Practice Of Clinical Supervision Research Articles

Clinical Supervision Practices in Vocational Rehabilitation Settings

Clinical Supervision Practices in Vocational Rehabilitation Settings

Multicultural Complexity: an Intersectional Lens for Clinical Supervision

The author discusses the need for counselor educators and supervisors to promote the intersectional nature of identities in counselor trainees and supervisees, especially as supervision serves as the vanguard for professional development and provides a more individually tailored space. This article introduces the concept of multicultural complexity, along with its current dearth in the counseling literature. The utility of multicultural complexity is explored, and recommendations made in the form of sample action plans (Appendix) regarding how counselor educators and supervisors can further incorporate the concept into the practice of clinical supervision.

Clinical Supervision in a Medical Setting: A Preliminary Study About the Practices and Beliefs of Expert and Novice Clinician Supervisors

This project explores perceptions of the clinical supervision practices from the perspective of expert and novice speech-language pathologists (SLPs) in a medical setting. Expert and novices may have different philosophies and beliefs about supervision that could impact a young clinician's learning (Peña & Kiran, 2008). An expert was defined as having more than five years of clinical experience in the medical setting with supervision experience of at least 10 students. Novice clinicians had worked for less than five years and had supervised a minimum of one student. An interview adapted from counseling literature (Okech & Rubel, 2009), was used to collect data on beliefs about supervision practices of two expert and two novice SLPs supervising graduate students at a hospital in Texas. Results indicated that novices were more likely to experience stress related to supervision and did not provide regular feedback to their supervisees in comparison to their expert peers. Experts were more likely to have a positive view of supervision and provide feedback more consistently. These reported differences in perceptions have implications for clinical teaching as novices and experts may have different ways of supervising potentially impacting learning for beginning speech-language pathology clinicians.

Supervision in social work in Aotearoa New Zealand: Challenges in changing contexts

In this article, I report on clinical supervision policy and practice within the profession of social work in Aotearoa New Zealand. I begin with an overview of New Zealand with reference to selected social and cultural considerations which impact on social work as a profession. Starting from a premise that supervision is an essential component of professional social work, the mandate for supervision and aspects of education for supervisors are explored. The importance of both cross-cultural and indigenous approaches to supervision within Aotearoa New Zealand is examined with reference to local literature. Developments in supervision policy and practice reflect many of the challenges faced by social work in the political and sociocultural context.

Clinical supervision: An emerging counseling specialty in Turkey

Clinical supervision is currently a hot topic among counselor professionals in Turkey. In this article, we first present the current status of the counseling profession, along with counselor education programs and accreditation efforts. Then, we detail current clinical supervision practices (i.e., parameters/predominate approaches in undergraduate and graduate counselor education programs, post-training practices), as well as ongoing efforts and challenges to adopt supervision standards. Next, we describe the profile of clinical supervisors and supervisor training. Finally, we report recent critical events and developments, and offer suggestions for further steps in promoting clinical supervision as a specialty area of the counseling field in Turkey.

Exploring Organizational Barriers to Strengthening Clinical Supervision of Psychiatric Nursing Staff: A Longitudinal Controlled Intervention Study

This article reports findings from a longitudinal controlled intervention study of 115 psychiatric nursing staff. The twofold objective of the study was: (a) To test whether the intervention could increase clinical supervision participation and effectiveness of existing supervision practices, and (b) To explore organizational constraints to implementation of these strengthened practices. Questionnaire responses and registration of participation in clinical supervision were registered prior and subsequent to the intervention consisting of an action learning oriented reflection on staff's existing clinical supervision practices. Major organizational changes in the intervention group during the study period obstructed the implementation of strengthened clinical supervision practices, but offered an opportunity for studying the influences of organizational constraints. The main findings were that a) diminishing experience of social support from colleagues was associated with reduced participation in clinical supervision, while b) additional quantitative demands were associated with staff reporting difficulties finding time for supervision. This probably explained a negative development in the experienced effectiveness of supervision. It is concluded that organizational support is an imperative for implementation of clinical supervision.

Prioritizing questions and methods for an international and interdisciplinary supervision research agenda: Suggestions by eight scholars

Eight active supervision scholars provide their perspectives on priorities for advancing research in clinical supervision. Based on proposals they presented at an invited symposium held during the 11th International Interdisciplinary Conference on Clinical Supervision, the authors propose research questions around multicultural identities, supervisor expertise, supervision models, and research methods. Although neither a comprehensive nor exhaustive list of priorities, the authors hope the article encourages dialogue across disciplines and countries that expand understanding of clinical supervision practice and supervisor education.

