Entrustment of student supervision to GP trainees - a qualitative interview study of factors influencing entrustment decisions

Abstract

Background

The concept of Entrustable Professional Activities (EPAs) is being increasingly adopted for teaching tasks. However, it is debated how entrustment of teaching EPAs compares to entrustment of clinical EPAs. This study investigates the factors influencing the decision to entrust trainees with the supervision of medical students in general practice.

Methods

Semi-structured interviews were conducted with nine general practitioners (GPs) and nine GP trainees. The interviews were transcribed and analyzed using the six steps of Braun and Clarke’s thematic analysis.

Results

Entrustment of student supervision to GP trainees was influenced by factors related to the GP trainee, the GP, the relationship between the GP trainee and the GP, the teaching task, and the context. Trainee factors included enjoyment of teaching, familiarity with the practice environment, teaching skills and knowledge. Teaching skills were often considered as personality traits rather than learnable skills. Contextual factors included workload and availability of protected teaching time, and availability of students, teachers, and patients. Risks are seen in overburdening trainees and passing on incorrect knowledge.

Conclusions

The entrustment of teaching EPAs is influenced by comparable factors as the entrustment of clinical EPAs. Didactic training could support trainees. Explicit entrustment and assessment by direct supervision are not established in the practice context but could help to minimize the risks associated with trainee teaching.