Educational Supervision

ES Training for Educational Supervisors

This page is for training up Educational Supervisors. If you’re a trainee who has stumbled across this page, please don’t run away. By all means have a look around – understanding what your Educational Supervisor is expecting from you will in turn help you deliver the ‘right stuff’.   This will help your training run smoothly and trouble-free (and that in turn means you can focus on enjoying it). If you’re a new Educational Supervisor, please read some other pages in the menu boxes above.  In particular: “Educational Supervision – intro” ad “Trainees – how to prepare for ES”.

Educational Supervision is quite an onerous task.  It’s not that easy to get your head around it in one go. To make this easier, I’ve broken it down into its contents and process. You may want to revisit this page over several days rather than do it “all in one go” – it’s a bit of a big hit to do it all in one.    To get the most out of this page, please do the tasks FIRST before watching the video clips.  Trust me – you will get more out of it that way.   As for the video clips – they are under 10 minutes long. If you have any suggestions, please let me know ([email protected]). In the mean time, don’t forget to switch your computer speakers on. Oh, and if there is a problem viewing the videos at work, try a non-NHS networked computer like the one in your home.

The Essential ES Reading List - great docs and webpages

If  you’re relatively new to Educational Supervision, please read the web pages and documents in the essential reading list below.     Remember to refer the trainee to some of these pages too.   In fact, if you refer the trainee to just the “Trainees – how to prepare for ES”, all the other pages and documents of interests are there too.   And as for yourself, don’t try and read all of this in one go; it’s too much.  Do a bit each day to keep the interest and enjoyment there.

A very important thing to say right now...

On the last page of the ES report in the ePortfolio, you will be ask whether the trainee has (a) made satisfactory progress, (b) unsatisfactory progress or (c) refer to panel.    Please remember, if you select (b) or (c) – a task IS NOT GENERATED to inform anyone that you are concerned.  So, if you are awarding unsatisfactory progress or refer to panel – PLEASE EMAIL the GP Training Scheme’s Administrator and the TPDs.

2 technical things to do BEFORE your ES meeting

As soon as the trainee starts a new post, the ePortfolio now requires you (the ES) to do two things

  1. Sign the Educational Agreement, Health Declaration and Probity Declaration 
    Actually, both of you have to do this.   It’s on the front page of the ePortfolio.  You only ever need to do this the once with each trainee.
  2. Setup a Review as soon as they start a new post.  
    This doesn’t mean you need to do a review, just that you need to “technically” set it up ASAP.  Otherwise, the trainee won’t be able to add things to their ePortfolio in the right time period.  Once the ‘Setup’ is completed all evidence pertaining to that post will automatically appear in the correct place.  In addition, without creating a review: the trainee cannot do a self-rating scale, the ES cannot see the MSF/PSQ results in a summarised format, and finally the ES cannot release any MSF or PSQ results.   In summary, if you don’t set up the review, the ESR becomes a technically difficult thing to do for everyone.
    To set up a review date: log into the ePortfolio, select your trainee and then click ‘create review’.  ONLY complete the first “Setup” page of the Review (takes 2-3 mins).  Add the start and end dates. This other sections can then be shelved until you actually meet your trainee for an ES meeting.   This needs to be done every time a GP trainee changes post.

THE PROCESS - in a nutshell

The Oasis 7 Stage model outlines some core principles to be mindful of when doing Educational Supervision.  These 7 C’s will not only help things run smoothly but also more educationally satisfying for both you and the trainee.

SOME TOP TIPS FOR THE NEW EDUCATIONAL SUPERVISOR

  • Try and do Educational Supervision in a nice setting.   
    Perhaps your home rather than the surgery.  Perhaps outside with your laptops and a mobile internet connection.
  • Get to like your trainee
    Spend some time getting to know them and their life.   Of course, this is a two way thing and you should share some things about you too.
  • Dispel fears and misconceptions
    Ask your trainee what they think Educational Supervision is all about.  How do they feel about their meeting with you?  Are they anxious or scared?
  • Assess current status
    Look at your trainee, do they look distressed? If so, this may not be the right time to do Educational Supervision.
  • Remember the principles of feedback
    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. Click here to learn more about Brown & Leigh’s principles of feedback.
  • Encourage your trainee to talk:  
    Educational Supervision is all about helping the trainee.   Therefore, the whole process needs to be a dialogue between you two rather than a one sided discussion.
  • Read our document: The Skilful Art of Facilitating an ES session.

