PhD candidate, University of South Australia
Clinical supervision is a form of professional support that health professionals working in health organisations can access. It is a platform to enhance their skills and knowledge to build competence within their roles. High quality clinical supervision has benefits for patients, staff and organisations. However, there is a lack of information on what constitutes high quality clinical supervision. This is especially true for allied health professionals practising in rural and remote areas. This research study used surveys and interviews to investigate the factors that contribute to high quality clinical supervision for rural and remote allied health professionals. The study recruited 175 supervisees from two states in Australia - Queensland and South Australia. Findings indicated that supervisee work setting and choice of supervisor had a positive influence on supervision quality. Supervisee profession and time in work role had a negative influence on supervision quality. Furthermore, we now know that clinical supervision is rural and remote settings is complex and multi-faceted given the broad scope of roles. This study has identified various factors that positively or negatively influence supervision quality for rural and remote health professionals. This information has the potential to influence policies and guidelines on supervision training and practice.
Abstract: To determine whether clinical supervision (CS) of health professionals improves patient safety.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. Thirty-two studies across three health professions [medicine (n = 29), nursing (n = 2) and paramedicine (n = 1)] were selected.The quality of each study was rated using the Medical Education Research Study Quality Instrument. Risk ratios (RR) were calculated for patient safety outcomes of mortality, complications, adverse events, reoperation following initial surgery, conversion to more invasive surgery and readmission to hospital.Results of meta-analyses provided low-quality evidence that supervision of medical professionals reduced the risk of mortality (RR 0.76, 95% CI 0.60-0.95, I (2) = 76%) and supervision of medical professionals and paramedics reduced the risk of complications (RR 0.69, 95% CI 0.53-0.89, I (2) = 76%). Due to a high level of statistical heterogeneity, sub-group analyses were performed. Sub-group analyses provided moderate-quality evidence that direct supervision of surgery significantly reduced the risk of mortality (RR 0.68, 95% CI 0.50-0.93, I (2) = 33%) and direct supervision of medical professionals conducting non-surgical invasive procedures significantly reduced the risk of complications (RR 0.33, 95% CI 0.24-0.46, I (2) = 0%).CS was associated with safer surgery and other invasive procedures for medical practitioners. There was a lack of evidence about the relationship between CS and safer patient care for non-medical health professionals.
Pub.: 11 Jun '16, Pinned: 19 Oct '17
Abstract: To systematically review evidence relating to clinical supervision for nurses, midwives and allied health professionals.Since 1902 statutory supervision has been a requirement for UK midwives, but this is due to change. Evidence relating to clinical supervision for nurses and allied health professions could inform a new model of clinical supervision for midwives.A systematic review with a contingent design, comprising a broad map of research relating to clinical supervision and two focussed syntheses answering specific review questions.Electronic databases were searched from 2005 - September 2015, limited to English-language peer-reviewed publications.Systematic reviews evaluating the effectiveness of clinical supervision were included in Synthesis 1. Primary research studies including a description of a clinical supervision intervention were included in Synthesis 2. Quality of reviews were judged using a risk of bias tool and review results summarised in tables. Data describing the key components of clinical supervision interventions were extracted from studies included in Synthesis 2, categorised using a reporting framework and a narrative account provided.Ten reviews were included in Synthesis 1; these demonstrated an absence of convincing empirical evidence and lack of agreement over the nature of clinical supervision. Nineteen primary studies were included in Synthesis 2; these highlighted a lack of consistency and large variations between delivered interventions.Despite insufficient evidence to directly inform the selection and implementation of a framework, the limited available evidence can inform the design of a new model of clinical supervision for UK-based midwives. This article is protected by copyright. All rights reserved.
Pub.: 11 Jan '17, Pinned: 19 Oct '17
Abstract: RECENT POLICY changes have highlighted the importance of clinical supervision (CS) for nurses. The most recent government report reinforcing the importance of CS on the policy agenda is Making a Difference ( DoH 1999 ). In this document the government launched a wide ranging programme of measures to improve the NHS and the health of people in England.
Pub.: 26 Jan '00, Pinned: 19 Oct '17
Abstract: To summarize the literature regarding the effect of clinical supervision on patient and educational outcomes, especially in light of the recent (2010) Accreditation Council for Graduate Medical Education report that recommends augmented supervision to improve resident education and patient safety.The authors searched the English-language literature from 1966 to 2010 using electronic databases and a hand search. They included studies that described a controlled design, and they have relayed the effects of supervision on patient- and education-related outcomes. Two authors abstracted prescribed data from the reviewed studies. The authors rated the quality of each study using the Medical Education Research Study Quality Instrument.Twenty-four articles across a variety of specialties (i.e., psychiatry, emergency medicine, surgery, anesthesia, and internal medicine) met inclusion criteria. Studies demonstrated that enhanced supervision in already-supervised activities resulted in improved patient- or education-related outcomes. Studies were limited by small sample sizes, nonrandomized designs, and a lack of objective measures of clinical supervision.Enhanced clinical supervision of trainees has been associated with improved patient- and education-related outcomes in published studies. Future work should focus on developing validated measures of the effects of clinical supervision.
Pub.: 01 Mar '12, Pinned: 19 Oct '17
Abstract: Clinical supervision has gained wide recognition in recent years as an essential component of a practitioner's continuing professional development. However, confusion exists in professional literature regarding the most effective models, styles, processes and methods of clinical supervision.This article outlines the elements required to establish and sustain an effective clinical supervision arrangement for health professionals, based on current evidence and the author's expert opinion.A set of practical strategies are proposed to assist practitioners to establish an ongoing, effective clinical supervision partnership.
Pub.: 22 Nov '13, Pinned: 19 Oct '17