Clinical supervisors play key roles in facilitating trainee learning. Yet combining that role with patient care complicates both roles. So, we need to know how both roles can effectively co-occur. When facilitating their trainees' learning through practice, supervisors draw on their skills - clinical and supervisory - and available opportunities in their practice. This process can be conceptualised as supervisory knowing in practice (or contextual knowing) and offers ways to elaborate on how facilitating trainees' learning can be optimised. The practice-based study presented and discussed here examined clinical supervisors' knowing in practice related to facilitating trainee learning, across three medical specialities. Nineteen clinical supervisors from emergency medicine, internal medicine and surgery, were interviewed about their roles and engagement with trainees. Interview transcripts were analysed in two stages. Firstly, a framework analysis, informed by interdependent learning theory was conducted, focussing on affordances and individual engagement. Secondly, drawing on practice theory, a further layer of analysis was undertaken interrogating supervisors' knowing in practice. We identified two common domains of supervisor practice used to facilitate trainee learning: (1) orientating and assessing trainees' readiness (or capabilities), (2) sequencing and enriching pedagogic practices. Yet across the speciality groups the supervisors' knowing in practice differed and were shaped by a trio of: (i) disciplinary practices, (ii) situational requirements and (iii) clinician preference. Overall, we offer a new reading of clinical supervision as practice differences generated distinct supervisory knowing in practice. These findings emphasise clinical supervision as fundamentally entwined in the speciality's practice; and reinforce alignments with patient care.

中文翻译：

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跨医学专业实践中的监督知识。

临床主管在促进受训者学习方面发挥着关键作用。然而，将这一角色与患者护理相结合会使这两种角色复杂化。因此，我们需要知道这两种角色如何有效地同时出现。在促进受训者通过实践学习时，主管会利用他们的技能（临床和监督）以及实践中的可用机会。这个过程可以被概念化为实践中的监督性知识（或情境性知识），并提供了详细说明如何优化受训者学习的方法。此处介绍和讨论的基于实践的研究检查了临床主管在实践中对促进受训者学习的了解，涉及三个医学专业。19名来自急诊科、内科和外科的临床主管，采访了他们的角色和与受训者的接触。访谈记录分两个阶段进行分析。首先，进行了以相互依存学习理论为基础的框架分析，重点关注可供性和个人参与。其次，借鉴实践理论，对监管者在实践中的认识进行了更深入的分析。我们确定了用于促进受训者学习的主管实践的两个常见领域：(1) 定位和评估受训者的准备情况（或能力），(2) 排序和丰富教学实践。然而，在不同的专业组中，主管在实践中的知识有所不同，并受到以下三者的影响：(i) 纪律实践，(ii) 情境要求和 (iii) 临床医生偏好。全面的，我们提供了对临床监督的新解读，因为实践差异在实践中产生了不同的监督知识。这些发现强调临床监督从根本上与专业实践交织在一起；并加强与患者护理的一致性。