Feeling stuck: exploring experiences of junior doctors

2021 ◽  
pp. 1-7
Author(s):  
Lauren Alexander ◽  
Eimear Counihan ◽  
Deirdre McNally ◽  
Leonard Douglas
Keyword(s):  
Reflective Practice ◽  
Clinical Supervision ◽  
Psychiatric Hospitals ◽  
Junior Doctors ◽  
Further Training ◽  
Paper Version ◽  
Item Questionnaire ◽  
Open Coding ◽  
System Factors ◽  
Clinical Interactions

Objectives: Staff working in mental health services provide care for individuals with a variety of difficulties, which can pose treatment challenges. Perceived lack of progress in patients can engender uncomfortable feelings within the clinician, such as frustration, ‘heartsink’ and ‘feeling stuck’. The aim of this study was to explore the phenomenon of ‘feeling stuck’ amongst NCHDs in psychiatry. Methods: A total of 30 participants were recruited from three psychiatric hospitals to complete a 15-item questionnaire. The survey was designed to pursue a thematic analysis. Participants were asked to complete the survey anonymously, either online or paper version. The analysis was carried out by two researchers using open coding, with themes finalised through collective discourse. Results: Three themes were elicited from the data. The central theme – ‘causes of feeling stuck’ – consisted of three subthemes (patient, doctor and system factors). Participants were adept at describing patient and system factors, but reflected on doctor factors, such as countertransference, less often and in less detail. Other themes, explored in less detail by respondents, were ‘the experience of feeling stuck’ and ‘responses to feeling stuck’, with participants tending to seek solutions to, rather than an understanding of, these feelings. Conclusions: Trainee psychiatrists can clearly identify the situations where they are ‘stuck’ with clinical interactions. In spite of clinical supervision and reflective practice groups, they desire further training in managing these scenarios. NCHDs would benefit from further training, using these ‘stuck’ interactions as material, to further develop their understanding of the underlying factors in both themselves and their patients.

Mentor Perspectives on Mentoring New School Leaders

2019 ◽  
Vol 30 (3) ◽  
pp. 219-237
Author(s):  
Raji Swaminathan ◽  
Latish Reed
Keyword(s):  
Reflective Practice ◽  
School Principals ◽  
School Leaders ◽  
Urban School District ◽  
New School ◽  
Open Coding ◽  
Mind Set ◽  
Self Learning ◽  
Practice Literature ◽  
Mentor Model

The purpose of this study was to understand the perspectives of recently retired principals who were mentors to new school leaders in a high-need urban school district. Mentors reflected on the mentoring needs and challenges faced by new school leaders while also reflecting on their own careers as school principals. This study was informed by the literature on mentoring as well as the reflective practice literature. We used focus groups as the primary method of collecting data. Data analysis followed the process of open coding and independently identifying relevant data followed by constant comparison to narrow down the list of codes. The findings point to the need for mentoring new school leaders and to focus on promoting confidence and a growth mind-set in principals. Additionally, the findings point to reflective mentoring as a possible mentor model to benefit and support mentor self-learning as well as supporting principals.

scholarly journals Working with people with personality disorder: utilising service users' views

2007 ◽  
Vol 31 (3) ◽  
pp. 85-88 ◽  
Author(s):  
Kimberley Barlow ◽  
Stephen Miller ◽  
Kingsley Norton
Keyword(s):  
Personality Disorder ◽  
Qualitative Methodology ◽  
Group Discussion ◽  
Nominal Group Technique ◽  
Nominal Group ◽  
Service Users ◽  
Further Training ◽  
Modified Nominal Group Technique ◽  
Clinical Interactions