Development of a staff training intervention for inpatient mental health rehabilitation units to increase service users’ engagement in activities

Introduction This study developed a training intervention (‘GetREAL’) to change the practice of staff working in National Health Service inpatient mental health rehabilitation units in order to increase service users’ engagement in activities. Method The intervention was developed through eight consultation events and piloting in two settings, drawing on the expertise of occupational therapists, psychiatrists, organisational change specialists and service users, together with multi-disciplinary teams. Results A manual for the intervention, a fidelity checklist, an induction programme and training materials were produced. The intervention applied a three-stage change model (predisposing, enabling and reinforcing) and was informed by theories from occupational therapy and organisational development. It was delivered by psychiatrists, occupational therapists, activity workers and service users. Staff were encouraged to change their ward structures and routines as well as their practice. Clinical supervision and reflective practice were integral to the trainers’ regime. Conclusion The intervention was theoretically coherent, allied to practice and shown to be feasible to deliver. It offered tailored work-based training to the whole multi-disciplinary team, including support staff. Making activity central to rehabilitation could improve patients’ use of time and their consequent function and wellbeing. However, questions were raised about long-term sustainability of change processes.

Barriers to Clinical Supervision Practices in Botswana Schools

This study was conducted to investigate possible barriers to the effective implementation of clinical supervision in Botswana primary schools, junior and senior secondary schools. Since the study sought views, experiences and observations of respondents, it adopted a qualitative approach to data collection. Teacher practitioners on study leave at the University of Botswana formed the subjects of the study. Data were analysed by being categorised into themes. The findings of the study revealed three major themes deemed to be barriers to clinical supervision practices. These are; large class sizes; the implementation of the Performance Management System in schools; and senior teachers who are designated as supervisors to junior teachers simply by virtue of their official position and not because they are experts in the areas they supervise. Recommendations were made on how these barriers could be addressed in order to facilitate clinical supervision activities in schools.

Effectiveness of clinical supervision of physiotherapists: a survey.

Limited literature exists on the practice of clinical supervision (CS) of professional physiotherapists despite current Australian safety and quality health standards stating that CS is to be provided to all physiotherapists. The aim of the present study was to evaluate the effectiveness of CS of physiotherapists working in an Australian public health service. CS was measured using the allied health-specific 26-item modified Manchester Clinical Supervision Scale (MCSS-26). Subscales of the MCSS-26 were summed for three domain scores (normative, restorative and formative) and a total score was calculated, which was compared with the reported threshold score of 73 for effective supervision. Sixty registered physiotherapists (response rate 92%), working for a large metropolitan public health service, with six different site locations, completed the survey. The mean (± s.d.) total MCSS-26 score was 71.0 ± 14.3 (95% confidence interval (CI) 67.4-74.6). Hospital site was the only variable that had a significant effect on total MCSS-26 score (P=0.005); there was no effect for supervisor or supervisee experience, or hospital setting (acute vs subacute). Physiotherapists scored a significantly lower mean percentage MCSS-26 score on the normative domain compared with the restorative domain (mean difference 7.8%; 95% CI 2.9-12.7; P=0.002) and the formative domain (mean difference 9.6%; 95% CI 6.3-13.0; P<0.001). Of the two subscales that form the normative domain, 'finding time' had a significantly lower mean percentage MCSS-26 score than 'importance/value of CS' (mean difference 35.4%; 95% CI 31.3-39.4; P<0.001). Within this publicly funded physiotherapy department there was uncertainty about the effectiveness of CS, with more than half the physiotherapists rating their supervision as less than effective, suggesting there is opportunity for improvement in the practice of physiotherapy CS. Physiotherapists scored lowest in the normative domain, indicating that they found it difficult to find time for CS.

The Heroic Supervisor: Using the Hero's Journey to Facilitate Development in Supervisors-in-Training

This qualitative study explored the perspectives of nine supervisors-in-training to understand how they used metaphoric stories containing the hero's/heroine's journey to conceptualize their process of transitioning from counselor to supervisor. Analysis revealed a three-phase process of counselor supervisor development similar to the process of development and transformation described in both the constructivist model of change (Mahoney, 2006) and the hero's journey (Campbell, 1988). Results also indicated that conceptualizing their development as supervisors using the stories provided students with a valuable opportunity for critical self-reflection and meaning making. Suggestions for clinical supervision practice, training, and future research are discussed.

