Educational Supervision

An introduction to Educational Supervision

The information in these pages is for GP trainees, Educational Supervisors, Clinical Supervisors, TPDs and ARCP panel members. By having everything all in one place, it is hoped that there will be a greater level of shared understanding amongst all stakeholders.  In these pages you will see the Educational Supervisor referred to as the ES, the Clinical Supervisor as the CS and the Training Programme Director as the TPD.

What exactly is Educational Supervision (ES)?

Educational Supervision is ‘a positive process to chart an individual’s continuing progress and to identify development needs’. It is a forward-looking process essential for the development and educational planning needs of an individual.’  Please don’t be scared of these meetings.   Their purpose is to help you along your training journey in order to make it as smooth as possible.    

Its educational aims are to facilitate your personal and professional development through…

  • Encouraging reflection.
  • Identifying your educational/developmental needs.
  • Formulating an educational plan

Other things it does…

  • It helps keep you on track for General Practice, especially when you’re in hospital posts.   
  • It also helps you to develop a relationship with your Educational Supervisor – thus enabling them to provide pastoral support for you when you’re facing difficulties.  Of course, this only works if the relationship is one which is built on openness, honesty, integrity and trust.  

Educational Supervision (ES) is a process which involves regular meetings between teacher and learner with support for the benefit of the learner.  It helps identify a learner’s strengths but also their difficulties so that these may be helped to be put right within the framework of the objectives set at the start of the programme.  It is confidential (except in defined circumstances), primarily educational and developmental, and designed to help the individual to progress.  it is positive and forward-looking:  giving someone feedback on their performance, charting their continuing progress, identifying developmental needs and putting an educational plan into place.  So, please try to see it as a positive thing.

What's the difference between Clinical and Educational Supervision?

Try not to confuse your Clinical Supervisor with your Educational Supervisor.   

  • The Clinical Supervisor oversees your day to day work and will change with each change of post.  
  • Your Educational Supervisor oversees your progress throughout training and will usually remain the same person throughout your 3 year training period.  Their aim is to keep you on track for training (primarily) and help you identify and meet your learning needs

And what about these ES meetings?

By now, it should be clear to you that a key feature of this process is that it is built on a supportive and facilitative relationship between two people.  Taking part in this process should prove rewarding: professional development supported in this way enriches working life, increases job satisfaction and should enable you to respond effectively to clinical, organisational and social change.

The ES meetings are there to help the learner by

  1. Ensuring that they are on track for GP training.
  2. Helping them with educational planning and helping them to develop in those areas where there is an identified need.
  3. Picking up on any difficulties they may be experiencing – whether personal or with the post so that they can iron these out and get the trainee back on track for training.
  4. Communicating to others (e.g. programme directors) whether or not the trainee is doing okay – thereby developing a network of support if they are not.

How many meetings and when?

The following TIMINGS are for full-timers.  If you are part-time, talk to your TPD about the best timings.  

  • If you’re an ST1 in your very first post, then you need TWO ES MEETINGS.  The first of these is an INFORMAL one that should happen somewhere near the start of your post.  The last one should happen in month 5 or 6.
  • Every other ST trainee is expected to have ONE ES MEETING towards the end of every post.    If you are not moving up an ST year – arrange it for month 5 or 6.   If you are moving an ST grade, arrange it for end of month 4 (because that allows enough time for an ARCP panel to meet and discuss you before allowing you onto your next post).
  • For the first half of the year (Feb-Aug) month four is usually MAY.  
  • For the second half of the year (Aug-Feb), month 4 is NOVEMBER.  
  • It is the trainee’s responsibility to organise these ES meetings.  You will not be reminded – so you need to put  it in your reminder system (like a diary) now!
  • Liaise with your Educational Supervisor EARLY about this meeting.   Don’t leave it until the last minute – please remember that your ES has a life too and may have other commitments or have booked a holiday during your last minute appeal!  Don’t expect them to be forgiving or drop everything for you not having sorted yourself out!
  • These meetings are incredibly important.  Without them, YOU CANNOT move onto your next post or your next ST stage.  Please take heed of this warning.

What's covered in the ES meetings?

