Clinical supervision among medical students and general practitioners

Research output: ThesisDoctoral ThesisCollection of Articles

Abstract

Clinical supervision (CS) in medicine has been defined as provision of monitoring, guidance and feedback on matters of personal, professional and educational development in the context of the physician’s care of patients, with the aim of maximizing patient safety. It is aimed at promoting reflection and professional development. The Balint group method is the most commonly used method of CS among physicians. However, properly carried out studies on the prevalence of CS, its associated factors, needs and benefits among GPs have largely been lacking. In this study the aim was to investigate the nature of student Balint groups, the use of and need for CS, emotional exhaustion among GPs and characteristics and work-related issues associated with CS. This study involved three samples. Mixed methods, i.e. both qualitative and quantitative were used. Study I involved analysis of the field notes of 15 student Balint group discussions of nine medical students in their clinical years. Most cases in the group discussions arose from patient encounters, but there was also a need to accept issues arising from other experiences as medical students. Many themes in the discussions dealt directly or indirectly with students’ future identity as physicians. In addition, feelings related to patients were a very common theme. These groups may foster medical students’ professional development. Study II the material of the annual Finnish Medical Association survey of 2008, focusing on specialists in general practice (n=1252) was analysed to assess the use of and need for CS and associations of them. In Study III and IV the survey material concerning health-centre physicians (n=165) was used to explore in Study III the prevalence of emotional exhaustion among them and factors associated with it and in Study IV associations of certain work-related factors with CS. In Study II, 42 % of GPs, and in Study IV, 35 % had either previous or current experience of CS. Furthermore, 25 % and 36 % of GPs reported having a need for CS, respectively. Study II indicated that female GPs had used CS, and acknowledged a need for it more often than their male colleagues, and that younger GPs had recognized a need for CS more often than older GPs. Study II also revealed that CS was associated with active participation in continuing medical education. In Study IV the experience of CS was associated with being older, whereas both the experience of and the need for CS were related to experiencing the job as being emotionally draining. In Study III indicated that the mean degree of satisfaction with work was high among GPs working as health-centre physicians, while at the same time 18 % of the GPs were emotionally exhausted, 30 % felt alone at work and 32 % felt that they had to work too hard. A longer working history, feeling alone at work, and having committed a medical error predicted emotional exhaustion, whereas good tolerance of uncertainty protected GPs from it.
Original languageEnglish
Awarding Institution
  • University of Helsinki
Supervisors/Advisors
  • Pitkälä, Kaisu, Supervisor
  • Kuikka (Pöysä), Liisa, Supervisor
Award date8 Dec 2017
Place of PublicationHelsinki
Publisher
Print ISBNs978-951-51-3879-8
Electronic ISBNs978-951-51-3880-4
Publication statusPublished - 8 Dec 2017
MoE publication typeG5 Doctoral dissertation (article)

Fields of Science

  • Attitude of Health Personnel
  • Burnout, Professional
  • +epidemiology
  • +etiology
  • Education, Medical
  • Emotions
  • Family Practice
  • General Practice
  • General Practitioners
  • +psychology
  • Job Satisfaction
  • Mentoring
  • Patient Participation
  • Physician-Patient Relations
  • Physician's Role
  • Physicians, Family
  • Preceptorship
  • Professional Competence
  • Psychoanalytic Therapy
  • +education
  • Self Concept
  • Social Support
  • Stress, Psychological
  • Students, Medical
  • Workload
  • 3142 Public health care science, environmental and occupational health