ALWAYS REMEMBER THESE POINTS IF YOU FEEL THINGS ARE GOING WRONG…

  • If there’s a problem, share it openly and early with the learner.   
    The best outcomes are always discussed and planned jointly.   Things go badly wrong when there are hidden surprises as a result of some things being kept ‘secret’.
  • If there’s a problem, try and remain neutral and simply gather more information.  
     
    It’s easy to inherit the feelings evoked by others like Clinical Supervisors.   Remember, you are here to help the trainee.   Stop and neutralise any negative feelings you may have developed.  Invite the trainee to explore the issue on neutral territory.   Simply gather more information.
  • If there’s a problem, define who’s got the problem?  
    Is it a learner problem?  Don’t automatically assume that a trainee labelled as bad is actually bad.  We’ve seen trainees who have been labelled as ‘work-shy’ or ‘lacking commitment/professionalism’ just because they complain about the work pressures in a department struggling with its staffing levels.   However, there are also times when the learner needs careers advice (esp. if you think they’re in the wrong job).
  • Give support at all times: 
    Trainees experiencing difficulty are often at a low point in their lives.  They need you to support them, not necessarily join in with those crucifying them!  And besides, the best outcome is when plans are made where all the stakeholders are involved and happy.
  • Involve others: 
    You may wish to discuss the situation with another trainer for further advice or new ideas (be mindful of confidentiality though).  However, please involve the TPDs and Deanery as EARLY as you can.  Often, TPDs are involved way too late – when too much damage has already been done!
  • Document all difficulties and plans. 
    Dysfunctional events are likely to scrutinised further.  Good documentation protects everyone – you, the TPDs, the deanery and even the trainee.

THE CONTENT - in a nutshell

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 the trainee develop no matter where their current performance position is.  By summative we mean making an end-judgement about where the trainee is at and whether they are progressing as expected at their level.  And where are all these summative and formative elements kept?   Answer – The ePORTFOLIO.   That’s why maintaining the ePortfolio is incredibly important point to emphasise to the trainee if they want to progress smoothly to the next ST year throughout GP training.

The types of things the ES will check in the trainee’s ePortfolio include…

  • The Learning Log – to see if they 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 the COTs, CBDs, CEXs, Audio-COTs , Prescribing Tools and CEPS (formerly called DOPS) – to ensure that they are 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 the trainee’s 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 the trainee is engaging in OOH, and writing logs to demonstrate the 6 OOH competencies. 

In addition, the ES will also talk to the trainee to see how they 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.

What Educational Supervision really is.... Tweet

THE CONTENT - other things MIGHT be worth exploring

Educational Supervision should explore a number of areas if we truly want to help the individual because all of the things below interact and affect each other – not just the assessments and GP training things.

  1. Their life at work
  2. Their life as a GP trainee (educational needs)
  3. Their life at home
  4. Their life socially

Here are some examples of things that you might want to cover.  Some will need covering each time you hold an ES review but others may be more important when they are relevant.  Some of the data for the discussion might be directly obtained from a dialogue with the supervisee, but you may also need to triangulate this with other data sources like their e-record, feedback from their colleagues, feedback from patients and so on.

  1. Work – things that are going well, achievements, workload issues, learning needs.  Personality issues and relationship problems.  Complaints & Investigations.  Time management.
  2. Educationally – review of assessments – COTs, CBDs, mini-CEXs, multisource feedback, patient surveys, Clinical Supervisor’s Report and so on.  Study leave and courses. Career issues.
  3. Home – factors (positive or negative) which have impacted on current performance.  Relationships, finances, family life.  Personal/medical problems.   Home-Work life balance.
  4. Socially – Network of friends, social belonging, communities.  Coping with stress.   Alcohol and drugs.
Of course, you wouldn’t ask about drugs, alcohol, relationship difficulties or things of that sensitive nature just out of the blue.  Be sensitive.  Ask if it seems relevant or you have an inking there’s other stuff going on that you feel you need to explore because it would help with formulating their educational journey.  