Supervisor social skill and supervision outcome

Background: The practice of clinical supervision is considered an effective procedure to achieve a variety of professional outcomes for supervisees. Supervisory alliance mediates many of the learning outcomes thought important for effective supervision. Therefore, it is important to identity supervisor characteristics that relate to the capacity to develop a positive supervisory alliance and achieve supervision outcome. Aim: Supervisor interpersonal skill was investigated as a characteristic involved with both supervisee assessment of supervisory alliance and learning outcomes of supervision. Method: Forty supervisors completed assessments for interpersonal skill and provided 8 sessions of supervision to 50 supervisees. Supervisees completed assessments for supervisory alliance and supervision evaluation. Findings: Supervisor interpersonal skill predicted supervisee rated supervisory alliance and supervision outcome. Implications: Supervisor interpersonal skill is important for the capacity to develop a positive supervisory alliance and manage the learning environment of supervision.

The ABIM’s Clinical Supervision Practice Improvement Module and Its Effect on Faculty’s Supervisory Skills

Inadequate supervision of medical trainees hampers education and patient care. The authors examine the use of the American Board of Internal Medicine's Clinical Supervision Practice Improvement Module (CS-PIM) to determine whether it facilitated and enhanced faculty's skills in direct observation, providing feedback, identifying errors, and auditing medical records. In this descriptive cohort study, module satisfaction was assessed using a five-point Likert scale. Changes in supervisory skills were measured using a retrospective pre-/postmodule self-assessment; deltas were compared by the Wilcoxon signed rank test. Between March 2009 and October 2010, 644 faculty completed 647 CS-PIMs. Asked how effective the module was for improving their observation and evaluation skills, 91% rated it excellent, very good, or good. Similarly high percentages of the faculty gave those same ratings to the module for facilitating documenting trainee evaluations, documenting feedback to trainees, reflecting on the summary report, developing an improvement plan, and documenting their self-assessment of supervisory skills. Faculty self-reported improved skills in observation, giving feedback, identifying errors, and auditing medical records. The CS-PIM facilitated and improved faculty skills in the supervision of trainees and led to self-reported changes in supervisory practices. Future research should evaluate trainees' perceptions and the actual impact on quality of care in the teaching setting.

Reflective insights on group clinical supervision; understanding transference in the nursing context

Reflecting on group theory within clinical supervision offers useful vantage points from which to engage nursing and the helping professions in the task of supervisory practice. This paper presents reflective experiences of group clinical supervision training and practice through a critique of Hawkins and Shohet’s process centred model. The underlying premise of transference hypothesis is that experiences and memories from the past inform present behaviours. Little has been written about the hypothesis in relation to clinical supervision in nursing and the helping professions. However, the hypothesis was criticised by John M. Shlien in the 1980s and remains pertinent today due to expansion into social and healthcare practice. Reflective autobiographical diary entries focus on the model’s two latter stages which propose the use of Sigmund Freud’s transference hypothesis. The work of Freud, Foulkes, Heidegger and Hawkins and Shohet are synthesised and conclude with a phenomenological suggestion that immediacy and openness are necessary ontological conditions for group clinical supervision. Valuing empathic attunement to better understand group clinical supervision may be more important than theoretical distractions for non-therapeutic clinical supervision practice

A Qualitative Analysis of Vocational Rehabilitation Counselor Perceptions of Clinical Supervision

Many vocational rehabilitation (VR) counselors in the state-federal public VR program are not satisfied with their clinical supervision. A qualitative grounded theory research design was used to study VR counselors' perceptions and descriptions of their clinical supervisory experiences and supervision needs. Datafrom interviews withfive VR counselors were analyzed and coded. Eight categories emerged from the data that describe a core phenomenon - VR counselors value and need clinical supervision. Results support previous research that indicates a need for a new service model in VR, one that values and prioritizes clinical supervision. Implications for clinical supervision practice in VR are discussed.

Systemic supervision practices compared: A closer look at ‘reflection’ and ‘self’ in Multisystemic Therapy and Family Therapy supervision

Family and systemic therapists are becoming increasingly interested in evidence-based practice. By implication, clinical supervision practices that support therapists need to keep step with this trend. Supervision practices within Multisystemic Therapy as a more outcome-focussed treatment model that works with families are compared with the supervision of family therapists working a mental health clinic. This paper looks at some of the more prominent supervisory practices in MST and Family Therapy and explores their similarities and differences. The various challenges that are present when working in clients' homes are explored and implications for supervision discussed. Therapists who frequent clients' homes may need a different skill-set and their supervisors in turn require taking a different approach. The clinical supervisor to a therapist working out in the community tends to (be able to) be more proactive. Systemic supervisors to more clinical based family therapist put emphasis on the explorative aspects of the therapeutic encounter including self-reflective practices, whereas MST supervisors' primary focus remains on the clinical outcomes for the clients. The place of self-reflexivity in both approaches to supervision is explored. Case examples drawn from the authors' own supervisory practice will be presented to illustrate the different practices presented.

