Abstract
BACKGROUND: Quality supervision in general practice (GP) is critical for the progress and satisfaction of GP registrars and for attracting future rural GPs. However, there is limited research to inform the implementation of feedback systems for enhancing supervision by rural supervisors, and no published evidence specific to distance education where a remote supervisor may be in a different practice and supervising from afar. This study aimed to develop and explore the outcomes of an easy-to-administer, safe and constructive, registrar-to-supervisor feedback system for a distance (or remote) supervision model. METHODS: Participatory action research involved the design of a standardised short-form questionnaire and an administration, data analysis and feedback process between registrars and supervisors. The questionnaire was administered each year between 16-20 weeks of the first year of registrar training within a 3-4-year rural and remote GP training program-the Remote Vocational Training Scheme (RVTS) (2020-2022). Participation in the project was voluntary. Registrars were asked 12 standardised questions about supervision over three domains: bond strength, task agreement and goal setting. Responses were summed by domain and evaluated using set criteria of high (> 80%), medium (51% to 79%) or low (50% or lower). High- and medium-level narrative feedback reports were provided to supervisors. Low domain scores were followed up by relevant internal staff to negotiate and resolve issues. RESULTS: All 106 commencing registrars completed the questionnaire, of which n = 99/106 (93%) reported high performance related to the bond with their supervisor, n = 94/106 (89%) reported high performance on training tasks, and n = 53/106 (50%) reported medium or low performance for supervisor's understanding the registrar goals. The majority of supervisors found the feedback useful. Ten registrars identified to be in need (9% of 106) were offered additional support. CONCLUSIONS: The system was found to be feasible, safe, and constructive for reviewing the quality of a distance supervision model for rural and remote registrars. It enabled prompt resolution of issues that would have otherwise been difficult to address and facilitated more open discussions about the quality of supervision. This process has been standardised within the RVTS.