THE VERY 1st ES MEETING: template ES email

In the Yorkshire & the Humber HEE region, all GP trainees who have just started (i.e. in their first post of ST1) get two ES meetings.  One “informal one” at the beginning – around month 1-2 and the second “official one” at around month 5 or 6.    And from ST2 onwards, they then only get one “official” ES meeting per 6 months.   I don’t know if that is the case everywhere else but I do think it is a great system because the first meeting allows a handshake to truly develop between ES and trainee (rather than going straight into task mode because there is otherwise so much to do).    The first meeting also enables you to concentrate on a few core areas that are worth “getting right” from the start; and it enables this to happen in a gentle manner rather than a rushed one.  So, here is what I do in that first of two ES meetings in ST1-post1.  I hope some of you find it helpful.   Please feel free to cut and paste the email template I send my trainees.  

Ramesh Mehay

The Email Template

Dear XXX

Welcome to the scheme.  I am your Educational Supervisor and I am really looking forward to meeting you and helping you until the day you finish your training scheme.   First things first, we need to arrange an ES meeting.  I have the following dates available, which of these would you like?

  • Date 1
  • Date 2
  • Date 3

As you will have gathered by now, there is an enormous amount to GP training.  And I don’t want to overload you too much.  So, let’s slow down and figure out what is important at this stage.   In preparation for this meeting there are 5 areas I would like you to “brush up” on and I have provided corresponding web-pages for you…

  1. Understand what Educational Supervision is about.  And how it differs from Clinical Supervision:  www.bradfordvts.co.uk/edsupervision
  2. Understand the Professional Competencies: www.bradfordvts.co.uk/mrcgp/competencies
  3. Understand the different components of WPBA – things like COTS, CBDS, CEXs, MSFs, PSQs, NOE: www.bradfordvts.co.uk/mrcgp
  4. Read some stuff about Reflection: www.bradfordvts.co.uk/teaching-learning/reflection
  5. Read some stuff about Writing Learning Log entries: www.bradfordvts.co.uk/mrcgp/log-entries  and www.bradfordvts.co.uk/mrcgp/log-entries/easy-method

And finally, there is ONLY ONE THING I would like you to do.     

I would like you to pick two clinical encounters in your current post and write a learning log entry about them.  Don’t stress over this.  Just write them in anyway that you want.  They don’t have to follow any of the guidance mentioned above.  Just feel free to write as you wish.  And on the day, we will use them for the basis of teaching and training you up.   We will also go through the above 5 things and explore your understanding of them. 

I know you’re probably feeling apprehensive.  There is no need to be.  As long as you can show a committment and enthusiasm for your own learning, there is nothing to fear.   I’m looking forward to it and hope you are too.

Dr YYY

PS You do NOT need to look at any of the ES Checklists on the Bradford VTS website for this first meeting.  

Things to cover in the VERY FIRST ES meeting

  • Please note – all supporting documents are available in the HOT DOCS downloadable section above.
  • Educational Supervision vs Clinical Supervision
    Discuss
  • The 13 Professional Competencies – how everything a GP does can be mapped to one or more of these 13 areas.   There is nothing that cannot.  Therefore if you show you are good at these 13 areas, then you must be good enough to be a GP.  Thus it’s important to have a really good understanding of each Professional Competency.   Do not think you can second guess what each is about.  Read the RCGP competency descriptors in the download links above.
  • The different WPBA components – and how they look at different bits of the professional competencies (with triangulation).  Don’t double dip – a CBD cannot be used as a log entry.
  • The grading system (E, C, NFD & IE) – and explaining NFD is the EXPECTED grade and not to be disappointed.   (In the past, as medical students and even in FY training, the doctor may have become used to being awared ‘excellent’).   Explain we have more robust and carefully designed criteria.
  • Discuss reflection and what it means.  Why is reflection such a big deal?   (Because learning can only happen if you reflect.   It helps you identify good behaviour to continue doing in the future.   It helps identify things that need to change).   Why not just reflect in our minds, why write it down?   (Because writing slows you down.  You therefore end up seeing links and making new connections (or learning) that are often missed by thinking on the spot.    This leads to deep and meaningful reflection which can have a transformative effect on our lives.   Thinking just quickly in our heads leads to superficial and less transformative learning.  
  • Discuss learning log entries – use their examples.  Ask them to explain one of them.   Then show them how to transform it into a deep meaningful reflective learning log entry.   Then give them time to work on the second one themselves. Explain learning can be split into three areas: Knowledge, Skills & Attitudes (KSA – the 3 domains of learning).Discuss what validating against the competences means.   Show them how the 13 Professional Competencies can provide a great reflective framework for writing their log entries.  
  • The ES Workbook  & Form R & ARCP panels
  • Responsibility – The RCGP says it is all the trainees.  Trainees will have to manage themselves when they qualify as a GP (things like appraisal, letters, blood results, meetings etc) and NO ONE will remind them.   In a similar way, they have to start managing themselves as GP trainees – and it all starts with Educational Supervision. They need to be on top of the right number of assessments.  That the competences are all being covered.   No one will give them nudges or reminders. And they can’t say “no one reminded me”.  

