What is a CSR?

The Clinical Supervisors Report (CSR) is a short, structured report completed by your Clinical Supervisor in each post. It is essential that 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 ensure the following:

• 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 personally carried out at least one of the mandatory Work Place Based Assessments (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, such as '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, 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. 

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.