1. Concerns and performance Dr Barry Lewis Director GP Education

2. Defining Clinical and Educational supervision Generic ‘supervision’ model –Normative Environment and ‘tools’ –Formative Teaching, coaching, mentoring Assessment –Restorative Recognising difficulty and responding remediation

3. Task Take the model and agree where the 3 domains fall into the ‘trainer’ roles Agree ‘key’ roles for CS and ES Allow 15 mins for task Summary

4. Coaching Clinical Coaching (JACSTAG) Demonstration of the full procedure talking through the procedure trainee talking through the procedure trainee undertaking the procedure GROW GOAL setting for the session as well as short and long term REALITY checking to explore the current situation OPTIONS and alternative strategies or courses of action WHAT is to be done, WHEN, by WHOM and the WILL to do it.

6. Concerns about performance Task –Produce a list of performance parameters that will allow ‘reporting’ of concerns –e.g – poor punctuality –Include clinical and educational areas Allow 20 minutes

7. National Patient Safety Agency Low standard of work, mistakes. Inability to cope with work volume Unacceptable attitudes –To patients –To colleagues Punctuality and absence issues Specific skill deficiencies

8. National Patient Safety Agency Lack of awareness of standards required Failing to meet agreed objectives Acting outside competence limits Poor supervision of others when this is required Health problems that impact on work

9. ARCP Flow Chart

10. E-portfolio competence areas Communication/consult ation skills Holistic practice Data gathering, interpretation Making diagnosis/decisions Clinical management Managing complexity Primary care admin Working with colleagues, teams Community orientation Performance, learning and teaching Ethical approach Fitness to practice

11. Handling concerns – good practice Receiving information Patient safety Informing the trainee Supporting the trainee Dealing with concern –Informally –…………………………………………. –formally CS/ES

12. Examples Task –In groups of 3-4 choose a specific example from experience, summarise it and decide how, in the new training environment, this should be recorded and handled. –Allow 15-20 min

13. Handling concerns – good practice Gathering further information Deciding what to do Understanding contributory factors Interventions and remediation Review Aftermath and rehab. PD >ARCP > AD