Supervisees’ experiences in supervision vary remarkably. To capture such variability, Ellis and colleagues offered a framework for understanding and assessing inadequate, harmful, and exceptional ...supervision. Although their framework was supported, it did not offer a nuanced understanding of these supervision experiences. Using consensual qualitative research–modified, this study sought to obtain a rich description of inadequate, harmful, and exceptional supervision. Participants (N = 135) were presented with definitions and provided responses (n = 156) to open-ended questions describing their inadequate (n = 63), harmful (n = 30), and/or exceptional (n = 63) supervision experiences. Supervisees reporting harmful experiences described supervisors as neglectful and callous, whereas inadequate supervision reflected inappropriate feedback, unavailability, and unresponsiveness. Conversely, exceptional supervision involved safety, clinical paradigm shifts, and modeling specific techniques or theories. Implications for supervision research, theory, and practice are discussed.
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NUK, OILJ, SAZU, UKNU, UL, UM, UPUK
Applying the relational humility model to address gaps in the clinical supervision literature, we tested the interpersonal constructs of relational humility, supervisory working alliance, and ...relational behavior as predictors of supervisee nondisclosure (i.e., clinically-related and supervision-related nondisclosure). We hypothesized that relational humility moderates the relation between supervisory working alliance and supervision-related nondisclosure and that the supervisory working alliance and relational behavior each uniquely predicts supervisee nondisclosure. Self-report data from 312 trainees in the United States receiving clinical supervision across training settings found relational humility, supervisory working alliance, and relational behavior explained over a quarter of the variance in the multivariate construct of supervisee nondisclosure. Relational humility significantly moderated (and amplified) the inverse relation between the supervisory working alliance and supervision-related nondisclosure. The supervisory working alliance and relational behavior did not uniquely predict clinically-related or supervision-related nondisclosure. Results are discussed for their practical, theoretical, and research implications.
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NUK, OILJ, SAZU, UKNU, UL, UM, UPUK
We present a reaction to Legha's (2023) anti-racist model of clinical supervision. We start by outlining the strengths of Legha's model, including the need for supervisor self-awareness and the ...understanding of racism from a historical perspective. We then outline ways in which the model could be enhanced by focusing on epistemic violence, and conclude by discussing potential barriers to clinical and institutional implementation of Legha's model. We appreciate Legha's anti-racist model and view it as an important step forward toward the eradication of racism within mental health practice.
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BFBNIB, NUK, PILJ, SAZU, UL, UM, UPUK
To ensure quality of care delivery clinical supervision has been implemented in health services. While clinical supervision of health professionals has been shown to improve patient safety, its ...effect on other dimensions of quality of care is unknown. The purpose of this systematic review is to determine whether clinical supervision of health professionals improves effectiveness of care and patient experience.
Databases MEDLINE, PsychINFO, CINAHL, EMBASE and AMED were searched from earliest date available. Additional studies were identified by searching of reference lists and citation tracking. Two reviewers independently applied inclusion and exclusion criteria. The quality of each study was rated using the Medical Education Research Study Quality Instrument. Data were extracted on effectiveness of care (process of care and patient health outcomes) and patient experience.
Seventeen studies across multiple health professions (medical (n = 4), nursing (n = 7), allied health (n = 2) and combination of nursing, medical and/or allied health (n = 4)) met the inclusion criteria. The clinical heterogeneity of the included studies precluded meta-analysis. Twelve of 14 studies investigating 38,483 episodes of care found that clinical supervision improved the process of care. This effect was most predominant in cardiopulmonary resuscitation and African health settings. Three of six studies investigating 1756 patients found that clinical supervision improved patient health outcomes, namely neurological recovery post cardiopulmonary resuscitation (n = 1) and psychological symptom severity (n = 2). None of three studies investigating 1856 patients found that clinical supervision had an effect on patient experience.
Clinical supervision of health professionals is associated with effectiveness of care. The review found significant improvement in the process of care that may improve compliance with processes that are associated with enhanced patient health outcomes. While few studies found a direct effect on patient health outcomes, when provided to mental health professionals clinical supervision may be associated with a reduction in psychological symptoms of patients diagnosed with a mental illness. There was no association found between clinical supervision and the patient experience.
CRD42015029643 .
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CEKLJ, DOBA, IZUM, KILJ, NUK, PILJ, PNG, SAZU, SIK, UILJ, UKNU, UL, UM, UPUK
Background
Research concerning transitions from one rotation to another during medical specialist training is scarce. This study examined trainee doctors' perceived preparedness for core clinical ...activities, trainee doctors' preparedness levels, and general perceptions of medical specialist training in geriatric psychiatry.
Method
Swiss trainee doctors in geriatric psychiatry were surveyed about their perceived preparedness for 18 preliminary entrustable professional activities (EPAs), curricular support, and general perceptions of their medical specialist training. Closed questions were analysed using descriptive statistics, while open questions were subjected to content analysis.
