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CLINICAL SUPERVISOR ASSESSMENT INSTRUCTIONS FOR USE GENERAL INFORMATION

WHAT IS THE CLINICAL SUPERVISOR ASSESSMENT? The Clinical Supervisor Assessment is held at the end of any teaching term/rotation. It is a meeting held between you and your Clinical Supervisor and is an opportunity for the Clinical Supervisor to give you feedback based on their observation and experience of supervising you for that term. The feedback should cover your performance in the medical expert role as well as the other capabilities of communicator, collaborator, manager, health advocate, scholar and professional. It provides an opportunity for the Clinical Supervisor to highlight areas of strength and weakness and to assist you to focus on areas for improvement and consolidation in the next term.

WHO SHOULD I ASK TO BE AN ASSESSOR? In order to complete the Clinical Supervisor Assessment, the assessor should be the primary Radiation Oncologist supervising you in your current term. Your Clinical Supervisor should have experience of working with you on a day-to-day basis.

HOW SHOULD IT WORK? The purpose of the session is to give you feedback which will help you understand in which areas you are progressing well and those which probably require focussed attention in your next term. If you have any specific questions about your performance, or areas of strength and weakness, ask your Clinical Supervisor to comment and to help you develop an action plan to assist you improve in these areas.

WHAT DO I DO WITH THE FORM? The form should be signed by you and your Clinical Supervisor, dated, and included in your Learning Portfolio.

_________________________________________________________________________________________ Education and Research Portfolio Learning Portfolio, Section 3: Assessments, Clinical Supervisor Assessment, Instructions, Version 2, 22 February 2010 The Royal Australian and New Zealand College of Radiologists 2010

COMPLETING THE FORM

SPECIFIC POINTS Please ensure that your name, year of training and the term dates which the assessment covers are completed on the top of the form. Please sign and date the form. Please ensure that your Clinical Supervisor also signs and dates the form. You will be rated taking into account your stage of training.

INCLUSION IN YOUR LEARNING PORTFOLIO You should include the original of your Clinical Supervisor Assessment in your Learning Portfolio.

FEEDBACK The Clinical Supervisor Assessment is an important opportunity for formative assessment and is intended to give feedback to you on your performance across a range of all the CanMEDS roles and competencies.

_________________________________________________________________________________________ Education and Research Portfolio Learning Portfolio, Section 3: Assessments, Clinical Supervisor Assessment, Instructions, Version 2, 22 February 2010 The Royal Australian and New Zealand College of Radiologists 2010

CLINICAL SUPERVISOR ASSESSMENT DOCUMENTATION

Clinical Supervisor completes assessment with trainee

Clinical Supervisor provides original to trainee and a copy to the Director of Training

Trainee includes Clinical Supervisor Assessment in Learning Portfolio

_________________________________________________________________________________________ Education and Research Portfolio Learning Portfolio, Section 3: Assessments, Clinical Supervisor Assessment, Flowchart, Version 2, 22 February 2010 The Royal Australian and New Zealand College of Radiologists 2010

CLINICAL SUPERVISOR ASSESSMENT

Trainee Name Term Dates From DD/MM/YY Assessor Name

Year of Training

To DD/MM/YY Department/Site

Please rate the trainees performance for each topic area by placing a rating of 1 3 in the box next to each topic area. Ratings should take into account the trainees level of training. You are not asked to complete all items. Only complete those items that you are confident you have observed in the training term. Rating Scale 1. Falls short of expected standard 2. Meets expected standard 3. Exceeds expected standard N/A Not applicable at this assessment Medical Expert Oncology knowledge Demonstrates knowledge of important oncology science and clinical oncology principles Clinical assessment Performs complete new patient, follow-up and inpatient assessments; competently identifies acute and late radiation toxicity; recommends appropriate investigations Clinical judgment and decision making Demonstrates a systematic approach to clinical problem solving and setting management priorities; can discuss the general principles of treatment; can discuss management options, then make timely and appropriate decisions; aware of the side effects of proposed therapies Procedural skills Undertakes or participates in procedures competently in a variety of settings and clinical situations Patient management Manages patients competently in a variety of settings and clinical situations RT techniques and RT planning Regularly attends planning sessions; takes initiative in developing and critically reviewing treatment plans; demonstrates understanding of important planning issues Overall Rating Communicator Demonstrates effective communication with patients and significant others Establishes rapport; encourages participation in decision-making; provides clear instructions to patient/family; provides clear information and checks understanding Demonstrates effective communication with other health professionals and hospital staff Presents patient problems clearly and concisely; maintains effective written communication Overall Rating Collaborator Multi-disciplinary clinical teams Establishes and maintains interpersonal and co-operative relationships with various other health care providers Research and/or education groups Participates in research and/or educational group activities Overall Rating Manager Resources Demonstrates ability to manage resources and shows understanding of wider resource issues

