Supervision
GPSA is dedicated to enabling the delivery of high-quality supervision in the clinical learning environment. We recognise that this relies not on one individual, but a team committed to scaffolding the learner – ensuring safety and positive outcomes for both the learner and the patient.
What is a GP Supervisor?
A GP supervisor is a general practitioner who establishes and maintains an educational alliance that supports the clinical, educational and personal development of a registrar. of roles including clinical overseer, educator, mentor, role model, assessor, coach and pastoral carer. GP supervisors juggle patient safety, teaching and learning, and the wellbeing of their learner, in addition to looking after themselves and the supervision team. It is therefore not surprising that GP supervisors are regarded as the cornerstone of general practice training.urprising that GP supervisors are regarded as the cornerstone of general practice training.
The role of the GP supervisor is diverse, combining a range of roles including clinical overseer, educator, mentor, role model, assessor, coach and pastoral carer. GP supervisors juggle patient safety, teaching and learning, and the wellbeing of their learner, in addition to looking after themselves and the supervision team. It is therefore not surprising that GP supervisors are regarded as the cornerstone of general practice training.
What are you looking for?
Welcome to GP supervision
Thanks for becoming a supervisor and joining a community of GPs dedicated to supporting registrars as they navigate their training into independent practice. You are embarking on a role that is hugely rewarding but also one that can be highly challenging. But there is plenty of help at hand.
- Accessibility
- Approachability
- Supportiveness
- Clinical Skills
- Communication and Teaching Skills
Dr Simon Morgan, GPSA Education Manager,
gives and overview of teaching and learning in General Practice.
Components of supervision
A GP supervisor is a general practitioner who establishes and maintains an educational alliance that supports the clinical, educational and personal development of a registrar.
Tips and tricks for new supervisors
YOU DON'T NEED TO KNOW IT ALL
One of the biggest concerns for many new GP supervisors is feeling like they need to ‘know it all’. With a registrar in the practice, suddenly they may feel like their hitherto hidden knowledge gaps will be exposed, their rudimentary teaching skills critiqued, and their discomfort giving feedback raised to a new level. New supervisors may even worry they will feel like an imposter in the role, especially those only recently graduated who are just getting comfortable with clinical practice.
But just like a new registrar starting out in clinical practice, embarking on this new role does not require freshly minted supervisors to know it all. Far from it, in fact. For example, it is far preferable to model lifelong learning by demonstrating information seeking rather than making up an answer to an unknown clinical query. Supervision knowledge and skills will develop with time, and confidence will grow with each successive registrar placement.
Many existing clinical skills are directly transferable to the supervision role. As GPs providing clinical care to patients on a daily basis, supervisors already have the foundational attributes – communication skills, advocacy, patient/learner-centeredness, curiosity, commitment, a passion for life-long learning, professionalism, organisational skills, and more – on which to build successful supervision.
YOU DON'T NEED TO DO IT ALL
Increasingly, general practice supervision is delivered by teams. Supervision teams may include other GPs in the practice, as well as practice nurses, the practice manager, allied health practitioners, Aboriginal Health Workers, cultural mentors, receptionists, and other administrative staff within the practice. It may be even broader, and include a community pharmacist or visiting physician, for example. Supervisors should build and support an effective supervision team, in order to give the registrar the broadest experience possible as well as make the supervision role more sustainable.
IDENTIFY YOUR OWN STRENGTHS AND WEAKNESSES, NOT JUST THE REGISTRAR'S
Apart from the generic skills, each supervisor will bring their own background and experiences to the role. It is useful to identify such knowledge and skills, and discuss them with the registrar. Take a few minutes to reflect on your supervision experiences – from both being supervised as a student or junior doctor or GP registrar, as well as supervising your own learners.
What is your experience of being supervised?
How would you describe your past supervision experiences? What were the highlights? Were there parts that you did not enjoy? Was there one great mentor who you remember over others? What was it about them that made them so effective?
What is your experience as a supervisor?
What do you like about the supervision role? What aspects do you find challenging What are your strengths as a GP supervisor What areas do you need to work on
What is your motivation to be a supervisor?
What are you particularly concerned about?
FOCUS YOUR ENERGY ON THE THINGS THAT WILL MAKE A DIFFERENCE IN THE LONG TERM
Registrars must learn a massive amount to be safe and effective practitioners, as well as to pass their exams. This can potentially be projected onto the GP supervisor, making them feel like they need to teach a correspondingly overwhelming amount to their registrar. The new supervisor may wonder therefore where to invest their energy. The following are suggestions to help focus this task.
Focus on skill development, not knowledge acquisition
GP registrars are required to learn not just knowledge, but also skills and attitudes. While registrars are often driven by knowledge acquisition e.g. ‘What are the clinical features of gout?’, and seek guidance about this from their supervisor, this aspect of learning may occur just as effectively from independent study. Skill development, however, requires deliberate practice and guidance, and could rightly be regarded as the primary aim of GP supervisor teaching. These skills include clinical reasoning, managing uncertainty, consultation skills, cultural safety, communication skills, and more.
