Group Clinical Supervision Research Articles

Clinical group supervision in an intensive care unit: a space for relief, and for sharing emotions and experiences of care.

Much has been written about models, aims and the concept of clinical group supervisional, although few studies are empirical or focus on intensive care. The aim of the study was to illuminate the process and describe, using qualitative content analysis, the content of conversations carried out during the course of clinical group supervision sessions among Registered Nurses (RN) and enrolled nurses (EN) working in an intensive care unit (ICU). During the supervision sessions, ENs talked about their life-world from a caring perspective, while RNs focused on their professional development. Both ENs and RNs regarded the supervision sessions as a space for relief and for sharing emotions and caring experiences, which helped to manage complex nursing care. The findings are viewed in the light of Roach's theoretical framework describing the attributes of professional care as five Cs. Clinical group supervision is interpreted as supportive in developing interpersonal skills and a sensitive nursing practice.

Dementia care nurses’ experiences of systematic clinical group supervision and supervised planned nursing care

Although clinical supervision has been used for many years in Swedish psychiatric settings, it has received comparatively little attention from researchers. In this study the sample consisted of 13 nurses, working on one ward housing 11 patients, in a psychogeriatric clinic in southern Sweden.

Dementia care nurses' experiences of systematic clinical group supervision and supervised planned nursing care

Aim To reveal 13 nurses' experiences of systematic clinical group supervision and supervised individually planned nursing care, while working with people suffering from severe dementia. Background Clinical supervision is a major issue in nursing, however empirical knowledge of the subject is limited. Nurse's narrations about their experiences may extend the knowledge available and serve as a basis for creating models of support systems for nurses in their care provision. Methods Open-ended interviews were performed and the text was analysed through content analysis. A questionnaire was used to evaluate the views of the effects of clinical supervision. Findings Two main themes were found. Confirmed uniqueness included two sub-themes: confirming the nurses as a person and as a professional and confirming the patient as a unique human being. Consolidated sense of community included three sub-themes: closer relationship between the nurses, changed organization of nursing care and improved individualizing in routines of nursing care. The questionnaire result showed improvements in co-operation and in providing professional nursing care and personal development. Conclusion Interventions to improve working conditions for the nurses and care quality for the patients may well focus the core process, i.e. feedback and support for the nurse–patient interaction and person-orientated nursing care, taking into account the constellation and conditions of the group.

The meaning and significance of clinical group supervision and supervised individually planned nursing care as narrated by nurses on a general team psychiatric ward.

By interviewing 22 psychiatric nurses, the present study aimed to reveal the meaning and significance of systematic clinical group supervision and supervised individually planned nursing care, using latent content analysis. The interpreted meaning was 'confronting the complexity of ongoing life in daily nursing care' and the interpreted significance was 'strengthening the foundation for nursing care'. Reflection on action and confirmation seemed to be core components in the process of clinical supervision. Focusing on the relational and task aspects in nursing care within a group approach may have contributed to the positive experiences of development that occurred.

Our journey with clinical supervision in an intensive care unit.

In 1991, the nursing profession began to pursue the idea of reflective practice with vigour, despite little evidence that reflective practice improved nursing care (Burnard 1991; Hunt 1993). A small qualitative study on the experiences of nurses writing reflective journals was undertaken in the intensive care unit at Newham General Hospital. (A Price 1995). This highlighted the need for clear initial guidance and support when introducing reflective practice. It also demonstrated a lack of knowledge about reflection within the unit. During this time, a group of nurses who were interested in developing clinical supervision as a method of support for staff was formed. Kohner's (1994) definition of clinical supervision, adopted by the group after review of literature, makes it clear that this involves reflection on practice. Johns' (1993) Model of Structured Reflection was amended and used to promote in-depth analysis of situations, and journal writing was encouraged within the group. A continuing process of group clinical supervision was started, initially with the help of a facilitator experienced in it. On the basis of this experience, a strategy for implementation of clinical supervision in the intensive care unit was developed and put into action by the group members. Consideration of the progress and problems experienced leads to the conclusion that continuing staff motivation and commitment, and adequate time are essential for implementation of clinical supervision.

Clinical Supervision for School Psychologists

A United States national survey of 500 practicing school psychologists was conducted to assess current practice trends in clinical supervision. A resultant sample of 323 responses were received, provid ing a usable response rate of 65 percent. The data indicated that while 10 percent of practicing school psychologists were participating in individual and/or group clinical supervision nationwide, respondents were receiving less supervision than recommended by APA or NASP professional standards. Of note, clinically supervised (91 percent) and non-clinically supervised (70 percent) school psychologists overwhelm ingly indicated that school psychologists should participate in clinical supervision.

