Lost in transition: from medical student to clinical supervisor - a mixed-methods study.

backgroundJunior doctors play an essential role in clinical education. The transition from medical student to junior doctor involves assuming a new role as a clinical supervisor, but the preparation for this assignment is minimal and research on what the transition entails is scarce. Our study aims to explore the experiences and challenges that junior doctors face as clinical supervisors.

methodsAn exploratory sequential mixed methods design, qualitative method first, was adopted. Qualitative data was collected through semi-structured individual interviews with junior doctors. Interviews were audio-recorded and transcribed verbatim. Reflexive thematic analysis was used to generate themes. Quantitative data was collected through a survey related to affections, challenges, and organizational aspects of supervision. The survey included the Positive and Negative Affects Schedule (PANAS) and self-constructed items and was analysed by calculating percentages. All data was subsequently merged and interpreted as a whole.

resultsTen junior doctors were interviewed and 89 (41%) junior doctors at two different hospitals responded to the survey. Four overarching themes were developed to describe junior doctors' experiences as clinical supervisors: T1) Learning to teach: Personal construct shaping supervisor development, T2) Learning through teaching: Dual growth from near-peer supervision, T3) Teaching while learning: Challenges and strategies of supervising as a novice, T4) Missing the manual: Organizational constrictions for efficient supervision. The main factor contributing to junior doctors' development as supervisors was their own experiences as students (T1). Engaging in clinical supervision was rewarding for junior doctors' learning, as it confirmed their progress in knowledge and skills and helped identify knowledge gaps (T2). However, supervising without medical expertise, formal pedagogical training, and familiarity with the clinic was a major challenge (T3). Providing effective supervision while maintaining a sustainable work-life was hindered by insufficient organizational support, and only 15% of junior doctors felt prepared to supervise (T4).

conclusionsEngaging in clinical supervision as a junior doctor can foster growth as a clinician and teacher, however, it may further increase the cognitive load that you already experience as a novice. This study highlights the affective, pedagogical, and organizational support that junior doctors need to develop as teachers.