Factors that contribute to high-quality clinical supervision of the rural allied health workforce: lessons from the coalface
Priya Martin A B D , Katherine Baldock A , Saravana Kumar A and Lucylynn Lizarondo C
+ Author Affiliations
- Author Affiliations
A School of Health Sciences, University of South Australia, GPO Box 2471, Adelaide, SA 5001, Australia. Email: Katherine.Baldock@unisa.edu.au; Saravana.Kumar@unisa.edu.au
B Cunningham Centre, Darling Downs Hospital and Health Service, PO Box 2, Toowoomba, Qld 4350, Australia.
C Joanna Briggs Institute, Faculty of Health and Medical Sciences, University of Adelaide, Adelaide, SA 5001, Australia. Email: lucylynn.lizarondo@adelaide.edu.au
D Corresponding author. Email: Priya.Martin@health.qld.gov.au
Australian Health Review 43(6) 682-688 https://doi.org/10.1071/AH17258
Submitted: 13 November 2017 Accepted: 25 June 2018 Published: 23 August 2018
Abstract
Objective The aim of this study was to identify the factors contributing to high-quality clinical supervision of the allied health workforce in rural and remote settings.
Methods This quantitative study was part of a broader project that used a mixed-methods sequential explanatory design. Participants were 159 allied health professionals from two Australian states. Quantitative data were collected using an online customised survey and the Manchester Clinical Supervision Scale (MCSS-26). Data were analysed using regression analyses.
Results Supervisee’s work setting and choice of supervisor were found to have a positive and significant influence on clinical supervision quality. Supervisee profession and time in work role were found to have a negative and significant influence on the quality of clinical supervision.
Conclusions High-quality clinical supervision is essential to achieve quality and safety of health care, as well as to support the health workforce. Information on high-quality clinical supervision identified in this study can be applied to clinical supervision practices in rural and remote settings, and to professional support policies and training to enhance the quality of supervision.
What is known about the topic? There is mounting evidence on the benefits of clinical supervision to health professionals, organisations and patients. Clinical supervision enhances recruitment and retention of the health workforce. However, there are still gaps regarding the factors that contribute to high-quality clinical supervision, especially for rural and remote health professionals.
What does this paper add? This study, the first of its kind, recruited rural and remote health professionals from seven allied health disciplines across two Australian states. It investigated the factors that influence high-quality clinical supervision in this under-resourced group. This paper outlines specific factors that contribute to clinical supervision quality for rural and remote allied health professionals.
What are the implications for practitioners? Effective and high-quality clinical supervision of the rural and remote allied health workforce can enhance recruitment and retention in those areas. Healthcare organisations can facilitate effective clinical supervision delivery by using the evidence gathered in this study in clinical supervision policy, training and practice.
Additional keywords: professional support, rural and remote workforce.
References
[1] Milne D. An empirical definition of clinical supervision. Br J Clin Psychol 2007; 46 437–47.| An empirical definition of clinical supervision.Crossref | GoogleScholarGoogle Scholar |
[2] Brykczyńska G. Implications of the Clothier Report: the Beverly Allitt case. Nurs Ethics 1994; 1 179–81.
| Implications of the Clothier Report: the Beverly Allitt case.Crossref | GoogleScholarGoogle Scholar |
[3] Bambling M, King R, Raue P, Schweitzer R, Lambert W. Clinical supervision: its influence on client-rated working alliance and client symptom 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 symptom reduction in the brief treatment of major depression.Crossref | GoogleScholarGoogle Scholar |
[4] Farnan JM, Petty LA, Georgitis E, Martin S, Chiu E, Prochaska M, Arora VM. A systematic review: the effect of clinical supervision on patient and residency education outcomes. Acad Med 2012; 87 428–42.
| A systematic review: the effect of clinical supervision on patient and residency education outcomes.Crossref | GoogleScholarGoogle Scholar |
[5] 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 |
[6] Saxby C, Wilson J, Newcombe P. Can clinical supervision sustain our workforce in the current healthcare landscape? Findings from a Queensland study of allied health professionals. Aust Health Rev 2015; 39 476–82.
| Can clinical supervision sustain our workforce in the current healthcare landscape? Findings from a Queensland study of allied health professionals.Crossref | GoogleScholarGoogle Scholar |
[7] Hall F, Bell K. Professional support framework: improving access to professional support for professionals. Aust Health Rev 2013; 37 560–5.
| Professional support framework: improving access to professional support for professionals.Crossref | GoogleScholarGoogle Scholar |
[8] Ducat WH, Kumar S. A systematic review of professional supervision experiences and effects for allied health practitioners working in non-metropolitan health care settings. J Multidiscip Healthc 2015; 8 397–407.
| A systematic review of professional supervision experiences and effects for allied health practitioners working in non-metropolitan health care settings.Crossref | GoogleScholarGoogle Scholar |
[9] Martin P, Kumar S, Lizarondo L, VanErp A. Enablers of and barriers to high quality clinical supervision among occupational therapists across Queensland in Australia: findings from a qualitative study. BMC Health Serv Res 2015; 15 413
| Enablers of and barriers to high quality clinical supervision among occupational therapists across Queensland in Australia: findings from a qualitative study.Crossref | GoogleScholarGoogle Scholar |
[10] Snowdon DA, Millard G, Taylor NF. Effectiveness of clinical supervision of allied health professionals. J Allied Health 2016; 45 113–21.
