Guidelines for remote supervision

Assessments in the context of remote supervision

Guidelines for safe and effective general practice training using remote supervision
Download PDF
  1. Acknowledgements
  2. Why we need remote supervision of GP registrars
  3. Background
  4. References
  5. Appendix 1: Guideline development
  6. Appendix 2: RACGP remote supervision documents and forms
  7. Appendix 3: Remote supervision placement example

Last revised: 02 Aug 2023

Assessments in the context of remote supervision

Registrar assessments are completed as per their training program requirements. This section discusses considerations of assessments in the context of remote supervision.

Assessments of a registrar’s progress and feedback about gaps and improvements are an integral part of training. For Australian GP registrars, the Fellowship exams can be used as reference points, but low stakes assessments, such as directly observed consulting, RCA, case-based discussions, workshops and other group educational activities, are essential as part of the RACGP progressive assessment framework and to ascertain whether a registrar is a safe and effective practitioner.17

In order for any assessment to be valid, the doctor doing the assessment must understand the context of the registrar’s workplace. This is particularly true for remote assessments when the assessor cannot directly see the environment in which the registrar is working.

The initial face-to-face orientation period will assist the supervisor in ascertaining the supervision the registrar is likely to need in the future, to build up a relationship with the registrar and to discuss how feedback will be given when the supervisor is remote. Further face-to-face periods of time throughout the term will also strengthen this.

If a supervisor is worried about a registrar’s progress in a face-to-face situation, they will usually choose to spend more time with the registrar. There will be an escalation process in place for registrars who are flagged or need remediation, but ascertaining the need for further input will be done after more information is gleaned.23

The use of IT to ‘Zoom in’ to the registrar’s consulting room can overcome some of the barriers to assessments, coaching and giving feedback. Some supervisors actually find this more useful than face to face because they can see what the registrar is writing in the notes, for example if they have a remote desktop access to the patient’s file in addition to the videoconference into the consultation.

The experience of one registrar exemplifies how this can be successful:

Sometimes they will be [a long way away] and they would web zoom into my consult room and I had a little camera on top of my computer and they could see me and the patient.

So they would just sit there muted and with my camera on in the background and watch me with the consult, which is actually really fantastic because usually you’ll have people that come in and watch you observe your practice and they’ll be sitting in your room and kind of make you feel uncomfortable.

This is great, because no one else was in the room, and it worked really well and it was a mix of getting direct feedback from consultations that I had, RCAs … and then if I wanted to learn more, it was what I wanted to do. Or whether the supervisor thought that I had a gap in my knowledge to focus on those kind of areas, so it was a mix of things.

Another advantage of videoconference-based assessments is the cost saving on travel for the supervisor or medical educator. Despite many assessments being undertaken remotely, all should still fulfil the requirements of the RACGP progressive assessment framework.

How assessments can be done remotely by the supervisor or medical educator

  • Remote supervisor observation of consultations using the registrar’s computer or another online camera in the room
  • Remote observation of registrar consultations with the ability to simultaneously watch them make notes in the patient file
  • Focused observation of consultations, which may be a Mini-Clinical Evaluation Exercise (MiniCEX), where the supervisor and registrar agree that the supervisor will focus on giving feedback on a particular issue (eg body language, open-ended questions, safety-netting, communication skills)
  • RCA where both the registrar and supervisor have access to the clinical software
  • Case-based discussions where the registrar presents a case of their choosing
  • Review of investigation ordering, referrals and prescribing where both the registrar and supervisor have access to the clinical software
  • Discussions with the onsite supervision team about the registrar’s competence
  • Role-playing, particularly for mental health issues, domestic violence, drug and alcohol, motivational interviewing for chronic disease management or ethical dilemmas
  • Review of ‘call for help’ list or EPAs25

