Clinical supervision for allied health staff: necessary but not sufficient
Sandra G. Leggat A G , Bev Phillips B , Philippa Pearce C , Margaret Dawson D , Debbie Schulz E and Jenni Smith FA Health Services Management, La Trobe University, Bundoora, Vic. 3086, Australia.
B La Trobe Rural Health School, La Trobe University, PO Box 199, Bendigo, Vic. 3552, Australia. Email: bev.phillips@latrobe.edu.au
C Department of Physiotherapy, Ballarat Health Services, Ballarat, Vic. 3350, Australia. Email: PhillipaP@bhs.org.au
D Allied Health, Ballarat Health Services, Ballarat, Vic. 3350, Australia. Email: margaretd@bhs.org.au
E East Grampians Health Service, Ararat, Vic. 3377, Australia. Email: debra.schulz@eghs.net.au
F Northern Health, Epping, Vic. 3076, Australia. Email: jenni.smith@nh.org.au
G Corresponding author. Email: S.Leggat@latrobe.edu.au
Australian Health Review 40(4) 431-437 https://doi.org/10.1071/AH15080
Submitted: 28 April 2015 Accepted: 1 August 2015 Published: 28 September 2015
Journal Compilation © AHHA 2016
Abstract
Objectives The aim of the present study was to explore the perspectives of allied health professionals on appropriate content for effective clinical supervision of staff.
Methods A set of statements regarding clinical supervision was identified from the literature and confirmed through a Q-sort process. The final set was administered as an online survey to 437 allied health professionals working in two Australian health services.
Results Of the 120 respondents, 82 had experienced six or more clinical supervision sessions and were included in the analysis. Respondents suggested that clinical supervision was beneficial to both staff and patients, and was distinct from line management performance monitoring and development. Curiously, some of the respondents did not agree that observation of the supervisee’s clinical practice was an aspect of clinical supervision.
Conclusions Although clinical supervision is included as a pillar of clinical governance, current practice may not be effective in addressing clinical risk. Australian health services need clear organisational policies that outline the relationship between supervisor and supervisee, the role and responsibilities of managers, the involvement of patients and the types of situations to be communicated to the line managers.
What is known about the topic? Clinical supervision for allied health professionals is an essential component of clinical governance and is aimed at ensuring safe and high-quality care. However, there is varied understanding of the relationship between clinical supervision and performance management.
What does this paper add? This paper provides the perspectives of allied health professionals who are experienced as supervisors or who have experienced supervision. The findings suggest a clear role for clinical supervision that needs to be better recognised within organisational policy and procedure.
What are the implications for practitioners? Supervisors and supervisees must remember their duty of care and ensure compliance with organisational policies in their clinical supervisory practices.
References
[1] NHS Quality Improvement. Clinical governance & risk management: achieving safe, effective, patient-focused care and services. Scotland: NHS Quality Improvement; 2007.[2] Howatson-Jones I. Difficulties in clinical supervision and lifelong learning. Nurs Stand 2003; 17 37–41.
| Difficulties in clinical supervision and lifelong learning.Crossref | GoogleScholarGoogle Scholar | 12794979PubMed |
[3] Fitzpatrick S, Smith M, Wilding C. Quality allied health clinical supervision policy in Australia: a literature review. Aust Health Rev 2012; 36 461–5.
| Quality allied health clinical supervision policy in Australia: a literature review.Crossref | GoogleScholarGoogle Scholar | 23116979PubMed |
[4] Dawson M, Phillips B, Leggat SG. Effective clinical supervision for regional allied health professionals: the supervisee’s perspective. Aust Health Rev 2012; 36 92–7.
| Effective clinical supervision for regional allied health professionals: the supervisee’s perspective.Crossref | GoogleScholarGoogle Scholar | 22513027PubMed |
[5] Snowdon DA, Millard G, Taylor NF. Effectiveness of clinical supervision of physiotherapists: a survey. Aust Health Rev 2015; 39 190–6.
