Supervisory Experience Research Articles

Creating Enthusiasm for Surgery - Perceptions of the Impact of Undergraduate Practical Education (Clerkship) for Occupational Choices

Background/Aim Surgical and other disciplines have been noticing difficulties in recruiting junior staff for several years. In response to a decrease in interest within study courses, surgical associations recommend better supervision during undergraduate practical education as "clerkships" in order to increase the attractiveness of surgery. This clerkship has an initiation function, as students for the first time - albeit marginally - can act as physicians. The aim of this study was to investigate the impact of clerkships on the disciplinary orientations and preferences of undergraduates' perceptions of specialist training. Methods Medical students of the Otto-von-Guericke University Medical School at Magdeburg were interviewed at 4 different time points in their clinical training (n = 373). The questionnaire included different dimensions on i) their choice of the subjects of clerkships and ii) on their clerkship experiences. Questions were subdivided into 5 basic topics, including 5 options to answer according to "Likert's scale" ranging from 1 to 5 ("completely true" to "does not apply at all"). Data were statistically analysed. Results Clerkships are an important component of medical studies. Undergraduate medical students deliberately use clerkships to get to know and to discriminate between medical disciplines they consider as possible choices for later specialisation. Their own assessment as well as reported experiences of specific clinics, departments or supervisors influence decision-making with regard to medical disciplines and locations/institutions for clerkships. The contents of the clerkships is expected to be closely related to the medical curricula. Students expect a detailed insight and practical, cross-departmental, interdisciplinary integration and collaboration in the medical discipline selected for clerkship. Clerkship experience in surgery affects the students' preference for surgical disciplines. They are a relevant predictor. Conclusion High-quality teaching - an important part of practical undergraduate training (clerkship) is effective in fostering a subsequent surgical orientation. Preference for surgical specialisation can be strengthened during medical studies by preparing seminars and extended practical experiences during clerkship.

How Supervisor Experience Influences Trust, Supervision, and Trainee Learning: A Qualitative Study.

Appropriate trust and supervision facilitate trainees' growth toward unsupervised practice. The authors investigated how supervisor experience influences trust, supervision, and subsequently trainee learning. In a two-phase qualitative inductive content analysis, phase one entailed reviewing 44 internal medicine resident and attending supervisor interviews from two institutions (July 2013 to September 2014) for themes on how supervisor experience influences trust and supervision. Three supervisor exemplars (early, developing, experienced) were developed and shared in phase two focus groups at a single institution, wherein 23 trainees validated the exemplars and discussed how each impacted learning (November 2015). Phase one: Four domains of trust and supervision varying with experience emerged: data, approach, perspective, clinical. Early supervisors were detail oriented and determined trust depending on task completion (data), were rule based (approach), drew on their experiences as trainees to guide supervision (perspective), and felt less confident clinically compared with more experienced supervisors (clinical). Experienced supervisors determined trust holistically (data), checked key aspects of patient care selectively and covertly (approach), reflected on individual experiences supervising (perspective), and felt comfortable managing clinical problems and gauging trainee abilities (clinical). Phase two: Trainees felt the exemplars reflected their experiences, described their preferences and learning needs shifting over time, and emphasized the importance of supervisor flexibility to match their learning needs. With experience, supervisors differ in their approach to trust and supervision. Supervisors need to trust themselves before being able to trust others. Trainees perceive these differences and seek supervision approaches that align with their learning needs.

Variation in clinical placement supervisors’ conceptions of and approaches to supervision in a veterinary internship programme

ABSTRACTGood teaching that supports final year students’ learning in clinical placements is critical for students’ successful transition from an academic environment to professional practice. Final year internship programmes are designed to encourage student-centred approaches to teaching and deep approaches to learning, but the extent to which clinical supervisors adopt a student-centred teaching approach is unknown. Survey data (n = 117) from veterinary supervisors were analysed using phenomenography. The results revealed qualitative differences in supervisors’ conceptions of and approaches to supervision. Quantitative statistical analysis was used to investigate relationships between supervisors’ conceptions and approaches. These analyses identified the types of supervisor experiences more likely to encourage students to participate in clinical practice in ways that will help them transition successfully to independent professional practice. The results have value for clinical educators and administrators seeking to improve the quality of placement supervision in a range of professional education programmes.

