Supervision Structure

Supervision Structure

The BST Ophthalmology Programme provides structured supervision throughout training to support clinical development, patient safety and progressive independence.

Each trainee will have both an Educational Supervisor and Clinical Supervisors. These roles are complementary but have different responsibilities within the programme.

Educational Supervisor

Each trainee will be allocated a named Educational Supervisor for the training year.

The Educational Supervisor provides longitudinal oversight of the trainee's overall development and progression. The role extends beyond individual clinical rotations and provides continuity throughout the training year.

The Educational Supervisor will:

• meet with the trainee at appropriate points during the training year to review progress and learning objectives;

• review the trainee's portfolio, procedural and surgical logbooks and workplace-based assessments;

• review feedback and reports from Clinical Supervisors;

• monitor progress in clinical knowledge, surgical and procedural skills, professional development and other programme requirements;

• review participation in teaching, audit and quality improvement, research and other professional activities;

• identify areas requiring further development and agree appropriate learning objectives;

• provide guidance and support where difficulties or concerns arise; and

• contribute to the trainee's annual review and progression assessment.

The Educational Supervisor should therefore have an overview of the trainee's development across the programme rather than within a single rotation.

Clinical Supervisor

A Clinical Supervisor will oversee the trainee's clinical development during an individual rotation or defined period of training.

Clinical Supervisors work directly with trainees in the clinical environment and are well placed to assess day-to-day performance, including clinical judgement, practical and surgical skills, communication, professionalism and increasing independence.

Clinical Supervisors are expected to:

• provide appropriate clinical supervision according to the trainee's level of competence;

• provide regular feedback during the rotation;

• facilitate appropriate clinical, procedural and surgical learning opportunities;

• contribute to workplace-based assessments where appropriate;

• identify strengths and areas requiring further development;

• raise concerns promptly where patient safety, professional conduct or trainee progression may be affected; and

• complete an End-of-Rotation Clinical Supervisor Report summarising the trainee's performance and progress.

Clinical Supervisor reports form part of the evidence considered by the Educational Supervisor and during the trainee's annual progression review.

Progressive Independence

Supervision should evolve as the trainee develops.

Early in training, trainees will generally require closer direct supervision. With demonstrated competence, appropriate professional behaviour and increasing experience, trainees should progressively undertake clinical and surgical activities with greater independence.

Progression to reduced supervision is competency-based rather than determined by case numbers or time in training alone. Procedural numbers provide important evidence of experience but do not, by themselves, demonstrate competence.

The level of supervision should always be appropriate to the trainee's demonstrated ability, the complexity of the clinical situation and patient safety.

Trainee Responsibility

Supervision is a shared process. Trainees are expected to take an active role in their own development by seeking feedback, arranging required assessments, maintaining their portfolio and logbooks, identifying learning needs and discussing difficulties or concerns with their supervisors at an early stage.

The overall aim is to provide supportive, consistent supervision while allowing increasing responsibility and independence as competence develops.