Research Area: Professional Training and Licensure

Early Career Psychologists (ECPs) are often called to act in a supervisory role whilst simultaneously developing their own knowledge and experiences of clinical practices. However, little training is available to offer guidance and direct the process of supervision for ECPs. The workshop will be facilitated by two ECPs who will reflect on their experiences of taking on a supervisory role in the UK, Australia and Singapore. A skills based workshop will: (a) Identifying the needs of ECPs (b) support for ECPs including newly qualified psychologist training, (c) key components of a successful supervisory relationship, (d) developing strategies for assessing trainee competency, (e) dealing with incompetency, and (f) adapting supervisory roles to match the trainee needs. The objectives are: (1) Enhance skills as a clinical supervisor in order to provide effective supervision for trainees, (2) to gain an awareness of theoretical models of clinical supervision to meet the developmental needs of trainees, (3) to gain practical experience of competency based supervision. Participants will be able to: (i) Share successes and pitfalls of ECP supervision, (ii) learn more about the theory and practice of clinical supervision, (iii) learn more about the practicalities of supervising trainee clinical psychologists, (iv) develop an awareness of the standards necessary to achieve good self care as an ECP, (v) develop an awareness of the standards necessary to achieve good practice in the supervision of clinical trainees. ECPs involved in the clinical supervision of trainee clinical psychologists.

Students Perceptions on the quality of clinical supervision among the 12 affiliated hospital of Medical Faculty of UNISSULA

Background: Clinical supervision has a vital role in the learning process of undergraduate medical education because it may improve the student’s clinical performance of the students. Supervision is a complex activity and covers wide variety of applications. Medical faculty of Islamic Sultan Agung University has 15 affiliated hospitals for its clinical education. To assure the quality of the clinical program, an evaluation on the quality of clinical program is required. This study was conducted to assess the effectiveness of the clinical supervision among the 12 affiliated hospitals.Design and Methods: This study involved 181 students of clinical internship of the year 2003, 2004 and 2005 of medical faculty of Islamic Sultan Agung University having the clinical rotation at the stage of surgery, obsgyn, pediatrics, internal medicine, ENT, neurology, dermatology and venerology, psychiatry, across the affiliated hospitals. The subject were divided into groups based on the hospital they were placed. Clinical Teaching Effectiveness Instrument (CTEI) adapted in bahasa Indonesia was used. The Descriptive and Kruskal-Wallis test were applied for the data analysis.Results: Means of the effectiveness of clinical supervision for 12 affiliated hospitals ranged from 3.25 to 4.02. Kruskal-Wallis test resulted in the value of Chi-S=13.32 and p=0.27.Conclusion: Over all the clinical supervision for the 12 affiliated hospitals is perceived good and shows no significant difference. However the practice of clinical supervision varies among the hospitals (Sains Medika, 3(2):135-149).

A Rationale for Evidence-Based Clinical Supervision

Although modern mental health systems increasingly require evidence-based practice (EBP), clinicians continue to object to restrictions on their professional independence, which they may perceive as counterproductive, divisive and even demeaning. In the face of such deep-seated objections, do we really need to strive for an evidence-based approach to supervision? We believe so, and begin our argument by noting a colourful illustration of the problems that can exist in the absence of EBP, those of poor training, therapist drift and weak professional regulation. Next, we present EBP as a mechanism to reduce such unacceptable variability in the way that treatments are delivered. We then apply the lessons from this divisive situation to the practice of clinical supervision, outlining a rationale for an inclusive, synergistic way forward. A number of fundamental psychological motives for this integration are noted, including supervisor training that is informed by practice-based research, corrective feedback on supervision, and a supportive professional system. Illustrative examples are provided in each of these areas. It is concluded that the traditional gulf between research and practice can and should be bridged in relation to supervision.

Counterbalancing Clinical Supervision and Independent Practice

Survey of Anesthesiology: June 2011 - Volume 55 - Issue 3 - p 126 doi: 10.1097/01.SA.0000396018.19754.77