Teaching and supervision skills for psychiatrists (MEQ)

(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]}