Supervisory Alliance in Medical Training: Associations with Educational Engagement and Satisfaction.

Objectives: While medical education requires frequent interactions with attending physicians and supervisors, little research has explored the role of supervisory alliance in the learning process. In other learning environments, supervisory alliance, or the bond between a supervisor and trainee, is considered a key ingredient of effective supervision. Medical educators or attending physicians who aim to enhance learning and engagement in medical education may benefit from understanding specific factors that increase or decrease engagement and how those might intersect within a context that requires learning through supervision. This cross-sectional study examined associations between supervisory alliance and (a) program satisfaction, (b) educational engagement, (c) and career purpose. Methods: Participants were medical trainees from the rural Northeast (n = 108, response rate = 81%) who completed an electronic and anonymous survey. Results: Multiple linear regression was used to examine whether total supervisory alliance independently predicted behavioral and emotional engagement in learning while controlling for hours slept, hours worked, and burnout. Supervisory alliance predicted trainees' career purpose, program satisfaction, and emotional engagement in learning. Conclusions: Findings from this study lay groundwork for consideration of the role of supervisory alliance in medical learning processes. Future research might explore whether targeted mentorship programs or faculty enhancement training that focuses on the supervisory relationship might positively impact learning outcomes.