Educational Supervision

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Educational Supervision

• Training requirements
• Revised October 28 2009

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PMETB DefinitionsOperational Guide for the PMETB
Quality Framework Version 4.2 published 26
February 2009

• Clinical Supervisor
• A trainer who is selected and appropriately
  trained to be responsible for overseeing a
  specified trainees clinical work and providing
  constructive feedback during a training
  placement. Some training schemes appoint an
  Educational Supervisor for each placement. The
  roles of Clinical and Educational Supervisor may
  then be merged.
• Educational Supervisor
• A trainer who is selected and appropriately
  trained to be responsible for the overall
  supervision and management of a specified
  trainees educational progress during a training
  placement or series of placements. The
  Educational Supervisor is responsible for the
  trainees Educational Agreement.

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All Educational Supervisors must have received
training in the following(see further slides for
content guidance and exemptions)

• Roles and Responsibilities of Educational
  Supervisors and an overview of the other key
  roles required in the training of doctors
• Guidance on required trainee assessments
• Appraisal processes and skills
• Educational theory and practice
• ARCP processes
• Equality and Diversity (certificated)
• Doctors in Difficulty

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Roles and Responsibilities

• The training must develop an understanding about
  the main processes an Educational and Clinical
  Supervisor must undertake and clarify individual
  Trust, Specialty and Deanery requirements of
  these roles
• In particular the training must ensure that
  participants are able to
• Describe the roles and responsibilities required
  of Educational and Clinical Supervisors
• Identify the key stakeholders in this area of
  work
• Define what supervision of medical trainees
  requires and the specific activities that
  Educational/Clinical supervisors should be
  undertaking regularly
• Identify where clinical governance impacts on
  post-graduate medical training
• Describe how to advise trainees on career
  management and list key sources of information
  and guidance about this
• Outline the learning in equality and diversity
  they must have undertaken

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Guidance on assessments

• The training must develop an understanding about
  good practice in using the key assessments
  processes and tools that an Educational
  Supervisor must be familiar with
• In particular the training must ensure that
  participants are able to
• Describe how to undertake assessments of medical
  trainees using a range of tools
• Describe the features and best use of the most
  commonly required trainee assessment processes
  and tools
• Outline the Royal College/specialty curricula and
  assessment requirements that apply to their own
  specialty area(s) or school
• Describe how e-portfolios function for their
  specialty or school
• Complete an Educational Supervisors report

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3. Appraisal processes

• The training must develop an understanding about
  good practice in educational and NHS workplace
  appraisal processes for trainee doctors
• In particular the training must ensure that
  participants are able to
• Understand the range of definitions of appraisal
  and how these relate to assessment and ARCP
  processes
• Apply a framework, method and skills for
  appraising trainees and giving feedback
• Outline the NHS Appraisal documentation for
  Doctors in Training
• Be able to help a trainee to write a Personal
  Development Plan (PDP)
• Describe ways to handle difficult feedback and
  problem trainees in appraisal sessions

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Educational theory and practice

• The training must develop an understanding of
  basic learning and educational theory and core
  teaching techniques including instructional
  methods, feedback and questioning to confirm
  learning transfer
• In particular the training must ensure that
  participants are able to
• Describe how medical trainees best learn and
  acquire knowledge and skills
• Outline the conditions under which training and
  education most successfully occurs
• Present information in a structured and clear way
• List the factors that tend to block effective
  adult learning
• Describe the principles and effective processes
  that assist helpful feedback
• Outline the stages required in assisting a
  trainee to develop a successful personal
  educational or development plan

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5. ARCP processes

• The training must develop an understanding about
  how educational supervisors contribute to the
  trainees annual review process and explain the
  range of activities required to conduct effective
  annual reviews of post graduate specialty
  trainees
• In particular the training must ensure that
  participants are able to
• Describe the roles and activities required of an
  ARCP review panel
• Outline the key elements that constitute an
  effective educational supervisors report for an
  ARCP panel
• Describe the process to be followed, the
  documents to be used and the decisions to be made
  in the annual assessment
• Support trainees through the assessment process
• Decide the extent to which a trainee has achieved
  the required competencies
• Advise on the construction of the development
  plan for the next stage of a specialty trainees
  education and training
• Conduct panel activities in a fair and equal
  manner, being pro-active about diversity issues
  where appropriate

