Determinants of undergraduate medical students' satisfaction with clinical supervision: A cohort study in a longitudinally structured sixth year clinical placement.

Background: Work satisfaction is associated with fewer employee turnover intentions, increased job engagement and interest, and has a greater impact on employee well-being than environmental factors, such as workload. In workplace learning, clinical supervisors promote student satisfaction by meeting students' supervision needs in providing safe practice opportunities, training, and guidance in the social field. To quantitatively investigate this relationship, we proposed a supervision deficit index as a measure of learner-centered supervision received and explored its correlation with satisfaction in workplace learning.

Method: In total, 1017 Austrian medical students (2015-2017) in year 6 selected the 5 most helpful supervisory activities (from 26 options) and rated their experience levels of these activities during surgery and internal medicine placement. A supervision deficit index was then created (range 0-3; 0 = no deficit).

Results: Students with no, minor or moderate supervision deficits reported higher overall satisfaction with their placements than those experiencing considerable deficits. Students' gender, clinical experience, hospital size, placement year, and clinical field did not influence the relationship. The deficit index's psychometric qualities were good. Training activities supporting competence, such as discussing patients, planning disease management, and practicing skills, were selected more often than activities supporting autonomy, such as an appropriate level of clinical duties, and social relatedness.

Discussion: Students favored competence support. Highlighting the importance of autonomy support to students and encouraging supervisors to engage in learner-centered supervision may improve the supervision experience and work satisfaction for both. The deficit index can be used to evaluate the effects of such interventions.