BMJ Qual Saf 22:609-612 doi:10.1136/bmjqs-2012-001637
  • Editorial

Clinical supervisors: are they the key to making care safer?

  1. Bruce Barraclough2
  1. 1Faculty of Medicine, Sydney School of Public Health, University of Sydney, Sydney, New South Wales, Australia
  2. 2Australian E Health Research Centre, Royal Brisbane and Women's Hospital, Herston, Queensland, Australia
  1. Correspondence to Professor Merrilyn Walton, Faculty of Medicine, Sydney School of Public Health, University of Sydney, Sydney, NSW 2006, Australia; merrilyn.walton{at},
  • Received 30 October 2012
  • Revised 28 April 2013
  • Accepted 5 May 2013
  • Published Online First 25 May 2013


The evidence shows that notwithstanding efforts by health professionals and hospital managers to improve the quality and safety of healthcare, adverse events remain prevalent. Clinical supervision is understandably dominated by transferring discipline knowledge and skills but the environment today requires equal attention to integrating patient safety concepts and principles into clinical supervision. Trainees learn from supervisors who themselves often have inadequate patient safety knowledge and skills. This conundrum may partly explain why there has been no visible reduction in adverse events. Patient safety literature has emphasised that clinical errors are rarely linked with incompetent doctors or trainees with inadequate knowledge but rather to failures in appreciating the context, complexity and uncertainty of clinical decisions made under the pressure of time. It is time to consider whether clinical supervisors themselves first need to demonstrate patient safety competencies before being responsible for supervising trainees.

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