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Table 2 Summary of story arcs and descriptions (N = 17)

From: Enabling uptake and sustainability of supervision roles by women GPs in Australia: a narrative analysis of interviews

Story arcs

Description

Power and control

• Women GPs describe having limited control over the decision to supervise registrars and were not fully informed about the role.

• Some women GPs play a key role in the formal and informal supervision workload in practices that is not appreciated as a valued contribution.

• Some male registrars may disrespect women GP supervisors as mentor-teachers.

• Some women GP supervisors felt unsupported by male superiors to manage male registrars who were not receptive to their feedback.

• Some women GPs lead the teaching and learning in their practice, but, if engaged as a non-practice owner, they may not get adequate practice support to sustain the task.

Pay

• Some women GPs describe being unaware of and unremunerated for aspects of the supervision role.

• Women GPs can experience unsuccessful negotiations with male practice owners around pay for the structured teaching they did.

• Women GP practice owners and non-practice owners with lead educational roles in the practice are inclined to remunerate women GPs for structured teaching.

• Inadequate remuneration relative to the workload can affect early-career GPs interest in doing supervision work and mature GPs from continuing it.

• Pay is valued as part of recognition by women GP supervisors of different demographics and career stages.

Time

• Women GPs believe they are sought out by registrars because they are approachable and value registrar learning and well-being, regardless of whether supervising formally or informally; but the time needed for frequent encounters is frustrating for women GPs when they are not the main supervisor.

• Women GPs are asked to support registrar learning across women’s health, mental health, sexual health and complex care where they are perceived as experts, and this interrupts the time they need for their own patients (sensitive consultations).

• The time commitment for supervising is worse if registrars are junior, unsafe or under-performing.

• When women GPs take a break from or relinquish supervision roles, they express a sense of relief at not having to worry about learners and having time to do other things, such as invest in their own learning.

Other life commit-ments

• Women GPs of various ages describe the challenge of managing personal commitments, particularly to parents and children, with committing to supervise registrars over a 6-month term.

• Informal supervision roles allow women to accommodate other life responsibilities whilst enabling them to be involved in supervision.

• Women planning to have children describe potential career disruptions as a barrier to supervising.

• The capacity to juggle children can vary depending on how family-friendly the practice is, and the proximity between practice and childcare/school.

• Overall, women GPs may view supervision as an additional effort atop of their professional and personal lives.

Quality of supervision

• Women GPs are intrinsically motivated to provide quality teaching and learning to create a positive experience for registrars. This could deter women from supervising unless they felt able to do it in a way that met their personal standards.

• Women GPs actively pursued ways to build their supervision expertise to enable them to supervise to a high standard. To this end, women GPs noted a lack of educational support and guidance to foster understanding of the supervision role.

• Women GPs preferred team supervision to provide backup for registrars and opportunities to share ideas.

• Women GPs gained confidence from teaching medical students and overseeing registrar learning in other general practices (as an independent clinical educator).

• Women GPs seek formal and informal opportunities to exchange ideas and share resources with other GP supervisors, such as supervision mentoring.

• Women reflect on and reconcile the level of uncertainty involved in supervision which enables them to keep supervising even when registrars don’t progress.

Supervisor identity

• Imposter syndrome is common in women GPs commencing supervision roles.

• Early-career women GPs think they lack sufficient technical GP knowledge to be teaching, but perceive strength in their fresh knowledge of the GP training program and are encouraged if they are in a supportive team where they can learn to supervise and their value to the team is acknowledged.

• The historical requirement for early-career GPs to get some experience before taking up supervision roles was viewed as a barrier to new women GPs to take up supervision.

• Some mid- and later-career women GPs experience imposter syndrome if they lack knowledge of current GP exams and clinical guidelines, but they draw confidence from their expertise in real-world practice, which helps them be assertive about their value.

• Women GPs overcome imposter syndrome and build confidence in a supervisor identity when they can bounce ideas around a team, reflect on their practice, and realise their unique contribution is based on the types of patients that they see, the way that they teach, their specialisations, and the nature of medicine that they practise.