Add practical wisdom to learning
The supervisor has an important role to put the registrar’s learning into context, so called ‘practice wisdom’. Operating in a workplace-based learning environment, supervisors must be nimble and opportunistic by enhancing the learning that ‘walks in the door’. While the registrar may read about the presentation or diagnosis from a textbook or online resource, the supervisor has a key role to ‘contextualise’ the information into the real world of general practice, adding their accumulated wisdom to the theoretical knowledge. This also relates to framing learning through the prism of primary care and community-based medicine, in contrast to the hospital system from which the registrar came.
Uncover unknowns
The Johari window illustrates how gaps in knowledge, skills and attitudes can be hidden from the registrar, the supervisor, or both. It is useful for the new supervisor to think about uncovering ‘unknowns’ in their registrar, especially ‘unknown unknowns’. This is explored in detail in the companion GPSA guide, ‘Helping your registrar plan their learning’.
Address the non clinical aspects of practice
GP registrars invariably focus on the clinical aspects of practice – diagnosis, investigation and management of illness. This is not all surprising and is even more of a focus as exams loom. However, as the curricula of both colleges describe, general practice is much broader than the clinical aspects of practice, and includes a breadth of nonclinical aspects of quality practice. In a similar way to focussing on skill development over knowledge acquisition, as above, we encourage GP supervisors to focus on the non-clinical aspects of practice in their supervision role – this includes communication and consultation skill development, population health, professional and ethical practice, organisational skills, risk management and medicolegal practice.
YOUR RELATIONSHIP WITH THE REGISTRAR IS THE FOUNDATION STONE
As previously stated, the foundation stone of effective supervision and registrar learning (and patient safety) is a respectful, trusting relationship between the supervisor and registrar. This can certainly begin before the registrar starts in the practice. GPSA recommends that once the placement has been confirmed, the supervisor should meet the new registrar well in advance of the commencement date, over a coffee is ideal. This may include a discussion of professional background and experience, as well as personal background and family (potentially for both the supervisor and registrar). The latter is particularly important if the registrar is relocating to join the practice. The conversation may cover cultural aspects, especially if the registrar trained in a country other than Australia. Roles and potential conflicts e.g. teacher versus assessor, might be raised. The conversation should certainly cover the registrar’s expectations, aspirations, and concerns for the term ahead.
Why structure a learning environment?
What is the GPCLE?
The GPCLE is a holistic and evidence-based framework to guide the development of best practice clinical learning environments in general practice. The framework is particularly applicable for new teaching practices, new supervisors and for benchmarking and planning quality improvement for existing practices.
The GPCLE framework comprises six elements, 19 objectives, and 53 descriptors of quality.
Recommended resources
Welcome to the GPSA Medical Student Supervisor’s toolbox!
Learning in General PracticeLearning in the general practice setting links application of knowledge and skills to patient care and motivates students to embrace self-directed learning. But more than that, through exposure to general practice as a professional environment with strong community connectivity, students will have the opportunity to envisage the exciting, varied and rewarding career they could have as a GP or rural generalist.
The toolbox
This toolbox is a repository of useful references and resources for supervisors of medical students in general practice.
Please review the Supervision Resources page for a range of other resources. It is hoped that this supervision toolbox will be useful to all practices involved in medical student education, that it will act as a guide for practices newly hosting medical students, and as a refresher for those more experienced ones already playing a part in student education.
Resource
It is well recognised that IMGs face multiple challenges to successful passage through, and completion of, GP training.GPSA recognises the important role that GP supervisors play in supporting IMG registrars and other GPs in training.For consultation skill teaching, please also refer to the Consultation Skills Toolbox and the Consultation Skills Teaching plans.
Key Resources
A range of practical tips for the supervisor to support the IMG GP registrar in the practice in the following resources:
Monitoring and maintaining patient safety is the most fundamental aspect of the GP supervisor’s role. It is essential that the supervisor implement a model of clinical oversight that reflects the learner’s competence and ensures safe patient care. This requires early and ongoing assessment of performance, and a clear understanding of the nature and volume of patient encounters.
One of the key planks of patient safety is for the learner to be able to seek assistance from the supervisor about clinical care, either within or soon after the encounter. This can be facilitated by a clinical supervision plan. Another important element of safety is cultural safety, in particular for Aboriginal and/or Torres Strait Islander patients.
Resources
- GPSA clinical supervision plan
- Can I ask you a quick question – ad hoc supervision webinar and FAQ
- Call for help webinar and FAQ
- Call for help list
- Patient safety incidents teaching plan
Date reviewed: 26 July 2024