Clinical Supervisors Report (CSR)

The Clinical Supervisors Report (CSR) is a short, structured report completed by your Clinical Supervisor in each post. It is essential this is done towards the end of your non-primary care posts and also in primary care posts if any of the following apply:

  • The Clinical Supervisor in practice is a different person to the Educational Supervisor.
  • The evidence in the Portfolio does not give a full enough picture of your progress in training and information in a CSR would provide this missing information. 
  • Either you or your supervisor feels it is appropriate.

The CSR is an opportunity for you to receive feedback about your performance and the conversation with the CS that accompanies it can be particularly useful. A well completed CSR is also a valuable source of evidence for each Capability in the Educational Supervisor Review and for ARCP panels.

The new CSR has been rewritten to: 

  • Make a clear link between each section and the relevant GP Capabilities.
  • Ensure that all the GP Capabilities are covered in the report.
  • Introduce an overall assessment by the Clinical Supervisor (CS) of the level of supervision that you have required.
  • Make the report shorter and easier for busy clinicians to complete.

Who carries out the CSR?

The Clinical Supervisor is responsible for writing the report although it is appropriate and usual for the CS to discuss the CSR with colleagues to inform the final report. In addition to this gathering of information from colleagues it is expected that the CS will have carried out at least one of the mandatory Workplace Based Assessments personally (CBD/MiniCEX/COT) prior to each CSR. Where there are particular concerns about your progress and there is more than one experienced CS working in the department or practice, it is appropriate, and good practice, for there to be more than one CSR written for a single period of training. 

It is your responsibility to arrange a meeting with your CS to ensure the report is completed before the end of your placement and in time for your ESR meeting.

What is the reference point? 

Because the CSR is used in both primary care and non-primary care, it is important that the reference point is one that will be recognised in both settings. Two versions of the CSR have been written - one for non-primary care posts and a second version for primary care posts.

The Clinical Supervisor in a non-primary care CSR is asked to make a comparison of your performance with the expected performance of a GP trainee at that level of experience in that post. The assessment form, therefore, asks the CS to make a judgement (after recording their comments) of whether you are:

  • Significantly Below Expectations
  • Below Expectations
  • Meets Expectations
  • Above Expectations 

The Clinical Supervisor in a primary care post is asked to make a comparison of your performance with the standard expected of a trainee at the end of ST3 (a newly qualified independent GP). The grades match those in the ESR and the form asks the CS to make a judgement of whether you are: 

  • Needing Further Development - Below Expectations
  • Needing Further Development - Meeting Expectations
  • Competent
  • Excellent

What does the form review?

Each of the seven questions covers a particular area of practice, for example Professionalism. There follows a description of how this is likely to be observed in the working environment. Professionalism, for example, includes being respectful, diligent and self-directed in your approach to patients and others and to your own learning needs, developing resilience and making appropriate ethical decisions. Each question will automatically be linked to specific Capabilities in the Portfolio (e.g. Maintaining Performance Learning and Teaching, Ethics, Fitness to practice). 

Word descriptors have been written to support the grading and feedback for each question. See below for non-primary and primary care posts.

The CS is also asked to make an assessment of the level of supervision required compared to the expected level of performance for a GP trainee at this stage. There are 4 levels of supervision and if more supervision than would be expected is required, or you cannot be left without supervision, then an additional comment box will appear asking for further details. 

Finally, in line with all other specialties there is a question about whether you have been involved in conduct, capability or Significant Events and what the outcome has been.

Short Posts (for example 3 months or less)

It is particularly important that a CSR is completed if you have been in a short post so that there is an assessment of engagement and learning in the post. (It would also be expected that there should be pro rata assessments (CBD/ MiniCEX/ COT) for these posts)

Being both ES and CS 

There are occasions when the same person will be your Clinical Supervisor and Educational Supervisor. The CSR is a summary of the observations of the supervisor (whether or not they are also an ES) on your performance under the various Capability headings. It is an opinion based on observation, debriefing, tutorials, etc. The ESR, in contrast, is a summary of the information from different sources of your performance, recorded in your Portfolio. It is appropriate for the ES to quote as evidence along with other evidence the assessment made by the CS (even if the ES also completed the CSR). 

If the CS is also your ES in a primary care post then the CSR does not need to be completed unless the evidence within the Portfolio does not give a full enough picture and information in a CSR would provide this missing information, or you and your supervisor feel it is appropriate. In these situations, the CSR should be completed irrespective of whether the CS and ES are the same person.