 

Where to record the 1st ES meeting for an ST1-1?

Simple – write it up as an Educator’s Note.   Log into the ePortfolio and look at the left hand navigation menu.  You should see a link to Educator’s Notes.   The second official one will be recorded in the official place – the ES section of the ePortfolio (click on Reviews).

SUBSEQUENT ES MEETINGS: template ES email

The Email Template

Dear XXX

I hope you’re well.  It is time to arrange an ES meeting.  I have the following dates available, which of these would you like?

  • Date 1
  • Date 2
  • Date 3

I’m really looking forward to meeting up with you and seeing how you are doing.  The meeting will go smoothly if you do the following…

  1. Use an ES checklist to help you fill out your part of the ES section in the ePortfolio.   Do not rush this.  Expect it to take 2-3 hours. 
  2. Upload a completed ES workbook
  3. Upload a completed “Form R”
    All can be found here: www.bradfordvts.co.uk/edsupervision.   Please fill these in with care and consideration (as opposed to filling them in quickly).  

The most difficult bit is writing up your Competency Self-Rating Scales.  Please pay close attention to the way you write this up.   If you have done it correctly, it will take you around 1-2 hours.  Follow this guide

Of course, from previous sessions, I hope you will have read the following information pages.   If not, or you can’t remember, here they are again.  Please read them because they contain everything you need to know for Educational Supervision and are designed to make your life easier.

  1. Understand what Educational Supervision is about.  And how it differs from Clinical Supervision:  www.bradfordvts.co.uk/edsupervision
  2. Understand the Professional Competencies: www.bradfordvts.co.uk/mrcgp/competencies
  3. Understand the different components of WPBA – things like COTS, CBDS, CEXs, MSFs, PSQs, NOE: www.bradfordvts.co.uk/mrcgp
  4. Read some stuff about Reflection: www.bradfordvts.co.uk/teaching-learning/reflection
  5. Read some stuff about Writing Learning Log entries: www.bradfordvts.co.uk/mrcgp/log-entries  and www.bradfordvts.co.uk/mrcgp/log-entries/easy-method

Any problems, please let me know early.   The meeting is expected to last 2-3 hours.  I’m really looking forward to it and I hope you are too.

