10 Min In Practice
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Pre-reg tutors are now known as designated supervisors – and it is not just their name that has changed.
In January 2021 the GPhC introduced new standards for the initial education and training (IET) of pharmacists. This included replacing the pre-registration year with a ‘foundation training year’ encompassing on-the-job, practical training in clinical settings, enabling trainees to build on and apply their pharmacy knowledge and previous experience in preparation for registration.
What makes a good supervisor?
A supervisor’s job is to guide the trainee through their foundation training year. This calls for good communication, empathy, role modelling, teaching and assessment skills, as well as the ability to provide constructive feedback.
An important role for supervisors is to certify that their trainee has met all of the GPhC’s learning outcomes and completed their training to a satisfactory standard – so the ability to review evidence and make an objective judgement is key.
While any pharmacist with at least three years’ practical experience in their sector can apply to become a supervisor, there are certain attributes that make some people more suitable for the role than others.
“The most important characteristic is enthusiasm”, says Mark Donaghy, professional development manager for Kamsons Pharmacy, who has managed the recruitment and training of hundreds of pre-reg pharmacists over the last 17 years. “You’ve got to want to do it,” he says. “There is nothing worse for a trainee pharmacist than to have a pharmacist supervisor who doesn’t want to be training them.”
For Aadil Mitha, learning and development lead at Knights Pharmacy, there are several additional elements. “A good supervisor is somebody who leads by example in their day-to-day work and is a positive role model at all times,” he says. “They also have to be able to give constructive in-the-moment feedback and advice to their trainee, as well as having time to sit with them and give more detailed feedback to help them progress and learn.
“Secondly, good supervisors are able to actively impart their clinical and professional knowledge while taking the time to understand the learning needs of their student. Everyone is receptive to different types of learning triggers.”
Creating a structured plan
As well as being a source of advice and support for their trainee pharmacists, supervisors should underpin their growth and professional development through a well-planned training programme.
“It is crucial to create a training plan as soon as the foundation year starts as this provides the structure for the next 12 months”, says Gail Fleming, director for education and professional development at the Royal Pharmaceutical Society. “This should be a collaborative exercise, fully involving the trainee pharmacist.”
There are several key milestones throughout the training year and while some organisations and employers have their own training plan templates, it makes sense to map out the structure of the year in three-month blocks aligned to progress reviews. “Use the GPhC IET standards to help you with this,” advises Fleming.
Noma Al-Ahmad, managing director of training provider ProPharmace, is responsible for overseeing around 500 trainee pharmacists across training sites in community pharmacy and primary care. She is also programme director for Health Education England’s practice and educational supervisor training schemes.
Her advice for supervisors creating a structured training plan is to get familiar with the learning outcomes that trainees are expected to meet, and map out tasks to them accordingly. “Fitting in everything that needs to be covered will require careful planning as well as ensuring you allow room for flexibility and adjustments, involving trainees in their training plan from the outset.”
She suggests the following essential elements to include in a training plan:
- An induction
- Time to complete progress reviews
- Review meetings (at least every two weeks)
- Placements in other areas of practice providing exposure to different services
- Multidisciplinary working or other identified learning opportunities
- Projects such as quality improvement studies or audits
- Training workshops or study events
- Learning objectives/tasks mapped to learning outcomes and/or the registration assessment framework
- Supervised learning events (work-based assessments)
- Appropriate learning resources
- Team members involved in supporting the trainee’s learning
- Learning assessments.
As well as working towards the registration assessment at the end of the foundation training year, an important aspect of the experience is for trainees to take ownership of their own work. It is the responsibility of supervisors to facilitate this.
“The GPhC requires the supervisor to sit with the trainee pharmacist every 13 weeks to do a progress report, which can be called up by the GPhC at any time,” says Aadil Mitha. “It is therefore important that supervisors delegate relevant and suitable tasks to their trainee to help with their development and gauge their competencies in various areas of practice.”
“Supervisors should make sure they put aside some time for developing their own skills including giving feedback”
A trainee's perspective
Bella Shah is the current president of the British Pharmaceutical Students Association, and as a trainee pharmacist in community pharmacy she has experience of being on the receiving end of supervision.
Her advice for everyone involved is that: “Communication throughout the year is key. Set out expectations, talk about challenges, reflect regularly and ask lots. Sharing knowledge and experiences is a powerful learning tool, including between trainees in different settings. However, it is important to consider that every trainee will be different and benefit from different styles of learning, which supervisors should try to accommodate for.
“Likewise, for trainees, don’t worry about what other trainees are doing, it is about doing what works best for you, at your own pace. It is about competence and confidence, not about competing.”
Giving feedback and assessment
Feedback is vital in order for trainees to learn from their experiences. Gail Fleming says it is essential that supervisors make time to provide feedback at regular points during the tutoring period and not just wait for the regular scheduled review meetings.
While there is not one specific process or format for providing feedback, Fleming suggests supervisors could use a structured model such as GROW, which is often used in mentoring and coaching when giving feedback. “It will help the supervisor and their trainee to focus on their Goals, the Reality [of] what is going on at the moment, and then their Options, and their Will and Way forward.”
