Perceptions about trust: a phenomenographic study of clinical supervisors in occupational therapy

Abstract

BackgroundFinding the best way to facilitate student learning in clinical practice can be challenging for clinical supervisors. While high levels of trust might jeopardize patient safety, low trust might hinder student learning; however, carrying out professional activities is necessary for students to develop professional competence. There is a dearth of scholarly literature regarding the concept of trust among clinical supervisors in occupational therapy education. A better understanding of how trust is created between the supervisor and student may thus aid in facilitating student learning. The aim of this study, therefore, was to explore occupational therapy clinical supervisors’ perception of trust and how it is formed.MethodsA qualitative method deploying a phenomenographic approach was chosen. Twelve clinical supervisors were interviewed, and the data were analyzed according to the seven-step phenomenographic approach.ResultsThree qualitatively different ways of thinking about trust were found: (1) that trust is about the student and is rather static; (2) trust as a dynamic process based on student performance; and (3) trust as something mutual and interrelated. The findings indicate that trust can be understood in various ways, such as being something inherent in the student or, alternatively, about the student, the supervisor, the relationship between them, and the surrounding context, including the tasks performed. Furthermore, the study shows that trust can be seen either as something static or as a dynamic process.ConclusionsThis study contributes to a deeper understanding of the variation of ways in which the concept of trust is understood among clinical supervisors in occupational therapy. The study corroborates the prior research finding that trust can be understood as a multifaceted construct. It contributes novel insights about the role of the supervisor as an influential factor in the trust-building process. A deep understanding of the possible differences in the ways of conceptualizing something can help supervisors support learning by building on this understanding. The results from this study contribute to our knowledge of the drivers behind entrusted decisions in clinical education in various professional contexts. We suggest that the results be used in the continuing professional development of clinical supervisors.

What about the supervisor? Clinical supervisors’ role in student nurses’ peer learning: A phenomenographic study

“…The development of trust in the student‐supervisor relationship has previously been shown to be a key factor in enabling peer learning to occur in a student ward 22 . The build‐up of trust is understood variably by clinical supervisors and can be seen as inherent to the student, or a dynamic process depending on the student, supervisor and contextual factors 57 . Creating opportunities for the supervisor to develop trust in the student can implemented, such as described previously in the literature, from direct observation of the trainee as a team leader or care provider, input from team members and patients 58 …”

Eight Ways to Erode Supervisor-Student Trust

“…The way students seek and respond to feedback can also shape the trust between them and supervisors. According to Lundh et al (2019), trust is something mutual and interrelated. They contend that it becomes stronger or weaker as supervisors and students get to know each other.…”

“…Communication is one of the mechanisms for healthy supervisor-student trust. If communication becomes a barrier, then trust can be eroded, hence the argument of Lundh, Palmgren and Stenfors (2019) that "by giving trust, you receive trust" seems substantive. Communication is one of the means for sustaining trust.…”

“…As per Lundh et al (2019) the lack of dialogue can undermine trust. In other words, as noted above, a communication barrier has a bearing on supervisor-student trust.…”

“…It goes without saying that the supervisor in the reference above did not show signs of emotional investment and caring for students. Since Lundh et al (2019) suggest that trust is mutual, it can be assumed that there is no mutual understanding between the supervisor and his students. It looks as if the supervisor lacks benevolence, which encompasses the degree to which the supervisor takes into account the students' needs and wellbeing (Nienaber et al, 2015).…”