Clinical & Educational Supervisors Course

1. Clinical & Educational Supervisors Course Dr Simon Frazer Director DoctorsTraining

2. What does the GMC expect ? 7 Domains for accreditation: • ensuring safe and effective patient care through training • establishing and maintaining an environment for learning • teaching and facilitating learning • enhancing learning through assessment • supporting and monitoring educational progress • guiding personal and professional development • continuing professional development as an educator.

3. Introduction Have a chat with someone you don’t know and find out • what they do • 2 things about them unrelated to work • what they enjoy about being an Educational Supervisor • What do they want to get out of today Be ready to introduce them to the rest of the group in 60s.

4. Outline • The current state of PG training • Role of the named clinical and educational supervisor • Review of Key Meetings • Learning, portfolios and assessment • Principles of good supervision and feedback • Trainers report and the ARCP • Doctors in difficulty • Learning environment • Education infrastructure and reporting

5. Learning Objectives By the end of today you should be able to: • Describe the roles of Educational & Clinical Supervisors as well as other relevant parties • Demonstrate knowledge of and familiarity with the Portfolio, ARCP and workplace assessment methods • Formulate useful learning objectives and suggest ways in which they might be addressed • Demonstrate the ability to give constructive educational feedback to a trainee • Support a trainee in difficulty and devise a developmental plan

7. Permission to Prompt

8. Current Training

9. Current Training – 3 mins • Half the room – good things • Half the room – not perfect YET

11. Supervisor Roles & Responsibilities

12. Roles • List at least 6 roles of an educational supervisor. • Discuss with your neighbour. • What are the roles of a clinical supervisor? • Are they the same or different?

13. Definitions Educational Supervisor: A named Trainer who is responsible for the overall supervision and management of a specified trainee’s educational progress during a placement or series of placements. Named Clinical Supervisor: A named Trainer who is responsible for overseeing a specified trainee’s clinical work and providing constructive feedback to the trainee during a placement. They must provide a written report of clinical performance and progress to the Educational Supervisor Educator: Any member of the multi-professional team involved in providing clinical supervision to less experienced doctors as part of their clinical job and professional duty to ensure patients receive safe and quality care. Involves observing practice, doing WPBA and giving feedback.

14. Roles of Ed Supervisor • Support trainees’ global professional development • Help identify goals and key milestones • Agree a work schedule • Feedback on progress and encourage reflection • Provide specialty specific careers guidance • Identify & provide initial management for trainees in difficulty • Deal with exception reports • Cover the requirements for trainee revalidation (SI’s / Complaints) • Write Educational Supervisors report • Support Trainee through the ARCP process (sign of professional capabilities)

15. Roles of the Clinical Supervisor • Support the trainee during the placement • Discuss learning plan for the placement – to focus on clinical skills • Provide feedback on performance & procedures • Ensure learning opportunities are accessed for required knowledge, skills and experience • Undertake required assessments upon request • Communicate and liaise with Educational Supervisor of trainee • Educate & support colleagues & multidisciplinary clinical team who are providing day-to-day clinical supervision

16. Educational Supervisor Essential Meetings Post 1 Post 3 Post 2 Mid point meeting Sign-off by Educ Super Iinitial meeting End of placement review Sign-off by FPD/ARCP

17. Post 1 Post 2 Post 3 Lots of Additional Meetings End of placement review Sign-off by Ed Sup Mid point meeting Sign-off by FPD/ARCP Initial meeting

18. Initial Meeting- Top tips Encourage Be Aware Interruptions (secretary, phone, bleep) Personal health advice Unrealistic expectations Limited time, Unavailability Overconfidence on role as supervisor Thoughtful about power differences and environment • Develop relationship and partnership • Prepare • review ARCP outcome, MSF, portfolio etc before meeting • Produce agenda in advance and share with trainee • Articulate expectations • Discuss Personal Learning Plan • Sign educational agreement • Check trainee familiar with clinical supervisor, environment etc • Where to seek help (career/personal) • Set dates for next meeting Provide • Space and time • Confidentiality, reassurance and trust • Guidance, Information and signposting

19. PDP

20. Training vs Education

21. Curricula

22. May 2017

23. Generic Professional Capabilities Framework - 9 domains

24. How did we learn to be a doctor?

25. Why do we all need to reflect? Step 4 Draw conclusions from the experience Step 2 Review and describe the experience Step 1 Have an experience Step 3 Analyse the experience Step 5 Plan the next steps Step 1 Have an experience Experiential learning Step 5 Plan the next steps Step 4 Draw conclusions from the experience

