Scheduled, cancelled, rescheduled: navigating educational supervision in residency training.

Objectives: This study aims to enhance our understanding of how educational supervision operates from the perspective of medical residents, and how they engage with it within the context of implementing competency-based medical education.

Methods: We conducted a qualitative research study following the principles of grounded theory methodology. Participants were recruited from national residency training courses. Data was collected using an electronically distributed questionnaire with open-ended questions, which invited respondents to share their experiences with educational supervision. 96 written narrative responses were applicable for analysis.

Results: We identified three categories indicative of residents' experiences with educational supervision: I) Access to educational supervision, II) Links between quality of educational supervision and organisational facilitation, and III) Pushbacks to educational supervision and how residents cope with pushbacks. Residents' experiences varied significantly. When educational supervision was well-organised and available, residents managed to express how educational supervision enhanced their education. However, many residents struggled to access educational supervision (ES). Conclusion: When educational supervision is integrated into clinical practice, residents perceive its benefit to their education. Conversely, inadequate organisation of educational supervision forces residents to expend significant effort to ensure meetings occur. Amidst the implementation of competency-based medical education, residents risk being left with the individual responsibility to initiate and sustain educational supervision, which in turn places an undue burden on trainees to navigate repeated pushbacks, and workplace cultures that devalues educational support. Further research is needed to explore the affordances relevant for different medical specialties, and observational studies are much needed as a complement to self-reported data.