The meetings will contain summative and formative elements. It is NOT about one or the other – it’s about both.  By formative, we mean things to help you develop no matter where you current position is.  By summative we mean making an end-judgement about where you are at and whether you are progressing as expected at your level.  And where are all these summative and formative elements kept?   Answer – YOUR ePORTFOLIO.   That’s why maintaining the ePortfolio is incredibly important if you want to progress smoothly to the next ST year throughout GP training.

The types of things the ES will check in your ePortfolio include…

  • The Learning Log – to see if you are making meaningful reflective learning entries with adequate coverage of the curriculum and evidence for the demonstration of the 13 Professional Capabilities.
  • The WPBA tools – like your COTs, CBDs, CEXs, Audio-COTs , Prescribing Tools – to ensure that you’re doing the right number of things in a timely way and making effective progress.
  • The WPBA reports – like the MSF, PSQ and CSR  – to see whether these different groups of people are happy with your progress.   Each of these reports are considered to be quite good discriminators of how well a trainee is doing.
  • Out of Hours (OOH) – to see whether you are engaging in OOH, and writing logs to demonstrate the 6 OOH competencies. 

In addition, your ES will also talk to you to see how you are getting on both at work and at home – because one can often interfere with the other – and we all want what is best for you.  The aim is to identify difficulties and help you get to a better position so that you finish GP training both successfully and happily. 

Educational supervision is not about disciplinary procedures but more about helping the trainee overcome or see them through the difficulties.

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Tell me more about the ES report (ESR)

After discussion and reviewing your ePortfolio, amongst other things, your ES will formulate a report – called the ESR.   This is an incredibly important report because others (like the ARCP panels) refer to it to decide how well you are doing and whether you should progress onto the next ST year.     

The ES report will contain a summary of all that has been reviewed and how you are doing.   In addition, an agreed Learning Plan will be formulated with you and tailored towards your educational needs. Of course, to get a good ESR means your ePortfolio has to be well maintained.  That means writing good learning log entries, doing more than the minimum number of assessments and doing the preparatory stuff that is required of you before your ES meeting (which you can find in the ES section menu link for the trainee – at the top of this page).

FAQs

Your scheme’s administrator will tell you who your Educational Supervisor is. Generally, your Educational Supervisor will remain the same throughout your entire training period (unless they become ill, emigrate, retire etc).  Some schemes try to allocate your very first GP trainer in ST1 as the Educational Supervisor for the rest of your training.  In this way, they believe you will form a positive relationship with them early that will serve you well for the remaining training years; it makes educational sense.

Once you know who your Educational Supervisor is, YOU need to get in touch with them EARLY ON so that you can schedule some appropriate dates. It is no good waiting til say in May and hoping they can squeeze you in during that month.   Please remember that Educational Supervisors have lives and their own plans too.

The RCGP endorses the notion that Educational Supervision is a trainee-led process.  In other words, it’s your responsibility to get in touch with your Educational Supervisor early on (and not the other way around). If you end up missing your ES session because you forgot (say) then I hope you will agree that it would be unfair to expect the supervisor to drop everything just to fit you in. As the saying goes, if you fail to prepare, then be prepared to fail. Only you will lose out!  I apologise for having to write in this way, but this is a key message you need to take on board early.  Too many trainees get into bother over this, and I don’t want you to be one of them.

  • Obviously, in the early stages of training it is unlikely that the GP trainee will be able to provide evidence for “readiness to practise” as a qualified GP.   Therefore each trainee is assessed according to the ST stage they are at.
  • So, if you’re and ST1 – you are judged according to what would be expected from a trainee at the ST1 stage.  And the Educational Supervisor (with their training experience) will know what is excellent, good, average and poor performance.  
  • When you reach the final stage of training – your evidence is then considered against the Professional Capabilities framework.   You are then assessed against “readiness to practise” as a qualified GP in all 13 Professional Capability domains.  
  • Each ES review will lead to a learning plan designed to enable the trainee to collect more evidence of competence and to build up a richer picture of readiness for practice.
  • It is only in the final year that the standard against which the GP trainee is judged is the level of capability expected of a doctor who is certified to practise independently as a general practitioner (i.e. a qualified GP).
  • Trainers are expected to use their personal experience as a GP to judge whether the evidence for each capability area and the totality of evidence indicate that the GP trainee is ready for independent practice in their final year.   Trainees should respect this decision.
  • The assessment of whether you have enough evidence for each Professional Capability area is a qualitative judgement not a quantitative one.
  • We would expect that towards the final year of training,  the GP trainee will have several sets of evidence in each Professional Capability area, collected from a range of settings and through different tools.  
  • The only requirement is that there is enough evidence to enable the GP Trainer and Educational Supervisor to feel confident that the trainee is competent to practise.  Trainees should respect the decision of their GP Trainer and Educational Supervisor.​
  • Each portfolio will look slightly different, but it should provide a rich picture of capabilities built up over the entire GP training period.
  • The “ticks” in the ePortfolio are simply a way of keeping a shared, transparent and systematic record of evidence.