The effectiveness of a group approach to clinical supervision in reducing stress: a review of the literature.

There is little research evidence to suggest that clinical supervision reduces stress. However, this probably does not mean that clinical supervision is not valuable, just that the evidence is not yet there, because consensus exists that group clinical supervision may be beneficial in reducing stress in nurses. The work by Butterworth et al. is the only directly relevant study investigating the stress-reducing potential that a group approach to clinical supervision has, and this work establishes ground rules for future evaluation.

Group clinical supervision in district nursing

There is growing evidence that clinical supervision is a useful means of developing practice in nursing (Butterworth et al, 1997). There is, however, little in the way of research evidence to support various approaches to supervision for district nurses. This article reports a practice development initiative in which clinical supervision was implemented in a community trust. The rationale which underpinned the decision to implement group supervision is explored and the supervision techniques described. Recommendations are made for further work in this area, most notably in relation to evaluation.

Caring for demented people in their homes or in sheltered accommodation as reflected on by home-care staff during clinical supervision sessions.

This study aimed to illuminate both the content of and the care given to demented people and the reflections of home care staff about it as revealed in two clinical group supervision sessions (n = 36). Verbatim transcriptions were analysed using a phenomenological hermeneutic approach and the following were found to be reflected on: the pensioners' personal situation--disease-related behaviour, ADL-functions, social network and self-esteem; the pensioners' environment--their relationships to significant others, adequate level of housing/care, access to activities, and satisfactory personal space; pensioner/staff interaction--their relations to each other, the staffs' relation to the pensioners' family, and the balance between reality-orientation vs. validation; the staff's situation--co-operation with other professionals, in primary health care, hospital, and within the social services; job satisfaction, lack of knowledge and sharing of knowledge, and lack of resources, especially time. The reasoning of the participants under supervision was found to be based on medical, historical, psychological, and environmental explanations, or personal beliefs. Feelings explored during supervision were directed towards the pensioners or the pensioners' families, towards themselves or towards the management. The findings were interpreted within a nursing model based on the four central concepts of nursing; person, environment, nursing intervention and health. The reasoning about nursing care revealed in the supervision sessions reflected a holistic approach and the relationship between the staff and the demented person stood out as central for care quality. Thus focusing on what promotes or, respectively, obstructs this relationship is likely to be one important focus in clinical supervision not only to achieve improvement and high quality in home care but also to develop and enhance the quality of the working life of the staff. Since the results could be understood within a theoretical nursing care model, it may well be that if the supervisor functions within some theoretical model the participants may reach a more conscious approach and the risk of losing important aspects of caring will decrease.

Clinical group supervision and supervised implementation of planned individualized care of severely demented people: effects on nurses, provision of the care, and patients.

Clinical group supervision and supervised implementation of planned individualized care of severely demented people: effects on nurses, provision of the care, and patients.

The growth of management connoisseurship through reflective practice.

Reflective practice offers a way to structure learning within supervision by paying attention to aspects of practice within reflected experiences, in such ways that the issues can be identified, understood, and worked through to resolve contradictions between desired outcomes and actual practice. In this process, emerging personal knowledge of practice is juxtaposed with relevant theory in such a way that the manager is able to meaningfully assimilate theory into his or her practice as appropriate. This paper illustrates how an H-grade unit nurse manager identified a number of situational management issues through reflecting and sharing experiences in a group clinical supervision milieu (over a period of 15 weeks). Clinical supervision is being advocated as a means to ensure practitioner development of effective practice (Vision for the Future, Department of Health 1993).

Group Clinical Supervision: A Feedback Model to Enhance Teachers' Classroom Questioning Skills

A peer-group feedback model of classroom supervision was used to facilitate 48 teachers' acquisition of questioning skills for use with discussion lessons. Teachers in 6 groups of 24 who received feedback through the feedback made significant gains on 10 of the 13 questioning skills. A control group of teachers made significant gains on four skills.

Group Clinical Supervision: A Paradigm for Preservice Instructional Enhancement

Group Clinical Supervision: A Paradigm for Preservice Instructional Enhancement

A Three Role Group Clinical Supervision System for Student Teaching

A Three Role Group Clinical Supervision System for Student Teaching