Supervisor Report

Registrar details	Training post
Name	Name
Commencement date	Address
Placement dates	FTE	State	Post code
Start date	Supervisor name
End date	Date of report

1.	About this report

The purpose of the report is to provide guidance to the registrar on their progress and to provide a basis for constructive and meaningful discussion and specific feedback. This report is based on progression indicators described in the Core Generalist competency standards. (see the Rural Generalist Curriculum pg. 12 to 21 for full details)

The report must be completed by the supervisor and provides an opportunity for the registrar to complete a self-assessment. This report is to be reviewed by the medical educator at the mid-point and or end point each semester.

2.	Instructions for Supervisors

The Core Generalist competency standards describe the indicators of levels of increasing progression and performance in rural generalist skills, knowledge and professional attributes. In reference to competencies for each relevant domain and your observations – select the level of progression and performance the registrar has demonstrated during their placement

Please complete and discuss the report with your registrar. Use your observations and this report to provide feedback to assist with developing training and learning plans and or additional support if required.

Note the registrar self- assessment is optional, if it is completed consider this in your feedback.

Finally provide comments for the registrar's overall progression and performance during the term of the placement. Consider the registrar's level of training when providing feedback on their overall performance

Please note that the outcomes and a summary of this report may be provided to the registrar's subsequent supervisors on confirmation of their next placement to inform and support ongoing training and development.

Once completed please send this report to your regional training team. Emails details are at the bottom of the report.

3.	Instructions for Registrars

Refer to the Core Generalist competency standards and indicators below and consider your personal strengths, areas where you could benefit from additional experience, and the appropriate ways in which you could gain experience.

You have the option to complete the self-assessment for each domain and assign a rating for reflection and discussion with your supervisor to assist with planning your training, learning and or additional support if required.

Once the report is completed it is important that you meet with your supervisor to discuss the outcome of this report.

Outcomes and a summary of this report may be provided to your subsequent supervisors on confirmation of your next placement to inform and support ongoing training and development.

4.	The Core Generalist Competency Standards

Please choose the domain you require:

Domain 1 – Provide expert medical care in all rural contexts

Domain 2 – Provide Primary Care

Domain 3 – Provide Secondary Medical Care

Domain 4 – Respond to Medical Emergencies

Domain 5 – Apply a Population Health Approach

Domain 6 – Work with Aboriginal, Torres Strait Islander and other culturally diverse communities to improve health and wellbeing.

Domain 7 – Practice medicine within an ethical, intellectual and professional framework

Domain 8 – Provide safe medical care while working in geographic, social and professional isolation.

Domain 1 – Provide expert medical care in all rural contexts

Competencies	Beginning	Progressing	Achieved
Establish a doctor-patient relationship Use a patient centred approach to care Diagnose and manage common and important conditions in rural primary, secondary and emergency settings Obtain a relevant and focused history using a logical and structured approach Perform an appropriate physical examination, across all age groups, Appropriately order, perform and interpret investigations Ensure safe & appropriate prescribing of medications and non-pharmacological treatment options Formulate an appropriate management plan, incorporate specialist practitioner’s advice or referral where applicable Demonstrate commitment to teamwork, collaboration, coordination and continuity of care Provide patient care in the home, nursing home and other sites away from the main health care service	Creates a non-judgmental, safe environment Identifies patient ideas, concerns and expectations through verbal cues Identifies barriers to communication Synthesises clinical information to generate a ranked problem list containing appropriate provisional diagnosis Takes a history of the presenting complaint with an appropriate review of systems, using biopsychosocial model Conducts an appropriate physical examination Identifies when physical examination signs are inconsistent with the history Selects, requests and can justify investigations in the context of a patient presentation Identifies key factors to consider when choosing most effective treatment Understands the roles of team members and participates as a respectful and effective team member	Effectively builds rapport with patients and families Engages patient in shared decision making Matches modality of communication to patient needs, health literacy and context Develops with the patient effective diagnostic and managements plans and communicates these. Refines diagnostic skills Takes a relevant, focused history of the presenting complaint with an appropriate review of systems, using biopsychosocial model Conducts a relevant and focused physical examination Judiciously orders investigations Knows referral networks & how to arrange Engages the appropriate team to provide safe, efficient, effective patient centred care Sustains appropriate respectful relationships with team members. Communicates effectively with health care team	Connects with patients and families in a manner that fosters respect and understanding, including the ability to manage conflict Effectively communicates difficult information, such as end of life discussions, delivery of bad news, and acknowledgement of errors Provides patient with most plausible diagnoses based on evidence gathered Negotiates individual evidence-based management plan, considering impact of the condition and proposed management on the patient's lifestyle/function. Integrates comprehensive but focused history of presenting problem into consultation Conducts relevant examination in organised, logical and efficient manner, including all key differentials Judiciously orders investigations with patient explanation. Reviews and revises own patterns of prescribing to improve quality and safety Arranges referrals in concert with the patient and/or carer considering the balance of potential benefits, harms and costs Provides leadership and participates as a respectful team member with local and distant teams
Registrar Rating (Optional)	Not Applicable	1	2	3	4	5	6
Supervisor Rating	Not Observed	1	2	3	4	5	6

