A lot can be said about this clinical supervision and how it can be used effectively in the training of interns and assistants, but that is not the point. The point here is that we, medical specialists, miss opportunities as a professional by considering ‘supervision’ only as clinical supervision.
I have argued many times before that GP training takes a more professional approach to train trainees than the specialist medical follow-up training.4 GP trainers spend five to eight full days a year on didactic refresher courses, compared to medical specialists on average 2 hours a year. Residents of general practice have monthly return days, during which they systematically discuss their experiences under supervision and receive training in matters such as patient-oriented conversation skills, practice management, and euthanasia. These subjects are only dealt with to a limited extent or in passing in specialist medical courses. In the last year of their training, all GP trainees are supervised in groups of two to four trainees, led by an experienced supervisor.
This is not clinical supervision of the medical content of patient consultations that the resident has seen himself, but a systematic way of learning from practical experiences, aimed at developing the professional functioning of the resident. The resident (supervisor) discovers for herself what she wants to learn in her professional functioning and how. These can be all kinds of questions, most of which are not or hardly addressed in the medical specialist’s further education. Questions like: what makes me worse about patients who do not take responsibility for their health problems? How do I prevent that I ending up in a yes-no-good battle in the event of a difference of opinion with my trainer? How do I deal with demanding or summarizing patients? How do I efficiently organize my consultation hours while patients leave satisfied? In two-hour sessions, the trainees reflect on their own questions, which they have prepared with detailed case histories (written down verbatim).
In this way, trainees learn not only about the specific questions they want to develop as professionals, but also about the learning process itself, and thus about how they can deal with such questions later in their career. And it stimulates a mindset of lifelong learning, that your education is never finished, that you can continue to develop your career for a long time.
In the supervisor/coach training that I now follow, I discover how different the way of listening and guiding is in learning supervision than in clinical training supervision and in patient contact. In the last two cases, we mainly focus on guiding listening: we want to analyze a problem, make a diagnosis and give advice. We are trained for that. With learning supervision, you do more with supportive listening. Sitting on your hands more, not advising, but actively listening and giving back, so that the resident (supervising person) can learn for themselves. I think it’s a huge discovery – difficult but instructive, and with enormous potential. I would also grant every resident in a specialist medical further training and every medical specialist, for example in the IFMS, such a form of learning supervision. Then we have to understand the importance of that and take the time for it. It’s a challenge, but I’m happy to take it.
