Analysis four researchers familiarised themselves

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for wordless sounds like laughs and non-verbal events like pauses were included. Analysis Four researchers familiarised themselves with all transcripts [ 41 ] and inductively coded one FGD at a time to subsequently discuss and agree on a code index for each FGD. Coders har- monised these into one overall code index, which was subsequently applied to all transcripts by 2 coders (VC and MS) using the software MAXQDA 11. Intercoder agreement was com- pared paragraph by paragraph, and a final harmonized version was completed. The purpose of this process was to facilitate discussions and analysis of the material. In comparing supervisors and providers we focussed on perceptions that were not unique to single participants, but re- appeared among several supervisors or providers. We were continuously in contact with participating supervisors and providers as well as other informants to clarify our emerging questions and discuss our hypotheses. We presented our findings in meetings for feedback and discussion: in March 2016 for 7 supervisors (of whom 3 participated in the study), and in October 2016 for 6 supervisors and another meeting for 8 providers (both in regions that had not participated in the study). This mainly confirmed our findings, and further refined our analysis. The manuscript was shared with an English- speaking supervisor participant prior to submitting. Ethical considerations Ethical and research clearance for this study was granted by the Faculty of Medicine Research Ethics Committee at the National University of Rwanda (Review Approval Notice N0 15/FoM- REC /2013). Signed informed consent was obtained from all study participants prior to participation. Results Table 1 shows key characteristics of participants as answered in a questionnaire. Supervisors were mainly males (11/15), 30 years or above except for one. Almost all had received their lat- est degree more than 4 years ago. Seven had less than 3 years of experience as a supervisor, and one had more than 10 years experience. Nine had not received clinical training in the past year. Providers were mostly female (12/16), three less than 30 years old. All had received their most recent degree more than 4 years ago. Only 1 had the advanced A0 bachelor degree, 5 had an A1 (full nursing) degree, and 10 had only the secondary school based nursing certificate called A2. Eleven had not received clinical training within the past 1 year. With our focus on the relationship between evaluative and formative supervision functions, we found 4 related but analytically separable conceptual levels within which this was discussed: 1) perceived theoretical reasoning behind supervision, i.e. intended supervision purposes and desired outcomes, 2) formal categories of supervision, i.e. how supervision is perceived and Evaluative and formative functions of external primary healthcare supervision in Rwanda PLOS ONE | https://doi.org/10.1371/journal.pone.0189844 February 20, 2018 6 / 23
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requested to be formally structured, 3) experienced events during supervision (supervision activities), and 4) how supervision motivates supervisees (motivation effect). We present
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