Domain 2 – Provide Primary Care

Competencies	Beginning	Progressing	Achieved
Apply diagnostic reasoning to undifferentiated health problems in an un-referred patient population Provide patient care across the lifespan Manage common presentations & conditions Provide longitudinal care Perform primary care procedures Effectively manage time pressure Provide continuous, consistent & coordinated chronic disease management Undertake preventive activities Provide cost conscious care Provide general & specific health checks and medical assessments	Describes the risks of managing patients with undifferentiated health problems Knows when to seek help from supervisor Gains skills in working with patients of different ages Developing skills in managing the most common presentations and conditions Understands the difference between episodic and longitudinal care Recognises the contributing factors to time pressure Follows established management plans and contributes to shared health summaries Describes protocols for screening and immunisation Knows how to access the Medical Benefits Schedule (MBS) and Pharmaceutical Benefits Schedule (PBS) Knows the relevant local and regional patient support processes Identifies cost implications for patient of treatment options	Develops management plans that support the early identification of evolving conditions Communicates uncertainties to the patient Manages common conditions in all age groups Consults with and refers to specialist medical services as appropriate Develops longitudinal care plans for important conditions Manages most typical procedures independently and seeks help when required Manages a patient consultation in an effective and time efficient manner Develops individualised management plans for patients with chronic conditions Implements screening and immunisation Uses and interprets the MBS and PBS Provides clear and timely information to patients on cost implications and support processes	Develops management plans for patients with long-term undifferentiated concerns Proficient in managing common and less common presentations and conditions in primary care Knows when and where to seek further help or to refer when additional, secondary and/or tertiary care is required Provides longitudinal care that is holistic, dynamic and integrated Manages all procedures safely, and effectively Manages varying degrees of patient needs in a highly efficient manner Develops and implements management plan for patients with multiple chronic conditions in consultation with patient Facilitates patient’s and family’s self-management of their chronic conditions Integrates prevention & health promotion seamlessly into the ongoing care of all patients Integrates patient needs, financial capabilities and support systems
Registrar Rating (Optional)	Not Applicable	1	2	3	4	5	6
Supervisor Rating	Not Observed	1	2	3	4	5	6

Domain 3 – Provide Secondary Medical Care

Competencies	Beginning	Progressing	Achieved
Manage common conditions requiring inpatient care Maintain a clinically relevant plan of fluid, electrolyte and blood product use Perform secondary care procedures Recognise and respond early to the deteriorating patient Communicate effectively with healthcare team, including effective handover Anticipate and judiciously arrange safe patient transfer Undertake early discharge planning, involving the multi-disciplinary team	Participates in the secondary care of patients Modifies orders in consultation Performs procedures under supervision Orders appropriate procedures Recognises the key signs and symptoms of a deteriorating patient Seeks assistance early Documents effective handover plans Assists in the preparation and transfer of patients Implements discharge arrangements as directed	Develops & implements secondary care management plans for common conditions Consults with colleagues Performs most procedures independently Seeks assistance when required Identifies patients at risk of deterioration and escalates level of observation Consults with colleagues to adjust treatment Describes the key elements required for effective clinical handover Identifies patients who require transfer Works with colleagues to arrange transfer Participates in multidisciplinary discharge planning	Develops, implements, monitors & modifies secondary care management plans Seeks assistance from colleagues as required especially for complex cases Performs essential procedures in the logbook independently Anticipates and identifies patients at risk of deterioration early and escalates accordingly Makes decisions about patient transfer with consideration of clinical indications, service capabilities, patient preferences, transportation and geography. Arranges transfer and prepares patient appropriately Coordinates multidisciplinary discharge planning
Registrar Rating (Optional)	Not Applicable	1	2	3	4	5	6
Supervisor Rating	Not Observed	1	2	3	4	5	6

