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Constraints and barriers

For both supervisors and trainees/students there are many constraints that can impede the supervision process.

In some situations, such as the role of an educational supervisor responsible for trainees, the role is very clearly defined, it fits within a clinical and educational structure, and the outcomes and activities are clearly established. Here the educational supervisor needs to make themselves aware of the requirements of the role and the expectations and support available at local level.

In other contexts, such as where clinicians are responsible for medical students or other learners, the ‘supervision’ role can be much looser. It is important for clinicians to clarify the expectations from both the learners and the organisation responsible for learners (this may be medical schools or other organisations) as these may differ between organisations and with the level of student/trainee.

In the same way that nurses and other health professionals are becoming increasingly involved in assessment and other formal learning activities with medical students and trainees, as healthcare workers’ roles are extended and changed, doctors may well be required to supervise non-medical staff.

The list below summarises some of the other constraints to effective supervision.

  • Time.
  • Worries about the possible enormity of the problem; opening a ‘can of worms’ or ‘Pandora’s box’.
  • Need for appropriate training to carry out supervision.
  • Embedded cultural attitudes: for some clinicians there is a tradition of working alone, taking individual responsibility, low priority for money or training.
  • Fear of showing areas of weakness or need.
  • Anxiety about professional revalidation.
  • Attitudes about ‘policing’ the profession.
  • Personality mismatches between supervisor and supervisee.

Thinking point

  • What constraints to effective supervision have you come across in your own work situation? How could these constraints be addressed?



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