Dr YYY

Additional notes on these subsequent ES meetings

  • Please note – all supporting documents are also available in the HOT DOCS downloadable section above.
  • Simply select an ES checklist and go through it. 
    It will guide you through exactly what you have to do task by task.  If you’re doing ES for the first time, expect it to take 3-4 hours.   As you get better and more familiar with the form, expect an average session to last 2-3 hours. 
    es checklist bradford.pdf
    es checklist bradford – supporting notes.pdf
  • Read some log entries
    You don’t heave to read every single one!  But try and make sure at least 90% have been read by someone (trainer or you).  In terms of how many to read – enough to give you a flavour of how the trainee is reflecting and learning.   If the log entries are a bit rubbish – figure out WHAT makes them rubbish – and educate the trainee HOW to write them better.  Discuss reflection theory again.  Use my easy way of writing log entries.  Perhaps pick a couple and re-write them together there and then!   How else will they learn if you only talk but don’t show or do?
    www.bradfordvts.co.uk/mrcgp/log-entries/easy-method
  • The hardest part is the Competency Rating Scales
    So get the trainee to do this really well.  If they write it up well in terms of the quantitative and qualitative evidence, then you can whizz through the bits that are clearly okay and slow down on those areas where you feel there is a genuine need for greater evidence and thus development.
  • Use The ES Workbook
    In fact, it should be one of the first things to open up.   It will provide all the quantitative evidence to you at a glance – like for example, the COTS and CBDs and where their strengths and weaknesses are in relation to the criteria.   The ES workbook is designed to make both your’s and your trainee’s lives easier.  Don’t ask why it’s not part of the ePortfolio – we’ve been asking the college for years but it falls on deaf ears.  
  • Remember to triangulate
    If one competency looks poor (especially if the trainee is at ST3 stage) – look at other pieces of evidence that also measure the same competency.   The dropdown box on this page will tell you which assessments provide a measure for which competency:
    www.bradfordvts.co.uk/edsupervision/evidence-for-rating-scales
  • The PDP and Action Points 
  • Develop some action points (and thus a PDP)  WITH the trainee.   Do not tell them what to do!   Ask what they feel they need to work on and suggest some things you have noticed and see what they think.    The page below provides a list of action points for EACH competency.   If you have any others you can think of, please post them via the comments box.
    www.bradfordvts.co.uk/edsupervision/action-points-for-capabilities
  • For ST1s & ST2s – essential things
    Make sure they have done a QIA project & Form R uploaded
  • For ST3s – essential things
    Make sure they have done a Prescribing Assessment, Audio COT, OOH competences all met, BLS & CPR certificate, Child Safeguarding Training Form R, and all the CEPS.
    st3 final arcp checklist.docx

 

ES training videos

Here are 6 videos breaking down Educational Supervision into short little chunks.     Please forgive me – they are pretty amateurish but they do get some of the core points across. 

ES training - you can do this individually, as a workshop or in groups

If you are part of an ES training group or workshop, or even developing one, consider going through the following questions in the session systematically.

Learning Log entries – the number of entries

  • Question 1: What is an appropriate number of learning log entries for a 6 month period?
  • Question 2: If a trainee was adding 1 log entry every month,what advise would you give?   What should they be aiming for?   Does it make a difference if they are in a hospital or GP post?

Learning Log entries – the quality of entries (reflection)

  • Question 3: A good log entry should show good signs of learning and reflection. What is good reflection or learning? 
    (Answer found in the ISCE criteria –  reflection levels, iscee and log entries.doc )
  • Question 4: Look at your trainees last three learning log entries – do they show evidence of learning or reflection?   Compare them using the ISCE criteria.
  • Question 5: Do the entries give you enough evidence to help you make a judgement of progress?
  • Question 6: Using the ISCE criteria, what advice would to give them to improve the quality of their log entries?

Curriculum Linkage

Look at the three learning log entries you’ve just looked at in the previous section again.

  • Question 7: What do you think about the curriculum linkage by the ST1?
  • Question 8: Is it acceptable? Are there more appropriate links?
  • Question 9: If this was your ST1, what advice would you give them regarding curriculum linkage?

Reading log entries

  • Question 10: Does the Educational Supervisor need to read all the entries in a trainee’s eportfolio?
  • Question 11: How many is enough? How does one decide?

Learning Log – making ES comments

  • Question 12: Look at a selection of ES comments in your group (say about 5-10 entries).  Can you spot on good features that make the comments helpful?   Are there any bad features?   How might you improve on them?
  • Question 13: Are ES comments important?  If so, what is their function
  • Question 14: How often should the ES be making comments?
  • Question 15: What makes a comment useful/helpful?

Validating against competency areas

Read 2-3 learning log entries from other ePortfolios within the group. Pay particular attention to the competency areas the Educational Supervisor has validating them against.

  • Question 16: Do you think the ES validation is appropriate?  Which, if any, are not? Are there any that you think should be included that are not? 
  • Question 17: How many VALIDATED learning log entries should there be per week?

The ES form within the ePortfolio will ask you to review the following WPBA evidence in order to determine how well the trainee is progressing. 

  • COT/CEX/CBD/OOH mapping sheets 
  • MSFs & PSQs
  • CEPS
  • CSR

There is something called “The ES workbook” (developed by a group of us in the Yorkshire & Humber) that we ask all trainees to fill in before their ES meeting.  It is basically a document designed to pull together all these different bits of evidence, to help you see AT A GLANCE how the trainee is progressing.  Once you take a look at it, you will see what we mean and you’ll be grateful that you did.     The ES workbook can be found in the HOT DOCS downloads secton above but it is provided here again for your convenience. 

