The Professional Agency in Supervision of General Practitioners Before Their Supervisor Training Module: A Narrative Positioning Analysis.

Abstract

Introduction: Supervising in the workplace plays a key role in increasing the skills of the trainee. The shift to competence-based medical education requires both clinical expertise and pedagogical skills from the supervisor. These are distinct types of expertise. We know only a little of how competencies of supervising develop in medical education. The aim of our study is to find out what kind of professional agency in supervision general practitioners describes before their supervisor training. Professional agency refers to the individual's skills, willingness, ability, and responsibility to act with others in the professional context.

Methods: Our participants wrote a presentation of themselves before starting a supervisor training module. We studied these texts with narrative positioning analysis to examine who they are as supervisors, that is, the kind of professional agency they describe.

Results: We found three types of descriptions of professional agency: traditional master-apprenticeship supervision, clinical skills supervising with a collegial relationship, and process-oriented dialogical supervision. Supervising is mostly described as supervising the trainee on clinical skills and participants have a will to be a good supervisor, but they also express uncertainty of achieving this goal.

Conclusion: The variation in general practice supervisors' agency and pedagogical skills poses challenges for training providers in how to tailor the training to suit the best to participants with different skills. However, it gives an excellent opportunity for fruitful peer-to-peer learning. With our findings, it is possible to further develop supervisor training.