Domain 4 – Respond to Medical Emergencies

Competencies	Beginning	Progressing	Achieved
Recognise severe, acute & life- threatening conditions & provide initial resuscitation & stabilisation Provide definitive emergency management across the lifespan in keeping with clinical need, own capabilities, local context and resources Perform emergency procedure Interpret common pathology, imaging and other diagnostic modalities Activate or support emergency patient retrieval, transport or evacuation when needed Provide inter-professional team leadership in emergency care Utilise assistance and/or guidance from other specialist practitioners and services as required	Recognises & effectively assesses acutely ill, deteriorating or dying patients Supports a colleague to stabilise patient Gathers essential information, generates differential diagnosis, and seeks assistance Implements Basic Life Support Reads and interpret pathology & imaging reports Identifies and manages risks prior to and during patient transfer Understands the need to gain assistance from colleagues and other service providers	Stabilises emergency presentations with support of an experienced colleague onsite Gathers essential information and generates differential diagnosis Understands more complex pain management and alternative routes of administration. Assists in preparing patients for transfer Participates in an inter- professional team to implement advanced life support for children and adults Describes the process required to gain assistance from colleagues and other health care providers to assist patient management	Recognises, provides and coordinates care for acutely ill patients within local community Stabilises emergency presentations with support of an experienced colleague onsite or off site if required Develops and implements appropriate diagnostic and therapeutic management plans for common acute conditions Arranges appropriate transitions of care Provides simple procedural sedation and simple nerve blocks Coordinates preparation of patients requiring transfer Leads an inter-professional team to implement advanced life support for children and adults
Registrar Rating (Optional)	Not Applicable	1	2	3	4	5	6
Supervisor Rating	Not Observed	1	2	3	4	5	6

Domain 5 – Apply a Population Health Approach

Competencies	Beginning	Progressing	Achieved
Analyse the social, environmental, economic and occupational determinants of health Describe the local community profile Apply a population health approach Integrate evidence-based prevention, early detection and health maintenance activities at a population level Fulfil reporting requirements in relation to statutory notification of health conditions Participate in disaster planning & implementation & post incident analysis & debriefing	Identifies information sources to assist in understanding the local community Identifies local and regional sources of community profile data Advocates for healthy lifestyles and explains environmental & lifestyle risks to health. Evaluates the positive and negative aspects of health screening and prevention when making healthcare decisions Is aware of individual and systemic reporting requirements in relation to statutory notification Is aware of disaster plans in the region	Investigates the key social, environmental, economic and occupational determinants of health Collates and synthesises appropriate data to describe the local community profile Accesses and collaborates with agencies responsible for key population health functions including public health services, employer groups and local government Advocates for patients to ensure equitable access to healthcare Seeks to improve health care systems Implements individual and national population-based screening activities in the consultation; motivates patients to participate Is prepared to act according to disaster plan if required	Analyses the social, environmental, economic and occupational determinants of health Presents and explains the implications of the local community profile Monitors population health trends and recognise ‘red flags’ that require action Actively participates in local community and regional groups and forums to advocate in the design, implementation and evaluation of interventions Integrates evidence-based prevention, early detection and health maintenance activities at a systems level Actively contributes to disaster planning with reference to previous post-incident analyses Collaborates with others to implement disaster planning Facilitates and actively contributes to post-incident analysis and debriefing
Registrar Rating (Optional)	Not Applicable	1	2	3	4	5	6
Supervisor Rating	Not Observed	1	2	3	4	5	6

Domain 6 – Work with Aboriginal, Torres Strait Islander and other culturally diverse communities to improve health and wellbeing.

