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Clinical Atlas Prestige · Evidence-first

Psych MEQs / SAQsProfessional — teaching and supervision skills

Psych MEQs / SAQs · Professional — teaching and supervision skills

Teaching and supervision skills for psychiatrists (MEQ)

FRANZCP-style MEQ on teaching/supervision definitions, Miller pyramid, WBA, feedback models, underperformance safety plan, and failure-to-fail.

20 marks20 min
On this page & tools

Target exams

FRANZCPMRCPsychABPNMD-DNB

Target exams

FRANZCPMRCPsychABPNMD-DNB
Prompt
You are the educational supervisor for a second-year psychiatry registrar. Over eight weeks, nursing staff report incomplete risk documentation after self-harm assessments, and a mini-CEX shows a disorganised MSE. The registrar is likeable, works hard, and previous supervisors rated them as 'satisfactory' without written concerns. Tomorrow they are rostered to cover the emergency psychiatry list independently overnight. (i) Distinguish educational supervision, clinical (case) supervision, and clinical teaching, and name the three Proctor-style supervision functions. (ii) Map the concerns to Miller's pyramid and outline how you would use workplace-based assessment educationally. (iii) Outline a feedback conversation using Ende principles and/or R2C2. (iv) State your immediate plan for overnight cover and for remediation if needed, including failure-to-fail risks. (v) Name four landmark literature anchors relevant to supervision, feedback, assessment, or remediation. (20 marks)

Model answer

Reveal model answer

(i) Definitions and functions. Clinical teaching is intentional facilitation of learning in authentic care settings. Educational supervision supports longitudinal curriculum progress, goals, and appraisal. Clinical (case) supervision focuses on formulation, risk, and care of specific patients. Proctor-style functions: normative (standards and patient safety), formative (skill development), restorative (support and wellbeing). Effective supervisors flex across all three.[1][2]

(ii) Miller and WBA. Incomplete risk documentation and disorganised MSE are workplace Does-level concerns (or at least failures of observed performance toward Does), not merely MCQ knowledge gaps. Use WBA educationally: further direct observation (mini-CEX/CBD-type encounters), specific feedback, sampling across cases, and learning plan against outcomes — not tick-box alone.[3][4]

(iii) Feedback. Private, expected conversation. Use first-hand data (named mini-CEX findings; specific documentation examples). Describe remediable behaviours. Explore reactions (R2C2: relationship → reaction → content → coaching). Agree concrete goals (structured MSE checklist; mandatory suicide enquiry fields; observed reassessments). Avoid character attack and public humiliation.[5][6]

(iv) Immediate safety and remediation. Independent overnight emergency cover is high risk given current data. Increase supervision / restrict independent high-risk duties until competence is re-demonstrated; arrange senior backup. Document objective concerns now — previous uncritical “satisfactory” ratings illustrate failure-to-fail risk. Remediation: needs analysis, targeted plan (deliberate practice of MSE and risk), resources, reassessment timeline, educational supervisor governance. Screen for illness/systems factors in parallel.[7][8][2]

(v) Literature anchors. Kilminster supervision reviews/AMEE Guide 27; Miller pyramid; Norcini WBA guide; Ende feedback; Sargeant R2C2; Yepes-Rios failure-to-fail BEME; Hauer remediation review.[1][2][3][4][5][6][7][8]

Common errors

Allowing independent overnight cover despite safety signals; vague “try harder” feedback without behaviours; failure-to-fail from likeability; inventing college form codes; equating knowledge with workplace performance; public shaming; ignoring restorative support while only punishing.[5][7]

References

  1. [1]Kilminster SM, Jolly BC Effective supervision in clinical practice settings: a literature review Med Educ, 2000.PMID 11012933
  2. [2]Kilminster S, Cottrell D, Grant J, Jolly B AMEE Guide No. 27: Effective educational and clinical supervision Med Teach, 2007.PMID 17538823
  3. [3]Miller GE The assessment of clinical skills/competence/performance Acad Med, 1990.PMID 2400509
  4. [4]Norcini J, Burch V Workplace-based assessment as an educational tool: AMEE Guide No. 31 Med Teach, 2007.PMID 18158655
  5. [5]Ende J Feedback in clinical medical education JAMA, 1983.PMID 6876333
  6. [6]Sargeant J, Lockyer J, Mann K, et al. Facilitated Reflective Performance Feedback (R2C2) Acad Med, 2015.PMID 26200584
  7. [7]Yepes-Rios M, Dudek N, Duboyce R, et al. The failure to fail underperforming trainees in health professions education: A BEME systematic review Med Teach, 2016.PMID 27602533
  8. [8]Hauer KE, Ciccone A, Henzel TR, et al. Remediation of the deficiencies of physicians across the continuum from medical school to practice Acad Med, 2009.PMID 19940595