Allowing failure for educational purposes in postgraduate clinical training: A narrative review

Abstract

Background: Educational domains such as pedagogy or psychology have embraced the philosophy that “allowing failure” in training and practice is essential to learn. In clinical training, however, allowing learners to fail is not explicitly discussed as a strategy, possibly due to the negative implications for patients. Therefore, we do not know whether clinical supervisors allow trainees to fail for educational purposes and, if so, how this supervisory strategy is used.

Methods: To inform research on this topic, we conducted a narrative review to understand what was known about this educational strategy in postgraduate medicine.

Results: Analyzing the selected literature, we found no studies directly exploring the question of clinical supervisors allowing failure as an educational strategy. However, related literature on resident errors suggested that trainees perceived their own errors to be highly instructive and that factors such as a sense of responsibility and emotional response influenced the educational impact of these errors.

Conclusions: The lack of discussion in the medical education literature regarding allowing failure for learning suggests that we need research into the nature and extent of this supervisory strategy which may hold educational benefits but must be employed in a manner that upholds patient safety and safeguards trainee resilience.

Glossary

Clinical supervision/Supervision: The provision of guidance and feedback on matters of personal, professional and educational development in the context of a trainee’s experience of providing safe and appropriate patient care.

Kilminster SM, Cottrell D, Grant J, Jolly B. 2007. AMEE guide no. 27: effective educational and clinical supervision. Med Teach. 29:1.

Kilminster SM, Jolly BC. 2000. Effective supervision in clinical practice settings: a literature review. Med Educ. 34(10):827–840.

Disclosure statement

The authors report no conflicts of interest. The authors alone are responsible for the content and writing of the article.

Additional information

Notes on contributors

Jennifer M. Klasen

Jennifer M. Klasen is a Ph.D. candidate of the School of Health Professions Education of the Maastricht University after she completed the Master program of Medical Education at the University of Bern 2018. She works as a surgical specialist in Switzerland for ten years.

Lorelei A. Lingard

Lorelei A. Lingard, Ph.D., is a Professor and Scientist in the Department of Medicine, and Director of the Center for Education Research & Innovation, both at the Schulich School of Medicine & Dentistry at Western University.