The butterfly effect is a well-known metaphor for the idea that complex, dynamic, nonlinear systems produce unpredictable effects due to the profound influence of tiny variations [1]. There are tacit assumptions of linearity made about many things in medical education, such as the way we talk about the progression of a trainee from incompetence to competence or the graded autonomy supervisors allow trainees over the course of this progression [2–6]. However, we also recognize that linear assumptions don’t always hold in our field [7]. To understand complex work-based training phenomena like supervision and entrustment, we need to acknowledge that the interactions among clinicians, trainees and patients are nonlinear [7]. This intersection, this tension between linear and nonlinear assumptions, is a tricky space to inhabit as educators and as researchers. But we must, if we are to develop robust understandings of how supervision and entrustment work in practice.
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