How General Practice Residents Evaluate Their Supervisors’ Clinical Reasoning?
Eva María SANTIAGO SÁNCHEZ, María Lourdes MATEOS SÁNCHEZ, Evelin TRASTOY JIMENEZ, Ana CHUCHON ALVA and Estefanía Dolores GONZÁLEZ MARTIN
In France, approximately 3,300 students enter general practice post-graduate program (residency) each year. They learn their future profession alongside university supervisors, who serve as role models—or counter-models. General practice residents seek supervisors with strong clinical reasoning skills, but the way they evaluate this reasoning remains unclear.To explore how general practice residents assess the clinical reasoning of their university supervisors, using a qualitative approach.We conducted an interpretative phenomenological analysis of open-ended interviews, based on Pierre Vermersch’s explicitation method. Participants were general practice residents from a faculty in the Grand Est region of France. Data collection took place from February to November 2024, with 9 interviews conducted until thematic saturation was reached.Participants identified five key criteria for evaluating their supervisors’ clinical reasoning: Up-to-date medical knowledge and its application. Experience and ease of understanding clinical situations, alongside potential cognitive biases from routine. Organizational factors affecting clinical reasoning (e.g., time constraints, workload). Handling of uncertainty in decision-making. Emotional and pedagogical modeling in the supervisor-resident relationship. Residents appreciated supervisors’ effortless comprehension of clinical situations but also noted cognitive biases and practice deviations from guidelines arising through experience . They valued open discussions about reasoning but feared negative reactions when challenging supervisors’ views. Supervisors, in turn, sought residents’ critical feedback to refine their practice.The hierarchical asymmetry in the supervisor-resident relationship may hinder constructive exchanges about clinical reasoning. Residents’ observations highlight the need for mutual feedback to improve both teaching and practice.Reducing hierarchical barriers could foster sincere, bidirectional discussions on clinical reasoning, benefiting both residents and supervisors. This approach may enhance the quality of general practice training.
