Rural junior doctor and medical student Clinical Supervision : transitioning to a teaching hospital

Professor Amanda Barnard

Aims of the project• Locally focussed and responsive to local

needs• Develop (based on needs) and deliver

rurally based supervisor workshops in SE NSW. Develop capacity in the rapidly increasing roles of rural hospitals as teaching hospitals

• Target VMO clinicians, CMOs and registrars.

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Context

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To date

• Literature review• Focus groups- students• Interviews – supervising staff• Continuing – interviews, on line surveys• Workshops (finally) locked in• Evaluation

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What have we learnt ? From the literature

• Limited, especially in difference rural vs major metropolitan teaching hospitals (e.g. Jelinek/EDs)

• Most rural focussed on medical students and post grad GP training

• No validated tool for evaluating clinical supervision from a supervisors perspective

• Most report multiplicity of roles/confusion re supervision

• Most conclude “more work needed”

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• Supervision/teaching nexus• Clinical supervision/line management

/performance/mentoring• Need more knowledge of program requirements• Service demands • Different ‘structures’ of rural hospital workforce –

VMOs, CMOs• ‘Isolation’ – is this how its done at the centre?• Support and feedback (two way)• Tensions around delivery of critical feedback

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What do our supervisors say?

Rural/small hospital supervision- multiplicity of roles

VMO consultan

t

Junior doctors

RegistrarsMedical students

VMO

Supervisor

Teacher

Assessor

Mentor

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Particular needs of supervising junior doctors on rotation

“On their own” - autonomy, anxiety, angst and accelerated learningCulture of different hospitalsConscription vs choiceRelationship - vertical integration

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Supervisees perspectives

• Feedback , feedback, feedback• Clarification of expectations,

responsibilities• Teaching is generally excellent• Orientation to ‘ culture’• Returning is great!

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