Communication between the CS and ES

The CSR is one of several sources of evidence used by the ES to reach a judgement about your progress. While it has been designed to provide useful structured information, it is no substitute for dialogue between the Clinical and Educational Supervisor. If there are known concerns about your performance prior to the start of a post it is appropriate for your ES and/or the Training Programme Director to ensure that the CS is aware of the concerns and for the ES to remain available for advice. It is good practice for you also to be aware of these conversations and their overall content.

Download the forms

Documents

Clinical Supervisors Report (CSR) - FAQs

When do I need a CSR completed?

You will need to have a CSR completed at the end of each non-primary care placement.

You will also need a CSR completed in your primary care placement if:

  1. your named Clinical Supervisor is different from your Educational Supervisor (ES)
  2. the evidence in your Portfolio does not give a full enough picture of your progress and information from a CSR could provide this missing information or
  3. either you or your Supervisor feel it is appropriate.
The CSR provides important evidence about you to your ES and must be completed prior to your Educational Supervisor Report (ESR).
 

What happens if I didn't complete my post due to absence or if I had to move post unexpectedly?

In this case, a CSR is especially important as it will help the ARCP panel determine whether a short post (less than 3 months) can count towards your overall training time. However, if you were only in a post for less than a month then you should contact your programme director as this post may not count and if this is the case, a CSR will not be necessary.

Who should complete my CSR?

Your named Clinical Supervisor in both non-primary and primary care posts should complete your CSR. If your Clinical Supervisor is also your ES in your primary care post then ideally another Clinical Supervisor in the practice should complete the CSR if it is required.  If this this is not possible then your ES should also complete the CSR.

If I work less than full time in a one-year hospital placement, will I need a CSR after 6 months to use in my ESR?

Yes.

I have only spent a small amount of time with my Clinical Supervisor. Can I ask another Clinical Supervisor to complete my CSR?

No.  Your named Clinical Supervisor must complete the assessment. However, your Clinical Supervisor is expected to seek the views of colleagues prior to completing the report.

Why are there three different versions of the CSR?

One is for use by hospital based Clinical Supervisors for trainees in non-primary care placements.  The second is for use by GP Clinical Supervisors in primary care placements during ST1 and ST2.  The third is for use by GP Clinical Supervisors in ST3 GP placements.  The key difference is that in hospital placements you are assessed against the expected level for a GP trainee at this stage in training, but in primary care placements you are assessed against a trainee at the point of Certificate of Completion of Training (CCT). The only difference between the two GP primary care forms is that the one for use in ST3 includes a fourth ‘Level of Supervision’ grade of ‘requires no supervision in their clinical role’.

Does every section of the CSR need to be completed?

Yes.

I disagree with comments on my CSR. How can I get it changed?

It cannot be changed. If you wish to clarify a matter it is suggested you discuss it with your Clinical Supervisor and ES. If you wish for your comments to be recorded, you should write them as a reflective log entry and add to ‘Supporting Documentation’ and ask your ES to reference them in Educator Notes or in your ESR. 

If level 1 or 2 of ‘Level of Supervision’ is ticked, why is referral to the Training Programme Director or Associate Dean required?

In this scenario the local Training Programme Director or Associate Dean would be expected to make an assessment of your training needs and, if necessary, arrange appropriate support and write an educational plan. An ARCP panel may need to be triggered. 

What is the difference between “significantly below expectations” and “below expectations”?

Please refer to ‘CSR with word descriptors for non-primary care placements’. At the bottom of the page, there is a description of a trainee performing significantly below or below expectations for each section.

I am a Clinical Supervisor and I have significant concerns about my trainee’s performance. Do I need to wait until the end of the post before completing the CSR and highlighting my concerns?

You should not wait until the end of the post to highlight if your trainee is performing significantly below expectations. You should contact your local GP Training Programme Director or Associate Dean and share your concerns. They may ask you to summarise your concerns in writing and may ask you to do this by writing an early CSR.

I am a Clinical Supervisor and I have highlighted significant concerns about a trainee’s performance in the CSR. How can I be certain these will be acted upon?

An Educational Supervisor’s report should be written every six months. This will involve reviewing that trainee’s CSR. However, if you have significant concerns you should contact your local GP Training Programme Director or Associate Dean.
Page last updated: 8 April 2020

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