Nicola Tyers, Director of The Pharmacy Training Company, says: “I always recommend using Pendleton’s feedback model, as this has seven easy steps that empower a trainee to develop insight and identify for themselves what has gone well and where there is room for improvement.
“If they are struggling to see where the issues are, then this may be because they struggle to have insight into their performance – and this needs fixing first.”
Whatever model a supervisor chooses to follow, it is important that feedback is constructive, based on evidence, is specific and encourages reflection on practice. This can be done by using open questions, encouraging the trainee to comment on the feedback given, and asking them if they have a solution.
Feedback should also be two-way, so the student can say if they felt their supervisor could have done something differently. “A good supervisor will not just give feedback to the trainee on the areas where they have performed well and not so well in the last week, alongside a target on how to improve for the next week,” says Mark Donaghy. “They will ask their trainee for the same feedback on how they are doing as a learning supervisor.”
More top tips
As well as focusing on their trainees, supervisors should also keep an eye on their own personal training and development.
“Just because someone is a good pharmacist doesn’t mean they will find the role of an educational supervisor an easy one”, says Nicola Tyers. “They should make sure they put aside some time for developing their own skills as well, around coaching and giving feedback and assessment as a minimum. They should also link up with other educational supervisors, either in person if local or online.”
Mark Donaghy’s advice is that supervisors may need to modify their teaching style for their trainee. “Before [the] Oriel [recruitment portal], we used to interview candidates and match them up with a tutor who had a similar teaching style to the trainee’s learning style,” he says. “However, now that students are allocated by Oriel to training sites, there can be a mismatch in personalities between supervisor and trainee.
“There is nothing worse for a foundation year trainee to have an enthusiastic supervisor firing questions off at them if they are the type of person that hates being put on the spot. Likewise, some trainees give feedback that they wish their supervisor had asked them more questions. Everyone is different,” as he points out.
Pitfalls to avoid
With so many variables in any supervisor-trainee relationship, there are bound to be some bumps in the road – but there are also obvious pitfalls that can be avoided.
Nicola Tyers says one pitfall is thinking that the trainee is a spare pair of hands and can simply help fix any staffing problems. “Trainees need their supervisor’s time and support. Without this, it is likely that both will be unhappy with the relationship.”
As all sorts of scenarios can occur during the foundation year, Aadil Mitha’s advice is to “address things when they happen. When students hit a roadblock it is the supervisor's role to guide them to where they need to be.”
What to do when things go wrong
Supervisors should foster a culture where trainees feel empowered to express their concerns as well as encouraging them to demonstrate leadership where possible, so both sides feel on the same team.
If things do go wrong, Aadil Mitha says communication is the key: “The main thing is – don’t panic, don’t stress and make sure you communicate openly and honestly about everything. Generally speaking a solution is almost always available.”
The advice from Nicola Tyers is to always write a log of what is happening. “If it is not written down, it didn’t happen,” she says. “Keep it factual and maintain a chronology of what has happened.”
Supervisors finding they need additional support themselves – for example, when helping a trainee in difficulty – can always call on their colleagues or training provider for help.
“Remember you are not alone when supervising a trainee,” says Noma Al-Ahmad. “Training providers will have a lot of experience in dealing with such scenarios and they should be the first point of contact for advice and support.”
If the issue cannot be resolved, Mark Donaghy of Kamson’s Pharmacy says a change of training site may be the solution, but stresses that “unless a change is made within the same company, training can only be ‘banked’ with the GPhC in blocks of thirteen-weeks.”
Gail Fleming did just this in an early experience as a pre-registration tutor in hospital pharmacy, supporting a trainee who was struggling to undertake some of the core clinical and dispensing tasks accurately.
“We agreed a development plan to support her and provided additional support in the dispensary environment,” she says, “but despite these additional measures things were not improving. Eventually we had to make the difficult decision to extend the training year. As part of this we moved the trainee to a different setting working with a different team.
“We found that the change of environment made a real difference and removed some of the stress that the trainee was feeling. This was a real good news story as the trainee went on to achieve all of the standards and successfully registered as a pharmacist.”
Key dates for the foundation training year can be found the GPhC website, which is updated regularly.
March 1 was the deadline for submitting adverts to appear on Oriel for the 2023-24 training year. You can still advertise elsewhere if you have missed the Oriel deadline.
April 1 is the deadline for submitting a training plan aligned to the new learning outcomes to the GPhC.
The professional bodies provide a range of resources for foundation trainees to support their learning and development, which are also helpful for supervisors.
- This educational series is financially supported by Accord UK, who have been given the opportunity to review the articles to ensure they meet requirements set out by the Association of the British Pharmaceutical Industry (ABPI Code of Practice) before submission. Any resulting changes were made at the expert reviewers’ and editor’s discretion.
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In Practice
We know you want to continue to build on your practice, why not hear from others in the sector striving to do the same.