Can clinical supervision sustain our workforce in the current healthcare landscape? Findings from a Queensland study of allied health professionals
Christine Saxby A B D , Jill Wilson A and Peter Newcombe CA School of Social Work and Human Services, The University of Queensland, Qld 4072, Australia. Email: j.wilson@social.uq.edu.au
B Subacute and Ambulatory Service, Metro North Hospital and Health Service, North Lakes Health Precinct, 9 Endeavour Boulevard, North Lakes, Qld, 4509, Australia.
C School of Psychology, The University of Queensland, Qld 4072, Australia. Email: newc@psy.uq.edu.au
D Corresponding author. Email: christine.saxby@uqconnect.edu.au
Australian Health Review 39(4) 476-482 https://doi.org/10.1071/AH14183
Submitted: 9 October 2014 Accepted: 9 January 2015 Published: 2 March 2015
Abstract
Objective Clinical supervision is widely recognised as a mechanism for providing professional support, professional development and clinical governance for healthcare workers. There have been limited studies about the effectiveness of clinical supervision for allied health and minimal studies conducted within the Australian health context. The aim of the present study was to identify whether clinical supervision was perceived to be effective by allied health professionals and to identify components that contributed to effectiveness. Participants completed an anonymous online questionnaire, administered through the health service’s intranet.
Methods A cross-sectional study was conducted with community allied health workers (n = 82) 8 months after implementation of structured clinical supervision. Demographic data (age, gender), work-related history (profession employment level, years of experience), and supervision practice (number and length of supervision sessions) were collected through an online survey. The outcome measure, clinical supervision effectiveness, was operationalised using the Manchester Clinical Supervision Scale-26 (MCSS-26©). Data were analysed with Pearson correlation (r) and independent sample t-tests (t) with significance set at 0.05 (ie the probability of significant difference set at P < 0.05).
Results The length of the supervision sessions (rs ≥0.44), the number of sessions (rs ≥ 0.35) and the total period supervision had been received (rs ≥ 0.42) were all significantly positively correlated with the MCSS-26© domains of clinical supervision effectiveness. Three individual variables, namely ‘receiving clinical supervision’, ‘having some choice in the allocation of clinical supervisor’ and ‘having a completed clinical supervision agreement’, were also significantly associated with higher total MCSS-26© scores (Ps < 0.014).
Conclusion The results of the study demonstrate that when clinical supervision uses best practice principles, it can provide professional support for allied health workers, even during times of rapid organisational change.
What is known about the topic? The provision of clinical supervision for allied health staff is being increasingly adopted within the Australian health context. However, current approaches to clinical supervision for allied health are fragmented and poorly coordinated. There have been limited clinical supervision studies undertaken in Australian allied health populations, and little is known about the evidence for outcomes in this cohort.
What does this paper add? The findings of the present study indicate that clinical supervision, when based on best practice principles, can provide professional support and guidance to allied health workers, even when staff are experiencing significant change in the workplace. The article describes specific elements of the clinical supervision infrastructure that appear to be critical for effective professional support outcomes.
What are the implications for practitioners? Effective clinical supervision can provide professional support to the allied health workforce. Healthcare organisations can facilitate effective clinical supervision delivery by ensuring that evidence-based principles are embedded in the infrastructure of the clinical supervision practice.
References
[1] Rodger S, Webb G, Devitt L, Gilbert J, Wrightson P, McMeeken J. Commentary: ‘clinical education and practice placements in the allied health professions: an international perspective’. J Allied Health 2008; 37 53–62.| 18444440PubMed |
[2] Sawbridge Y, Hewison A. Time to care? Responding to concerns about poor nursing care. Research that makes a real difference. University of Birmingham, Health Services Management Centre, Policy Paper 12; 2011.
[3] Lloyd C, King R, Chenoweth L. Social work, stress and burnout: a review. J Mental Health 2002; 11 255–65.
| Social work, stress and burnout: a review.Crossref | GoogleScholarGoogle Scholar |
[4] Wells J. The impact of stress amongst health professionals . J Mental Health 2011; 20 111–14.
[5] Maslach C, Jackson SE, Leiter MP. Maslach burnout inventory manual. 3rd edn. Palo Alto: Consulting Psychologists Press; 1996.
[6] Thanacoody PR, Bartram T, Casimir G. The effects of burnout and supervisory social support on the relationship between work-family conflict and intention to leave. J Health Organization Manage 2009; 23 53–69.
| The effects of burnout and supervisory social support on the relationship between work-family conflict and intention to leave.Crossref | GoogleScholarGoogle Scholar |
[7] Hawes K. Nurse job stress, burnout, practice environment and maternal satisfaction in the neonatal intensive care unit. Ann Arbor: University of Rhode Island; 2009.
[8] Edwards D, Burnard P. A systematic review of the efffects of stress and coping strategies used by occupational therapists working in mental health settings. Br J Occup Ther 2003; 66 345–55.
[9] 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 |
[10] Winstanley J, White E. The MCSS-26© user manual. Version 1.0. Sydney: Osman Consulting; 2011.
[11] Proctor B. Training for the supervision alliance: Attitude, Skills and Intention. In: Cutcliffe JR, Hyrkas K, Fowler J, editors. Routledge handbook of clinical supervision: fundamental international themes. London: Routledge; 2011. pp. 23–34.