| Effectiveness of clinical supervision of physiotherapists: a survey.Crossref | GoogleScholarGoogle Scholar | 25556758PubMed |
[6] Rice F, Cullene P, McKenna H, Kelly B, Keeney S, Richey R. Clinical supervision for mental health nurses in Northern Ireland: formulating best practice guidelines. J Psychiatr Ment Health Nurs 2007; 14 516–21.
| Clinical supervision for mental health nurses in Northern Ireland: formulating best practice guidelines.Crossref | GoogleScholarGoogle Scholar | 1:STN:280:DC%2BD2svhvVKhsg%3D%3D&md5=cf07f1cb67ee00ef77b7a64d768631c6CAS | 17635261PubMed |
[7] Dawson M, Phillips B, Leggat SG. Clinical supervision for allied health professionals: a systematic review. J Allied Health 2013; 42 65–73.
| 23752232PubMed |
[8] Armstrong M, Baron A. Performance management. In Dransfield R, editor. Human resource management. Oxford: Heinemann; 2000. pp. 69–84.
[9] Winstanley J, White E. The MCSS-26: revision of the Manchester Clinical Supervision Scale using the Rasch measurement model. J Nurs Meas 2011; 19 160–78.
| The MCSS-26: revision of the Manchester Clinical Supervision Scale using the Rasch measurement model.Crossref | GoogleScholarGoogle Scholar | 22372092PubMed |
[10] Bambling M, King R, Raue P, Schweitzer R, Lambert W. Clinical supervision: its influence on client-rated working alliance and client sypmtom reduction in the brief treatment of major depression. Psychother Res 2006; 16 317–31.
| Clinical supervision: its influence on client-rated working alliance and client sypmtom reduction in the brief treatment of major depression.Crossref | GoogleScholarGoogle Scholar |
[11] Bradshaw T, Butterworth A, Mairs H. Does structured clinical supervision during psychosocial intervention education enhance outcome for mental health nurses and the service users they work with? Ment Health Nurs 2007; 14 4–12.
| 1:STN:280:DC%2BD2s%2FksVyjtg%3D%3D&md5=02c6c81e65c39735eaaf4300e9346eacCAS |
[12] Pearce P, Phillips B, Dawson M, Leggat SG. Content of clinical supervision sessions for nurses and allied health professionals: a systematic review. Clin Govern: Int J 2013; 18 139–54.
| Content of clinical supervision sessions for nurses and allied health professionals: a systematic review.Crossref | GoogleScholarGoogle Scholar |
[13] Nahm AY, Rao SS, Solis-Galvan LE, Ragu-Nathan TS. The Q-sort method: assessing reliability and construct validity of questionnaire items at a pre-testing stage. J Mod Appl Stat Methods 2002; 1 114–25.
[14] Harkness D, Hensley H. Changing the focus of social work supervision: effects on client satisfaction and generalized contentment. Soc Work 1991; 36 506–12.
| 1:STN:280:DyaK38%2FpsVCnuw%3D%3D&md5=a36eda1a962c4fc4fb509a48142bc9daCAS | 1754927PubMed |
[15] Shulman L. Skills of supervision and staff management. Itasca, IL: Peacock; 1982.
[16] Brunnetto Y. The impact of growing managerialism amongst professionals in Australia: a comparative study of university academics and hospital nurses. Res Pract Human Res Manage 2002; 10 5–21.
[17] Australian Commission on Safety and Quality in Health Care (ACSQHC). Safety and quality improvement guide standard 1: governance for safety and quality in health service organisations. Sydney: ACSQHC; 2012.
[18] Yegdich T. Clinical supervision and managerial supervision: some historical and conceptual considerations. J Adv Nurs 1999; 30 1195–204.
| Clinical supervision and managerial supervision: some historical and conceptual considerations.Crossref | GoogleScholarGoogle Scholar | 1:STN:280:DC%2BD3c%2Fjt1eisA%3D%3D&md5=6c00b3c1217f0dc3408a0e0ab2548a32CAS | 10564419PubMed |
[19] Cutcliffe JR, Butterworth T, Proctor B, editors. Fundamental themes in clinical supervision. London: Psychology Press; 2001.