[11] Hyrkäs K, Appelqvist-Schmidlechner K, Haataja R. Efficacy of clinical supervision: influence on job satisfaction, burnout and quality of care. J Adv Nurs 2006; 55 521–35.
| Efficacy of clinical supervision: influence on job satisfaction, burnout and quality of care.Crossref | GoogleScholarGoogle Scholar |
[12] Edwards D, Burnard P, Hannigan B, Cooper L, Adams J, Juggessur T, Fothergil A, Coyle D. Clinical supervision and burnout: the influence of clinical supervision for community mental health nurses. J Clin Nurs 2006; 15 1007–15.
| Clinical supervision and burnout: the influence of clinical supervision for community mental health nurses.Crossref | GoogleScholarGoogle Scholar |
[13] Manthorpe J, Moriarty J, Stevens M, Hussein S, Sharif N. Promoting the mental well-being of older people from Black and minority ethnic communities in United Kingdom rural areas: findings from an interview study. J Rural Stud 2012; 28 406–11.
| Promoting the mental well-being of older people from Black and minority ethnic communities in United Kingdom rural areas: findings from an interview study.Crossref | GoogleScholarGoogle Scholar |
[14] Bradley S, Kamwendo F, Masanja H, Pinho H, Waxman R, Boostrom C, McAuliffe E. District health managers’ perceptions of supervision in Malawi and Tanzania. Hum Resour Health 2013; 11 43
| District health managers’ perceptions of supervision in Malawi and Tanzania.Crossref | GoogleScholarGoogle Scholar |
[15] Nickson A, Gair S, Miles D. Supporting isolated workers in their work with families in rural and remote Australia: exploring peer group supervision. Child Aust 2016; 41 265–74.
| Supporting isolated workers in their work with families in rural and remote Australia: exploring peer group supervision.Crossref | GoogleScholarGoogle Scholar |
[16] 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 |
[17] Dawson M, Phillips B, Leggat S. Clinical supervision for allied health professionals: a systematic review. J Allied Health 2013; 42 65–73.
[18] Pollock A, Campbell P, Deery R, Fleming M, Rankin J, Sloanm G, Cheyne H. A systematic review of evidence relating to clinical supervision for nurses, midwives and allied health professionals. J Adv Nurs 2017; 73 1825–37.
| A systematic review of evidence relating to clinical supervision for nurses, midwives and allied health professionals.Crossref | GoogleScholarGoogle Scholar |
[19] Kilminster SM, Jolly BC. 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 |
[20] Pearce P, Phillips B, Dawson M, Leggat SG. Content of clinical supervision for nurses and allied health professionals, a systematic review. Clin Govern Int J 2013; 18 139–54.
| Content of clinical supervision for nurses and allied health professionals, a systematic review.Crossref | GoogleScholarGoogle Scholar |
[21] Australian Health Ministers’ Advisory Council’s Rural Health Standing Committee. National Strategic Framework for Rural and Remote Health. 2012. Available at: http://www.health.gov.au/internet/main/publishing.nsf/content/national-strategic-framework-rural-remote-health [verified 7 August 2018].
[22] Department of Health and Ageing. Report on the audit of health workforce in rural and regional Australia. Canberra: Commonwealth of Australia; 2008.
[23] Stagnitti K, Schoo A, Dunbar J, Reid C. An exploration of issues of management and intention to stay: allied health professionals in south west Victoria, Australia. J Allied Health 2006; 35 226–32.
[24] Martin P, Abernathy L, Kumar S. Making the most of what you have: challenges and opportunities from funding restrictions on health practitioners’ professional development. Internet J Allied Health Sci Pract 2013; 11 Article 3.
