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It is an exciting opportunity for a trainer to train a Senior Registrar and many see it as a privilege. The GP Registrar year is very crowded with a packed curriculum and many assessments. It can be a great relief to think of six months relatively uncluttered.
Most SRs have also completed their MRCGP but some may have a module still to do.
The key to being a successful SR trainer is the development of a mentoring relationship. This may be difficult initially, particularly if this is a continuation of a GP registrar year. The SR may still look to the trainer for guidance and expect them to lead tutorials and if the trainer normally prides himself in preparing material for tutorials it may feel unprofessional, even lazy, to come to a tutorial with no specific preparation. Yet it is essential that the SR takes the lead in tutorials, sets the direction and uses the trainer in a mentoring role. It is likely that early tutorials may focus on reflections on their performance so far, plans for their future career and the gradual development of a learning plan to meet their needs. Aspects of their planned weekly timetable may need to be discussed to more accurately reflect their learning needs and a learning contract clearly setting out expectations on both sides is essential.
The trainer has a key role in these discussions. It is likely that they will have invaluable information about the SRs strengths and weaknesses, particularly if they have already been training them. The key here is to facilitate the SRs reflections so that they identify key issues for themselves. When the discussion moves on to how they plan to learn, the trainer's role is to help the SR to be imaginative about potential learning opportunities. The trainer's encouragement and confidence in their ability will help SRs agree to plans that will really stretch them. The SR six months is about taking risks - risks with projects and risks with new clinical techniques. Trainers should help SRs to see that learning can be about mistakes as well as success. Trainers should help SRs to develop confidence and self-belief, essential in any leadership training programme. The trainer, and other members of the practice, should use their network of contacts in and out of the health service to enable the SR to develop a broad perspective of health issues.
As the weeks go by, the trainer's role is increasingly to aid effective reflective practice for the SR. Within a mature mentoring relationship, the trainer needs to facilitate this by developing an appropriate balance of support and challenge which promotes self-direction and self-appraisal.
Towards the end of the six months, trainers should expect SRs to prepare their revalidation folders. This is a good opportunity for the trainer to feedback to the Senior Registrar and encourage them to recognise for themselves both their strengths and areas for improvement. It is also a good moment to finally sign off the trainers report. SRs should also be actively seeking feedback from staff, colleagues and patients and reflecting on the answers. Common pitfalls that trainers and SRs should be aware of are:
- Fragmentation - between clinical and project work, practice and secondment, trainer and supervisor.
- Taking on too much - projects may need to be focused and reduced in scope.
- Isolation - the SR may not feel he/she "belongs" in either setting.
- Perceived lack of progress - change management takes time. Frustrations about progress can lead to insights about resistance to change and failures can provide real learning.
- Undervalued/unsupported - some SRs find being totally supernumerary and self-directed difficult to adjust to at first.
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