Cite this

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title = "Clinical supervision among medical students and general practitioners",
abstract = "Clinical supervision (CS) in medicine has been defined as provision of monitoring, guidance and feedback on matters of personal, professional and educational development in the context of the physician’s care of patients, with the aim of maximizing patient safety. It is aimed at promoting reflection and professional development. The Balint group method is the most commonly used method of CS among physicians. However, properly carried out studies on the prevalence of CS, its associated factors, needs and benefits among GPs have largely been lacking. In this study the aim was to investigate the nature of student Balint groups, the use of and need for CS, emotional exhaustion among GPs and characteristics and work-related issues associated with CS. This study involved three samples. Mixed methods, i.e. both qualitative and quantitative were used. Study I involved analysis of the field notes of 15 student Balint group discussions of nine medical students in their clinical years. Most cases in the group discussions arose from patient encounters, but there was also a need to accept issues arising from other experiences as medical students. Many themes in the discussions dealt directly or indirectly with students’ future identity as physicians. In addition, feelings related to patients were a very common theme. These groups may foster medical students’ professional development. Study II the material of the annual Finnish Medical Association survey of 2008, focusing on specialists in general practice (n=1252) was analysed to assess the use of and need for CS and associations of them. In Study III and IV the survey material concerning health-centre physicians (n=165) was used to explore in Study III the prevalence of emotional exhaustion among them and factors associated with it and in Study IV associations of certain work-related factors with CS. In Study II, 42 {\%} of GPs, and in Study IV, 35 {\%} had either previous or current experience of CS. Furthermore, 25 {\%} and 36 {\%} of GPs reported having a need for CS, respectively. Study II indicated that female GPs had used CS, and acknowledged a need for it more often than their male colleagues, and that younger GPs had recognized a need for CS more often than older GPs. Study II also revealed that CS was associated with active participation in continuing medical education. In Study IV the experience of CS was associated with being older, whereas both the experience of and the need for CS were related to experiencing the job as being emotionally draining. In Study III indicated that the mean degree of satisfaction with work was high among GPs working as health-centre physicians, while at the same time 18 {\%} of the GPs were emotionally exhausted, 30 {\%} felt alone at work and 32 {\%} felt that they had to work too hard. A longer working history, feeling alone at work, and having committed a medical error predicted emotional exhaustion, whereas good tolerance of uncertainty protected GPs from it.",
keywords = "Attitude of Health Personnel, Burnout, Professional, +epidemiology, +etiology, Education, Medical, Emotions, Family Practice, General Practice, General Practitioners, +psychology, Job Satisfaction, Mentoring, Patient Participation, Physician-Patient Relations, Physician's Role, Physicians, Family, Preceptorship, Professional Competence, Psychoanalytic Therapy, +education, Self Concept, Social Support, Stress, Psychological, Students, Medical, Workload, 3142 Public health care science, environmental and occupational health",
author = "Torppa, {Martina A.}",
note = "M1 - 101 s. + liitteet",
year = "2017",
month = "12",
day = "8",
language = "English",
isbn = "978-951-51-3879-8",
publisher = "[M. A. Torppa]",
address = "Finland",
school = "University of Helsinki",

}

Clinical supervision among medical students and general practitioners. / Torppa, Martina A.

Helsinki : [M. A. Torppa], 2017. 101 p.

Research output: ThesisDoctoral ThesisCollection of Articles

TY - THES

T1 - Clinical supervision among medical students and general practitioners

AU - Torppa, Martina A.

N1 - M1 - 101 s. + liitteet

PY - 2017/12/8

Y1 - 2017/12/8

N2 - Clinical supervision (CS) in medicine has been defined as provision of monitoring, guidance and feedback on matters of personal, professional and educational development in the context of the physician’s care of patients, with the aim of maximizing patient safety. It is aimed at promoting reflection and professional development. The Balint group method is the most commonly used method of CS among physicians. However, properly carried out studies on the prevalence of CS, its associated factors, needs and benefits among GPs have largely been lacking. In this study the aim was to investigate the nature of student Balint groups, the use of and need for CS, emotional exhaustion among GPs and characteristics and work-related issues associated with CS. This study involved three samples. Mixed methods, i.e. both qualitative and quantitative were used. Study I involved analysis of the field notes of 15 student Balint group discussions of nine medical students in their clinical years. Most cases in the group discussions arose from patient encounters, but there was also a need to accept issues arising from other experiences as medical students. Many themes in the discussions dealt directly or indirectly with students’ future identity as physicians. In addition, feelings related to patients were a very common theme. These groups may foster medical students’ professional development. Study II the material of the annual Finnish Medical Association survey of 2008, focusing on specialists in general practice (n=1252) was analysed to assess the use of and need for CS and associations of them. In Study III and IV the survey material concerning health-centre physicians (n=165) was used to explore in Study III the prevalence of emotional exhaustion among them and factors associated with it and in Study IV associations of certain work-related factors with CS. In Study II, 42 % of GPs, and in Study IV, 35 % had either previous or current experience of CS. Furthermore, 25 % and 36 % of GPs reported having a need for CS, respectively. Study II indicated that female GPs had used CS, and acknowledged a need for it more often than their male colleagues, and that younger GPs had recognized a need for CS more often than older GPs. Study II also revealed that CS was associated with active participation in continuing medical education. In Study IV the experience of CS was associated with being older, whereas both the experience of and the need for CS were related to experiencing the job as being emotionally draining. In Study III indicated that the mean degree of satisfaction with work was high among GPs working as health-centre physicians, while at the same time 18 % of the GPs were emotionally exhausted, 30 % felt alone at work and 32 % felt that they had to work too hard. A longer working history, feeling alone at work, and having committed a medical error predicted emotional exhaustion, whereas good tolerance of uncertainty protected GPs from it.

