title: Physical isolation with virtual support: Registrars' learning via remote supervision.
abstract: OBJECTIVE
  Changing the current geographical maldistribution of the medical workforce is important for global health. Research regarding programs that train doctors for work with disadvantaged, rural populations is needed. This paper explores one approach of remote supervision of registrars in isolated rural practice. Researching how learning occurs without on-site supervision may also reveal other key elements of postgraduate education.
  
  
  METHODS
  Thematic analysis of in-depth interviews exploring 11 respondents' experiences of learning via remote supervision.
  
  
  RESULTS
  Remote supervision created distinctive learning environments. Respondents' attributes interacted with external supports to influence whether and how their learning was promoted or impeded. Registrars with clinical and/or life experience, who were insightful and motivated to direct their learning, turned the challenges of isolated practice into opportunities that accelerated their professional development.
  
  
  CONCLUSIONS
  Remote supervision was not necessarily problematic but instead provided rich learning for doctors training in and for the context where they were needed. Registrars learnt through clinical responsibility for defined populations and longitudinal, supportive supervisory relationships. Responsibility and continuity may be as important as supervisory proximity for experienced registrars.
authors.affiliation: a General Practice Education and Training , Australia.
authors.forename: Susan M
authors.initials: SM
authors.lastname: Wearne
authors.affiliation: b Maastricht University , The Netherlands.|c VU University Medical Center , The Netherlands.
authors.forename: Pim W
authors.initials: PW
authors.lastname: Teunissen
authors.affiliation: b Maastricht University , The Netherlands.
authors.forename: Tim
authors.initials: T
authors.lastname: Dornan
authors.affiliation: d Charles Darwin University , Australia.
authors.forename: Timothy
authors.initials: T
authors.lastname: Skinner