Supervised Learning Events (SLEs) – are you Getting the most out of them?
Now that Supervised learning events (SLEs) are part of the Trainee Foundation Pharmacist Year it is worth reflecting on how their use can be optimised.
Introduction
Supervised learning events (SLEs) are the revised term for workplace-based assessments; many of those used in pharmacy training have evolved from tools used in medical education and training. They use real-life patients and scenarios to assess specific knowledge (and its application), skills and behaviours. SLEs have more recently been introduced into the Trainee Foundation Pharmacist Year as well as being an integral part of the Royal Pharmaceutical Society’s (RPS) various credentialling programmes, with some tools being mandatory evidence for some curriculum outcomes.
I have been using SLEs in the PgDip in Clinical Pharmacy at Liverpool John Moores university since 2008 and after reflecting on my experiences have produced some top tips on how to maximise the value of these tools in training and development.
Tip 1. Familiarise yourself with the different tools and feedback forms
The suite of tools now advocated in the RPS’ credentialling programmes has expanded beyond the Mini Clinical Evaluation Exercise (mini-CEX), Medicines-related Consultation Framework (MRCF) and Case-based Discussion. Both the practitioners being assessed, and the assessors have a responsibility to familiarise themselves with these tools. Descriptions of these are provided on the RPS website and I will endeavour to write further blogs that focus on the use of individual tools.
Tip 2. You don’t have to use all of the different SLE tools
Although a portfolio that contains several examples of one SLE tool will only provide feedback on a practitioner’s performance from one angle, not very tool needs to be used. Trying to include examples of every tool can a drive a “tick box” mentality (see Tip 4) and potentially result in a tool being used incorrectly. It is better to use the most appropriate tool for the scenario being assessed and considering which curriculum outcomes or competencies it aligns with.
Tip 3. Remember that SLEs are formative assessments
Although the term Supervised Learning Event has replaced workplace-based assessment, practitioners may still think of them as pass / fail assessments. Individual SLEs operate as low stakes formative assessments but can be used as part of a larger summative (i.e. pass / fail) programmatic assessment. They can also be used to identify practitioners that require additional or more tailored support before these individuals have their annual appraisal or are required to submit a portfolio as part of a programmatic assessment. Practitioners may be reluctant to use SLEs that they have performed poorly in as part of such assessments, however, including evidence that development needs from these have been addressed demonstrates a commitment to ongoing development and a degree of feedback literacy.
Tip 4. Don’t obsess about minimum numbers
Insistence on minimum numbers can also result in a “tick box” approach being adopted. Potential bunching of SLEs can then occur as practitioners may wish to “get them out of the way” early on or not undertake them until they have completed other learning and development activities (possibly due to concerns about failing a SLE – see Tip 3). I would advise early career pharmacists to aim to complete at least one SLE per month so that they are receiving regular developmental feedback and can accumulate a sufficient pool from which to select appropriate exemplars as part of a programmatic assessment strategy. If a period of more than two months elapses without any SLEs being completed, then early career pharmacists are likely to have missed out on valuable learning opportunities.
Tip 5. Choose a variety of scenarios and try not to look for scenarios that are too specific
Although it is not possible to complete a SLE for every therapeutic area or workplace-based task that you encounter, you will benefit more (and have a stronger portfolio) if you choose the more challenging scenarios and cover a variety of areas (including those you are less familiar with) than if you "cherry-pick" simple scenarios and / or those within your comfort zone. A trap that is easy to fall into is to look for the “perfect patient” for a SLE, when they don’t exist. Almost any workplace-based scenario can be used for a SLE and if you are familiar with the range of tools available, you will find it easier to identify which one to use for a particular scenario you encounter.
Tip 6. Choose appropriate assessors
Previous surveys of students studying the postgraduate diploma in clinical pharmacy (that I have conducted) have revealed that an assessor’s availability, personality (i.e. more friendly) and expertise in a specialty are the main factors that influence their selection. With the exception of multi-source feedback, I would recommend that pharmacists chosen as assessors have at least two (but ideally three) years’ post-registration experience and have achieved their postgraduate diploma in clinical pharmacy. Pharmacy technicians may also be suitable assessors for some SLEs (examples will be discussed in future blogs).
Ideally all assessors will be trained in the use of these tools as well as how to provide good quality feedback. However, a lack of supervisor training should not prevent a supervised learning event being completed as assessor availability is likely to be the biggest hurdle to SLEs being completed. For those that have more limited access to assessors, the Royal Pharmaceutical Society’s mentoring scheme could help with completing retrospective SLE tools.
Tip 7. Ensure feedback is specific and timely
If feedback is to aid development, it needs to highlight specific aspects of knowledge or skills / behaviours that were observed as being demonstrated well (and thus should continue to be exhibited) or in need of further development. Generic statements will become increasingly meaningless as time passes – if you are reviewing SLE feedback forms as evidence during an appraisal or programmatic assessment, you may need to reject those that lack feedback on specific areas of practice. The table below provides examples of how vague statements could be re-phrased depending on what was observed.
Tip 8. Reflect on and use feedback to improve practice
Reflecting on feedback helps you to understand why you performed well in certain areas but need to work on others. The development needs identified can also be used for “planned” continuing professional development records required by the GPhC as part of the revalidation process. Reflecting on feedback can also help with completing the reflective account and SLE feedback forms (and examples of how you have addressed feedback) may also be used to support your peer discussion.
Final Thoughts
Supervised learning events will become embedded within the MPharm programme in the next couple of years once students are undertaking more placements. Many of the tips in this article are applicable to the different levels of practice for pharmacists (from Foundation to Consultant level) and can be implemented to support undergraduate students during their practice-based placements.
Further Resources