Educational Supervision in GP Specialty Training Dr Jane Mamelok RCGP WPBA Clinical Lead

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Educational Supervision in GP Specialty
TrainingDr Jane MamelokRCGP WPBA Clinical Lead
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What this session aims to achieve..

• Define the role of the educational supervisor in
  WPBA?
• Identify qualities of an ES.
• How to be an effective ES.
• How to navigate the e-portfolio?
• How to write the ES report.
• Consider the conflict between formative and
  summative roles.

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Workplace Based Assessment

• The evaluation of a doctors progress over time,
  in their performance in those areas of
  professional practice best tested in the
  workplace
• FORMATIVE
• Summative judgment made by panels informed by
  evidence from WPBA

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Millers Pyramid
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Psychomotor skills
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RELATIONSHIP
DIAGNOSTICS
Professionalism
MANAGEMENT
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The potential of linking WPBA the learning
portfolio.

• WPBA assesses performance in the workplace over
  the entire training programme against 12 defined
  competencies.
• The portfolio gathers the information and offers
  the opportunity for reflection and formative
  feedback.
• Links assessment to learning outcomes and
  continuing professional development.

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Clinical Supervision

• Clinical supervision describes the framework for
  regular, structured encounters reflecting on
  casework in the context of the post or specialty
  in which the health professionals are working and
  aims to identify areas of best practice and
  developmental needs.
• It has an important clinical governance function.

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Educational supervision

• Educational supervision is organised supervision
  taking place in the context of a training
  programme, it is aimed more to act as an umbrella
  to guide the trainee through the training
  programme than assessing and discussing
  individual cases (which is in the domain of the
  clinical supervisor).

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Gold Guide Requirements

• Clinical supervision
• 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.

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Gold Guide Requirements

• Educational supervision
• 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
  trainees to have the same educational supervisor
  for the whole of their training programme or for
  stages of training (e.g. the early years or more
  advanced years of training).

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What makes a good educational supervisor ?

• Senior educator with an understanding of training
  programme, assessments and employment issues.
• Good listener offering supportive challenge.
• Can give constructive feedback
• Professionalism, recognises the conflicting
  roles, sets boundaries etc.

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The role of the ES in GP specialty training.

• This can be summarised as providing an
  overarching umbrella of guidance helping the
  trainee get the best out of their programme and
  navigating their way through it.
• However, the ES assesses the rate of progress and
  development of competence contributing to a
  summative judgement.

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Varied roles of the Educational Supervisor

• Guidance and support with performance appraisal
• Learning needs assessment, empowering and
  facilitating the learner.
• Conduit and network function
• Appraiser and counsellor
• Coaching and career counselling
• Guardian role

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So you are supervising a GP specialty trainee,
what do you need to do?

• Identify you learner, ST1 ST2 or ST3.
• Arrange an early meeting to set boundaries,
  frequency of meetings etc.
• The ES needs to be able to navigate the
  e-portfolio proficiently.
• Review the evidence.
• Give formative feedback and define PDP at the
  staged reviews.

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Reviewing the evidence

• Check assessment schedule.
• Review the self assessment ratings.
• Review PDP objectives if follow on review.
• Review competency and curriculum coverage
• Purposeful sampling of the learning log
  descriptive v reflective.
• Look at CSR is there evidence to support their
  judgement?
• Hone in on some of the COTs and CBDs

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The Review page e-portfolio
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Check the assessment schedule
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Review the PDP
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Review curriculum competency coverage and self
rating scales
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Sample the learning log
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Review the Clinical Supervisors report
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Questions for debate

• How much is enough?
• How much evidence do you need to make a
  judgement?
• What do we mean by competence?

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How much evidence is enough?

• The evidence gathered from WPBA builds up a
  picture of the competent GP.

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Defence of evidence

• Have we got this right yet?
• Medical Schools using portfolios for
  undergraduates have a portfolio interview which
  allows the trainees to defend the evidence and
  this informs the portfolio assessment decision.
• Is there a role for portfolio viva?
• Is that final ARCP panels
• Or RCGP oral examiners?

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Assessment decision

• Portfolios are criticised because they depend on
  subjective judgements that are unreliable.
• Schuwirth (2002) argues that they can be reliable
  if but the judgements must be collected in a way
  that samples through possible sources of bias
  sampling professional behaviours on multiple
  occasions and multiple assessors

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Key steps for development

• Define a portfolio framework but no so
  restrictive as to trivialise the evidence .
• Encourage reflection can be learned.
• Educator and assessor training are crucial.
• Need to understand competency framework
• Define competence
• Achieve acceptable inter rater reliability
• Encourage Balanced portfolios
• Robust WPBA and portfolio standards for portfolio
  assessment defend the JPC decision.
• Developments in e-portfolio functionality must
  match the work on standards and competency
  framework.

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Summary

• The educational supervisor has a key role in
  directing and supporting the training programme
  for each learner.
• There are useful analogies between the role of
  the appraiser and the appraisal portfolio and the
  similar role for educational supervisors.
• Training and support for trainees and educators
  are key.
• The e-portfolio must be user friendly and
  functionality appropriate to purpose.
• Your feedback (to WPBA group) is important. Email
  WPBA Lead j.mamelok_at_nwpgmd.nhs.uk