We at Bradford think that your Clinical Supervisor should read most of your log entries and validate them.  If you’re in a GP post, the Clinical Supervisor will be your nominate GP Trainer.  If you’re in a hospital post, the Clinical Supervisor will be the hospital consultant you are working for.   PLEASE encourage and remind them to look at your ePortfolio entries frequently.  They lead such busy lives that they often forget – and they need someone like you to nudge them.   Perhaps one tutorial you might say ‘Would you mind if we just go through my learning log entries today to see what you think or how I might improve on them?’   We are sure they will find this a welcome suggestion.  They don’t have to read all of them – but as a minimum, they should aim to read at least 80%.

However, if you are in a hospital post, and have tried really really hard to get your hospital consultant to read them without much joy, then let your Educational Supervisor know early.    You should have insight by the end of month 3 of your post whether your hospital consultant is reading them or not.   And if you have tried your best to encourage your hospital consultant to read them, then the task of reading your eP entries falls to your Educational Supervisor – but tell them early on because they cannot second guess and they have busy lives too.

Reasons Why We Think it Should Be Your Clinical Rather than Educational Supervisor

  • It’s more practical – it’s very time consuming for an ES to go through all the eportfolio entries and validate them in one-two-or-three goes. A GP Trainer can do them gradually throughout the 6m post.
  • A good proportion of the e-portfolio entries will have been discussed with the Trainer or hospital consultant already. They would then be able to easily and more reliably validate that entry against the 13 Professional Capabilities.
  • If the Clinical Supervisor does it in a progressive way (i.e. gradually throughout the 6m period), then he or she is also in an ideal position to employ a drip-feed method of feedback. In this way, skills can be gradually developed and feedback more readily accepted.  As the ES and trainee only meet twice a year, the ES giving volumes of feedback during these sessions would prove overwhelming and difficult for anyone.
  • Reviewing how the trainee is writing up log entries in a progressive manner provides the Clinical Supervisor with another informal form of assessment on how the trainee is progressing.  No doubt this will contribute to a more reliable and valid Clinical Supervisor’s Report.
    • NUMBERS: It’s not about the numbers.   You don’t have to do a particular number of OOH sessions.   You basically have to do enough which you can write about and provide evidence for the 6 OOH competences.    For those of you desperate for a number, think one per month of GP for at least the last 12m of your training.   You don’t have to engage in ST1/S2 (although, it’s probably good practice to get started).  But you must engaged in your last year of GP.

    • LENGTH: Again, there is no definition of how long your OOH session should be.  Most usually last 4-6 hours though.    The emphasis on the experience rather than the length.  You need to get enough experience to help you gather enough evidence in your ePortfolio that you are meeting the 6 OOH competences.

    • EDUCATIONAL VALUE: It is recognised that some OOH sessions provide more experience than others.  Some sessions can provide very little!  That is why there is a move away from counting the number of hours you do in OOH towards gathering evidence for the 6 OOH competences.  The Panel will expect evidence of the educational quality of the OOH experience.  Therefore, the trainee needs to make sure that each session is supported by a log entry clearly indicating what they have demonstrated, experienced and learned in relation to the 6 OOH comptences. 

    • PART-TIME TRAINEES: How many OOH sessions should you do?   Again, it is NOT about the numbers.  So, the pro-rata stuff doesn’t come into it.  You basically need to do enough to gather evidence in your ePortfolio to demonstrate your exposure and experience to the 6 OOH competences,
      Less than full-time trainees should undertake the same number of sessions as their full time colleagues but over a longer timeframe.

