Lack of consensus in supervision

This study describes what occurs when trainees and supervisors encounter a lack of consensus in supervision. We identified 120 episodes indicating a l ack of consensus between a supervisor and a trainee during 23 hr of supervi sion. Qualitative analysis of the episodes described 10 supervisor response s, characterized as influence and evaluation, and eight trainee responses, characterized as cooperation and deference. The pattern of supervisor-train ee interaction was characterized by negotiation and collaboration. Supervis ors and trainees collaborate to produce a presentation of the trainee as a competent clinician and a cooperative trainee. Supervisors identify deficie ncies and offer requests in a subtle manner that appears open to modificati on, thus cooperating with the trainee's competent and cooperative image.