Trainee’s name Trainee GMC Number Educational Educational Supervisor’s Supervisor’s name GMC Number Trainee’s IBTPHEM Date of meeting registration number Current Training Phase Current Training Unit Type of meeting Initial Mid Term End of placement ☐ ☐ ☐ Summary of previous 3-6 months of PHEM training (if applicable) Summary of PHEM exposure in current phase of training Number of shifts Unsupervised Directly Supervised by Consultant TOTAL for phase of training Percentage of supervised shifts % Summary of PHEM assessments CEX CbD SIM DOPS MSF ACAT TO Current phase Running total Target for 12 month WTE PHEM 15 30 10 30 2 25 5 training Educational Supervisor’s Trainee’s name name Current Training Phase Date of meeting Type of meeting Initial Mid Term End of placement ☐ ☐ ☐
Trainee’s name Trainee GMC Number Educational Supervisor’s name Educational Supervisor’s GMC Number Trainee’s IBTPHEM registration number Date of meeting Current Training Phase Current Training Unit Type of meeting ☐ Initial ☐ Mid Term ☐ End of placement Summary of previous 3-6 months of PHEM training (if applicable) Summary of PHEM exposure in current phase of training Number of shifts Unsupervised Directly Supervised by Consultant TOTAL for phase of training Percentage of supervised shifts % Summary of PHEM assessments CEX CbD SIM DOPS MSF ACAT TO Current phase Running total Target for 12 month WTE PHEM training 15 30 10 30 2 25 5 Trainee’s name Educational Supervisor’s name Current Training Phase Date of meeting Type of meeting ☐ Initial ☐ Mid Term ☐ End of placement
educational_supervisor_report.docx