Striking a balance between independent practice and clinical supervision in residency training: how the cognitive apprenticeship model might help.

Learning in postgraduate settings has been framed traditionally under the paradigm of allowing progressive resident independence whilst decreasing the amount of supervision provided by the clinical teacher, despite little empirical evidence that supports this approach (Kennedy, Regehr, Baker, & Lingard, 2005). In fact, numerous studies have highlighted the positive effects of clinical supervision on trainees¿ development and patient outcomes (J.M. Farnan et al., 2012; van der Leeuw, Lombarts, Arah, & Heineman, 2012). As a result, effective CS guidelines suggest that clinical supervision should be provided at all levels of training (Kilminster, Cottrel, Grant, & Jolly, 2007). However, there is still a debate in the literature on how to solve the tension between allowing independent resident practice and providing CS, and between residents and clinical supervisors¿ preferences with regard to the teaching methods used throughout postgraduate training.