GPwER Form Test Page

Step 1 of 3

Please complete this report with your educational supervisor. This should capture your progress throughout the clinical attachment and provide a structure for your feedback. Please use the free-text areas to justify any comments and highlight any areas of concern or excellence. It should take approximately 1 hour to complete. It is advisable that you complete some of the sections prior to meeting with your educational supervisor, these sections are highlighted as, “For completion by the GPwER trainee”.

Trainee Name *

First

Last

Supervisor Name *

First

Last

General overview

For completion by the GPwER trainee

1. Please summarise the nature and frequency of clinical interaction between you and your educational supervisor throughout the placement. Please include any induction or review meetings that took place.

2. Was a personal development plan (PDP) agreed at the start of the clinical placement? If, so has the PDP or educational contract been achieved?

3. Where there any barriers to achieving your PDP?

4. What are you most proud of achieving this year?

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GPwER Form Test Page

General overview

Online modules and learning

Clinical component