There are TWO competency rating scales in the ES section of the ePortfolio.  One is to be done by the trainee – and is called the self-rating competency scale for obvious reasons.   The other is the same thing but you – the Educational Supervisor – has to fill in.     The reason for the two is to see which bits you both agree on and which bits you don’t – which means you can explore those competencies on which you both differ so that you can get to a point of a shared understanding.  By the way, you CANNOT do your rating scale until the trainee has done theirs – so before your ES meeting, make sure your trainee does theirs and does so properly (more on this below).

IT IS THESE COMPETENCY RATING SCALES THAT TAKES AN ENORMOUS AMOUNT OF TIME TO DO.  If you feel your ES meetings go on and on and it takes you hours to do, it is often because of this area.    If you want to make your ES sessions half the time, easier to do and more enjoyable, then follow my advice outlined below. 

  • First of all, train your trainee to do their self-competency rating scale well.   By well, I mean with care and consideration – get them to follow the guidance on this page: www.bradfordvts.co.uk/edsupervision/evidence-for-rating-scales.  Have a read of this and tell them to read it too.
  • Then, if you agree with what they have written and the evidence they have provided, you can write yours up really quickly.   The college does NOT like you writing a one liner statement like “I agree with what the trainee has written”.  Personally, I don’t see what’s wrong with it – if they’ve written it well and you agree – what’s the problem?  So, what I do is write the one liner statement along with a few words of my own to add an additional “qualitative” layer to what the trainee has written.  For example, Practising Holistically might go something like this “I agree with what the trainee has written.  Her CS is incredibly impressed with the way she explores the psycho-social in most of her patient encounters”.
  • Of course, the bits you don’t agree with – you would need to expand on.  But this then becomes a lot easier to do and focus on if you don’t have to do the same level of hard work on the other competencies (that the trainee has written well).

PULLING IT ALL TOGETHER 

To be added

  • Pulling it all together
  • Show a video of the whole thing
  • Summary check list for educational supervision.
  • ES checklists

ES FEEDBACK DONE BADLY

Making ES quicker - time saving tips

If you have any time saving tips, post them using the comments box below and I will gradually add to this list.   Let’s share our wisdom and make it easier for everyone.

  • In your very first ES meeting with your GP trainee – spend time thoroughly going through
    a) what is reflection,
    b) how to write a good reflective learning log,
    c) what the competencies mean,
    d) how to write up the self-rating scales. 
    If you get the trainee “trained up” really well from the beginning, the next 3 years will be easy!
  • You don’t have to write reams and reams.   Remember, your report is for ARCP panel members who will probably review about 15 ePortfolios in a sitting – so they only want good concise entries.
  • The Light Touch Approach: short, concise and to the point for those who are doing well.  For those with concerns – write longer.
  • Make sure the trainee fills out “The ESR Workbook” – do not do your ES review without it.  Otherwise the meeting will take an additional  2 hours!
  • Did you know you can open two RCGP ePortfolio pages at once.   Even better if you do the review on two screens.  One to write the report and the other the glance at the evidence. 
  • When reading log entries and validating them against the competencies, I only award it if there is a STRONG MEANINGFUL indication for the competency.   In that way, when it comes to the ESR, and especially the time-consuming Competency Rating Scale, I tag any evidence that I have validated because I know to have been given that validation, there must be a strong indicator of a particular competency.  So – do not validate a competency if a log entry presents only weak evidence of a competency.  It would be great to get trainers to do this across the board because in that way you could pick any of theirs too if you had stronger faith in the validation system.   Perhaps something to suggest at scheme trainer training days?  
  • The competency rating scale for me takes the longest – and I am sure for many others.  I used to dread writing this section – because it takes forever and is laborious.  Now, I train the trainee to write it up well, and then I just add “Agree with what the trainee has written” (or not agree) and then add a one or two liner with my own summarised thoughts.  In this way, the trainee provides the quantitative “shop-floor” detail and I provide the “bird’s eye” qualitative picture.  
  • Some people like to read the log entries before the ESR meeting and perhaps make a comment or two and then focus the ES meeting on the rest of it.   Yes this saves time.   Personally, I like to read the log entries with the trainee and show them in person why it is good or bad – so they learn for the next time round.  I don’t think you can capture everything you want to feedback on in a comments box and when you come to review them in the ESR meeting, “the moment” will have gone.
  • When reading log entries – I open 10 at a time so that I can quickly read one, validate, move onto the next and so on.    To open 10, in the learning log section RIGHT CLICK a log entry and select “open in a new tab” and repeat for the one underneath, and the one underneath that and so on.