26. Why do we all need to reflect? Reflection ‘The process whereby an individual thinks analytically about anything relating to their professional practice with the intention of gaining insight and using the lessons learned to maintain good practice or make improvements where possible.’ Co-produced guidance by AoMRC, COPMeD, GMC and MSC Ste 1 Have an experience Step 5 Plan the next steps Step 4 Draw conclusions from the experience

27. So what? (feeling) What? (thinking) Now what? (doing) Framework for reflection

28. Explores thought processes when a particular action or decision was taken and how those may have impacted on actions and feelings. ‘What was I thinking when I took the actions or made the decision that I did?’ So what? (feeling) What? (thinking) Now what? (doing)

29. Involves considering the significance of what happened as well as the values and feelings at the time. ‘How did I feel at the time of and after the experience, why was it important?’ So what? (feeling) What? (thinking) Now what? (doing)

30. So what? (feeling) What? (thinking) Now what? (doing) Looks at the processes and opportunities that can help learning from the experience and identifying future actions. ’What can I/we learn from or do differently next time?’

31. Case scenario 1 Dr Jones Review the scenario in groups of 3-4 • What happened? • So what does this actually mean? • Now what can they learn from this and change for the future?

32. ‘Learning conversation with supervisor’ Watch Video > Watch this interaction with Dr Stone and their clinical supervisor. It’s at the end of an operating list in the coffee room. Think about If there’s any structure Any areas of good practice Suggestions for improvement

33. Review

34. Creating the right environment for an open reflective discussion

35. Appropriate time Effective communication Venue Creating the right environment for an open reflective discussion Be aware of hierarchy gradients Request prior preparation Be mindful of emotional impact and 2nd victim harm Signpost useful framework Consider all contributing factors

36. Effective communication – active listening Superficial Words Deeper Feelings Deepest Meaning It’s all about communication and active listening skills. Levels of listening

37. Avoiding confused messages Check out • A mismatch of understanding can lead to ongoing confusion and distress leading to inappropriate reflection and learning • This is particularly important if there are cross cultural differences • At the end of the discussion ask the individual what they have understood from the conversation and will take away. Rebuild confidence in the process of reflection.

38. 2nd meeting Now watch the second video with the same trainee and supervisor as they undertake a planned meeting to reflect on Mr Jones case • Compare and contrast the difference between the 1st and 2nd meeting • Notice who does most of the talking Watch Video >

39. Demonstrating reflection • Discussing or writing down reflections as part of education, training and development. • Focus equally on positive encounters and achievements, not only incidents or complaints • Emphasis on quality rather than quantity • Structure a note and capture learning outcomes and future plans • Anonymise reflective notes as far as possible • Need time and space for individual and group reflection

40. Disclosure • Reflective notes can currently be required by a court • Don’t record actual details in reflective discussions – should be recorded elsewhere • Seek advice from a supervisor or appraiser if in doubt about the content • The GMC does not ask a doctor to provide their reflective notes in order to investigate a concern about them.

41. Questions ?

42. Acknowledgements This training resource has been developed by the GMC with support from DoctorsTraining and Dynamic Business Services Ltd.

43. What does a goodsupervisor’s report look like?

44. ARCPAnnual Review of Competence ProgressionEducation Supervisor’s role • Regular appraisal meetings with trainee & set objectives / PDP etc • Give regular feedback on progress against the curriculum & clinical performance • Discuss Incidents & Complaints • Review portfolio • Collate trainers views – Placement Supervision group / Dept Faculty Group • Ensure coverage of Good Medical Practice • Provide the structured report which looks at the evidence of progress in training and informs the ARCP panel

45. What does a good supervisor’s report look like? ARCP panel perspective Sign off of progression • Breadth of experiences • Depth of skills and knowledge • Rate and quality of progression Comments on: • Professionalism • Attitude • Application

46. ARCP Outcomes • Achieving progress and the development of competences at the expected rate • Development of specific competences required – additional training time notrequired • Inadequate progress by the trainee + additional training time required • Released from training programme with or without specified competences • Incomplete evidence presented – additional training time may be required • Gained all required Competences - CCT • For FTSTA/LATs • Out of Programme • Top up training

47. Revalidation for Trainees • Responsible Officer for trainees Post Graduate Dean • Process signed off at the time of the ARCP process • Paper work includes a Trainee Declaration • SIRI & Complaints discussed with ES, reflected & documented in portfolio (DME provides a regular return to the Deanery) • Whole scope of practice discussed

48. Gold Guide • The Gold Guide is reference text for Specialty Training

49. Evidence of Progression

50. Observation of Performance • How do we do this? • What structured tools do we know? • What does these tell us? • What are the value of these? • What is Millers Pyramid?