Some Important Notes First:

• * WPBA won’t necessarily pick up struggling trainees / poor performance all the time. Therefore the information from educational supervisors will be key as they make the most comprehensive review of all the evidence.

• * Communication between E.S and C.S and/or feedback to TPDs is fundamental if concerns arise.

 

* "the trainee describes, interprets and reflects. The educational supervisor describes interprets and evaluates"

 

* Multiple sampling of evidence provides "triangulation and justification": so, the educational supervisor should tap into a few random log entries and PDPs as well as reviewing the evidence, curriculum coverage etc.

 

 

What Should I Do Before the Meeting?

 

* Familiarise yourself with the principles that underlie educational supervision and the art of giving feedback. You can find most of this information on the following web page: click here and go through each of the boxes

 

* Decide on a venue to meet. Try and choose a quiet and pleasant location. Consider going somewhere away from work.

 

* Set aside a minimum of 1 hour. Time committment will depend on the requirements of your registrar.

 

* Familiarise yourself with the e-portfolio so that most of the meeting is dedicated to educational supervision rather than a computer training session on the e-portfolio

 

* Ramesh Mehay regularly runs educational supervision training sessions to synchronise all the supervisors and align our objectives. Ask him when the next one will be: contact him on mehay.uk@lineone.net

 

* Alternatively, contact Yorkshire Deanery who also run regular educational supervision training sessions (main lead: Paul Robinson)

 

* The MSF & PSQ: It has been suggested that the person who is going to give feedback should have a meeting before the MSF/PSQ starts to agree with the trainee how they would like to receive their feedback, after the trainee has seen it first. Eg “Would you like me to send you the feedback so you can have a chance to reflect on it overnight, then we’ll have a meeting the next day to discuss it and agree actions?”. And there are many other ways it can be done. Don’t send the feedback to the trainee when you’re about to go on holiday for 2 weeks!

 

 

 

Structured Reflective Templates

 

Encourage trainees to download and consider using these prior to the meeting to help them reflect on things. Don't forget to remind them to bring these to that meeting.

 

 

 

What About At the Meeting During 1-1 Sessions?

 

* Discuss with trainee : what educational supervison is all about (formative!), what information is to be used and spend some time discussing the principles of giving and receiving feedback.

 

* Agree on an agenda (together!). Consider exploring the following three educational domains : Knowledge, Skills and Attitudes

 

* Allow the learner the opportunity to put forward his/her achievements

 

* Encourage the trainee to appraise him/herself (Critical Reflection). Critical self reflection is a good principle of adult education. Get them to look at both good and weaker areas. Beware - some trainees can be too self critical.

 

* The MSF/PSQ and the clinical supervisors report are felt to be quite good discriminators of how a trainee is doing.

 

* Start off with open questions, then, as the meeting progresses, become more focussed: very much like a consultation. SHO Educational supervision should be a two way dialogue ( don’t do all of the talking; don’t just sit there and listen all the time). A 50:50 contribution from both parties is the ideal.

 

* Setting Action Plans - always set these WITH the trainee. Review each one and ensure that they are realistic and achievable . Provide help in ways the trainee might achieve them. Keep tabs on problem areas; review the situation regularly until the learner is back on course.

 

* Watch for signs of stress in the trainee. Offer help early rather than later BUT be careful not to convert your trainee into your patient. If health issue arise, refer them to their GP, occupational health or counsellor. Do not take them on as your own patient; you can potentially make things worse if you take on a dual role!

 

The supervisor is not necessarily the learner’s personal counsellor. Refer where appropriate.

Appraisal IS NOT a substitute for day-day feedback, supervision or support on day-day work.

Remember, immediate feedback is the gold standard.

Both learner and supervisor should be familiar with the principles of feedback and appraisal. You may need to spend some time exploring this. Consider attending a workshop on feedback.

Concentrate on : a) Giving Feedback b) Receiving Feedback c) What appraisal is all about and how to do it.

 



 

 

 

 

What standards should be used?

 

In the early stages of training it is unlikely that the GPStR will be able to provide evidence of readiness to practise. The structured evidence, considered against the competence framework, will highlight the areas where the GPStR is doing well and those areas where more learning and support is needed. Thus each of the reviews will lead to a learning plan designed to enable the GPStR to collect more evidence of competence and to build up a richer picture of readiness for practice.

 

The standard against which the GPStR is judged is always the level of competence expected of a doctor who is certified to practise independently as a general practitioner.

 

This standard is used throughout the three years of training. This means that in the first two years of training the GPStR is being judged against the standard they should have reached at the end of training. Inevitably there will be less evidence from the application of the WPBA tools in the first two years of training, and more developmental needs will be identified. This is what the assessment system is designed to do, so that further training experiences can be directed toward the developmental needs of GPStRs.

 

So, it's okay for a GPStR to have many areas that "need further development"; they just need to work on them with time. The GPStR must show competence in all twelve competence areas by the end of year 3.

 

 

 

How much evidence of each competence does a GPStR need in order to complete the WPBA?

 

Assessment of competences is about making a qualitative judgement not a quantitative one. We would expect that at the end of ST3 the GPStR will have several sets of evidence in each competence area, collected from a range of settings and through different tools. However, the only requirement is that there is enough evidence to enable the trainer to feel confident that the GPStR is competent to practise. Each portfolio will look slightly different, but it should provide a rich picture of competence built up over three years. The “ticks” in the ePortfolio are simply a way of keeping a shared, transparent and systematic record of evidence.

 

 

 

I'm Worried Because I've Never Done These Type of Sessions Before.

 

We all give and receive feedback in every aspect of our daily lives. Don’t worry - it wont be anything new. Relax and enjoy the art of fine tuning another skill. It is important to:

 

1. LISTEN - THIS IS REALLY IMPORTANT. Eyes & brain open, mouth shut. Don’t interrupt, don’t dominate, don’t pre-judge!

2. REFLECT - on what is being said & judge constructively. Identify learning needs.

3. SUPPORT - construct & negotiate ACHIEVABLE plans.

4. COUNSEL

 

We do all these three things on a daily basis with our patients. Transferring these skills to trainee supervision should not prove too difficult. Relax...

 



 

 

 

 

What Can I Do To Stop Things Going Horribly Wrong?

 

* FEEDBACK PRINCIPLES: To prevent the trainee from reacting badly to any feedback or criticism given, both parties must be fully versed in the key principles of giving and recieving feedback. Attending courses on appraisal or on "giving and receiving" feedback are always invaluable.

 

* ASSESS CURRENT STATUS: look at your trainee, do they look distressed? If so, this may not be the right time to carry out appraisal.

 

* WHO'S GOT THE PROBLEM: Is it a learner problem, an appraiser problem or both? Does the learner need careers advice? Are they in the wrong job?

 

* DISCUSS the problem OPENLY and EARLY with the learner. Try and negotiate on how to get back on track - set agreed objectives

 

* GIVE SUPPORT where necessary, show them they are not in it alone

 

* DISCUSS WITH OTHERS : Involve the course organiser and deaneryearly on. You may wish to discuss the situation with another trainer for further advice or new ideas (remember, confidentiality though).

 

* CAN WE GET BACK ON COURSE? Sometimes the relationship is permanently irrecoverable. In such situations the only alternative may be to find another appraiser. (ASK Course Organisers for help and advice).

 

* DOCUMENT all difficulties and plans. Such dysfunctional events are likely to scrutinised further.