Supervision of junior doctors

At the early registrar level it is expected that a prevocational doctor will have acquired the skills, knowledge and behaviours to competently supervise junior doctors.

This task describes a number of activities, as below, where proficiency should be achievable by the end of PGY3.  The doctor is encouraged to download the key clinical task guidelines and seek the support of his/her supervisor for feedback on performance. Updated key clinical tasks will be available soon for download.

  • Lead on ward round
  • Manage/supervise delegated tasks, e.g. review at bedside, depending on course of treatment
  • Assist with queries/procedures
  • Check documentation, e.g. progress notes; clear, correct drug chart
  • Plan discharge arrangements, e.g. home supports, appointments, documents

Related Competencies:

Collaboration and teamwork

Establish respectful good working relationships with team members and other healthcare professionals

Collaboration and teamwork

Recognise the roles and responsibilities of other professionals within the healthcare team; respect and listen to their concerns about the patient
Communication

Accurately document medicine prescription, calculations and administration, using recommended terminology, including symbols and abbreviations
Communication

Demonstrate high-quality written skills to communicate clinical reasoning, e.g. write case notes legibly, concisely and informatively
Communication

Attend to clarity, structure and appropriate content for specific correspondence, e.g. handover notes and investigation requests
Communication

Use electronic resources in patient care, e.g. to obtain results, populate discharge summaries, access medicines information and maintain health records
Communication

Gather information from a variety of sources and use it to ensure continuity of patient care, e.g. referral letters, case records, test results, electronic information
Health advocacy

Is courteous and compassionate to all patients, without discrimination, regardless of a patient’s chosen lifestyle, e.g. discuss options, offer choices
Health advocacy

Recognise the interaction between mental, physical and social wellbeing in relation to health
Health advocacy

Demonstrate awareness of the cultural diversity and requirements of patients
Judgement and clinical decision making

Use available evidence effectively and efficiently to inform clinical decision making
Judgement and clinical decision making

Use basic algorithms and decision trees to manage common problems
Judgement and clinical decision making

Recognise personal limitations and ensure appropriate supervision
Leadership and management

Respond positively to direction
Leadership and management

Identify and follow patient care protocols, for example:
Medical expertise

Manage common conditions
Professionalism

Recognise discrimination, sexual harassment and bullying issues and know the hospital response requirements for such issues

Professionalism

Maintain an appropriate standard of professional practice and work within personal capabilities
Professionalism

Treat colleagues and other health care workers with respect
Scholarship and teaching

Assist with training of medical students in clinical examination and simple skills
Technical expertise

Perform some generic elementary technical skills
Collaboration and teamwork

Support new unit (team) members
Collaboration and teamwork

Collaborate with colleagues to plan and implement work rosters
Communication

Can explain the common conditions of the unit effectively to patients and undertake informed consent for common elective and emergency conditions
Communication

Explain clinical reasoning to current health team using concise language and a structured approach
Communication

Keep patients and significant others informed of management plan progress
Health advocacy

Identify key issues on which to advocate for the patient to ensure their immediate clinical care and requirements are achieved
Health advocacy

Recognise health needs of an individual patient beyond their immediate condition
Judgement and clinical decision making

Review patients on a regular basis and make decisions based on their response to treatment
Judgement and clinical decision making

Recognise when advice and guidance is required in development of management plans
Leadership and management

Accept opportunities for increased autonomy and patient responsibility under direction of supervisor
Leadership and management

Contribute fully in handover of patients within unit

Medical expertise

Work within unit-based protocols with regard to pre-operative assessment and care, operative procedures and post-operative care:

  • apply medical knowledge to clinical practice
  • implement and evaluate a management plan relevant to the patient following discussion with a senior clinician
  • identify when patient transfer is required, and manage risks prior to and during patient transfer
  • recognise indications for, and risks of, fluid and electrolyte therapy and blood products
  • provide appropriate aftercare and arrange follow up for common procedures 
  • safely manage anti-coagulant therapy and manage diabetes
  • recognise acute cardiac events and use relevant resuscitation/drug protocols
  • initiate resuscitation of the unwell patient. Recognise indicators for sepsis and implement clinically relevant plan
  • maintain a clinically relevant patient management plan of fluid, electrolyte and blood product use
  • recognise and manage fluid and electrolyte imbalances in a patient
  • effectively use semi-automatic and automatic defibrillators
  • provide appropriate aftercare and arrange follow up for more complex procedures
  • recognise when patients are ready for discharge and arrange referral to relevant members of the healthcare team to promote planning for safe discharge
Medical expertise

Safely prescribe use of antimicrobials and be aware of the influence of the pharmaceutical industry. Clearly understand proper surgical prophylaxis and distinguish this from therapeutic use of antibiotics for bacterial infections
Medical expertise

Specify peri-operative management of anticoagulants and antiplatelet agents and recognise prescription and/or administration errors
Medical expertise

Identify common risks in older and complex patients, e.g. falls risk and cognitive decline
Medical expertise

Follow-up and interpret investigation results appropriately to guide patient management
Professionalism

Critically reflect on own performance and make an accurate assessment of this
Scholarship and teaching

Lead the training of junior doctors in clinical examination and teaching of simple skills using a teaching plan
Scholarship and teaching

Provide constructive, timely and specific feedback to interns based on observation of a junior’s performance, encouraging them to reflect on their own learning
Technical expertise

Assist with teaching junior staff
Collaboration and teamwork

Effectively prioritise patients with multiple medical conditions of varying disease severity
Collaboration and teamwork

Able to coach or supervise juniors, as required by the clinical task
Collaboration and teamwork

Encourage participation of all team members and allocate appropriate tasks to junior members
Collaboration and teamwork

Engage junior doctors, nursing and ancillary staff in ward rounds
Communication

Set an appropriate tone for any communication with patients and their families, peers and colleagues
Communication

Collect and collate relevant information from other team members or specialist teams pertinent to decision making or patient management
Health advocacy

Able to advise on health needs of an individual patient beyond their immediate condition
Health advocacy

Work with the patient/family/carers to develop a management plan that addresses the needs and preferences of the patient
Judgement and clinical decision making

Undertake continued timely reviews of patient progress and respond appropriately to any changes of condition
Judgement and clinical decision making

Able to explain decision making while performing a simple procedure
Leadership and management

Delegate appropriate tasks to junior members, ensuring supervision is maintained
Leadership and management

Lead handover of patients within unit
Professionalism

Act as a role model of professional behaviour in the workplace
Professionalism

Identify and actively intervene in areas of unprofessional behaviour
Scholarship and teaching

Provide effective supervision using recognised techniques and skills (availability, orientation, learning opportunities, role modelling, delegation)
Scholarship and teaching

Adapt level of supervision to learner’s competence and confidence
Scholarship and teaching

Conduct assessments of (e.g. mini-CEX, 360° assessment), and observe, juniors; discuss and escalate performance issues where appropriate
Technical expertise

Able to demonstrate that basic essential surgical skills constructs are well established
Technical expertise

Able to teach basic Essential Surgical Skills constructs to juniors and supervise their clinical application established

The JDocs website is an initiative of the Royal Australasian College of Surgeons.

The aim is to provide career guidance to junior doctors in Australia and Aotearoa New Zealand during the early prevocational years.

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