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Best practice supervision of medical students

GP supervision across the pipeline

As a GP supervisor, you play a vital role in shaping the educational journey of medical students in Australia. Your guidance helps them develop essential clinical skills, professional attitudes, and an understanding of the fundamental place of general practice in the Australian healthcare system.

In a review paper from 2012, the GP supervisor was defined as ‘a general practitioner who establishes and maintains an educational alliance that supports the clinical, educational and personal development of a resident.’1 In practical terms, this definition means that supervision in general practice comprises three core, but intersecting, elements:

  • Clinical supervision, ensuring that the patient is safe
  • Educational supervision, ensuring the medical student is learning
  • Personal supervision, ensuring that the medical student is ‘OK’.

1.Wearne S, Dornan T, Teunissen PW, Skinner T. General practitioners as supervisors in postgraduate clinical education: an integrative review. Med Educ. 2012;46(12):1161-73. 

Patient safety must underpin every aspect of supervision. Clinical supervision is the oversight role that the supervisor has over the safety of their patients. Supervisors must be able to answer the question ‘Is the student safe in there?’

Educational supervision parallels the clinical oversight role and involves the supervision of a student’s learning and progress. This comprises identification of learning needs, planning learning, teaching, assessment, and provision of feedback. GPSA has a wide range of resources which elaborate further on the educational supervision role.

Effective supervision is underpinned by a good relationship between the supervisor and medical student. It is therefore important for supervisors to have a good understanding of the student’s background and experience, and monitor their wellbeing.

Tasks of the GP supervisor - best practice supervision

The GP supervisor role includes the following tasks:

  1. Establish and maintain a safe and high-quality learning environment
  2. Orientate the student to the practice and community
  3. Monitor patient safety
  4. Facilitate teaching and learning
  5. Assess competence and give feedback on performance
  6. Support wellbeing
  7. Undertake ongoing professional development

Establish and maintain a high-quality learning environment

Actively developing and maintaining a ‘culture of learning’ in the practice provides the foundation for success in all aspects of supervision, as it:

  • Helps both the supervisor and student utilise the whole context to promote learning
  • Provides a mechanism to regularly appraise the quality of the learning environment and make ongoing improvements
  • Complements existing accreditation requirements
  • Ultimately reduces workload.

GPSA has developed a framework that provides the tools, strategies, and supports to help transform a GP practice into a high quality clinical learning environment.

Orientate the student to the practice and community

Ensuring a smooth start for the medical student takes planning and preparation before they commence at the practice. While most administrative requirements are likely to be managed by the practice manager, supervisors also need to be aware these tasks.

Orientation should be a whole-of-practice activity and involve all staff. Ideally it should involve a checklist and investment of adequate time. A practice manual is a useful resource. Other important aspects of orientation include discussion of professionalism, work health and safety, teaching and learning, and pastoral care. Orientation includes the following activities:

  • Orientation to the practice supervision team – roles, expectations etc.
  • Patient safety – calling for help, monitoring etc.
  • Education – learning opportunities, formal teaching, resources etc.
  • Consulting room (if available) – proximity to supervisor, set-up, equipment etc.
  • Patient bookings – for both student and supervisor, after-hours etc.

Preparation for the student’s commencement also includes orientation of the supervision team. For practices that have regular student placements, this may be as simple as briefly discussing the upcoming placement at a staff or clinical team meeting. For practices that are new to supervision or have irregular placements, supervision team orientation may need to be more comprehensive, including discussion of expectations, roles and responsibilities of various team members.

Monitor patient safety

Monitoring and maintaining patient safety is the most fundamental aspect of the GP supervisor’s role. It is essential therefore that the supervisor implement a model of clinical oversight that reflects the student’s competence and ensures safe patient care.

Competence can be informed by a range of methods and tools, including:

  • Assessment of past experience and training
  • Self-assessed competence and confidence
  • Direct observation

Another important element of safety is cultural safety, in particular for Aboriginal and/or Torres Strait Islander staff and patients.

TOP TIPS!
  1. Discuss patient safety as the most fundamental element of supervision
  2. Always be available, accessible, and approachable

Facilitate teaching and learning

Facilitating teaching and learning is one of the most prominent tasks of the GP supervisor.  And one of the most challenging questions for the GP supervisor is ‘What should I teach my student?’.