AB - Clinical supervision (CS) in medicine has been defined as provision of monitoring, guidance and feedback on matters of personal, professional and educational development in the context of the physician’s care of patients, with the aim of maximizing patient safety. It is aimed at promoting reflection and professional development. The Balint group method is the most commonly used method of CS among physicians. However, properly carried out studies on the prevalence of CS, its associated factors, needs and benefits among GPs have largely been lacking. In this study the aim was to investigate the nature of student Balint groups, the use of and need for CS, emotional exhaustion among GPs and characteristics and work-related issues associated with CS. This study involved three samples. Mixed methods, i.e. both qualitative and quantitative were used. Study I involved analysis of the field notes of 15 student Balint group discussions of nine medical students in their clinical years. Most cases in the group discussions arose from patient encounters, but there was also a need to accept issues arising from other experiences as medical students. Many themes in the discussions dealt directly or indirectly with students’ future identity as physicians. In addition, feelings related to patients were a very common theme. These groups may foster medical students’ professional development. Study II the material of the annual Finnish Medical Association survey of 2008, focusing on specialists in general practice (n=1252) was analysed to assess the use of and need for CS and associations of them. In Study III and IV the survey material concerning health-centre physicians (n=165) was used to explore in Study III the prevalence of emotional exhaustion among them and factors associated with it and in Study IV associations of certain work-related factors with CS. In Study II, 42 % of GPs, and in Study IV, 35 % had either previous or current experience of CS. Furthermore, 25 % and 36 % of GPs reported having a need for CS, respectively. Study II indicated that female GPs had used CS, and acknowledged a need for it more often than their male colleagues, and that younger GPs had recognized a need for CS more often than older GPs. Study II also revealed that CS was associated with active participation in continuing medical education. In Study IV the experience of CS was associated with being older, whereas both the experience of and the need for CS were related to experiencing the job as being emotionally draining. In Study III indicated that the mean degree of satisfaction with work was high among GPs working as health-centre physicians, while at the same time 18 % of the GPs were emotionally exhausted, 30 % felt alone at work and 32 % felt that they had to work too hard. A longer working history, feeling alone at work, and having committed a medical error predicted emotional exhaustion, whereas good tolerance of uncertainty protected GPs from it.

KW - Attitude of Health Personnel

KW - Burnout, Professional

KW - +epidemiology

KW - +etiology

KW - Education, Medical

KW - Emotions

KW - Family Practice

KW - General Practice

KW - General Practitioners

KW - +psychology

KW - Job Satisfaction

KW - Mentoring

KW - Patient Participation

KW - Physician-Patient Relations

KW - Physician's Role

KW - Physicians, Family

KW - Preceptorship

KW - Professional Competence

KW - Psychoanalytic Therapy

KW - +education

KW - Self Concept

KW - Social Support

KW - Stress, Psychological

KW - Students, Medical

KW - Workload

KW - 3142 Public health care science, environmental and occupational health

M3 - Doctoral Thesis

SN - 978-951-51-3879-8

PB - [M. A. Torppa]

CY - Helsinki

ER -