"It's the Time they Take to Give Feedback; it has Become a Problem" Exploring Barriers and Facilitators for Research Supervision in Postgraduate Medical Education in Tanzania. A Qualitative Study.

Background: Research supervision is a multifaceted task that combines academic knowledge with managing interpersonal relationships. Postgraduate trainees often receive inadequate supervision due to their supervisors' demanding schedules and limited supervision competencies. Most supervisors, especially in low-resource settings, lack formal training in supervision and thus rely on personal experiences to fulfil this role. Poor supervision contributes to high dropout rates and subpar research output in many universities. We aimed to explore the barriers and facilitators for research supervision in postgraduate medical education in Tanzania.

Methods: We adopted an exploratory qualitative case study and conducted key informant interviews with three purposively selected faculty in leadership and four focus group discussions with 14 postgraduate trainees and 10 faculty members. Topic guides focusing on experiences, challenges, and needs were used for data collection. The data were audio recorded and transcribed verbatim. A framework matrix was used to summarize and analyze data using an excel workbook. An inductive qualitative data analysis approach was employed using thematic analysis as described by Braun and Clarke.

Results: Two main thematic areas emerged from analysis: Barriers and facilitators for research supervision in postgraduate medical education. Difficulty balancing workload, delays in feedback, limited access to some resources, funding constraints and limited research skills emerged as key barriers. Participants recognised the role of a well-equipped library in facilitating the supervision process and trainees appreciated flexibility from their supervisors.

Conclusion: Addressing the identified barriers is crucial to enhance the supervisor-trainee relationship and overall dissertation outcomes. Ensuring protected time for research and strengthening faculty research and supervision skills through targeted training is important to ensure high quality research output.