Perceptions about trust: a phenomenographic study of clinical supervisors in occupational therapy

BMC Med Educ. 2019 Nov 4;19(1):404. doi: 10.1186/s12909-019-1850-1.


Background: Finding the best way to facilitate student learning in clinical practice can be challenging for clinical supervisors. While high levels of trust might jeopardize patient safety, low trust might hinder student learning; however, carrying out professional activities is necessary for students to develop professional competence. There is a dearth of scholarly literature regarding the concept of trust among clinical supervisors in occupational therapy education. A better understanding of how trust is created between the supervisor and student may thus aid in facilitating student learning. The aim of this study, therefore, was to explore occupational therapy clinical supervisors' perception of trust and how it is formed.

Methods: A qualitative method deploying a phenomenographic approach was chosen. Twelve clinical supervisors were interviewed, and the data were analyzed according to the seven-step phenomenographic approach.

Results: Three qualitatively different ways of thinking about trust were found: (1) that trust is about the student and is rather static; (2) trust as a dynamic process based on student performance; and (3) trust as something mutual and interrelated. The findings indicate that trust can be understood in various ways, such as being something inherent in the student or, alternatively, about the student, the supervisor, the relationship between them, and the surrounding context, including the tasks performed. Furthermore, the study shows that trust can be seen either as something static or as a dynamic process.

Conclusions: This study contributes to a deeper understanding of the variation of ways in which the concept of trust is understood among clinical supervisors in occupational therapy. The study corroborates the prior research finding that trust can be understood as a multifaceted construct. It contributes novel insights about the role of the supervisor as an influential factor in the trust-building process. A deep understanding of the possible differences in the ways of conceptualizing something can help supervisors support learning by building on this understanding. The results from this study contribute to our knowledge of the drivers behind entrusted decisions in clinical education in various professional contexts. We suggest that the results be used in the continuing professional development of clinical supervisors.

Keywords: Continuing education; Education; Learning; Occupational therapist; Phenomenography; Qualitative research; Trust.

MeSH terms

  • Administrative Personnel / psychology*
  • Female
  • Health Knowledge, Attitudes, Practice
  • Humans
  • Interprofessional Relations
  • Interviews as Topic
  • Learning*
  • Male
  • Occupational Therapy / education*
  • Qualitative Research
  • Sweden
  • Trust*