Teaching Feedback Form Template NHS

NHS CLINICAL TEACHING AND EDUCATIONAL SUPERVISION FEEDBACK FORM

1. DOCUMENT CONTROL & ADMINISTRATIVE METADATA

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2. OFFICIAL NOTICE & COMPLIANCE DISCLAIMER

CONFIDENTIALITY & DATA PROTECTION NOTICE: This document contains confidential information relating to clinical performance, educational assessment, and professional development within the National Health Service (NHS). The data collected herein is processed in strict accordance with the UK General Data Protection Regulation (UK GDPR) and the Data Protection Act 2018. Unauthorized access, distribution, copying, or disclosure of this document is strictly prohibited and may result in disciplinary action, professional regulatory referral, and civil or criminal liability.

LEGAL & REGULATORY DISCLAIMER: This feedback form is designed to capture objective, evidence-based evaluations of clinical teaching and educational supervision. It does not constitute a formal employment performance review or a legally binding disciplinary record. All evaluations must be conducted in good faith, adhering strictly to principles of natural justice, equality, diversity, and inclusion (EDI), and without bias or malice. The issuing NHS Trust/Health Board assumes no liability for subjective or unsubstantiated remarks entered into this document by evaluators.

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3. PARTIES & CONTEXTUAL IDENTIFICATION

3.1 Evaluating Party (The Trainee / Learner)

• Full Legal Name: [Trainee Full Legal Name]
• Professional Registration Number: [GMC / NMC / HCPC / GDC Number]
• Current Grade / Role: [e.g., FY1, FY2, Core Trainee, ST3+, Nursing Student]
• Specialty / Department: [e.g., Acute Internal Medicine, Paediatrics, Surgery]

3.2 Evaluated Party (The Clinical Educator / Supervisor)

• Full Legal Name: [Educator Full Legal Name]
• Professional Registration Number: [GMC / NMC / HCPC / GDC Number]
• Subspecialty / Clinical Role: [e.g., Consultant Cardiologist, Clinical Supervisor, Educational Supervisor]
• Host NHS Trust / Organisation: [Name of NHS Trust / Health Board / Primary Care Network]

3.3 Administrative Context

• Clinical Placement Site: [Hospital Name, Clinic, or Practice Location]
• Evaluation Period (Start Date): [DD/MM/YYYY]
• Evaluation Period (End Date): [DD/MM/YYYY]
• Encounter / Rotation ID: [Internal Reference Code / e.g., Rotation 2, Block A]

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4. OPERATIVE CLAUSES & EVALUATION FRAMEWORK

Clause 1: Purpose and Scope of Assessment

1.1 This instrument serves as the standardized evaluation mechanism for clinical teaching, direct observation, and educational supervision delivered within the scope of NHS postgraduate and undergraduate training programs. 1.2 The feedback gathered shall be utilized for educator development, annual appraisal evidence under GMC/NMC revalidation frameworks, and continuous quality improvement (CQI) of the clinical learning environment.

Clause 2: Objective Scoring Matrix

Instructions to Evaluator (Trainee): Rate the Clinical Educator’s performance across the following core domains using the standardized 4-point Likert scale defined below. Every score of 1 (Unsatisfactory) or 4 (Exemplary) must be substantiated with qualitative remarks in Clause 3.

• Scale: 1 = Unsatisfactory | 2 = Developing / Satisfactory | 3 = Competent / Good | 4 = Exemplary

Clause 3: Qualitative Feedback & Substantiation

3.1 Key Strengths: Detail specific instances where the educator demonstrated exceptional teaching, supervision, or pastoral support:

[Insert detailed qualitative comments regarding educator strengths, or state "N/A"]

3.2 Areas for Development: Identify constructive, actionable recommendations for enhancing the educator's teaching practice or supervisory approach:

[Insert constructive development points, or state "N/A"]

3.3 Concerns Regarding Patient Safety or Professional Conduct (If Any):

[Mandatory completion if any score in Clause 2 is rated "1". Detail specific concerns or state "None identified"]

Clause 4: Action Plan & Follow-Up

4.1 If developmental areas are identified under Clause 3.2, the Educator and Trainee (or Educational Supervisor) shall formulate an agreed-upon action plan within [Number, e.g., 14] business days. 4.2 This form shall be archived in the educator's educational portfolio for review during their annual appraisal and revalidation cycle.

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5. SIGNATURES & ACKNOWLEDGMENT BLOCK

By executing this document below, the parties acknowledge that the feedback provided herein has been completed in good faith, accurately reflects the educational experience during the specified period, and complies with applicable NHS governance standards.

5.1 Evaluating Party (Trainee / Learner)

• Signature: [________________________________________]
• Printed Name: [Trainee Full Legal Name]
• Title / Grade: [Trainee Grade]
• Date: [DD/MM/YYYY]

5.2 Evaluated Party (Clinical Educator / Supervisor - Acknowledgment Only)

• Signature: [________________________________________]
• Printed Name: [Educator Full Legal Name]
• Job Title: [Educator Job Title]
• Date: [DD/MM/YYYY]

5.3 Clinical Director / Director of Medical Education (DME) (Countersignature if required by Trust policy)

• Signature: [________________________________________]
• Printed Name: [Director Name]
• Designation: [Director of Medical Education / Associate Postgraduate Dean]
• Date: [DD/MM/YYYY]

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6. STEP-BY-STEP EXECUTION & ENFORCEMENT GUIDE

• Step 1: Completion and Submission: The Trainee must complete Sections 3, 4, and 5 independently at the conclusion of a clinical placement rotation or mid-point review, ensuring all scores are justified by qualitative remarks where mandated.
• Step 2: Educator Review and Acknowledgment: The Clinical Educator must be provided a copy of the completed form for review and acknowledgment. This step promotes reflective practice and fulfills revalidation requirements without compromising the integrity of confidential feedback.
• Step 3: Governance and Archiving: The finalized document must be submitted securely to the Trust’s Medical Education Department, Postgraduate Deanery administrator, or uploaded to the designated e-portfolio platform (e.g., Horus, Kaizen, NHS Turas) in compliance with institutional data retention policies.
• Step 4: Escalation Protocol: Any score of "1" (Unsatisfactory) or any reported patient safety concern under Clause 3.3 must trigger an immediate confidential review by the Director of Medical Education (DME) or Guardian of Safe Working Hours in accordance with NHS Trust incident reporting pathways.