What is effective supervision and how does it happen? A critical incident study

Objectives To identify the key features of supervision from the perspectives of educational supervisors and specialist registrars. Design Critical incident study. Telephone interviews were conducted with selected informants representing a range of specialties. The sample comprised educational supervisors with an identified interest in supervision, specialist registrars and GP trainees in the Yorkshire region. Results Educational supervisors and specialist registrars were generally agreed on what constitutes effective supervision: direct supervision was seen as very important. Educational supervisors and specialist registrars had very different concerns in relation to ineffective supervision: specialist registrars were concerned with inadequate supervision whilst educational supervisors were concerned with failures in direct supervision and poorly performing trainees. Supervision practices varied between specialties; in this study there seemed to be particular problems in anaesthesia, medicine and paediatrics. Conclusions Direct supervision and the quality of the supervisory relationship are key to effective supervision. There is a need for clear guidance on supervision and the establishment of appropriate procedures and mechanisms to resolve difficulties relating to inadequate supervision for trainees and performing trainees. Insufficient numbers of supervisors have received training in supervision.