FAQs

You use the same username and password that you use to log in as a GP Trainer.   So, go to  https://gpeportfolio.rcgp.org.uk/Login.aspx

  1. Log in using your NORMAL log in username and password.
  2. Look at the left hand menu for ‘Switch Roles’ – click it and select ‘Educational Supervisor’.
  3. Now click on ‘Select Trainee’ (again in the same left hand navigation menu).
  4. Voila, the trainee(s) for whom you are the Educational Supervisor appear as a list.  Select one.

It’s likely that you haven’t countersigned the Educational Agreement.  Go back to the trainee’s summary page and scroll down to the contracts.  Click on ‘countersign’ next to the Educational Agreement – which needs to be signed by both trainee and ES first.

  • 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, an ST1 is 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 they reach the final stage of training – the evidence is then considered against the Professional Capabilities framework.   Trainees 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).
  • Educational Supervisors 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.

Yes, scroll to the top of this webpage and click one of the GREY boxes called “Which Assessments at Which Stage?”.   It is provided below for your convenience. 

Which WPBA at Which Stage?

It would be useful to explore why he or she isn’t doing it.   Often, we assume (quite wrongly) it’s because the trainee is being a bit lazy and ‘needs to pull their finger out’.   But don’t forget, we’re talking about young intelligent doctors – it’s difficult to get into medical school if your lazy and have a generally laissez faire attitude to life.   There are an infinite number of reasons why they are not engaged with their ePortfolio.  Here’s just a small list of possibilities…

  1. Not understanding its value both in terms of assessment (for others) and of recording experiences and reflection (for him) – an attitudinal shift required.
    Understands its value but hasn’t got into a routine of doing it.   They can’t find the time in their busy day job.   The trainee is otherwise disorganised.  They may need an explicit suggestion of a routine.
  2. The trainee is scared of the ePortfolio.  Who will read it?  Is this big brother judging me?  They are not feeling comfortable about writing about their feelings and emotions for others to read (and especially as they don’t even know these others).   And especially not since the Bawa-Garba case.
  3. They don’t know what to write about (a knowledge deficit).   Is it just clinical type stuff?  What sorts of clinical stuff?   The emotional stuff – will that not make them look weak to others?   Which of their plethora of experiences does they pick?   Linking to curriculum coverage/professional competencies (and understanding what these truly mean).
  4. Not knowing how to reflect (a skills deficit) – how does one reflect?   What does a reflective entry look like?  What is the educational value of reflecting?  ‘I do it all in my head anyway’.

 So, what can we do as Educational Supervisors?

MAKE SURE YOU ARE EMOTIONALLY NEUTRAL ( or neutralise any negative or angry feelings).

  • Only then sit down with your trainee.
  • Establish a climate of openness and honesty.
  • Define the performance problem (i.e. not recording enough ePortfolio entries and its future implications).
  • Signpost clearly that you want to help make things better but that you can only do that if you know how things are going for the trainee.
  • Invite the trainee into a dialogue.   Simply let the trainee speak.
  • Clarify what they say – try and get a good understanding of their situation.
  • Jointly formulate some possible causes.
  • Jointly formulate an action plan to make things better.
  • Review the situation in a couple of months.
  • Top Tip: consider using The RDM-p manual to help you establish why a trainee is struggling with writing things in their ePortfolio.   Click here to access that document now.  

Panel Assessor…

Mandatory evidence is mandatory!   And the numbers stipulated for things like CBDs and COTs are MINIMUM numbers – in other words, trainees should be aiming to do a lot more.  Therefore, if a trainee is not achieving the minimum number, even if it is one, you have to flag this up in your ARCP report and let your Panel know – and let them decide.   The panel may still decide to approve – but put a strong proviso that the trainee has to do  the missed assessment things in the remaining time.   If they do this, then it is the responsibility for checking that they have fulfilled this before the end of the GP training programme falls to the GP Training Scheme’s administror + TPD.

