Academic journal article Australian Health Review

Effective Clinical Supervision for Regional Allied Health Professionals: The Supervisor's Perspective

Academic journal article Australian Health Review

Effective Clinical Supervision for Regional Allied Health Professionals: The Supervisor's Perspective

Article excerpt

Introduction

Clinical supervision (CS) is emerging as an important component of clinical governance. It supports quality patient care, delivered by skilled and competent health professionals who have taken responsibility for their own development and support through the use of effective CS.1 The process ofCSdemands a commitment of resources and time. It is important to evaluate CS and its effectiveness for the support of individuals within the supervisory relationship and for the patients receiving care to ensure sound clinical governance for the employing organisation.2,3

Key topics covered in the CS literature include defining CS and its importance, the skills required for CS, the impacts of past CS experiences and improvement ideas.4 Definitions of CS in the literature have generally described a relationship which seeks to enhance clinical skill and professional knowledge, and provide support.5,6 Emphasis has also been placed on the working alliance where professionals work collaboratively together in CS, to ensure that organisational goals and the clinical and ethical standards of the profession are met.5

A frequently used model of CS is Proctor's model, which consists of three components that are described as restorative, formative and normative.7-9 The restorative area is the supportive component of CS and is concerned with checking for work distress and burnout and directing to appropriate help. The formative area critically examines clinical interventions and interactions with clients, develops clinical skill and embeds evidence based practice. Finally, the normative area deals with professional issues including confidentiality, codes of practice and boundaries and quality.7,8,10 Proctor's model has been reported to have face validity and may be useful in providing a conceptual framework in which supervisors consider their CS practice.11,12

The effectiveness of CS has previously been evaluated using focus group or semi-structured interviews, Delphi technique, selfcompletion questionnaires and instruments such as the Minnesota Job Satisfaction Scale, the Maslach Burnout Scale and the Manchester Clinical Supervision Scale, which is a validated tool used to evaluate supervisee perceptions of CS.9,10 However, no validated tool for evaluating CS from a supervisor's perspective was identified in the literature.

This study explored CS for AHPs from the supervisor's perspective and used Proctor's model of CS as a theoretical framework to interpret the results. It builds on a previously published paper exploring the supervisee's perspective of CS.13

Methods

This mixed methods study involved two phases. In Phase 1, focus groups were used to explore CS as perceived by clinical supervisors. In Phase 2, a questionnaire tool was developed to explore the themes identified from the focus group data.

The sample was drawn from the allied health directorate of a large regional health service, where ~120 AHPs were employed, representing the following professions: speech pathology, physiotherapy, podiatry, psychology, prosthetics and orthotics, exercise therapy, dietetics, social work and occupational therapy. Eligible for inclusion in this study were all AHPs who currently acted as supervisors for clinical practice. Discipline managers provided a list of current supervisors to an independent researcher, who did not have a reporting relationship with any of the supervisors, and who sent an email to all potential participants, inviting their voluntary participation.

For Phase 1, an interview question guide for the focus groups was developed using the themes identified from a literature review. An experienced external moderator and an independent note taker were used and data were recorded anonymously. The duration for each of the three focus groups was 1-1.5 h. Focus group transcripts, which were not reviewed by the participants, were analysed using manual coding to identify themes and subthemes; as the themes were collapsed into fewer more comprehensive themes the transcripts were reviewed to check the fit of data. …

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