Aims and MethodTo ascertain the views of people with personality disorder on their clinical interactions with professionals, to identify potential solutions to problematic interactions and to compile guidelines on how professionals could improve their interactions with these service users. Qualitative methodology was employed, comprising a modified nominal group technique with two iterative groups and ranking by importance the issues and themes raised.ResultsThere were 13 service users from three separate personality disorder services who actively participated in a group discussion and iterative process. Collectively they indicated considerable areas of deficiency in the quality of their interaction and communication with professionals. These deficits were defined clearly enough to allow the construction of guidelines aimed at preventing or remedying such deficiencies.ConclusionsThe contribution of those people with personality disorder who took part in this study was sufficiently thoughtful to allow the development of guidelines that might help staff improve their interactions with such service users. From these guidelines, further training tools are being developed, which will be evaluated in the future. However, because not all those approached chose to participate, the views expressed might not be representative of this group as a whole.

scholarly journals Junior doctors' workloads in psychiatric hospitals

1989 ◽  
Vol 13 (9) ◽  
pp. 507-509 ◽  
Author(s):  
N. S. Brown ◽  
M. R. Ward
Keyword(s):  
Psychiatric Hospitals ◽  
Junior Doctors

Promoting reflective practice through structured clinical supervision

1997 ◽  
Vol 5 (2) ◽  
pp. 77-82 ◽  
Author(s):  
C. E. Marrow ◽  
D. M. Macauley ◽  
A. Crumbie
Keyword(s):  
Reflective Practice ◽  
Clinical Supervision

scholarly journals ICT and Reflective Practice integration; A Constructivists Approach in Teacher Preparation at Primary Teachers Colleges in South Eastern Uganda

2021 ◽  
Vol 5 (1) ◽  
pp. 37-52
Author(s):  
Emmanuel Gusango ◽  
John Maani ◽  
John Ssetumba
Keyword(s):  
Teacher Preparation ◽  
Reflective Practice ◽  
Clinical Supervision ◽  
Phenomenological Study ◽  
Primary Teachers ◽  
The Body ◽  
Unique Contribution ◽  
Design Data ◽  
Teachers Colleges ◽  
Integration Of Ict

Purpose: The purpose of this study was to explore the ICT and reflective practice integration in teacher preparation at Primary Teachers Colleges and to establish whether these practices were among the constructivist approaches being used to teach students. Methodology: This phenomenological study explored the lived experiences of tutors and students in light of constructivists’ teaching. It involved 3 PTCs and 15 participants who were purposively sampled. This study used a qualitative research design. Data was gathered using in-depth multiple interviews and analyzed following Moustakas (1994) procedure. Findings: Data analysis and results revealed that tutor‘s continue to rely on traditional approaches in both instruction and supervision of school practice. The colleges are in a nascent stage in the integration of ICT and reflective practice in education being accustomed to traditional instructional practices and lack of motivation and knowledge among tutors to adopt ICT in teaching. Unique Contribution to Theory, Practice and Policy: This research study adds to the body of knowledge suggesting ways in which constructivists’ teaching supports teaching effectiveness and promotes students’ learning amplifying the need for ICT and reflective practice integration in instruction. The study recommends establishing and setting up Reflective Practice Laboratories in Primary Teachers Colleges for tutors and students  induction on several constructivists’ practices that include systematic reflection, clinical supervision, use and integration of ICT and other interventions in a proper and professional  setting

'Hands on, Hands off': a model of clinical supervision that recognises trainees' need for support and independence

2010 ◽  
Vol 34 (3) ◽  
pp. 286 ◽  
Author(s):  
Rick Iedema ◽  
Suzanne Brownhill ◽  
Mary Haines ◽  
Bill Lancashire ◽  
Tim Shaw ◽  
...  
Keyword(s):  
Clinical Supervision ◽  
Hospital Setting ◽  
Rural Hospital ◽  
Depth Information ◽  
Junior Doctors ◽  
Supervisory Support ◽  
Medical Supervision ◽  
Hands On ◽  
Being There

