Clinical and educational supervision
The term ‘clinical supervision’ is sometimes used in the sense of the everyday supervision of a trainee’s performance. Clinical supervision according to ‘The Gold Guide’ to specialty training (Department of Health, 2007) involves being available, looking over the shoulder of the trainee, teaching on the job with developmental conversations, regular feedback and the provision of a rapid response to issues as they arise.
All trainees must have a named clinical supervisor for each post (although there may be contextual differences between specialties), who should be able to tailor the level of supervision to the competence, confidence and experience of their trainee. We can, however, use the term in a much wider sense to include all professional conversations at many different levels of practice.
Clinical supervision is increasingly being carried out as an aspect of personal and professional development in both primary and secondary care. It is an aspect of lifelong learning with potential benefits for both supervisor and supervisee.
Clinical supervision has been defined as ‘An exchange between practising professional to enable the development of professional skills’ (Butterworth, 2001). Within the context of primary care Burton and Launer (2003) define clinical supervision as ‘facilitated learning in relation to live practical issues.’ However, Clark et al. (2006) suggest a wide definition that includes a variety of one-to-one professional encounters including mentoring and coaching.
Educational supervision has been defined as ‘The provision of guidance and feedback on matters of personal, professional and educational development in the context of a trainee’s experience of providing safe and appropriate patient care’ (Kilminster et al., 2007, p. 2). All doctors are now required to have educational supervision across their whole training period, from qualification to specialist certification (Department of Health, 2007).
Educational supervision involves the teaching of specific skills and competencies, helping the learner to develop self-sufficiency in the ongoing acquirement of skills and knowledge. Educational supervision sometimes includes an element of assessment and may require the provision of pastoral care for some students or trainees. It is important that the educational supervisor flags up any concerns at an early stage (see also the Managing Poor Performance module).
Mentoring, coaching and appraisal
Mentoring, coaching and appraisal can all be viewed as specific examples of supervision in the sense that they all involve some of the similar interpersonal skills required in one-to-one conversations. The Appraisal e-learning module focuses specifically on appraisal in the educational setting.
Mentoring is guidance and support offered by a more experienced colleague. There is also co-mentoring, where colleagues meet to offer mutual support and help to each other. This might include such activities as ‘action learning sets’.
Coaching is a form of supervision aimed at unlocking someone’s potential to maximise their performance (Whitmore, 1996), whereas appraisal can be described as a process aimed at developing a person’s professional performance, potential and ideas about career development (Peyton, 2000). Skills for carrying out appraisal are closely related to those for supervision.