitly and intuitively, and often unconsciously and superficially. We identified a series of factors that influenced the discussion of CCs: (i) CCs must be both known and valued; (ii) discussion of CCs occurs in a constant adaptation to numerous contextual factors, such as residents’ characteristics; (iii) the teaching and learning of CCs is influenced by six challenges in the preceptor–resident interaction, such as residents’ active engagement, and (iv) coherence with other curricular elements contributes to learning about CCs. Differences between residents’ and preceptors’ perspectives are discussed.
Conclusions This is the first descriptive study focusing on the teaching of CCs during clinical supervision, as experienced in a family medicine residency programme. Content and process issues were equally influential on the discussion of CCs. Our findings led to a representation of factors determining the teaching and learning of CCs in supervision, and suggest directions for research, for faculty development, and for interventions with learners.