Results
The participants comprised 48 trainee doctors (30.4% response rate) who differed in their educational experience (years of residency and specialism) and clinical subspecialisation goals. Trainee doctors felt adequately prepared for most EPAs but less prepared for some, including electroconvulsive therapy, psychotherapy, and treating older adults in the home environment or residential facilities. Despite the trainee doctors' diversity, they did not differ significantly in perceived preparedness for most EPAs. The most often offered suggestions for improving geriatric psychiatry training were intensified clinical supervision and a structured induction programme.
Conclusion
Trainee doctors reported that they felt sufficiently prepared for most EPAs, regardless of their backgrounds and professional goals. However, several professional activities in geriatric psychiatry warrant further training. Our findings indicate the need for a higher intensity of clinical supervision (e.g. more direct observation and specific feedback), the introduction of structured induction programmes (e.g. orientation week), and specific teachings (e.g. on neurocognitive assessment).
Key points
Clinical activities in geriatric psychiatry, such as electroconvulsive therapy (ECT) and home‐treatment, may require further training.
The trainee doctors' backgrounds had no influence on their perceived preparedness for most clinical tasks in geriatric psychiatry.
Direct observation of and high‐quality feedback for trainees are necessary for effective learning in geriatric psychiatry.
Intensified clinical supervision and structured induction were suggested to improve geriatric psychiatry specialist training.
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FZAB, GIS, IJS, KILJ, NLZOH, NUK, OILJ, SBCE, SBMB, UL, UM, UPUK
Purpose: To determine if the addition of direct supervision to usual clinical supervision practice of physiotherapists can improve compliance with clinical practice guidelines and post-surgical ...outcomes for inpatients with hip fracture.
Methods: A controlled before-and-after study was conducted on two acute orthopedic wards. Junior and mid-level physiotherapists on one ward were provided with direct supervision during their post-operative management of patients with hip fracture. Physiotherapists on the comparison ward received usual reflective supervision. The primary outcome was patient compliance with the hip fracture guideline to mobilize on the day following surgery. Secondary patient outcomes included physical function on the fifth post-operative day.
Results: Data were collected from 290 patients with acute hip fracture. Patients at the direct supervision site were more likely to mobilize on the day after surgery OR 3.14, 95% confidence interval (CI) 1.41-7.01; p = 0.005 and by the second post-operative day (OR 4.62, 95% CI 2.31-9.23; p < 0.001) compared to patients at the comparison site. Patients walked further on the fifth post-operative day (p < 0.001) with less assistance from therapists (p = 0.044).
Conclusions: The addition of direct supervision improved physiotherapists' compliance with hip fracture guidelines and walking endurance and independence in hospitalized patients with hip fracture.
Implications for rehabilitation
The addition of a direct supervision model, where physiotherapists are directly observed in their management of patients with hip fracture, to usual practice supervision improved early mobilization of patients with hip fracture
Direct supervision appears to be an effective guideline implementation strategy that can improve care and outcomes for hospitalized patients with hip fracture
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IJS, NUK, UL, UM, UPUK, VSZLJ
Medical education relies on clinical supervision for critical functions, including trainee assessment and ensuring patient safety. Yet, there is substantial variance in supervision, which has led to ...calls for a shared definition of the concept and guidelines to inform practice.
provided these desired elements and is highly cited, suggesting that translation and utilization of the Guide's knowledge is suboptimal. This study investigates utilization by systematically characterizing citations to the Guide and by describing translation of its recommendations in relation to supervision.
Citations were identified using Web of Science, Scopus, and Google Scholar. The authors coded all citations and conducted a subanalysis of studies specific to supervision.
583 studies were identified; 268 met inclusion criteria for general analysis of which 167 studies were further analyzed. Most studies reiterated the Guide's characterization of effective supervision, but few demonstrate how these recommendations inform innovations in supervisory practice.
Translation of the Guide's recommendations regarding clinical supervision appears limited. Future research should consider the extent of knowledge translation occurring in clinical supervision literature as well as AMEE Guides. Increased attention to knowledge translation in medical education may benefit the distribution of similar knowledge products.
Working With Conflict in Clinical Supervision Nelson, Mary Lee; Barnes, Kristin L; Evans, Amelia L ...
Journal of counseling psychology,
04/2008, Volume:
55, Issue:
2
Journal Article
Peer reviewed
Eight female and 4 male supervisors identified by professional peers as highly competent were interviewed about experiences of conflict in supervision and their dependable strategies for managing it. ...Highly competent supervisors were open to conflict and interpersonal processing, willing to acknowledge shortcomings, developmentally oriented, and willing to learn from mistakes. They believed in creating strong supervisory alliances, discussing evaluation early on, modeling openness to conflict, and providing timely feedback. Dependable strategies included contextualizing conflicts in light of developmental and environmental factors, seeking consultation with colleagues, self-coaching, processing conflicts, accentuating supervisee strengths, interpreting parallel processes, and withdrawing from supervisee dynamics.
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CEKLJ, FFLJ, NUK, ODKLJ, PEFLJ, UPUK
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