Supervision
Theme: Curriculum implementation
Training provider criteria and requirements
8.1 | The training provider establishes a trainee has accessible, timely and supportive supervision for all aspects of training while recognising the principle of increasing professional responsibility.
Supervision includes establishing and maintaining a learning environment, clinical and educational supervision. Both clinical and educational supervision guide a trainee’s professional development.
Clinical supervision supports safe, high-quality patient care and involves provision of timely point-of-care assistance, regular communication, feedback and patient-based teaching.
Educational supervision is the provision of oversight, including guidance, assessment, feedback and support, of a trainee’s learning experience, so the trainee successfully completes the training program.
Supervision involves maintaining a balance between closely supervising and providing sufficient autonomy to trainees. A trainee receives supervision from a named supervisor(s) who observes and oversees:
- the trainee’s work at the point of care
- individual trainee learning, teaching and assessment within a rotation
- training program requirements, trajectory of learning and longitudinal progression
A trainee is monitored by a named Director of Training who reviews the trainee’s performance and decides whether they can progress. A trainee:
- can access the supervision they require
- has supervision when learning a new skill
- can identify the supervisors providing supervision
- knows their responsibilities and the supervisors’ responsibilities
- knows the direct and indirect supervision arrangements
- knows from whom to seek assistance
- knows the circumstances under which supervisors are consulted about care
There is regular communication and collaboration between educators to support the trainee’s achievement of learning goals and completion of the training program.
8.1.1 | A Setting provides accessible clinical supervision 100% of the time a trainee provides service.
A Basic Trainee has a clear understanding of who is providing clinical supervision and the chain of clinical supervision. A Basic Trainee has consultant supervision 100% of the time they provide service.
If a consultant is unavailable on-site, they’re available by phone and can be called to the Setting when required. The consultant is located near the Setting and can reach the Setting in a reasonable timeframe. The timeframe for arrival is documented.
A second consultant is available to take on the supervision responsibilities when the primary consultant is unavailable. A minimum of 2 consultants is preferred. A second consultant offers:
- another opinion of a trainee’s performance and progress, ensuring robust feedback
- to be an alternate consultant when there are issues between a trainee and their designated consultant
A Basic Trainee has ready access to clinical supervision that aligns to their level of competence. A supervisor actively assesses the level of supervision a trainee requires:
- direct supervision
- indirect supervision
or
- supervision at distance
During work hours, a clinical supervisor is available on site most of a Basic Trainee’s working day. A consultant can have an Advanced Trainee provide some clinical supervision, when they have been assessed as competent to provide supervision required.
A Basic Trainee is expected to be the most senior doctor on-site by the end of Basic Training. It’s important the clinical supervision during this transition supports and keeps a trainee and their patients safe.
A Basic Trainee in their PGY2 year is not to be the most senior doctor on site. They require accessible clinical support for emergencies and critical care from a senior doctor on-site who is competent to manage the situation. This can include an Advanced Trainee or a Career Medical Officer where there is a clear chain of command back to the consultant.
A Basic Trainee beyond their PGY2 year is assessed to ensure they are competent to manage emergencies and provide critical care with supervision at a distance prior to being the most senior doctor on-site. The assessment and outcome are documented
8.1.2 | A Setting ensures there is on-site clinical supervision in an ambulatory Setting when a Basic Trainees provides service.
A clinical supervisor is available in the ambulatory Setting to review all new and complex patients. Ambulatory Settings can include clinics, outpatient departments and consultant offices.
Setting criteria
8.2 | Supervision arrangements are outlined to the trainee.
A training provider has a written supervision process and arrangements. The process needs to recognise and incorporate the principle of increasing professional responsibility. This is communicated to and enacted by the trainee and their supervisor(s).
8.3 | Supervision is provided by a sufficient number of qualified and skilled medical staff with an appropriate level of training and experience.
The doctors providing supervision deliver high quality patient care and trainee learning opportunities. They have appropriate clinical skills and experiences and supervision competencies. Supervisors are accessible, have good communication and teaching skills, utilise learning opportunities effectively and are responsive to trainee queries.
8.4 | The supervisor determines the trainee’s level of competence and confidence and provides the trainee with responsibilities and supervision appropriate to their level.
A trainee is assessed at the commencement of each rotation to establish whether they have the required knowledge and skills to fulfil their work responsibilities. Training deficiencies are rectified. A trainee knows their scope of authority and only manages situations where they are deemed competent.