title: Paediatric trainee supervision: management changes and perceived education value.
abstract: OBJECTIVE
  Supervision in postgraduate training is an under-researched area. We measured the amount, type and effect of supervision on patient care and perceived education value in a general paediatric service.
  
  
  METHODS
  We designed a structured observation form and questionnaire to document the type, duration and effect of supervision on patient management and perceived education value.
  
  
  RESULTS
  Most supervision occurred without the paediatrician confirming the trainee's findings. Direct observation of the trainee was rare. Management was changed in 30% of patients seen on the inpatient ward round and in 42% of the patients discussed during the chart reviews but not seen by the paediatrician. Management was changed in 48% of the cases when the paediatrician saw the patient with the trainee in outpatients but in only 21% of patients when the patient was but not seen. Changes made to patient management, understanding and perceived education value, differed between inpatient and out patient settings. There was more impact when the paediatrician saw the patient with the trainee in outpatients; while for inpatients, the opposite was true. Trainees rated the value of the supervision more highly than their supervisors did. Trainees' comments on what they learnt from their supervisor related almost exclusively to clinical knowledge rather than professional behaviours.
  
  
  CONCLUSIONS
  We observed little evidence of supervisors directly observing trainees and trainees learning professional behaviours. A review of supervisory practices to promote more effective learning is needed. Communicating to paediatricians the value their trainees place on their input could have a positive effect on their engagement in supervision.
authors: University of Auckland Centre for Medical and Health Science Education, Auckland, New Zealand.
authors: Mirjam
authors: M
authors: van den Boom
authors: Ralph
authors: R
authors: Pinnock
authors: Jennifer
authors: J
authors: Weller
authors: Peter
authors: P
authors: Reed
authors: Boaz
authors: B
authors: Shulruf
mesh_terms: D001315:Australia; D002983:Clinical Competence; D004522:Educational Status; D006801:Humans; D007396:Internship and Residency / Q000458:organization & administration*; D010372:Pediatrics / Q000193:education*; D011795:Surveys and Questionnaires