[12] Health Workforce Australia. Australia’s health workforce series: health workforce by numbers. Adelaide: Health Workforce Australia; 2013.
[13] Bradley G, Hojer S. Supervision reviewed: reflections on two different social work models in England and Sweden. Eur J Social Work 2009; 12 71–85.
| Supervision reviewed: reflections on two different social work models in England and Sweden.Crossref | GoogleScholarGoogle Scholar |
[14] Clinical Education and Training Queensland. Framework for best practice clinical learning environments in Queensland Health, final draft for external comment, 2010. Brisbane: Queensland Government; 2010.
[15] Clinical Education and Training Institute (CETI). The superguide: a handbook for supervising allied health professionals. Sydney: CETI; 2011.
[16] Spence S, Wilson J, Kavanagh D, Strong J, Worrall L. Clinical supervision in four mental health professions: a review of the evidence. Behav Change 2001; 18 135–55.
| Clinical supervision in four mental health professions: a review of the evidence.Crossref | GoogleScholarGoogle Scholar |
[17] Proctor B. Group supervision: a guide to creative practice. 2nd edn. London: Sage; 2008.
[18] Bogo M, Paterson J, Tufford L, King R. Interprofessional clinical supervision in mental health and addiction: toward identifying common elements. Clin Supervisor 2011; 30 124–40.
| Interprofessional clinical supervision in mental health and addiction: toward identifying common elements.Crossref | GoogleScholarGoogle Scholar |
[19] Dawson M, Phillips B, Leggat S. 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 |
[20] Kilminster S, Jolly B. Effective supervision in clinical practice settings: a literature review. Med Educ 2000; 34 827–40.
| Effective supervision in clinical practice settings: a literature review.Crossref | GoogleScholarGoogle Scholar | 1:STN:280:DC%2BD3M%2Fit1WrtA%3D%3D&md5=c9877b91929a26e37c9b914657fa910eCAS | 11012933PubMed |
[21] Bambling M. The effect of clinical supervision on the development of counsellor competency. Psychother Aust 2000; 6
[22] Siggins Miller Consultants. Promoting quality in clinical placements: literature review and national stakeholder consultation. Adelaide: Health Workforce Australia; 2012.
[23] Edwards D, Cooper L, Burnard P, Hanningan B, Adams J, Fothergill A, Coyle D. Factors influencing the effectiveness of clinical supervision. J Psychiatr Mental Health Nurs 2005; 12 405–14.
| Factors influencing the effectiveness of clinical supervision.Crossref | GoogleScholarGoogle Scholar | 1:STN:280:DC%2BD2MzlvVKnsQ%3D%3D&md5=84c10531d8b17586c63df247f577cd1cCAS |
[24] Dawson M, Phillips B, Leggat S. Effective clinical supervision for regional allied health professionals: the supervisor’s perspective. Aust Health Rev 2013; 37 262–7.
| 23498922PubMed |
[25] Watkins CE. Does psychotherapy supervision contribute to patient outcomes? Considering 30 years of research. Clin Supervisor 2011; 30 235–56.
| Does psychotherapy supervision contribute to patient outcomes? Considering 30 years of research.Crossref | GoogleScholarGoogle Scholar |
[26] Hyrkas K, Appelqvist-Schmidlechner K, Haataja R. Efficacy of clinical supervision: influence on job satisfaction, burnout and quality of care. Nurs Healthcare Manag Policy 2006; 521–35.
[27] Kavanagh D, Sturk H, Strong J, Wilson DJ, Waldrop D, Crow N, Skerrett R. Outcomes of training in supervision: randomised controlled trial. Aust Psychologist 2008; 43 96–104.
| Outcomes of training in supervision: randomised controlled trial.Crossref | GoogleScholarGoogle Scholar |
[28] Milne D, Sheikh A, Pattison S, Wilkinson A. Evidence-based training for clinical supervisors: a systematic review of 11 controlled studies. Clin Supervisor 2011; 30 53–71.
| Evidence-based training for clinical supervisors: a systematic review of 11 controlled studies.Crossref | GoogleScholarGoogle Scholar |
[29] Hyrkäs K. Clinical supervision, burnout, and job satisfaction among mental health and psychiatric nurses in Finland. Issues Mental Health Nurs 2005; 26 531–56.
| Clinical supervision, burnout, and job satisfaction among mental health and psychiatric nurses in Finland.Crossref | GoogleScholarGoogle Scholar |
[30] Spence C, Cantrell J, Christie I, Samet W. A collaborative approach to the implementation of clinical supervision. J Nurs Manag 2002; 10 65–74.
| A collaborative approach to the implementation of clinical supervision.Crossref | GoogleScholarGoogle Scholar | 1:STN:280:DC%2BD387ltVahsA%3D%3D&md5=0513ef16a1815bf93a8a40b9d90aebdeCAS | 11882107PubMed |
[31] Veronesi G, Harley K, Dugdale P, Shiort S. Governance, transparency and alignment in the Council of Australian Governments (COAG). National Health Reform Agreement. Aust Health Rev 2011; 2014 288–94.
[32] Dell A. Public servants in fear for their jobs. Local Radio Brisbane ABC. 2012. Available at: http://blogs.abc.net.au/queensland/2012/05/public-servants-in-fear-for-their-jobs.html?site=brisbane&program=612_morning [verified 20 January 2013].