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6. Equality and diversity

• The training must develop an understanding of
  how deliberate and inadvertent unfair
  discrimination can occur against trainees,
  colleagues and applicants and provide guidance on
  what to do about this and how to maintain human
  rights
• In particular the training must ensure that
  participants are able to
• Explain the key concepts underpinning human
  rights, equality and diversity initiatives,
  particularly indirect discrimination and cultural
  diversity
• Summarise the legislative requirements that
  affect job interviews and trainee assessments
• Describe how to prepare for and conduct
  interactions (formal and informal) that are fair
  and equitable
• Devise useful and appropriate questions for
  selection interviews and assessments
• Outline how interview and assessment panels
  should work together to bring fairness and
  equality to their work

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7. Doctors in Difficulty

• The training must develop an understanding about
  recommended practice in managing trainees who are
  in difficulty or about who there are specific
  concerns that require tackling
• In particular the training must ensure that
  participants are able to
• Recognise a trainee in difficulty
• Understand and describe the causes and
  contributory factors
• Summarise what is expected of Educational
  Supervisors when they come across a trainee in
  difficulty or about who there are specific
  concerns
• Confidently and skilfully discuss and clarify any
  concerns with a trainee, and give effective
  feedback about these
• Describe how to document the feedback discussion
  fairly in a simple report including making
  specific recommendations and creating or adapting
  an educational plan

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All Educational Supervisors must attend to their
ongoing professional development as trainers by
at least

• Updating their knowledge base on Educational
  Supervision through an e-learning module
  annually- available from January 2010
• Refreshing their trainer skills through
  attending a skills programme in the following
  areas minimum of one day every two years (could
  be ½ day annually)
• Interviewing skills
• Careers guidance
• Mentoring
• Coaching
• Teaching skills
• Leadership skills
• Managing cultural diversity

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Exemptions

• Educational Supervisors can claim exemption from
  the listed minimum requirements if they have
  attended prior training which covers the aims and
  objectives of the seven required areas this may
  have been through attending a lengthy training
  programme such as a post graduate Diploma in
  Education or through attending shorter workshops
  or training days that cover specific aspects.
  Exemption can therefore be claimed from all or
  parts of the minimum requirements.
• It is also recognised that experienced
  Educational Supervisors who have been carrying
  out this role for considerable time will have
  developed the understanding, knowledge and skills
  required without necessarily attending a formal
  training course. The Deanery is developing a
  process for recognising and accrediting this too.

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Appendix 1

• Relevant excerpts from the Foundation Programme
  Operational Framework and PMETB Gold Guides that
  define the roles of Educational and Clinical
  Supervisors and indicate the training that is
  appropriate for undertaking these

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Operational Framework Requirements excerpts 1

• all doctors involved in clinical and
  educational supervision will have to meet the
  standards for trainingagreed by the GMC and
  PMETB (para 174)
• Educational and clinical supervisors will,have
  to demonstrate their competence in educational
  appraisal and feedback, and in assessment
  methods, including their ability to use the
  specific workplace-based assessment tools(para
  175)
• All foundation doctors must have named
  educational and clinical supervisor for each
  foundation placement or part of a placement as
  appropriate..relevant information about progress
  and performance is regularly exchanged between
  clinical and education supervisor. (para 178)
• Educational supervisors must be trained for
  their roleshould include equality and diversity
  training. Educational Supervisors must have time
  set aside in their contracts and job plans to
  allow for educational supervision (para 179)

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Operational Framework Requirements excerpts 2

• All educational supervisors should
• ..understand educational theory and practical
  educational techniques
• Be trained and accredited as competent to offer
  educational supervision and assess the competence
  of foundation doctors
• .regular, planned reviews through educational
  appraisals
• All clinical supervisors should
• Be fully trained in clinical care and understand
  their responsibilities for patient safety
• Offer a level of clinical supervision appropriate
  forcompetence and experience and appropriately
  tailored..
• Make sure that no foundation doctor is expected
  to take responsibility for, or perform, any
  clinical, surgical or other technique if they do
  not have the appropriate experience and expertise
• Make sure that foundation doctors only perform
  tasks unsupervised if if the supervisor is
  satisfied that they are competent to do so..
• Be appropriately trained to teach, provide
  feedback and assess foundation doctors

