Supervised workplace learning in postgraduate training: a realist synthesis

• DOI: 10.1111/medu.13655
• Publication Date: 2018-08-22T17:24:08Z
• Authors: Anel Wiese; Caroline Kilty; Deirdre Bennett
• Keywords: Supervisor; Empirical Research

Context This paper presents a realist synthesis of the literature that began with objective developing theory workplace learning specific to postgraduate medical education (PME). As review progressed, we focused on informal between trainee and senior doctor or supervisor, asking what mechanisms occur lead outcomes PME, contexts shape operation these they produce? Methods We followed procedures outlined in RAMESES Publication Standards for Realist Synthesis. searched English-language published 1995 2017 empirical papers related supervisor trainee, excluding formal interventions such as workplace-based assessment. made pragmatic decision exclude general practice training keep within manageable limits. Results reviewed 5197 selected 90. Synthesis revealed three processes occurring supervisors trainees, each underpinned by pair mechanisms: supervised participation (entrustment support seeking); mutual observation (monitoring modelling), dialogue during (meaning making feedback). These result including safe practice, skills, attitudes behaviours professional identity development. Contexts shaping were identified at individual, interpersonal, local systems levels. Conclusions Our trainees is informed research. It highlights two-way nature supervision, importance trainees' agency their own deleterious effect fragmented working patterns supervisor–trainee mechanisms. Further research required test refine this theory. In meantime, it provides useful framework design supportive environments preparation roles learning.