Competencies	Beginning	Progressing	Achieved
Understands diverse local health practices and their benefits for communities Applies principles of partnership, community ownership, consultation, capacity building, reciprocity and respect to health care delivery, health surveillance and research Deliver culturally safe care to Aboriginal and Torres Strait Islander peoples and other cultural groups	Knowledge of health practices of Aboriginal & Torres Strait Islander peoples & other cultural groups Behaves in a manner that acknowledges the impact of cultural, ethnic, spiritual, social, and economic factors on health Has knowledge of the barriers to access and the social & cultural determinants of health Reflects on own assumptions, cultural beliefs & emotional reactions in providing culturally safe care Behaves in a manner that acknowledges the impact of cultural, ethnic, spiritual, social, and economic factors on health Knows how to find an interpreter and key community contacts	Growing knowledge of health practices and their benefits Learns about the community and its resources, strengths and vulnerabilities Participates in activities to improve outcomes of care Identifies own cultural values that may impact on his/her role as a doctor. Identifies own cultural norms and the impact that this may have on interactions with the community	Sound knowledge of health practices and benefits for communities Works alongside culturally diverse groups to address health issues Delivers culturally safe care considering their own cultural values and those of different cultural groups Reflects and seeks feedback on own provision of culturally safe care Engages interpreters and community contacts as appropriate
Registrar Rating (Optional)	Not Applicable	1	2	3	4	5	6
Supervisor Rating	Not Observed	1	2	3	4	5	6

Domain 7 – Practice medicine within an ethical, intellectual and professional framework

Competencies	Beginning	Progressing	Achieved
Works within relevant national and state legislation & professional guidelines Keeps clinical documentation in accordance with legal & professional standard Manages, appraises & assesses own performance Participates in quality & safety improvement & risk management activities Teaches & supervises others Recognises & responds to unprofessional behaviour & signs of the practitioner in difficulty Provides leadership Critically appraises and applies relevant research	Behaves in a way that acknowledges the ethical complexity of practice & follows professional & ethical codes Uses a structure to ensure that consultation notes are clear and complete Consults with colleagues about ethical concerns and accepts responsibility for ethical decisions Reports errors if they occur Identifies appropriate channels to report unprofessional behaviour Identifies key qualities of positive leadership in professional practice Acknowledges and seeks to address gaps in knowledge and expertise Participates in research and quality improvement activities	Makes ethical decisions and accepts responsibility for decisions made Records concise, with enough information on a patient consult to allow others to follow. Demonstrates an understanding of patient competency and shared decision making Recognises, documents and manages adverse events and near misses Participates in quality improvement activities Plans, develops & conducts teaching Reports unprofessional behaviour using appropriate reporting procedures Reflects and develops own ability to provide leadership Seeks feedback from others Critically appraises information	Appreciates the legalities of caring for patients who cannot consent Establishes and reviews processes to improve safety Undertakes regular audit and improvement activities Facilitates institutional quality and safety improvement and risk management activities Works with peers and juniors to identify learning needs and develop and deliver an appropriate teaching session Develops own ability to identify and support practitioners in difficulty Provides positive leadership in professional practice
Registrar Rating (Optional)	Not Applicable	1	2	3	4	5	6
Supervisor Rating	Not Observed	1	2	3	4	5	6

Domain 8 – Provide safe medical care while working in geographic, social and professional isolation.

Competencies	Beginning	Progressing	Achieved
Demonstrates resourcefulness, independence & self-reliance Develops & applies strategies for self-care, personal support & caring for family Establishes a community network while maintaining appropriate boundaries Establishes, maintains & uses professional networks Provides safe, effective care when away from ready access to specialist medical, diagnostic & allied health services Uses information & communication technology Identifies & acquires skills to meet health care needs of the local population	Participates in the provision of care away from other medical services Behaves in ways which acknowledge the professional responsibilities relevant to his/her health care role Describes the issues around providing care to self, family and colleagues Seeks support and information from supervisors and colleagues Understands the factors that contribute to safe, effective provision of care when working in professional isolation Is aware of own limitations and seeks assistance appropriately Knows how to use the information and communication technology Commits to acquisition of knowledge required to care for the local community	Learning resourcefulness when working with others in a rural or remote setting Respects local community norms and values in own life and work practices Starts to identify a support network outside the training program Considers own expertise, local resources, support and transport when providing care Recognises and manages conditions more commonly found in rural environments with support from supervisors Collaborates with colleagues to use information and communication technology to provide medical care or to facilitate access to specialised care for patients Developing skills and knowledge in response to community needs	Independently provides effective clinical care when distant from medical services Considers continuity of care and importance of long-term doctor patient relationship in small town context. Has developed an ongoing support network Recognises and manages conditions more commonly found in rural environments Independently uses information and communication technology to provide medical care or to facilitate access to specialised care for patients Developed skills and knowledge in response to community needs
Registrar Rating (Optional)	Not Applicable	1	2	3	4	5	6
Supervisor Rating	Not Observed	1	2	3	4	5	6

