Distant supervision of trainee emergency physicians undertaking a remote placement: A preliminary evaluation

OBJECTIVE: Clinical supervision is an essential part of post-graduate medical training. The current study investigated emergency medicine trainees' experiences and preferences regarding distant supervision via information and communication technology (ICT). METHODS: Four emergency medicine trainees completed a 6-month placement, one at a time, at a rural urgent care centre. Trainees were remotely supervised by emergency physicians located at another ED using ICT. Trainees recorded the frequency and content of their distant supervision experiences. Trainees also completed semi-structured interviews before and after the placement to describe their experiences and preferences regarding distant supervision. Quantitative data were analysed descriptively using counts and proportions. Qualitative data were analysed using the principles of thematic analysis. RESULTS: Trainees provided care to 1458 patients and communicated with a supervisor for 126 (8.6%) patients. Phone or audio-visual ICT was used for 111 (88.1%) and 12 (9.5%) patients, respectively. Trainees described the placement as a unique learning experience that demanded independent practice, enhanced their communication and leadership skills and increased their confidence. The trainees also described disadvantages to the placement such as reduced quality and quantity of communication with supervisors, ICT failure and the supervisor's inability to provide hands-on assistance. Trainees provided their perspectives on the essential requirements of a successful remote placement that involved distant supervision. CONCLUSIONS: According to trainees, distant supervision had positive and negative effects on their supervision experiences, professional development and on patient management. Trainees used ICT infrequently. The trainee's perspectives on the ideal components of a remote placement programme are presented.