Please turn over Education and Research Portfolio Learning Portfolio, Section 3: Assessments, Clinical Supervisor Assessment, Tool, Version 2, 22 February 2010 The Royal Australian and New Zealand College of Radiologists 2010

People Demonstrates ability to act in leadership roles Technologies Shows awareness of new technologies and attempts to integrate their use appropriately Overall Rating Health advocate Applies expertise and influence to improve cancer services in relation to: Individual patients Community groups Overall Rating Scholar Teaching others Shows interest and aptitude in education of others Lifelong learning Shows a resourceful attitude towards continuing education to enhance quality of patient care; develops and acts on personal learning goals; accepts and acts on constructive feedback Evidence-based practice Takes evidence based approach to patient management; demonstrates ability to critically appraise published literature; integrates emerging evidence into clinical practice Research activity Understands scientific methodology; participates in research and audit activities Overall Rating Professional Empathic and ethical behaviour Demonstrates compassion in management of patients, demonstrates respect for patient confidentiality, privacy and autonomy Professional behaviour Displays professional attitudes and integrity; demonstrates initiative, reliability, and availability Organisational skills Demonstrates ability to plan, coordinate and complete administrative tasks in a timely manner; assumes appropriate responsibility for day to day activities Quality assurance and risk management Demonstrates ability to initiate and evaluate Quality Assurance programs; demonstrates importance of patient safety Responsibility and self assessment Accepts responsibility for own actions; accepts the limits of own competence, and functions within own capabilities; seeks advice and assistance when appropriate Overall Rating 1. What is the trainee doing particularly well?

2. What should the trainee work on in the next rotation?

3. Any other comments about progress of the trainee?

Clinical Supervisor Signature Trainee comment on this assessment

Date

Trainee Signature

Date

_________________________________________________________________________________________ Education and Research Portfolio Learning Portfolio, Section 3: Assessments, Clinical Supervisor Assessment, Tool, Version 2, 22 February 2010 The Royal Australian and New Zealand College of Radiologists 2010

REFERENCES AND FURTHER READING

Bandiera G, Sherbino J, Frank JR. The CanMEDS assessment tools handbook. An introductory guide to assessment methods for the CanMEDS competencies. Ottowa: The Royal College of Physicians and Surgeons of Canada; 2006. Review of work-based assessment methods. Centre for Innovation in Professional Health Education and Research, The University of Sydney, Australia. 2007. Burch VC, Seggie JL. Use of a structured interview to assess portfolio-based learning. Medical Education 2008; 42:894-900 Driessen E, van Tartwijk J, van der Vleuten C, Wass V. Portfolios in medical education: why do they meet with mixed success? A systematic review. Medical Education 2007; 41:1224-1233. Van de Ridder, JMM, Stokking KM, McGaghie WC, ten Cate OTJ. What is feedback in clinical education? Medical education 2008; 42: 189-197. McMullan M, Endacott R, Gray MA, Jasper M, Miller CML, Scholes J, Webb C. Porftolios and assessment of competence: a review of the literature. Journal of Advanced Nursing 2003; 41(3): 283-294.

_________________________________________________________________________________________ Education and Research Portfolio Learning Portfolio, Section 3: Assessments, Clinical Supervisor Assessment, References, Version 2, 22 February 2010 The Royal Australian and New Zealand College of Radiologists 2010