Abstract
Welcome to Crammer’s Corner and our continuing consideration of different elements of training and the MRCGP. Last month we considered ideas and ways to reduce personal stress in the consultation. This month we look at a more practical element – how to prepare for meetings with your educational supervisor.
Trainees overall educational progress is supervised by an educational supervisor (ES) throughout their training. To maximise benefit from this supervision (which is intended to be supportive) it is usual for there to be regular meetings between the ES and trainee. These happen at least twice per year for the formal educational supervisor review (ESR) as required by the RCGP. However, most training schemes suggest interim meetings (the frequency varying between training schemes) to maximise benefit from educational supervision. Here we will consider the aim of these meetings and how to prepare for them.
Purpose of educational supervision
The ultimate aim of educational supervision is to support trainees through their training and ensure it runs as smoothly as possible. Most trainees build up a good relationship with their ES and this can help pastorally with the ES being the person a trainee can turn to in times of difficulty. Educational supervision should be forward looking and ultimately a positive experience. It may include features such as facilitation of development (personal and professional), identification of educational and development needs, help and encouragement with reflection and the formulation of a plan detailing future needs and aims. It is confidential (except in specific circumstances) and this helps the trainee to develop trust in their ES and to value their support.
Role of ES meetings
Regular meetings help development of a strong relationship between the trainee and ES and help the ES to build a picture of the trainee’s development and progress as well as giving the trainee support. All trainees are required to have 6-monthly meetings with their ES for the ESR, as required by the RCGP, however meetings between these 6-monthly intervals can be of great benefit; picking up problems early before ESRs and Annual Review of Competence Progression (ARCP) and by the supportive nature of informal meetings apart from the ESR. The frequency of these more informal meetings can vary. Some training schemes suggest an extra meeting per 6 months (so essentially every 3 months). Others suggest more frequent visits. For example, on the Gloucestershire scheme where I train, ST1s and 2s visit the ES four times per 6 months – this also allows time for general practice contact in terms of joint consultations, assessments or sitting with multidisciplinary members outside the hospital environment in addition to reviewing progress.
Whether formal or informal, most meetings will involve a combination of summative and formative elements and should include some of the following topics.
Review of the ePortfolio, together with a discussion around progress towards curriculum coverage and competency mapping. Are the appropriate number of log entries being made and are there any obvious gaps? Consideration of the reflective nature of the learning log entries. How could these be improved? Is progress and development being made in the detail of these? Review of the personal development plan (PDP) – are learning aims being achieved and how could these be developed and adjusted? Determining if progress is being made in Workplace-based Assessment (WPBA). Are the appropriate number of assessments being completed at the correct pace and (for ESR meetings) have the minimum number been completed in that 6-month period? Are there themes emerging from the WPBA that could be talked through? Review of the multi-source feedback (MSF) or patient satisfaction questionnaire (PSQ) if completed. Again, are there any learning or development points that could be considered? Consideration of progress with out-of-hours sessions (if relevant) and other areas, such as the quality improvement project and significant event reviews – is there learning to be gained here? Discussion around the current post the trainee is undertaking – how is it going? Is the rota working? Is it educational enough? Are learning needs being addressed? Is the clinical supervisor keeping in touch? Are there any problems or concerns that need escalating? Are there any other difficulties occurring personally in life that need to be borne in mind or require advice? What can be done to help with these difficulties, either personally or educationally? What is study leave being used for? Are there any upcoming courses that would be helpful? Is approval or application for funding required? Are there any other learning matters that come up during the discussion that are relevant? Completion of the formal ESR report including a formal 6-monthly review with completion of ratings in each competency area; review and agreement on a PDP with formal assessment on rate of progress and whether satisfactory.
Preparation for ES meetings
Trainees should expect meetings with the ES to be supportive and open and should not find them intimidating (and should certainly not expect or receive a grilling). However, to get the most out of meetings it is helpful if the trainee prepares well in advance, bearing in mind the areas mentioned and the role of ES meetings. Areas likely to be covered include the following:
A review of the plan from the last meeting with the ES. Have you made progress with this? Is there anything that needs addressing? The ePortfolio and learning log. Have you put all your entries on there and most important have they been shared (otherwise they cannot be seen externally)? Have you recorded teaching sessions and tutorials, and are you making the required number of entries? Even for a meeting at the beginning of ST1 it is helpful to have a couple of entries before meeting the ES to gain some feedback. Have the entries been commented on and linked to competency statements? A review of WPBAs. Have you completed the relevant number for the stage of training? If a 6-month review, have you completed the minimum number? Is there variety in the cases (such as elderly, paediatrics, etc). Remember the recommended numbers are minimums! Have you done MSFs or PSQs? Are you completing clinical examination and procedural skills (CEPs)? What was agreed at previous meetings? Are you updating your PDP? Have you achieved any aims? Do you need to create new ones? Remember PDP entries need to be created in advance of ESR meetings to be edited during the meeting. Have you had any complaints? Have you documented significant event analyses? Have you signed off any appropriate forms? Have you been meeting with your clinical supervisor? Have they completed a report if needed? How is your current attachment going? Is it giving you educational and clinical experience relevant to general practice. Are there any issues that need bringing up? Are you being supported in the job? How are things personally? Is there anything that needs sharing with the ES? Are you struggling at all? Is there an upcoming ESR? If so, then the self-rating needs to be completed ideally 2 weeks in advance, along with all the other items needed for the ESR. Is there anything else you want to discuss with the ES? Jot it down to ensure you don’t forget. Most training schemes have helpful websites giving a variety of information and produce checklists in advance of formal ES meetings – use these to help guide preparation. Remember not to be afraid of sharing things with your ES. They are there to help and support you through training.
Formal review requirements and ESR recommendations do change. For the most up-to-date information, please visit the RCGP website.
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