[25] Moran AM, Coyle J, Pope R, Boxall D, Nancarrow SA, Yound J. Supervision, support and mentoring interventions for health practitioners in rural and remote contexts: an integrative review and thematic synthesis of the literature to identify mechanisms for successful outcomes. Hum Resour Health 2014; 12 10
| Supervision, support and mentoring interventions for health practitioners in rural and remote contexts: an integrative review and thematic synthesis of the literature to identify mechanisms for successful outcomes.Crossref | GoogleScholarGoogle Scholar |
[26] Martin P, Kumar S, Lizarondo L, Tyack Z. Factors influencing the perceived quality of clinical supervision of occupational therapists in a large Australian state. Aust Occup Ther J 2016; 63 338–46.
| Factors influencing the perceived quality of clinical supervision of occupational therapists in a large Australian state.Crossref | GoogleScholarGoogle Scholar |
[27] Martin P, Lizarondo L, Kumar S. A systematic review of the factors that influence the quality and effectiveness of telesupervision for health professionals. J Telemed Telecare 2018; 24 271–81.
| A systematic review of the factors that influence the quality and effectiveness of telesupervision for health professionals.Crossref | GoogleScholarGoogle Scholar |
[28] Creswell JW. Mixed Methods Procedures. In: Research Design: Qualitative, Quantitative and Mixed Methods Approaches. 3rd edn. California: Sage; 2009; pp. 203–226.
[29] Queensland Health. Credentialing and defining the scope of clinical practice: Health Service Directive, August 2014. 2014. Available at: https://www.health.qld.gov.au/__data/assets/pdf_file/0038/670979/qh-hsd-034.pdf [verified 7 August 2018].
[30] SA Health. Allied health clinical supervision framework. 2014. Available at: http://www.sahealth.sa.gov.au/wps/wcm/connect/ad788900438bd2b689308dfd37f1549d/ASH+Clin+Super+Framework+2014.pdf?MOD=AJPERES&CACHEID=ad788900438bd2b689308dfd37f1549d [verified 1 September 2016].
[31] Winstanley J, White E. Clinical Supervision: models, measures and best practice. Nurse Res 2003; 10 7–38.
| Clinical Supervision: models, measures and best practice.Crossref | GoogleScholarGoogle Scholar |
[32] Winstanley J, White E. The MCSS-26: revision of the Manchester Clinical Supervision Scale using the Rasch measurement model. J Nurs Meas 2011a; 19 160–78.
| The MCSS-26: revision of the Manchester Clinical Supervision Scale using the Rasch measurement model.Crossref | GoogleScholarGoogle Scholar |
[33] Edwards D, Burnard P, Hannigan B, Cooper L, Adams J, Juggesur T, Fothergill A, Coyle D. Factors influencing the effectiveness of clinical supervision. J Psychiatr Ment Health Nurs 2005; 12 405–14.
| Factors influencing the effectiveness of clinical supervision.Crossref | GoogleScholarGoogle Scholar |
[34] Winstanley J, White E. The MCSS-26 user manual. Sydney: Osman Consulting; 2011.
[35] White E, Winstanley J. A randomised controlled trial of clinical supervision: selected findings from a novel Australian attempt to establish the evidence base for causal relationships with quality of care and patient outcomes, as an informed contribution to mental health nursing practice development. J Res Nurs 2010; 15 151–67.
| A randomised controlled trial of clinical supervision: selected findings from a novel Australian attempt to establish the evidence base for causal relationships with quality of care and patient outcomes, as an informed contribution to mental health nursing practice development.Crossref | GoogleScholarGoogle Scholar |
[36] Bursac Z, Gauss CH, Williams DK, Hosmer DW. Purposeful selection of variables in logistic regression. Source Code Biol Med 2008; 3 17
| Purposeful selection of variables in logistic regression.Crossref | GoogleScholarGoogle Scholar |
[37] Ducat W, Martin P, Kumar S, Burge V, Abernathy L. Oceans apart yet connected: findings from a qualitative study on professional supervision in rural and remote allied health services. Aust J Rural Health 2016; 24 29–35.
| Oceans apart yet connected: findings from a qualitative study on professional supervision in rural and remote allied health services.Crossref | GoogleScholarGoogle Scholar |
[38] Martin P, Copley J, Tyack Z. Twelve tips for effective clinical supervision based on a narrative literature review and expert opinion. Med Teach 2014; 36 201–7.
| Twelve tips for effective clinical supervision based on a narrative literature review and expert opinion.Crossref | GoogleScholarGoogle Scholar |
[39] Martin P, Milne D. Choice of clinical supervisor: cunning or collusion? J Adv Nurs 2018; 74 1229–30.
| Choice of clinical supervisor: cunning or collusion?Crossref | GoogleScholarGoogle Scholar |
[40] Cook JV, Dickinson HO, Eccles MP. Response rates in postal surveys of healthcare professionals between 1996 and 2005: An observational study. BMC Health Serv Res 2009; 9 160
| Response rates in postal surveys of healthcare professionals between 1996 and 2005: An observational study.Crossref | GoogleScholarGoogle Scholar |
