When supervising physicians see patients - Strategies used in difficult situations

As part of training in an internal medicine ambulatory clinic, a supervising physician may see a patient who has already been seen by a trainee. The authors conducted qualitative analyses of videotapes of medical interactions and of the participants' commentaries regarding the interactions. They found that physicians and trainees showed concerns regarding the emerging definitions of their relationship to each other and to the patient in opening the interaction and in taking history from the patient. The concerns experienced by supervising physicians and by trainees are described and the strategies used in opening the interaction and in interviewing the patient are analyzed. The article concludes with an evaluation of the strategies used to manage interactional difficulties.