[20] Long CG, Harding S, Payne K, Collins L. Nursing and health care assistant experience of supervision in a medium secure psychiatric service for women: implications for service development. J Psychiatr Ment Health Nurs 2014; 21 154–62.
| Nursing and health care assistant experience of supervision in a medium secure psychiatric service for women: implications for service development.Crossref | GoogleScholarGoogle Scholar | 1:STN:280:DC%2BC3srhvVWjsg%3D%3D&md5=6586ad535823bca60e2d630ff2e880b9CAS | 23551325PubMed |
[21] Cousins C. Becoming a social work supervisor: a significant role transition. Aust Soc Work 2004; 57 175–85.
| Becoming a social work supervisor: a significant role transition.Crossref | GoogleScholarGoogle Scholar |
[22] Johns C. Depending on the intent and emphasis of the supervisor, clinical supervision can be a different experience. J Nurs Manag 2001; 9 139–45.
| Depending on the intent and emphasis of the supervisor, clinical supervision can be a different experience.Crossref | GoogleScholarGoogle Scholar | 1:STN:280:DC%2BD387ks1ygtg%3D%3D&md5=5794349d80ba86be939f7c6d58eafbf4CAS | 11879460PubMed |
[23] Braithwaite J, Travaglia JF. An overview of clinical governance policies, practices and initiatives. Aust Health Rev 2008; 32 10–22.
| An overview of clinical governance policies, practices and initiatives.Crossref | GoogleScholarGoogle Scholar | 18241145PubMed |
[24] Young A. Review: the legal duty of care for nurses and other health professionals. J Clin Nurs 2009; 18 3071–8.
| Review: the legal duty of care for nurses and other health professionals.Crossref | GoogleScholarGoogle Scholar | 19825113PubMed |
[25] Hales C. Rooted in supervision, branching into management: continuity and change in the role of first-line manager. J Manage Stud 2005; 42 471–506.
| Rooted in supervision, branching into management: continuity and change in the role of first-line manager.Crossref | GoogleScholarGoogle Scholar |
[26] Carroll M. Supervision: critical reflection for transformational learning. Clin Supervisor 2010; 29 1–19.
| Supervision: critical reflection for transformational learning.Crossref | GoogleScholarGoogle Scholar |
[27] Milne D, Aylott H, Fitzpatrick H, Ellis MV. How does clinical supervision work? Using a “best evidence synthesis” approach to construct a basic model of supervision. Clin Supervisor 2008; 27 170–90.
| How does clinical supervision work? Using a “best evidence synthesis” approach to construct a basic model of supervision.Crossref | GoogleScholarGoogle Scholar |
[28] Bear TM, Kivlighan DM. Single-subject examination of the process of supervision of beginning and advanced supervisees. Prof Psychol Res Pr 1994; 25 450–7.
| Single-subject examination of the process of supervision of beginning and advanced supervisees.Crossref | GoogleScholarGoogle Scholar |
[29] Australian Commission on Safety and Quality in Health Care (ACSQHC). National safety and quality health service standards. Sydney: ACSQHC; 2011.
[30] Towle A, Bainbridge L, Godolphin W, Katz A, Kline C, Lown B, Madularu I, Solomon P, Thistlethwaite J. Active patient involvement in the education of health professionals. Med Educ 2010; 44 64–74.
| Active patient involvement in the education of health professionals.Crossref | GoogleScholarGoogle Scholar | 20078757PubMed |
[31] Coster JS, Schwebel M. Well-functioning in professional psychologists. Prof Psychol Res Pr 1997; 28 5–13.
| Well-functioning in professional psychologists.Crossref | GoogleScholarGoogle Scholar |
[32] Strong J, Kavanagh D, Wilson J, Spence SH, Worrall L, Crow N. Supervision practice for allied health professionals within a large mental health service. Clin Supervisor 2008; 29 191–210.
