A practical primer on clinical supervision of learners in the emergency department

Introduction: Effective supervision of learners in the clinical environment is essential for learner professional development and patient safety. Despite this importance, many supervising attendings receive little to no training around supervising learners. As faculty join emergency departments (EDs) at primary and affiliate training sites, it is essential to provide them with a framework to utilize when approaching learner supervision. Methods: A workgroup of members from the Society for Academic Emergency Medicine (SAEM) Education Committee was formed to respond to a directive from the SAEM board to identify best practices for new clinician educators when supervising learners. Drawing on their experience and expertise in learner supervision, medical education, and faculty development, the members completed a literature search to identify best practices in supervision, with a special focus on the ED environment. Analysis: The workgroup identified three domains that must be considered to provide effective supervision to learners: learner characteristics, supervisor characteristics, and clinical environment. Recommendations: Implementing effective supervision in the clinical environment requires a multifaceted approach and consideration of factors for both the learner and the supervisor. Direct observation, supplemented by standardized assessment tools, is the preferred supervision method; however, the demands of our clinical environment may require supervisors to assess the learner's proficiency using other methods including informal knowledge assessments, inference from oral presentations, review of clinical documentation, feedback from patients themselves, procedural walkthroughs, and secondhand information from the health care or training team.