SLEs and MTRs: additional guidance for the new curriculum

Published: 28/06/2022

Please note that this guidance will be merged into the relevant sections Assessment Guidance in due course, and this standalone page will be removed.

Supervised Learning Events (SLEs)

Numbers of SLEs:

  • There is no minimum requirement for numbers of SLEs.
  • SLEs are low stakes episodes of feedback and reflection in the workplace.
  • Feedback is enhanced using supervision level judgments, that can show evidence of learning progression.
  • SLEs should be a regular part of everyday clinical training.
  • SLEs can be used as evidence together with personal activities and personal reflections to demonstrate achievement of key capabilities.

Supervision levels:

  • Anaesthetists in training will need to demonstrate progression through the supervision levels for the different key capabilities within the HALOs.
  • The assessor should identify the supervision level that the anaesthetist in training requires for that activity at the time the SLE is completed.
  • This is the supervision level the anaesthetist in training would require if they were to repeat that same activity right here, right now.

In other words, if the anaesthetist in training were presented with a similar case, what supervision level would the assessor think that they would need? Would they need a supervisor to be with them at all times, to stay close (in the anaesthetic room), to be around but not necessarily that close (in the department), or could the supervisor be at home?

Using supervision level judgments and other evidence to determine progress:

  • Anaesthetists in training do not have to have a specific SLE with the suggested supervision level to meet the HALO requirements but they do need to demonstrate progress and the faculty decision will be made based on all the evidence supplied and observation in practice.
  • Supervision levels are indicative and are intended to guide and reflect progress; SLEs are not individual assessments of competence.
  • To allow trainers to review progress we suggest that anaesthetists in training use the ‘Create HALO’ function. This then allows both trainer and anaesthetist in training to see evidence as it is linked to the clusters of capabilities. It will also show the supervision levels in due course, although this function is still being worked on by the LLp team.
  • The ‘Create HALO’ can only be used once evidence has been linked to that HALO.
  • Trainers must not press ‘Create HALO’ when viewing portfolios as this then means that the anaesthetist in training can no longer add any further evidence and it needs to be ‘unlocked’ by the LLp team.

Multiple Trainer Reports (MTRs):

  • The fundamental purpose of the MTR is to ascertain whether the anaesthetist in training is making satisfactory progress for their stage of training or not.
  • Completing an MTR can be as simple as answering the opening question and providing feedback in the general comments box.
  • The curriculum domains are there to enable trainers to put additional comments on different domains if they wish to. Trainers do not have to comment on each domain.
  • MTRs for the IAC should have:
    • an answer to the first question: Is the anaesthetist in training making satisfactory progress for their stage of training?
    • comments on Professional Behaviours and Communication, Perioperative Medicine and Health Promotion, and General Anaesthesia domains as a minimum; additional comments in other domains are at the discretion of the trainer
    • general feedback which can include aspects such as non-clinical skills.


If there is further information or clarification you would like on this topic please email to let us know.