Supervision Types Level/type of supervision Word Pictures Assessment by Trainer/ES Learning Outcomes Expected stage of training* Level of supervision - RED (Direct Supervision) Direct supervision of the trainee by the clinical supervisor. The trainee takes no clinical responsibility The model for direct supervision is based on graded experience based on the joint surgery format Trainee observes OOH Clinical Supervisor Trainee progressively takes clinical responsibility for a caseload initially under direct observation (to include face-to-face consults and telephone triage) Trainee consults separately reporting to Supervisor to agree a management plan prior to completing the consultation End of Session debrief with OOH CS and OOH record sheet completed with feedback to trainee Best practice would include a similar but accelerated Trainer/ES Guidance for assessing going from RED to AMBER The judgement concerning the level of supervision most appropriate for a trainee must be made by the Trainer/ES. For a trainee to move from RED to AMBER there should be evidence that they have met the learning outcomes Trainer/ESs should discuss the RAG rating with the trainee and should record this discussion and judgement in the educator notes of the trainee’s e-portfolio. Learning Outcomes to be achieved for moving from RED to AMBER Demonstrate an understanding of the basic organisational aspects of NHS OOH care Show familiarity in working with OOH IT systems, including recording facilities and sources of IT help Demonstrate safe and appropriate standards of data entry Prescribe safely and appropriately using the OOH IT system Demonstrate a basic understanding of the management of common medical / surgical / psychiatric conditions in OOH setting Demonstrate a basic understanding of the provision of services available in OOH Demonstrate telephone triage skills with emphasis on patient safety Show Reflection on patient referrals and contacts with other health professionals and discuss with Supervisor/Trainer/ES on case by case basis. Show reflection on personal response to stresses of working in OOH setting Demonstrate an appropriate approach to personal security and awareness of security risks to others Where a Trainer/ES has concerns regarding trainee progression towards amber the specific Months 1-2 of ST3 and all of ST1/2.
process at the beginning of a shift where a Clinical Supervisor is supervising unknown amber (green) trainee concerns should be shared with the trainee and an action plan developed (and recorded in the e-portfolio) to clarify what steps the trainee should take and how evidence of progression will be measured. Level of supervision - AMBER (Direct/Close Supervision) Close supervision of the trainee who consults independently but with the clinical supervisor close at hand (in the same building) The model for amber supervision is based on graded experience. OOH CS undertakes an initial review with trainee to review experience An accelerated process of direct observation of the trainee may take place at the start of the session Trainee routinely consults separately, with supervisor immediately available for discussion of cases Joint consultation where appropriate Trainee is offered opportunity for observed practice Trainer/ES Guidance for assessing going from AMBER to GREEN The judgement concerning the level of supervision most appropriate for a trainee must be made by the Trainer/ES For a trainee to move from AMBER to GREEN there should be evidence that they have met the learning outcomes Trainer/ESs should discuss the RAG rating with the trainee and should record this discussion and judgement in the educator notes of the trainee’s e-portfolio. Where a Trainer/ES has concerns regarding trainee progression towards green the specific concerns should be shared with the trainee and an action plan developed (and Learning Outcomes to be achieved for moving from AMBER to GREEN Demonstrate a working knowledge of the OOH organisation and infrastructure Demonstrate a good working knowledge of OOH IT systems Demonstrate safe prescribing to include use of opiates and drugs of abuse Demonstrate a good understanding of the management of common medical / surgical / psychiatric conditions in OOH setting Demonstrate enhanced consulting skills in telephone triage, to include: • Establishing rapport, eliciting patient’s ‘ICE’, use of appropriate language Appropriately managing communication with third party Exercise communication skills for assessing the ‘urgency’ of a presentation Recognition and management of clinical red flag symptoms and signs Performing ‘safety netting’, and show Months 3-5 of ST3.
Trainee Name Location: Time of session and length (hours): Date of session Trainee Status (circle relevant session): RED AMBER GREEN Type of session Base doctor Visiting doctor Telephone triage Induction Ambulance or Police attachments On-call with duty Psychiatrists, Community Psychiatric Nurses and teams OOH and Terminal Care Nursing services to include Macmillan services Social Workers and Social Care Services Seeing patients in places like detention centres and prisons Community Midwives Walk in clinics etc. Specific local provision e.g. Community Paediatric Admission Prevention services, etc. Other(please specify – will have had to have been agreed by your Programme Director) Type of cases seen and significant events Competencies demonstrated Learning areas and needs identified Debriefing notes from Clinical Supervisor Signature of Clinical Supervisor Date Signature of Trainer Date NB This Form must be discussed with your own Trainer for signing off and then scanned into your e-Portfolio.