Professionalism

Professional Attributes and Behaviours	Consistent	Sometimes	Comments
Punctuality	Arrives on time for meetings, appointments, and deadlines.
Responds to communications within expected timeframes.
Respectful Communication	Uses courteous language in all forms of communication.
Listens actively and avoids interrupting.
Avoids sarcasm, offensive jokes, or dismissive tones.
Accountability	Takes responsibility for tasks and outcomes.
Admits to mistakes and takes steps to correct them.
Completes tasks without the need for constant supervision
Integrity	Acts in accordance with ACRRM values and ethical standards.
Avoids conflicts of interest and declares them when they arise.
Does not falsify or misrepresent information.
Reliability	Meets commitments.
Follows through on promises and obligations.
Constructive Feedback and Conflict Resolution	Accepts feedback without defensiveness.
Manages disagreements professionally and seeks resolution.
Initiative and Self-Management	Demonstrates motivation without needing to be prompted.
Manages time and priorities effectively.

Overall rating and summary

Supervisor to complete:

Please provide overall feedback on progress and performance during the placement. Consider the registrars’ ability to practice safely, work with increasing levels of independence, application of existing knowledge and skills and reflective practice appropriate to their individual training level i.e. PGY 3 - 1st primary care term.

Overall rating
3	The registrar has demonstrated good performance for their stage of training
2	The registrar has demonstrated adequate performance for their stage of training
1	The registrar has demonstrated inadequate performance for their stage of training
Comments

Confirmation

Registrar

I confirm that I have met with my supervisor and have discussed the outcome of this report and
understand that a summary of this report will be made available to my future supervisor/s.

Registrar signature	Date

Supervisor

I confirm that I have met and discussed my feedback and the outcome of this report with the registrar. And understand that a summary of this report will be available to future supervisor/s

I confirm that I have reviewed the CGT Logbook with the registrar

Please tick if you would like to be contacted to provide additional feedback.

Supervisor signature	Date

Case Log Clinical Supervisor Only:

I confirm that I am the clinical supervisor and have reviewed and endorsed procedures in the: (please tick all that apply):

Case Log Obstetrics Case Log Paediatrics Case Log Anaesthetics

Supervisor signature	Date

Thank you for taking the time to complete this report now it is time to send this report to your regional training team at:

New South Wales	Training.nswact@acrrm.org.au

Northern Territory	Training.nt@acrrm.org.au

Queensland	Training.qld@acrrm.org.au

South Australia	Training.sa@acrrm.org.au

Tasmania	Training.tas@acrrm.org.au

Victoria	Training.vic@acrrm.org.au

Western Australia	Training.wa@acrrm.org.au

ACRRM STAFF - Office Use Only

ACRRM Officer

Acknowledge and log recipient of the report and notify the TPA and Medical Educator.

Medical Educators

Review the report in line with the individual registrar's level of training and identify any competencies not observed including identified ways for the registrar to gain experience or additional learning to address any gaps.

Discuss with the registrar their overall progression and performance during the term of the placement.

Manage expectations

Acknowledge and celebrate success

Identify any additional experience or learning is required

Set progression goals and develop a learning plan as required

Medical Educator must ensure that the registrar is aware of any identified risk of delayed-progression and where appropriate work with the registrar to develop a learning plan to address these gaps/needs.

Where it is identified that additional support or a remediation program may be required, this must be discussed with the registrar and escalated so that an approved plan is developed, agreed and implemented.

Medical Educator: I confirm that I have reviewed the report and discuss the outcome with the registrar.

Name	Date