Defining a Supportive Teaching Climate for Clinical Supervisors in Residency Training

Abstract – Purpose – This study aimed to develop a broad and contextualized understanding of what clinical supervisors require to optimally fulfill their teaching roles by operationalizing the newly formed theoretical construct of the teaching climate. Method – From September 2022 to March 2024, the authors conducted individual interviews and focus group discussions with program directors and clinical supervisors in postgraduate medical education from various specialties in multiple teaching hospitals in the Netherlands. The authors followed a constructivist interpretative phenomenological approach, studying the phenomenon of the teaching climate through iterative and axial data coding. Results – Twelve individual interviews, 8 with (deputy) program directors and 4 with clinical supervisors, were conducted. Sixteen additional participants attended the subsequent 2 focus groups, with 8 participants in each group. In total, 16 program directors and 12 nondirectors participated, of whom 17 were women. The authors identified 6 themes encompassing the needs of clinical supervisors: (1) social cohesion, (2) resources for individual clinical supervisors, (3) a dialogue with residents, (4) a strong teaching team, (5) administrative support and facilities in residency training, and (6) support in balancing residency training and patient care. A seventh theme described the specific resources for program directors. Social cohesion not only represented a separate need but also served as an intermediary among themes 2, 3, 4, and 7, characterizing clinical supervisors’ needs in predominantly social interactions, and themes 5 and 6, representing context requirements influencing the work of clinical supervisors in an organizational sense. Conclusions – This study describes the needs of clinical supervisors in their work environment. A collective effort of all stakeholders involved in residency training is deemed crucial to providing high-quality guidance to residents, requiring organizational acknowledgment of educational efforts and social cohesion. Use of the teaching climate construct might help in the design of more actionable approaches to support clinical supervisors.