Medical Education 2012: 46: 1161–1173 Context  General practice supervisors are said to serve as the cornerstones of general practice postgraduate education and therefore it is important to clearly define their roles and what makes them effective. The commonly used definition of a supervisor is not primarily based on general practice and does not cover aspects predicted to be important according to work‐based learning theory. Methods  We searched for papers published between 1991 and 2011 inclusive, categorised them according to whether they provided empirical evidence, descriptions or recommendations, open‐coded the empirical evidence, and used the resulting coding scheme as an analytic framework within which to present a narrative summary of findings. Results  Recommendations and descriptions far outweighed empirical evidence, which showed how supervisors intertwined clinical and educational activities and formed educational alliances with resident doctors that provided a foundation for learning. Residents needed a balance of challenge, usually provided by patients, and support, provided by supervisors. Supervisors established learning environments, assessed residents' learning needs, facilitated learning, monitored the content and process of learning and the well‐being of residents, and summarised learning in ways that turned ‘know that’ into ‘know how’. Conclusions  General practice must be expert in ensuring patients are well cared for ‘by proxy’ and in giving residents just the right amount of support they need to face the challenges posed by those patients. As general practice responds to contemporary clinical demands and rising numbers of undergraduate medical students, it is essential that the ability of general practice supervisors to develop and sustain supportive supervisory relationships with residents is preserved.

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Remote supervision was not necessarily problematic but instead provided rich learning for doctors training in and for the context where they were needed. Registrars learnt through clinical responsibility for defined populations and longitudinal, supportive supervisory relationships. Responsibility and continuity may be as important as supervisory proximity for experienced registrars.

Doctors-in-training can now be supervised remotely by specialist clinicians using information and communication technology. This provides an intermediate stage of professional development between on-site supervision and independent medical practice. Remote supervision could increase training capacity, particularly in underserved areas and ensure doctors are willing and able to practice where they are needed once qualified. Remotely supervised doctors learn via virtual autonomy in clinical decision making and working at the limits of their abilities. It suits experienced registrars with resilience, insight into their strengths and weaknesses, capacity to self-monitor and correct, and willingness to seek help. These doctors benefit from remote supervisors who facilitate their learning, monitor their well-being, and support them holistically. Educational organisations need to oversee remote placements and match the right registrar, to the right placement with the right supervisor. We outline in our twelve tips how to set up remote supervision in order to maximise the educational benefits and minimise the risks.