Docendo discimus: promoting patient personhood in clinical supervision – a critical phenomenological study of reciprocal professional formation in medicine
摘要
Medicine has long been understood as both a scientific discipline and a moral and relational practice. Yet within contemporary hospital environments shaped by efficiency demands, digital infrastructures, and performance metrics, the promotion of a patient’s personhood cannot be assumed to remain visible or structurally supported. Clinical supervision represents a central site in which professional values are embodied and transferred to the future generation of physicians, yet little is known about how supervisors themselves experience sustaining their own commitments to personhood within this context.
MethodsThis study explores how clinical supervisors experience fostering and sustaining the promotion of patient personhood while supervising medical students, interns, and residents in two Swedish university hospitals. Seventeen physicians participated in in-depth semi-structured interviews. Data analysis employed a critical phenomenological approach, enabling examination of both lived experiences and the institutional conditions shaping these.
FindingsTwo interrelated dimensions were identified. First, supervisors described actively rendering patient personhood visible and legitimate within clinical reasoning, translating relational attentiveness into recognised forms of professional competence, modelling humility within hierarchical settings, and protecting core humanistic values within organisational cultures. Second, they described sustaining personhood in their own work as ongoing moral work requiring development over time, reminders in practice, inspiration through interaction, and deliberate inner resolve. Promoting personhood, thus, emerged as reciprocal and cumulative, where through teaching, supervisors simultaneously renewed and reshaped their own ethical commitments.
ConclusionsThe findings suggest that patient personhood is not passively inherited within contemporary clinical environments but actively cultivated through supervisory and relational practice. By situating supervisors’ experiences within organisational and cultural structures, the study contributes a theoretically grounded account of how medicine’s dual character as both a technocratic and a humanistic practice is negotiated in everyday work. Ultimately, sustaining patient personhood, and promoting it in the future generation of physicians depends not only on supervisors’ individual commitment but also on institutional conditions that either enable or constrain its visibility.