Background The relationship between supervisors and residents plays a prominent role in the professional development of general practice (GP) residents. When disruptions occur in the normal course of healthcare, due to effects of e.g. war or emerging epidemics, we need to consider how this may affect the training of the next generation of general practitioners. As both supervisors and residents face new and unprecedented challenges that impact overall quality of the training. In this study, we examined the characteristics of the supervisory relationship in GP training during the disruptions early on during COVID-19. Our aim was to understand better how resident learning is affected in these circumstances, which is a first step in enabling supervisors, residents and faculty to anticipate disruptive situations better in the future. Methods We conducted a qualitative case study with a constructivist approach. Seven GP residents at the start of their second placement, and their 10 supervisors participated in this study. Participants came from a University Medical Centre in the Netherlands. Semi-structured interviews were held between September 2020 and February 2021. The subjects were (1) interviewed individually about what they had learned regarding COVID-19, and (2) they were interviewed in supervisory pairs about how they had learned. Data were iteratively analysed; thematic analysis for (1) and template analysis in (2). Results We identified notable changes in the supervisor-resident relationship attributable to COVID-19. Supervisors and residents were confronted with an all-encompassing uncertainty in the workplace, and disruptive changes in patient care and learning opportunities for residents. Supervisors and residents addressed these emerging workplace challenges through three types of collaboration, (1) getting the job done; (2) residents’ learning; and (3) collective learning. Each type had a different focus and distinctive characteristics of the supervisory relationship. Conclusion With the outbreak of COVID-19, supervisors and residents were faced with disruptive uncertainty. In these circumstances, learning occurred not only between residents and their supervisors, but also with non-supervising GPs and assistants in collective learning. We propose to complement collective learning in the workplace with reflection between residents and supervisors at the training institution.

No abstract

Background: The expert-novice dynamic in the relationship between supervisors and residents plays a prominent role in medical residents’ workplace learning. However, during the Covid-19 outbreak, both supervisors and residents faced unprecedented circumstances. In this study we explored the characteristics of the supervisory relationship in GP-residency during the disruptive pandemic to enhance our understanding of the changed dynamics between supervisors and residents. This is important, considering the new topics such as e-health and sustainable health in medical education.Methods: We conducted a qualitative study with a constructivist approach that included 7 GP residents at the start of their second placement, and their 10 supervisors. Participants came from a University Medical Centre in the Netherlands. Semi-structured interviews were held between September 2020 and February 2021. The subjects were interviewed individually (1st round) about what they had learned regarding COVID-19, and in supervisory pairs (2nd round) about how they had learned. Data were iteratively analysed; thematic analysis in round 1 and template analysis in round 2.Results: We identified notable changes in the supervisor-resident relationship attributable to COVID-19. Supervisors and residents were confronted with an all-encompassing uncertainty in the workplace, and disruptive changes in patient care and learning opportunities for residents. Supervisors and residents addressed emerging workplace challenges through three types of collaboration, 1) ‘getting the job done’; 2) residents’ learning; and 3) collective learning. Each type had a different focus and distinctive characteristics of the supervisory relationship. Conclusion: The outbreak of the pandemic caused an overwhelming sense of uncertainty. Under these circumstances learning did not only occur one-on -one, between resident and supervisor, but also with the entire team in collective learning. We propose stimulating collective team learning when GPs, residents, and other team members face new disruptive challenges in the field of medicine.