    • TRY AND LOOK FORWARD TO YOUR OOH SESSIONS: Remember, that OOH is less pressurised that your on-call duties in the hospital.  At least you will get some sleep!  And the sessions only last 4-6 hours rather than the whole night!   And you have a Clinical Supervisor at all times to guide you.  It can be a very rich educational experience if you want it to be.

    • The 6 OOH competencies are….  (mnemonic T-SCORE)
      1. Individual personal Time and stress management.
      2. Maintenance of personal Security and awareness and management of the security risks to others 
      3. The demonstration of Communication and consultation skills required for out of hours care.
      4. Understanding the Organisational aspects of NHS out of hours care (nationally & locally)    
      5. The ability to make appropriate Referral to hospitals and other professionals.
      6. Ability to manage common medical, surgical and psychiatric Emergencies.     
  • You and your ES MUST fill in the ePortfolio’s Educational Supervisor’s Report (ESR).
  • This report will highlight any difficulties – either personal, educational or with the post. Please don’t worry about these being documented. Educational Supervision is not about disciplinary procedures but more about helping you overcome or see you through the difficulties.
  • Therefore, the report has an “agreed action plan” to help your GP training journey become smoother.
  • In the first instance, your friendly Educational Supervisor will try and help you identify what it is that you need to do to get your ePortfolio and the evidence within it ‘up to scratch’.  
  • Please listen to the feedback that they give you.  If you find the feedback that they give you uncomfortable and difficult to accept, take a deep breath and accept responsibility for it.  Please also remember that it was probably hard for them to give it to you in the first place.  No body likes telling other people about their deficiencies, but the problem is that if no one does, then you never improve.   And you ES will want you to succeed.   So – deep breath, accept it, work on it to become a better you.
  • The Educational Supervisor may involve other people to try and HELP you.  For instance, they may seek the advice of the Training Programme Directors and even the deanery.   Again, please remember that they’re not being unkind by doing this.  They just want to make sure that there is a network of people ready to support you.
  • And finally, if, after repeated advice you fail to take the advice on board and your ePortfolio continues to show a lack of evidence appropriate to your training stage, then you will be referred to an ARCP panel which in all probability will involve you attending an interview and having to explain yourself.    If ARCPs are not happy with your response, they can make you repeat an ST year and in very bad situations – terminate your training pathway early.   Is it worth that risk?    .
  • Every year, the ARCP panel will look at your ES reports anyway – irrespective of whether your ES has flagged any concerns.  So please, take your ePortfolio seriously – IT IS AS IMPORTANT AS THE AKT AND CSA.   I cannot emphasise enough how important it is for your to devote time to your ePortfolio right from the start, and take it seriously by showing it the respect it deserves.

This is a common and understandable feeling.   After all, the ES meeting is an important one and has major implications if it is deemed that you are not making satisfactory progress.   But try and relax a little….  although it might sometimes feel like we’re checking up on you, please remember that it is out of doing what’s right FOR YOU as an INDIVIDUAL. We want to make sure you are on track for training so that YOU DON’T LOSE OUT and we want YOU to make the most of the OPPORTUNITIES that are available to you during your time with us.

We’re not here to tell you off. We are here to help you make things better or put things right.   In assessment the trainee tries to hide what they are bad at; in Educational Supervision they should be comfortable about displaying it.

If you find your relationship with your ES is not as good as you hoped then it is worth discussing it early on with your Programme Directors. Similarly if it works well it is also worth mentioning as they will be keen to develop models of good practice.

However, before you deem your Educational Supervisor as not likeable, pause and reflect for a moment.   Why is it that you are not particularly fond of them?   Is it because

  • they have given you some feedback that you are not particularly happy with
  • you feel they are nit-picking
  • you feel they are strict with things
  • the meetings are quite detailed and lengthy?

If it is any of these things, it is highly likely you’ve got a very good Educational Supervisor who is trying there best to help you get through GP training smoothly,    It is possible that they are trying to get your potential out of you.    And in such circumstances, you may want to pause and think whether the problem lies with them or with you.    Do you need to re-adjust your mindset about Educational Supervision and GP Training?   Is it possible that your ES has a point and there’s some things that have been said which, after a bit of reflection, are valid and perhaps you need to take on board?

In rare circumstances, there can be personality clashes – but like I said, these are rare!  If you think this is the case, talk to your TPDs. 

 

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