How to be a good educational or clinical supervisor

Providing clinical supervision to junior doctors (or indeed other health care professionals) is an integral part of modern consultant life. If handled well it can become one of the most engaging and satisfying aspects of the consultant role. As with some many things at the start of a consultant career, there is a difficult to navigate nomenclature and website and different requirements for each grade of doctor. It is therefore crucial to work out what your role is and what you need to do to help with development.

Nomenclature

Educational supervisor; - oversees educational development, guidance, feedback, and career progression of a trainee throughout the year, will be responsible for support and pre –ARCP support and report. The education supervisor is responsible for the educational agreement and for bringing together all relevant evidence to forma summative judgement at the end of a placement.

Clinical supervisor; is a named clinical supervisor on a specific rotation and oversees / guides clinical development. Both offer a degree of safety netting for clinical practice and patient safety. Good supervision fosters reflections, supports professional learning and development.

This guide is intended to serve as an aide memoir or reference sheet for a new supervisor. Most trusts will require new supervisors to attend a ‘new supervisor course’ and this is not intended to be a replacement for this.

Set up

  • Make sure you are familiar with your trainee's requirements of either this rotation or this academic year. There is an ARCP decision aide which should provide this information.
  • Ensure you are meeting in an appropriate location such as a private office and that both parties are meeting on an equal footing. This is a private meeting, and sensitive issues may need to be raised.
  • Set and agree an agenda – PDP (Personal Development Plan) should be written by the trainee prior to this meeting. This is the opportunity to agree it, so if it has not been completed you may wish to review it later before locking the entry or re-scheduling.
  • Look at the trainee’s previous ARCP outcome (if >foundation year 1) and see if there were any development needs raised.
  • Get to know your trainee – sometimes trainees need support for issues outside of education and you may be the first port of call. The role of the supervisor can often include signposting / helping them get the help they need. Make sure they know who to approach if there are issues at work
  • Supporting professional development – trainees will often need career advice or guidance. The local postgraduate education department often has a wealth of resources. Doctors in foundation year 2 onwards can arrange taster weeksI. t may be helpful to be forearmed with exam revision ideas (are there PACES practice available?) and some signposting ideas on audits or QUIPs (there is always a colleague with a planned project).
  • Agree a date and time for the next meeting and agree any other outcomes not already included in the PDP – such as collection of multi-source feedback

Clinical supervisor specific points

  • Discuss / agree a work schedule during their rotation (often this is set well in advance and may well be a template outside the supervisor's control). In some trusts trainees may have clinic days set aside from ward work. Ensure the trainee knows when and what clinic to attend.
  • Discuss teaching opportunities – both formal, organised teaching but also the often overlooked bedside teaching on a consultant ward round.
  • It may be the case that the trainee may need additional support or a modification to their work schedule to be agreed – see below.
  • Discuss with your trainee how they can make the most of clinical time, such as when to aim for difficult to obtain WBPA’s such as a mini-cex (mini clinical examination) or ACAT. Consultant ward rounds are a good learning source and often a fantastic opportunity for trainees to get WBPA’s done. Encourage trainees to present (particularly post nights) or agree to lead the consultation on one case. ACATs (for some curricula) are easy for trainees to achieve and require little input into each case.

Trainees in difficulty

Clearly the role of the supervisor is to support trainees through difficulties and encourage reflection and learning from a clinical event. It is also important that we ensure patient safety. There may be a requirement for extra support such as sim teaching or even a change to the work schedule such as time off on calls / supernumerary time. Trainees may also require support via the occupational health service. All of this can be accessed via the local education team or the deanery.

Sometimes the trainee – supervisor relationship breaks down. It is important to recognise that this is not a sign of individual failure. It is crucial that when this happens the postgraduate education team / college tutor or deanery are informed, and an alternative supervisor is identified.

The ARCP (annual review of competence progression) report

At the end of the academic year the supervisor is responsible for meeting with the trainee and writing the end of year supervisor’s report. This is a yearlong account of progress and learning and will provide the evidence and guide decision making for the ARCP panel. It is therefore important to review the trainee's portfolio against the decision aide to help ensure they have all the required evidence. Some curriculums (such as the IMT (Internal Medicine Training) curriculum) put a lot of emphasis on the multiple consultant reports (MCR’s) – it is therefore very helpful if they are well written!

Attending an ARCP panel as a panel member is a particularly useful way to gain an understanding of what is required of trainees. It also counts as CPD for consultants.

Useful links: