Training and Supervision in High-Stakes Environments

Many of the doctors who end up supervising and training others in the operating theatre or on interventional lists were never actually taught how to do it. The clinical skills were there. The teaching role arrived anyway. And suddenly you are responsible for someone else’s learning in an environment where the margin for error is small, the team dynamics are complex, and the pressure is constant.

This half-day workshop from DoctorsTraining is designed for surgeons, anaesthetists, interventionalists, and proceduralists who supervise and train others in high-pressure procedural environments. Drawing on evidence-based frameworks grounded in real surgical and clinical experience, you will reflect on the environment you are creating, develop practical tools for structuring training in the moment, and build confidence in the conversations that matter most when the stakes are high.

Together you will explore what it actually takes to train well under pressure: how to brief, how to hand over and take back control, how to give feedback that lands, and how to build a learning environment where your trainees feel safe enough to grow and honest enough to speak up when it counts.

To equip trainers working in high-stakes procedural environments with the reflective insight, practical tools and communication skills to lead, teach and supervise safely and effectively under pressure, in a way that protects both patients and the next generation of doctors.

• Reflect honestly on the current pressures facing trainers in procedural medicine and recognise that the challenges you face are system-wide, not personal failings.
• Analyse your own training environment using the Areas of Work Life model and Lencioni’s Five Dysfunctions framework to identify what is working and what needs to change.
• Understand psychological safety at a deeper level and distinguish it from trust, so you can build the conditions where trainees speak up rather than stay silent when something is wrong.
• Apply the GAPS Framework (Goals, Autonomy, Preparation, Strategy) to structure educational briefings before procedures and structured reviews afterwards.
• Use the NOTSS taxonomy to observe, describe and give feedback on non-technical surgical behaviours in a fair and structured way.
• Develop the judgement to know when and how to take over from a trainee in difficulty, and crucially how to hand control back without eroding their confidence or your relationship.
• Give feedback that is honest, balanced and received, not just delivered, using principles that take into account the emotional weight of high-stakes environments and second victim harm.
• Recognise the difference between a learning conversation that genuinely develops a trainee and one that colludes, criticises, or closes down rather than opens up.
• Leave with a clear sense of what good training in your environment looks like and practical steps you can take to move towards it, even within a challenged and under-resourced system.