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The supervisor’s toolkit – activitiesActive supervisionActive supervision occurs when the supervisor is sufficiently engaged and vigilant to provide support when needed,whether or not a request for help is made. This should be a feature of ongoing supervision.Active supervision acknowledges that some supervisees, or all supervisees in some situations, are “unconsciouslyincompetent” - that is, they do not know what they do not know, and will not always recognise situations that arebeyond their current abilities where patient safety may be at risk. Active supervision requires the supervisorto continually seek clues or evidence that direct patient care or more support from the supervisor is required.In the learning cycle described by Peyton 3 , trainees move through four stages in the acquisition of particularcompetencies, from unconsciously incompetent to unconsciously competent.Knowing your supervisee’s competence levelKnowing your supervisee’s competence levelUnconciously incompetent:The trainee does not know what they do not know.Danger at this stage:An inadequately supervised trainee may unwittingly do harm.Response:Supervise closely (hands-on), and challengethe knowledge gaps of trainees.Conciously incompetent:The trainee know that they do not know.Danger at this stage:Trainee may avoid situations that test theirincompetence.Response:Supervise closely (hands-on), and challengethe trainee to overcome their inexperience.Unconciously competent:The trainee can perform the task competentlywith practiced ease.Response:The trainee no longer needs supervision inthis task. Get them involved in teaching itto others.Conciously competent:The trainee can, with thought, perform the taskcompetently.Danger at this stage:Atypical circumstances or pressure may cause thetrainee to fail despite previous success.Response:Supervise with hands off, provide praise,recognition, opportunities to practise.3 Peyton, J. (1998). The learning cycle, in Peyton, J. , (ed.), Teaching and learning in medical practice, Manticore Europe Ltd, Rickmansworth, UK, 13-19.84 HETI The Superguide FIRST EDITION