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Appendix 3: Remote supervision placement example

Guidelines for safe and effective general practice training using remote supervision

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Guidelines for remote supervision

Last revised: 02 Aug 2023

Appendix 3: Remote supervision placement example

Example of how the remote supervision guidelines have been applied.

Context/location	Aboriginal Medical Service, Modified Monash Model (MMM) 6
Selection and accreditation process	Training site was previously accredited for general practitioner (GP) training, but previous supervisors left. No regular onsite GP at the time, and the site had not had a registrar in a number of years. Training site accredited for remote supervision. Two supervisors who had previously worked at the training site or worked as locums engaged and accredited for remote supervision. Registrar and supervisors participated in contextualised remote supervision placement process (CRSPP) to confirm suitability for remote supervision and to conduct gap analysis.
Model of remote supervision	Fully remote supervision
Remote supervisor/s	1 × primary remote supervisor 1 × secondary remote supervisor Shared supervision and teaching responsibilities
Registrar GP term	GPT3
Orientation period	Two weeks face-to-face orientation for the registrar. Each remote supervisor conducted orientation for one week. Each supervisor had a different focus based on their expertise and familiarity with the practice. One remote supervisor focused more on clinical supervision activities and the other focused more on clinic and community orientation. Both supervisors had a Medicare provider number (MPN) for the practice and were able to consult with the registrar during orientation. Orientation included: development of a ‘call for help’ list and supervision plan building an education alliance between both supervisors and the registrar development of an onsite team and introduction into the community establishing escalation and emergency procedures establishing communication channels and plans for how they will communicate in different situations arranging scheduled times in advance consultation observation.
Weekly remote supervision	Three hours per week remote supervision, shared between two remote supervisors. Two hours per week allocated and paid to the primary remote supervisor for one hour each week scheduled time for teaching, case review, assessment and debriefing and one hour of ad hoc support and supervision. One hour per week allocated and paid to the secondary remote supervisor for ad hoc clinical case questions and support to manage patients. The two supervisors organised between themselves who would be the first point of contact for the registrar, depending on their schedule, commitments and the clinical issue. Developing a ‘call for help’ list aided this process. Both remote supervisors met regularly to ensure consistent support for the registrar and to keep each other informed of progress and issues.
Onsite team	Practice manager Aboriginal health practitioner Chronic disease manager Cultural mentor Regular locums and remote area nurses The primary remote supervisor had regular contact with the onsite team to monitor registrar progress.
Site visit	Site visit planned mid-term, but was rescheduled and then cancelled due to flooding. Registrar progress and safety were assessed and extended virtual meetings were conducted in place of the site visit. An additional external clinical teaching visit was conducted by a medical educator.
Funding	The practice was in an MMM6 location and was identified as an area of workforce need, so was eligible for Australian General Practice Training program flexible funds for remote supervision at that time.
Evaluation	The registrar enjoyed placement and felt well supported. The registrar continued in the same location under the same model of remote supervision for GPT4.

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