Panels, to help you decide…

We need to weigh up the deficient item in light of all the other evidence that is there.  Does any of the other evidence make up for it?  Ultimately, we’re going to weigh up the WHOLE evidence to see if the portfolio is evidence deficient for any of the 13 Professional Competencies (esp for ST3s).

When doing the competency ratings, if you mark the trainee as having 3 OR MORE competencies which are NFD-BELOW EXPECTATIONS, then you must sign off the report and ‘refer to panel’.     Three or more competencies below expectations clearly means that the trainee is not progressing well and therefore you cannot issue a satisfactory ES report.

Remember, mark the ESR as “unsatisfactory progress” and email the GP scheme administrator and TPDs that you have done this and highlight your concerns.    Just marking the ESR as unsatisfactory DOES NOT generate a task to the right people.  You have to email them too.

If a trainee is planning to take some time out of programme (for example to experience work abroad) or go on maternity, you should arrange an ES meeting with a view to doing an ES report JUST BEFORE THEY LEAVE.   In this meeting…

  • Review the evidence – is it satisfactory for where they are at?
  • Make plans for the future – upon their return to the programme.
  • Email the GP Scheme’s administrator and tell them about the Maternity/OOP –  and ask them to give the trainee and OOP outcome so that the ARCP panel can record the exact dates the trainee is away.  
  • Tell the trainee to arrange another ES meeting when they return – within 2 months.  Do a formal ES review.
  • If the trainee is Out of Programme for more than 12 months, they need to have their competencies reassessed when they come back.

Trainees going on maternity will also need an ARCP before they leave – please check with the Training Programme Director/GP Scheme administrator that this is in place.  ARCP panels will need a ES report and a CS report.    Make sure the trainee gets the latter from the current post they are in.

A special case: 

If the trainee is coming back from maternity with just a few weeks before their CCT – they will need two ESRs and two ARCPs.  

  1. The first (penultimate) set will be done before they leave  – to basically say they are fully competent and that you are happy to recommend for CCT once the remainder of their time is completed.   Keep in touch with them.
  2. Then do the final ESR when they come back (but no more than 2 months before the final ARCP) and inform the Training Programme Directors to sort out an ARCP in timely way so they can be quickly signed off.  Otherwise, their CCT will be delayed.

 

It has been suggested that the person who is going to give feedback should have a meeting before the MSF starts to agree with the trainee how they would like to receive their feedback, after the trainer has seen it first. This should include the possibility that the feedback is unhelpful or destructive: “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?”.   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!  By the way, the MSF, PSQ and the CSR are felt to be quite good discriminators of how a trainee is doing. So, look at these too to build a bigger and clearer picture.

To get a graphical summary of the results…

  • Log in and click Evidence
  • Then click MSF
  • Make sure you select the correct Review Period
  • Once you’ve done that, you’ll see a little graph icon which if clicked, will analyse the results.

To release the MSF results…

  • Log in and click Evidence
  • Then click MSF
  • Make sure you select the correct Review Period

Once you’ve done that, you’ll see a little graph icon which if clicked, will analyse the results.  At the bottom of that page, you will see a box where you can make comments and a button which says something like ‘release scores to trainee’

I'm still a little worried as a newbie Educational Supervisor

Of course you are!  It’s totally understandable that you would still be a little worried.  It’s a sign of a conscientious educator who wants to do a good job.   Accept your worry but also remind yourself that your likely to enjoy the experience.  Here are some final tips below.

The way you talk and facilitate the session is the most important thing.    And you do that with patients all the time – so try not to worry.  Relax and enjoy the art of facilitating the session. 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

In other words, exactly what we do on a daily basis with our patients, families and friends.   Be human.

Final two things…

  1. First, don’t view the ePortfolio using the trainee’s login in and password. Use your own. The layout and navigation menu is a bit different from the trainee’s view of the ePortfolio.
  2. Secondly, I’m going to re-emphasise the point about the ES meetings being about developing a dialogue and relationship with the trainee in which you both trust, respect and feel you can be open with one another. It is not about a good old grilling. And it’s far more enjoyable and satisfying if you manage to create an optimal educational climate.

Got any suggestions or advice?

Got any advice?  Anything we’ve missed?  Anything that you think is inaccurate? Then leave a message below.   Got a resource to share: contact [email protected]

Make GP Training Better Together’

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