Registrars must learn a massive amount to be safe and effective practitioners, as well as to pass their exams. This can potentially be projected onto the GP supervisor, making them feel like they need to teach a correspondingly overwhelming amount to their registrar. The new supervisor may wonder therefore where to invest their energy. The following are suggestions to help focus this task.

Focus on skill development, not knowledge acquisition

GP registrars are required to learn not just knowledge, but also skills and attitudes. While registrars are often driven by knowledge acquisition e.g. ‘What are the clinical features of gout?’, and seek guidance about this from their supervisor, this aspect of learning may occur just as effectively from independent study. Skill development, however, requires deliberate practice and guidance, and could rightly be regarded as the primary aim of GP supervisor teaching. These skills include clinical reasoning, managing uncertainty, consultation skills, cultural safety, communication skills, and more.

Add practical wisdom to learning

The supervisor has an important role to put the registrar’s learning into context, so called ‘practice wisdom’. Operating in a workplace-based learning environment, supervisors must be nimble and opportunistic by enhancing the learning that ‘walks in the door’. While the registrar may read about the presentation or diagnosis from a textbook or online resource, the supervisor has a key role to ‘contextualise’ the information into the real world of general practice, adding their accumulated wisdom to the theoretical knowledge. This also relates to framing learning through the prism of primary care and community-based medicine, in contrast to the hospital system from which the registrar came.

Uncover unknowns

The Johari window illustrates how gaps in knowledge, skills and attitudes can be hidden from the registrar, the supervisor, or both. It is useful for the new supervisor to think about uncovering ‘unknowns’ in their registrar, especially ‘unknown unknowns’. This is explored in detail in the companion GPSA guide, ‘Helping your registrar plan their learning’.

Address the non clinical aspects of practice

GP registrars invariably focus on the clinical aspects of practice – diagnosis, investigation and management of illness. This is not all surprising and is even more of a focus as exams loom. However, as the curricula of both colleges describe, general practice is much broader than the clinical aspects of practice, and includes a breadth of nonclinical aspects of quality practice. In a similar way to focussing on skill development over knowledge acquisition, as above, we encourage GP supervisors to focus on the non-clinical aspects of practice in their supervision role – this includes communication and consultation skill development, population health, professional and ethical practice, organisational skills, risk management and medicolegal practice.