As the number of doctors undertaking GP training placements steadily increases and the calls on the skills and expertise of trainers steadily expands, it is inevitable that locums will be asked to supervise trainees for single sessions of clinical practice in training environments.
Check before the session that the locum can, and wants to, supervise
The most important piece of the jigsaw is for the practice to check the willingness and perceived ability of the locum to undertake this role before s/he arrives in the building rather than stating the expectation on arrival. This will avoid embarrassment and ensure trainee safety.
Make sure all parties understand that the locum is not the clinical supervisor
It is important from the outset to be clear that a locum is not required to take on the role of the clinical supervisor (as defined by the GMC and Academy of Medical Educators).
Employ a locum GP with good teaching skills
Clinical supervision of a single clinical session still, however, has prerequisites if it is to be delivered safely and to the satisfaction of both the supervisor and trainee.
The combination of personal and organisational requirements may, on first reading, appear to make locum supervision of trainees an impossibility, but the personal skills requirements should be in place for any GP who has completed training in the last five years as these are embedded in the RCGP curriculum and usually covered during ST3 training in one to one or group teaching sessions.
To demonstrate personal skills in supervising trainees, a locum should aim to show they know:
- What is an acceptable level of practice for each of the different stages of training
- How adults learn best and the relevance of this to teaching.
- How best to teach a clinical skill
- How a variety of techniques and methods can be used to teach a skill
- How the role, types and formative nature of workplace based assessments (WBAs) are appropriate to each relevant specialty
Locums should include a record of this role in their appraisal portfolio towards revalidation - a useful adjunct to career development.
Make sure the partner prepares the locum and practice staff
The seven key requirements for the clinical supervisor/partner employing the locum, are to:
- Give the locum appropriate time for this role in addition to its clinical commitments
- Share the trainee’s name, current stage of training and specialty/foundation level
- Be informed of existing concerns about the trainee’s clinical skills
- Use a clear method for handing over information to the trainer (the trainee’s clinical supervisor)
- Provide a contact number for the trainer (or another partner in the practice) should there be a significant event during the period of supervision
- Agree a clear statement of the expectations for the supervision, for example if the locum is supervising a trainee undertaking home visits
- Allocate a senior receptionist or administrator to ensure adequate time is allowed for supervision and appropriate contact information is maintained
Many practices also have a locum ‘handbook’ of key information, adding in the processes and information outlined would facilitate delivery of supervision by locums.
For a practice delivering training placements for GP trainees in years one to three , GP Foundation Year Two placements and/or hospital specialty training placements at any stage of specialty training, the organisational requirements are not onerous and many would regard as standard ‘best practice’.
Dr Barry Lewis is the chairman of COGPED and director of the North-West Deanery.
