Faculty perspectives on supervising endocrinology residents in the longitudinal clinic setting

Introduction: Longitudinal clinic supervision is complex but key to training residents, such as endocrinology residents. Supervisors report difficulties providing learners with the right balance of supervision and autonomy. Cognitive apprenticeship theory applies to teaching in workplace-based settings, such as the endocrinology longitudinal clinic. While this theory identifies effective strategies for supervising medical students in longitudinal settings, little is known about how and why supervisors adapt their strategies when offering longitudinal supervision to endocrinology residents. Objective: To understand supervisors' perspectives on supervision of endocrinology residents over time in the longitudinal clinic. Methods: This is a qualitative study set in the endocrinology division of a Canadian multi-site academic centre in 2023-2024 using semi-structured interviews of endocrinology longitudinal clinic supervisors. Transcripts were analyzed using inductive and deductive thematic analysis, with cognitive apprenticeship theory as a sensitizing concept. Results: Five main themes were identified articulating how participants perceive their supervision and its changes over time. These include supervisors treating residents as colleagues and making clinic experiences reflect real life when possible. Supervisors also tailor clinic experiences to resident needs and career goals. They provide residents with support but also autonomy to execute their own management plans even if discordant with that of supervisors provided that patient safety is maintained. Similarly, supervisors encourage residents to take patient ownership. Together, these strategies enable supervisors to support resident development into independent professional endocrinologists. Conclusion: Overall, supervisors try to encourage residents to self-regulate their learning, but also offer support and autonomy to enhance their longitudinal growth and development.