Balancing Serving & Learning in the Workplace

Clinical supervisors have a responsibility to ensure patient safety whilst also ensuring that each trainee is performing at the appropriate level for their competence. To address this adequately, the first step is to ensure that all trainees receive adequate induction to new placements so that they are familiar with the setting and process to be followed in their new workplace.

Supervisors should also ensure that trainees are adequately supervised and supported, particularly when learning new skills. To do this effectively, competence of trainees needs to be assessed and as trainees acquire knowledge, skills and experience and develop competence, the level of supervision needed changes from direct to distant supervision as follows:

Balancing Service Work and Learning Opportunities

Competence of trainees can be assessed through various means such as direct observation, workplace-based assessments, training log books and enquiry from other staff.

Educational needs come from 3 main sources – the trainee themselves (what they want to learn/ experience), the supervisor (what they think is relevant to learn from their clinical experience in that specialism) and the governing body or curricular learning outcomes to be achieved.

How to Optimise Service and Training in the Workplace:

1. Early identification of educational needs is important. Once the needs are identified a plan can be made to meet these needs. Encouraging a trainee to meet with you to discuss their personal development plan would be a good way to approach this. Allow additional time for supervision and mentoring at the beginning of a placement to facilitate this.
2. Identifying existing opportunities within that placement that might address the trainee’s learning needs. For example, if a trainee wishes to gain experience in case presentation it may be that trainees are already expected to present cases at clinical meetings or multidisciplinary team meetings and this could be used as a learning opportunity. It is important for a supervisor to share the departmental teaching opportunities with the trainee.
3. Work as a team. It is sensible to suggest that the trainee works with their peers to timetable in educational needs. For example, if there are certain days on a rota where more staff are available, take it in turns on those days to spend time on education such as clinic or theatre. This can then be reciprocated within the team ensuring fair working, and addressing educational needs.
4. If a trainee wishes or is required to go on specific courses, training days or exams ensure that the trainer and trainee are familiar with the study leave policy. If there are issues with providing study leave this could be addressed with the department and others as required.
5. Personal organisation skills and being proactive are helpful in maintaining this balance. Educational needs will always exist throughout one’s career. Ensuring that trainees take responsibility for their own learning is important. It might be appropriate for supervisors to support junior trainees to improve their personal organisation skills to ensure that their educational needs are met.
6. Networking and specific education focused roles. Often there are consultants or senior colleagues in a department who might be leads in research or teaching. Identifying this with your supervisor early on, and making contact with these individuals might be useful.
7. Finally, there are some roles which specifically allocate time for education such as academic fellowships and clinical fellowships in teaching or research and mentoring schemes. Trainees could be proactively looking for these and supervisors could also signpost trainees to these opportunities where possible.