External clinical teaching visits

External clinical teaching (ECT) visitors will need to have a thorough understanding of the guidelines, especially because they will be assessing the risk management plan and the utility of the onsite supervision team.
The following questions should be asked during an ECT visit at a remote supervision site:
  • Do you think you have adequate access to your supervisor?
  • Has the onsite supervision team been useful?
  • Has the risk management matrix identified and mitigated any risks you have encountered?
  • Has the contextualised remote supervision plan helped you identify gaps and issues?
  1. Young L, Peel R, O’Sullivan B, Reeve C. Building general practice training capacity in rural and remote Australia with underserved primary care services: A qualitative investigation. BMC Health Serv Res 2019;19(1):338. doi: 10.1186/s12913-019-4078-1.
  2. Australian Institute of Health and Welfare (AIHW). Rural and remote health. AIHW, 2022. Available at [Accessed 9 March 2022].
  3. The Royal Australian College of General Practitioners (RACGP). General practice: Health of the nation 2019. RACGP, 2019.
  4. Harrison C, Britt H. General practice – workforce gaps now and in 2020. Aust Fam Physician 2011;40(1–2):12–15.
  5. doi:" target="_blank"> Wearne SM. Is it remotely possible? Remote supervision of general practice trainees Maastricht University, 2015. .
     [PhD thesis].
  6. Wearne SM, Teunissen PW, Dornan T, Skinner T. Physical isolation with virtual support: Registrars’ learning via remote supervision. Med Teach 2015;37(7):670–76. doi: 10.3109/0142159X.2014.947941.
  7. Varela SM, Hays C, Knight S, Hays R. Models of remote professional supervision for psychologists in rural and remote locations: A systematic review. Aust J Rural Health 2021;29(2):211–25. doi: 10.1111/ajr.12740.
  8. Hays RB. Remote supervision of health professionals in areas of workforce need: Time to extend the model? Rural Remote Health 2012;12:2322. doi: 10.22605/RRH2322.
  9. https://www.amc.org.au/wp-content/uploads/accreditation_recognition/specialist_edu_and_training/assessment/standards_for_assessment.pdf" target="_blank"> Australian Medical Council (AMC). Standards for assessment and accreditation of specialist medical programs and professional development programs by the Australian Medical Council 2015. AMC, 2015. Available at [Accessed 3 July 2023].
  10. Worley PS, O’Sullivan B, Ellis R. From locum-led outposts to locally led continuous rural training networks: The National Rural Generalist Pathway. Med J Aust 2019;211(2):57–59.e1. doi: 10.5694/mja2.50225.
  11. Wearne S. Remote supervision during general practice training. Educ Prim Care 2016;27(4):333–34. doi: 10.1080/14739879.2016.1207103.
  12. Kanakis K, Young L, Reeve C, Hays R, Gupta TS, Malau-Aduli B. How does GP training impact rural and remote underserved communities? Exploring community and professional perceptions. BMC Health Serv Res 2020;20(1):812. doi: 10.1186/s12913-020-05684-7.
  13. Thomson JS, Anderson KJ, Mara PR, Stevenson AD. Supervision – growing and building a sustainable general practice supervisor system. Med J Aust 2011;194(11):S101–04. doi: 10.5694/j.1326-5377.2011.tb03139.x.
  14. Wearne SM. In-practice and distance consultant on-call general practitioner supervisors for Australian general practice? Med J Aust 2011;195(4):224–28. doi: 10.5694/j.1326-5377.2011.tb03288.x.
  15. Wearne SM. Remote supervision in postgraduate training: A personal view. Med J Aust 2013;198(11):633–34. doi: 10.5694/mja13.10296.
  16. Ingham G, Fry J. A blended supervision model in Australian general practice training. Aust Fam Physician 2016;45(5):343–46.
  17. Wearne S, Dornan T, Teunissen PW, Skinner T. Twelve tips on how to set up postgraduate training via remote clinical supervision. Med Teach 2013;35(11):891–94. doi: 10.3109/0142159X.2013.805878.
  18. Hays R, Peterson L. Distant supervision in training for remote medical practice. Educ Gen Pract 1997;8:123–27.
  19. Moran AM, Coyle J, Pope R, Boxall D, Nancarrow SA, Young J. Supervision, support and mentoring interventions for health practitioners in rural and remote contexts: An integrative review and thematic synthesis of the literature to identify mechanisms for successful outcomes. Hum Resour Health 2014;12(1):10. doi: 10.1186/1478-4491-12-10.
  20. Bayley SA, Magin PJ, Sweatman JM, Regan CM. Effects of compulsory rural vocational training for Australian general practitioners: A qualitative study. Aust Health Rev 2011;35(1):81–85. doi: 10.1071/AH09853.
  21. Pront L, Gillham D, Schuwirth LW. Competencies to enable learning-focused clinical supervision: A thematic analysis of the literature. Med Educ 2016;50(4):485–95. doi: 10.1111/medu.12854.
  22. Campbell N, Wozniak H. A guide to creating a culture of quality supervision: work-based peer review of clinical supervision practice. Greater Northern Australia Regional Training Network with Flinders University, 2014., Available at [Accessed 3 July 2023].
  23. Wearne SM, Dornan T, Teunissen PW, Skinner T. Supervisor continuity or co-location: Which matters in residency education? Findings from a qualitative study of remote supervisor family physicians in Australia and Canada. Acad Med 2015;90(4):525–31. doi: 10.1097/ACM.0000000000000587.
  24. Ingham G, Plastow K, Kippen R, White N. A ‘call for help’ list for Australian general practice registrars. Aust J Gen Pract 2020;49(5):280–87. doi: 10.31128/AJGP-07-19-4997.
  25. Valentine N, Wignes J, Benson J, Clota S, Schuwirth LW. Entrustable professional activities for workplace assessment of general practice trainees. Med J Aust 2019;210(8):354–59. doi: 10.5694/mja2.50130.
  26. Telio S, Ajjawi R, Regehr G. The ‘educational alliance’ as a framework for reconceptualizing feedback in medical education. Acad Med 2015;90(5):609–14. doi: 10.1097/ACM.0000000000000560.
  27. Costello S, Benson J, Burns J, Bentley M, Elliott T, Kippen R. Adaptation and initial examination of the psychometric properties of the Short Supervisory Relationship Questionnaire (SSRQ) for use with general practice registrars. Educ Prim Care 2020;31(6):341–48. doi: 10.1080/14739879.2020.1806114.
This event attracts CPD points and can be self recorded

Did you know you can now log your CPD with a click of a button?

Create Quick log

Advertising