 Students will have guidance on anticipated placement learning outcomes. But there are two overarching themes which we encourage supervisors on which to focus – these are 1. conducting a safe and effective consultation and 2. applying sound clinical reasoning skills. GPSA have collated and developed a wide range of resources on teaching and learning the core general practice skills of consultation skills and clinical reasoning.

Every medical student enters GP training with a unique background and experience, and therefore has a unique set of learning needs. While learning is ultimately the responsibility of the student, the GP supervisor has an important role to help their medical student identify, clarify, prioritise, and address learning needs. This included their ‘unknown unknown’ learning needs. There are a wide range of methods and tools that can be used for this purpose.

TOP TIPS!
  1. Identify, discuss and document learning needs before the student starts seeing patients and ongoing throughout the term
  2. Focus on ‘unknown’ learning needs.
  3. Consider non-clinical learning needs e.g. consultation skills, professionalism.

The other fundamental question is ‘How should I teach my student?’. There are a number of possible teaching methods that the GP supervisor can employ, including direct observation, discussing challenging cases, and topic teaching. Ideally, supervisors should use a diversity of methods to make the teaching experience engaging and rewarding for the student (and themselves!). GPSA have developed a teaching and learning toolbox, a repository of resources for use by supervisors and educators, to support their teaching. Key resources include the GPSA guide to Practice-based teaching and the GPSA teaching plans.

TOP TIPS!
  1. Reassure the student that questions are both expected and essential for patient safety and learning.
  2. Focus on skill development rather than knowledge acquisition, especially encouraging your medical student how to ‘think like a GP’.
  3. Involve a wide range of staff members in teaching e.g. nurse, practice manager.
  4. When teaching, adopt an ‘ask before tell’ approach i.e., always probe the medical student for their understanding first before offering your advice.
  5. Explicitly discuss how and when the student should ‘seek help’ i.e., how to contact the supervisor etc.
  6. Schedule sufficient time in the day for teaching the student e.g., book fewer patients, especially in the first weeks.

Assess competence and give feedback on performance

In comparison to ‘summative’ assessment (assessment of learning, for example exams), so-called ‘formative’ assessment is assessment for learning. Formative assessment is the low-stakes assessment of performance that supervisors undertake with students throughout the placement. Formative assessment can be both formal, for example by direct observation, or informal.

Perhaps more important than assessment per se is using the information gathered to give effective feedback. Feedback is at the heart of effective teaching and clinical supervision. It is an essential element of the supervision process to help develop a student’s knowledge and skills. Feedback is ideally not one-way but should be more of a two-way dialogue. Feedback can be formal, as part of structured performance reviews, or informal (‘on the run’).

To be effective, feedback needs to be:

  • Based on observation
  • Specific and relevant
  • Given in a timely manner
  • Given in a non-threatening environment
  • Descriptive rather than judgemental.
TOP TIPS!
  1. Competence is broad and includes non-clinical aspects of practice – ensure assessment of professionalism and other skills.
  2. Seek assistance early when needing to identify and manage issues for the medical student in difficulty.
  3. Establish the process for feedback at the commencement of term.

Support wellbeing

Supporting wellbeing is a broad task, and includes that of the student, the supervision team and themself.

The GP supervisor has a key role as pastoral carer in both prevention and early intervention of stress-related issues in the student. Student wellbeing should be explicitly addressed in the first week of the placement and monitored throughout. Supervisors should enquire as to the support structures available to the student, particularly in the case of students who have relocated or are separated from family and friends.

The supervisor also has an important role to ensure the wellbeing and function of the broader supervision team. Effective self-care for all is critical to ensure effective teaching and learning, and patient safety.

TOP TIPS!
  1. Consider the student’s personal wellbeing and development as the third aspect of your supervision role, in addition to the clinical and educational aspects.
  2. Ensure that the student knows that you ‘have their back’.
  3. Conduct regular supervision team meetings.

Undertake ongoing professional development

Ongoing professional development is an important commitment for the GP supervisor. Both colleges highlight the importance of ongoing professional development in their standards. Professional development should include supervision topics, as well as topics in clinical and non-clinical aspects of practice. 

Date reviewed: 24 February 2025

Please note that while reasonable care is taken to provide accurate information at the time of creation, we frequently update content and links as needed. If you identify any inconsistencies or broken links, please let us know by email.
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