BACKGROUND 'Ad hoc' help-seeking by trainees from their supervisors during trainee consultations is important for patient safety, and trainee professional development. We explored trainee objectives and activities in seeking supervisor assistance, and trainee perceptions of the outcomes of this help-seeking (including the utility of supervisor responses). METHODS Focus groups with Australian general practice trainees were undertaken. All data was audio-recorded and transcribed, coded using in-vivo and descriptive codes, and analysed by the constant comparison of provisional interpretations and themes with the data. Findings are reported under the over-arching categories of help-seeking objectives, activities and outcomes. RESULTS Early in their general practice placements trainees needed information about practice facilities, and the "complex maze" of local patient resources and referral preferences: some clinical presentations were also unfamiliar, and many trainees were unaccustomed to making patient management decisions. Subsequent help-seeking was often characterised informally as "having a chat" or "getting a second opinion" so as not to "miss anything" when trainees were "not 100% sure". Trainees emphasised the importance of being (and demonstrating that they were) clinically safe. Workflow constraints, and supervisory and doctor-patient relationships, had a powerful influence on trainee help-seeking activities. An etiquette for providing help in front of patients was described. Trainees assessed the credibility of supervisors based on their approach to risk and their clinical expertise in the relevant area. Several trainees reported reservations about their supervisor's advice on occasions. CONCLUSION A trainee's subsequent help-seeking is strongly influenced by how their supervisor responds when their help is sought. Trainees prefer to seek help from credible supervisors who respond promptly and maintain trainee 'face' in front of patients. Trainees learn through help-seeking to make their own clinical decisions but may remain uncertain about professional and societal expectations, and curious about how other general practitioners practise. Trainees value opportunities throughout their training to observe expert general practice.

中文翻译：

---

用一粒盐？主管的信誉和其他影响受训者寻求咨询帮助决定的因素：澳大利亚全科受训者的焦点小组研究。

背景技术在受训者咨询期间，受训者从其上级向受训者寻求“临时”帮助对于患者安全和受训者专业发展至关重要。我们探索了学员寻求上级协助的目标和活动，以及学员对这种寻求帮助的结果的认识（包括上级对策的效用）。方法进行了具有澳大利亚普通实践培训生的焦点小组讨论。所有数据都经过录音和转录，并使用体内和描述性代码进行编码，并通过将临时解释和主题与数据进行不断比较来进行分析。研究结果报告在寻求帮助的目标，活动和成果的总体类别下。结果在实习初期，受训人员需要有关实习设施的信息，以及当地患者资源和转诊偏好的“复杂迷宫”：一些临床表现也不熟悉，许多受训者不习惯于制定患者管理决策。随后的求助通常被非正式地描述为“进行交谈”或“获得第二意见”，以便在受训者“不是100％确定”时不会“遗漏任何东西”。学员强调了（并证明他们）临床安全的重要性。工作流程的限制以及监督和医患关系对受训者的求助活动产生了很大的影响。描述了在患者面前提供帮助的礼节。学员根据他们在相关领域的风险方法和临床专业知识，评估了主管人员的信誉。几名受训人员有时对他们的主管的建议有所保留。结论受训者在寻求帮助时，其上级如何响应，会对受训者随后的寻求帮助产生很大影响。受训者更愿意从可靠的主管那里寻求帮助，这些主管应迅速做出反应并在患者面前保持受训者的“面子”。受训者通过寻求帮助来学习以做出自己的临床决策，但他们可能对职业和社会期望仍然不确定，并对其他全科医生的执业方式感到好奇。学员在整个培训过程中珍视机会，以观察专家的一般实践。主管随后寻求帮助时的响应方式会严重影响其随后的寻求帮助。受训者更愿意从可靠的主管那里寻求帮助，这些主管应迅速做出反应并在患者面前保持受训者的“面子”。受训者通过寻求帮助来学习以做出自己的临床决策，但他们可能对职业和社会期望仍然不确定，并对其他全科医生的执业方式感到好奇。学员在整个培训过程中珍视机会，以观察专家的一般实践。主管随后寻求帮助时的响应方式会严重影响其随后的寻求帮助。受训者更愿意从可靠的主管那里寻求帮助，这些主管应迅速做出反应并在患者面前保持受训者的“面子”。受训者通过寻求帮助来学习以做出自己的临床决策，但他们可能对职业和社会期望仍然不确定，并对其他全科医生的执业方式感到好奇。学员在整个培训过程中珍视机会，以观察专家的一般实践。对其他全科医生的执业方式感到好奇。学员在整个培训过程中珍视机会，以观察专家的一般实践。对其他全科医生的执业方式感到好奇。学员在整个培训过程中珍视机会，以观察专家的一般实践。