Attitudes Emphasized in the Clinical Supervision of Medical Students: An Ethnographic Study in Sweden

ABSTRACT

Medical student's professional attitudes are expected to be developed in medical school, and particularly during clinical education. In this study we focus on supervision in order to describe the attitudes emphasized in the clinical education of fourth-year medical students taking a surgical course.

An ethnographic approach was applied where observation and interviews were conducted. Nine medical students and twelve supervisors at a teaching hospital in Sweden participated. Field notes were made during observation as well as interviews; these were transcribed and analysed qualitatively.

The analysis resulted in six topic areas describing the attitudes emphasized. The medical students were expected to be: 1) Informed and effective decision makers, 2) Sensitive to patients' needs and expectations, 3) Communicative, 4) Authoritative and patriarchal, 5) Adaptable to organizational demands, and 6) Mindful of nurse's knowledge and requests.

This study reveals that the attitudes emphasised during supervision are: dualistic and complex to learn, developed by a former generation and influence student learning. Students need support in order to handle the state of tension that exists in the attitudes emphasized. Medical students might experience difficulties in adopting some attitudes belonging to a former generation. There is a need for competence development among supervisors concerning how students may experience the attitudes emphasized in supervision.