Table 4 Themes related to the quality of supervision of GP registrars in general practice

Understand the meaning of quality supervision and seek to continually refine practice

Having a concept of quality in supervision work, drawing from lived experience as a registrar.

Continually refining practice, reflecting and learning from other supervisors and personal experience.

Listening to feedback about your supervision from registrars.

Structure placements with a focus on optimising learning

Ensuring a good match between registrar interest and their motivations and what the practice/supervisor can offer.

Using resources and doing a holistic orientation to improve understanding of the business.

Establishing the foundations for how the learning will happen around the GP business of seeing patients.

Establishing learning boundaries, respecting business responsibilities and the availability of other supervisors onsite.

Build secure and caring relationships with registrars

Front-loading support and maintaining the registrar relationship to build the foundations for discussing and coping with uncertainty, mistakes, and difficulties.

Showing genuine care about registrar and holistically understanding the registrar to contextualise teaching and learning.

Demonstrating vulnerability to promote open lines of communication.

Sustain and enhance learning opportunities drawing from the whole practice team

Ensuring registrars engage with the whole practice team so that supervision is sustainable.

Promoting connections to the wider practice, specific to a achieving a breadth of learning goals.

Ensuring registrars can access different skills and styles of supervision in the practice team.

Use learner-centred supervision, adjusting the supervision model as required

Tailoring learning to the needs and style of each registrar.

Preparing to adjust the teaching or supervision style to suit the learner.

Evaluating learning across the breadth of general practice and using structured and opportunistic ways to extend learners.

Build professional identity and foster safe, independent decision-making

Building understanding of working effectively in the general practice context, clinical best practice and understanding of comprehensive practice.

Encouraging registrars to build their own style and achieve independent decision-making, also knowing when to ask for help.

Encourage registrar reflection and give quality feedback to drive learning

Giving feedback on positive and negative aspects of performance even when conversations may be difficult.

Giving registrars space to reflect and problem-solve.

Gathering perspectives of registrar’s performance from others in the practice as another source of feedback.