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Operational Framework Requirements excerpts 3

• Training for educational and clinical
  supervisors in appraisal, assessing competency,
  career management and equality, diversity and
  human rights is available. (para 177)
• ..foundation doctors need advice and accurate
  information about current and future career
  opportunities. They will also need support,
  advice and coachiongto help them plan their
  careers. (para 185)
• It will not be enough for only educational
  supervisors to offer informal career advice, as
  has often happened in the past. (para 187)

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Operational Framework Requirements excerpts 4

• The main principles of the assessment process
  are that it is
• Based on the doctor's competence
• Led by the doctor's individual circumstances
• Based on the workplace-based assessment
• Open and fair
• Developmental
• Can be used to confirm that a doctor has reached
  the required standard of competence (para 194)
• Assessments
• 6 DOPs per year
• 6 Mini-CEXs per year
• 6 CbDs per yesr
• 2 Mini-PATS

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Operational Framework Requirements excerpts 5

• When a foundation doctor fails to make progress
  during foundation training
• Educational supervisors should look for these
  (reluctance or failure to take part in training
  or assessments, concerns raised and serious
  incidents) and other early signs of problems, and
  be ready to offer support to foundation doctors
  who are having difficulty adjusting to the role.
  It is essential that the educational supervisor
  raises such concerns early and formally with the
  foundation doctor concerned. (para 198)
• The educational supervisor may need to arrange
  an in-depth assessment, looking at the foundation
  doctor's health, attitudes, skills and their
  training environment, so that they can take
  appropriate supportive action. All meetings,
  discussions, assessments and so on should be
  recorded in writing. (para 199)

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PMETB Requirements 1

• Healthcare organisations should explicitly
  recognise that supervised training is a core
  responsibility, in order to ensure both patient
  safety and the development of the medical
  workforce to provide for future service needs
  (Gold Guide 2008, 4.15)
• All of these individuals (training programme
  directors, educational and clinical supervisors,
  and any other Deanery or NHS agents) must receive
  training in equality, diversity and human rights
  legislation which is kept up to date (4.19)
• There should be explicit and sufficient time in
  job plans for both clinical and educational
  supervision of trainees (4.20)
• Educational supervisors are responsible for
  overseeing training to ensure that trainees are
  making the necessary clinical and educational
  progress. Where possible, it is desirable for
  the trainee to have the same educational
  supervisor for the whole of their training
  programme or for stages of training (4.23)

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PMETB Requirements 2

• Educational supervisors also have
  responsibilities through their supervision of
  trainees to support the delivery of the
  educational contract which exists between
  employers which provide postgraduate training and
  Postgraduate Deaneries (4.23)
• Employers of educational supervisors must have
  this role recognised within job planning
  arrangements (4.26)
• Each trainee should have a named clinical
  supervisor for each placement, usually a senior
  doctor, who is responsible for ensuring that
  appropriate clinical supervision of the trainees
  day to day clinical performance occurs at all
  times, with regular feedback (must ensure patient
  safety, clinical care, tailored experiences for
  trainees and proper delegation for out of hours
  etc) (4.27)

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PMETB Requirements 3

• Educational and clinical supervisors should
  demonstrate their competence in educational
  appraisal and feedback and in assessment methods,
  including the use of specific in-work assessment
  tools approved by the PMETB for the specialty
  (Gold Guide 2008 4.17)
• Educational supervisors are responsible for both
  the educational appraisal of trainees, and also
  for review of their performance based on Good
  Medical Practice. This links educational
  appraisal and performance review (workplace based
  NHS appraisal) of trainees. (4.24)
• All clinical supervisors should
• Be appropriately trained to teach, provide
  feedback and undertake competence assessment to
  trainees in the specialty (4.27)