The remote supervisor
Remote supervisor expectations
Remote supervision is more complex than face-to-face supervision and, as such, requires significant supervision experience to be safe and effective. It is expected that a remote supervisor will be able to:
- understand the complexities of remote supervision and the requirements to do it safely and effectively
- develop and maintain the remote supervisor–registrar relationship
- effectively use technology in clinical supervision, teaching and communications
- provide proactive as well as reactive remote supervision
- develop connection with the onsite supervisory team and local community
- complete registrar assessments and provide effective feedback remotely.
The remote supervisor will visit the training site at specified times, will have regular communication with the registrar and will provide advice regarding clinical issues and other work-related concerns, as well as other professional support and mentoring. The remote supervisor will ensure that appropriate feedback is given about the progress of the placement to the registrar, the RACGP and the clinic.
In addition, the remote supervisor will:
- ensure they have regular ‘quarantined’ time for teaching with the registrar
- ensure they are available for ad hoc clinical advice whenever the registrar is working, or organise another appropriate GP to be available, communicating this arrangement to the registrar and onsite team
- follow clear guidelines about the management of significant issues regarding the registrar, and be able to escalate support appropriately
- ensure the onsite supervision team has appropriate expectations, and establish and respond to ongoing communication with that team.
Clinical responsibility while supervising remotely is the same as traditional face-to-face supervision and, as such, the requirements for medical indemnity are the same.
Remote supervisor eligibility
Supervisors interested in remote supervision will need to be accredited as a remote supervisor. In addition to meeting the standard RACGP supervisor accreditation requirements, a remote supervisor is required to have:
- experience and competence as a supervisor
- current and/or previous working experience in the proposed location or similar
- capacity to be available and to travel to the location as required
- the ability to use practice software and to manage connectivity
- creativity and commitment to provide high-level remote support.
Identification of potential remote supervisors will be a collaborative effort between the remote supervision team and the regional and local teams. Potential supervisors to consider include:
- supervisors recommended by the local team who have recently left the training site of interest
- supervisors who have previously (recently) worked at the training site of interest
- supervisors nearing retirement and who have flexibility and availability as required
- GPs who have worked in the location as locums and who have the necessary skill set
- supervisors without necessary experience who could work with a more experienced supervisor.
Other possibilities could include those taking family leave and doctors who have expressed interest and have been directed to gain locum experience at the proposed site.
Remote supervisor accreditation
The accreditation of remote supervisors follows the same process as standard supervisor accreditation as per the National Accreditation Framework with additional criteria and activities specific to remote supervision. These include submitting a curriculum vitae (CV) and a cover letter outlining their interest in becoming a remote supervisor, completing the Remote supervisor accreditation requirements document and meeting each of the criteria listed in that document.
The accreditation process includes an informal interview with the remote supervision team to determine whether the supervisor has the capacity, willingness and skills to provide quality supervision, understands the remote supervision guidelines and requirements, and is willing to work with the RACGP local team and onsite supervision team.
Remote supervisors are also expected to complete the Introduction to Remote supervision in general practice training online module in gplearning. This module covers the following topics:
- the registrar–remote supervisor relationship and education alliance
- technology and communication
- proactive and ad hoc remote supervision
- remotely conducted assessments and feedback
- remote community connections.
Contextualised remote supervision placement process
The supervisor contextualised remote supervision placement process (CRSPP) interview is a discussion designed to ensure suitability for the training site and the model of remote supervision. The supervisor will be required to participate in a CRSPP interview for each new location to ensure they are appropriate for the context at that time and are a good fit for the particular registrar. The interview will identify any areas of skill development that may be required before or during the training term. It is important that the remote supervisor understands the local context that the registrar will be working in, and has the ability to respond appropriately to the needs of the registrar. The remote supervisor must be committed to the process and understand the challenges and risks associated with the individual training site.
For experienced remote supervisors, the interview will be used as a basis for reflective discussion and review of previous supervision, as well as a means to determine whether further preparation or training is helpful. If the supervisor is new to remote supervision, the accreditation interview and CRSPP interview will be combined.
The CRSPP interview for supervisors should be conducted by an RACGP medical educator and a representative from the training site, and the Remote supervisor interview outcomes document completed.
The Remote supervisor interview guide provides the interview structure and questions, as well as suggested scenarios to discuss, including the potential supervisor’s strengths and weaknesses, anticipated challenges and how they will address them, and potential areas for upskilling.
The scenarios will explore what the supervisor would do if they had a registrar who was:
- highly anxious
- clinically unsafe
- identified as having an issue with substance abuse
- not accepting feedback
- having personal problems
- kept the supervisor ‘out of the loop’ of what was happening in the clinic
- culturally inappropriate.
Potential outcomes and recommendations of the interview include, but are not limited to:
- appropriate for the training site and to supervise the registrar assigned to this site
- recommended to upskill in a certain area prior to this particular placement (eg IT, cultural training relevant to the local area)
- co-supervise with an experienced remote supervisor
- recommended to complete a short locum position at the proposed site or participate in a site visit to get to know the community
- complete training modules such as those developed by Remote Area Health Corps (RAHC) to enable supervision in a geographically remote area
- not appropriate for this training site at this time or suitable for a different training site
- not appropriate for remote supervision at this time.
Remote supervisor support
A community of practice between remote supervisors will be established and will provide opportunities to share experiences and help with problem solving. It could be facilitated by the remote supervision team, or remote supervisors may choose to connect independently. Such a community of practice can also support a supervisor who might have particular problems such as IT or supporting a registrar in difficulty. The ‘tips and tricks’ from such a group will be invaluable, and there will be accountability and support of each other.