Rationale.This article presents a study of junior doctor supervision at a rural hospital. The objective of the present study was to gain insight into the types of supervision events experienced, the quality of supervisory relationships, the frequencies of supervision contact in a rural hospital setting, and the implications of these factors for supervision practice. Methods.A cohort of junior doctors was asked to provide in-depth information about their interactions with their supervisors and other relevant clinical colleagues. The information was filled in on diary sheets to capture the nature, focus and quality of the cohort’s supervision experiences over 2 weeks. The information also covered frequency and types of supervisory contacts. Results.The quantitative data reveals that supervisory events occur predominantly as part of ongoing patient care and rarely off-line as part of targeted supervisory practice. The qualitative data analysis reveals that junior doctors value supervisory support of two kinds: assistance from more senior clinicians who are expert in areas where trainees need help, and trust to act independently, without being abandoned. Conclusion.Supervision must be both structured and dynamic. Besides providing a regular forum for discussion and reflection, supervision must accommodate the variable needs of individual junior doctors and navigate between being hands-on and hands-off. Such dynamic approach is necessary to reassure junior doctors they are in a ‘zone of safe learning’ where they can act with adequate and flexible support and negotiate changes in supervisory attention. What is known about the topic?Research is recognising the challenges of treatment complexity and unexpected outcomes faced by junior doctors. These factors mean that supervision needs to include dealing with the experiential and interpersonal aspects of junior doctors’ clinical work. It is also recognised that the supervisory relationship remains to be investigated in depth. Further, because supervision guidelines in Australia are still under development, they do not as yet specify senior doctors’ or registrar’s supervisory accountabilities. Relying on conventional approaches to managing medical supervision, hospitals and associated medical schools are struggling to ensure that supervising doctors’ perceptions of and approaches to supervision are aligned with emerging definitions of effective supervision. What does this paper add?The ‘hands on, hands off’ model developed here enriches post-graduate medical curricula on two fronts. First, it advises supervisors that they need to be hands-on, practising ‘active supervision’. This involves regular and structured contact with junior doctors to enhance the safety and quality of the care provided by them. Second, it advises supervisors to be hands-off, practising ‘passive supervision’. This involves ‘trustful’ monitoring junior doctors’ everyday work and negotiating with them their unique and changing learning trajectories. What are the implications for practitioners?The model proposed here has three implications for practitioners. First, the model posits that medical supervision is about ‘being there’. Junior doctors set great store by being granted ready access to advice and help if and when that is needed. Second, the model emphasises that junior doctors expect to gain supervisors’ trust to act independently albeit with supervisory access and guidance being readily available. Third, junior doctors’ needs change, not necessarily in a linear, uni-directional way. For supervisors, this means that they need to devise regular feedback opportunities for their trainees to articulate their developments, concerns and changing needs.

Learning to stay still: reflective practice in the context of supervision—integrating the personal and the professional

2020 ◽  
Vol 5 (1) ◽  
pp. 1-6
Author(s):  
Angie Cucchi
Keyword(s):  
Professional Development ◽  
Case Management ◽  
Reflective Practice ◽  
Clinical Supervision ◽  
Transformational Learning ◽  
Crucial Role ◽  
Personal Style ◽  
Personal Journey ◽  
Style Of Writing ◽  
The Relationship

Clinical supervision plays a crucial role for professional development and is mandatory for trainees and qualified psychologists and psychotherapists alike. Its function and style can vary significantly and range from case management to the depth of reflexive supervision characteristic of counselling psychology and psychotherapy. While the literature has thoroughly described the purpose and the characteristics of helpful and unhelpful supervision, the relationship between the personal and the professional elements of supervision is largely ignored. Trainees often embark on their professional journey with an unclear and, at times, fearful sense of integrating the clinical and the personal. Yet, the two cannot be separated. This article aims to reflect on a personal journey in supervision and to bridge the gap between the professional and the personal. The reader can expect a very personal style of writing as I recount some episodes of my own learning and transformation, and I use the theory to make sense of that journey. Given that it’s in the intersection between the different selves that transformational learning is created, the profession ought to encourage and foster more transparent, reflexive dialogues.

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