The stifling silence around scholarly creativity in doctoral education: experiences of students and supervisors in four disciplines

The demand for developing creativity among doctoral students is found in a number of educational policies all over the world. Yet, earlier studies on Swedish doctoral education suggest that doctoral students’ creativity is not always encouraged. Based on a critical hermeneutic approach and cases in four different disciplines, the aim of this study was therefore (1) to explore different shapes of doctoral students’ creativity in Swedish doctoral education and (2) to reveal and find possible explanations to some of the conditions stifling doctoral students’ scholarly creativity. Interview data was collected from 28 participants, constituting 14 dyads of students and supervisors in four disciplines. Through hermeneutic interpretative analysis of the disciplinary cases, the results show that creativity kept on playing in musical performance, was an unexpected guest in pedagogical work, was captured in frames in philosophy and put on hold in psychiatry. Across the cases, students’ scholarly creativity was essentially encapsulated in silence. This silence seemed to emanate from controlling intellectual, political and economic agendas that enabled stifling conditions of the students’ scholarly creativity, where it was as follows: restricted by scholarly traditions, embodying supervisors’ power and unrequested in practice. Based on these findings, the article ends in suggestions for preventing such conditions, holding that it is important to establish a discourse on scholarly creativity in doctoral education, to view doctoral students as capable creative agents and to actually ask for their scholarly creativity.

Clinical radiography education across Europe

PurposeTo establish a picture of clinical education models within radiography programmes across Europe by surveying higher education institutions registered as affiliate members of the European Federation of Radiography Societies (EFRS). MethodAn online survey was developed to ascertain data on: practical training, supervisory arrangements, placement logistics, quality assurance processes, and the assessment of clinical competencies. Responses were identifiable in terms of educational institution and country. All educational institutions who were affiliate members at the time of the study were invited to participate (n = 46). Descriptive and thematic analyses are reported. ResultsA response rate of 82.6% (n = 38) was achieved from educational institutions representing 21 countries. Over half of responding institutions (n = 21) allocated in excess of 60 European Credit Transfer and Accumulation System (ECTS) credits to practical training. In nearly three-quarters of clinical placements there was a dedicated clinical practice supervisor in place; two-thirds of these were employed directly by the hospital. Clinical practice supervisors were typically state registered radiographers, who had a number of years of clinical experience and had received specific training for the role. Typical responsibilities included monitoring student progress, providing feedback and completing paperwork, this did however vary between respondents. In almost all institutions there were support systems in place for clinical placement supervisors within their roles. ConclusionsSimilarities exist in the provision of clinical radiography education across Europe. Clinical placements are a core component of radiography education and are supported by experienced clinical practice supervisors. Mechanisms are in place for the selection, training and support of clinical practice supervisors. Professional societies should work collaboratively to establish guidelines for effective clinical placements.

Postgraduate supervision at an open distance e-learning institution in South Africa

Effective postgraduate supervision is a concern at universities worldwide, even under optimal conditions where post-graduate students are studying full-time. Universities are being pressured by their governments to increase the throughput of postgraduates where there is a need for supervisory guidance in order to produce quality graduates within a shorter period of time than was previously thought possible. In an Open Distance E-learning (ODeL) context in South Africa, postgraduate supervision presents an even more formidable task as face-to-face communication between supervisor and student is restricted or totally non-existent. Informed by a review of the Community of Practice Theory, the researcher undertook a qualitative study to investigate the challenges of supervisors by means of a purposeful sample of postgraduate supervisors at a major ODeL institution in South Africa. Open-ended questionnaires were the means of collecting the data. The results indicated weaknesses in respect of the following: the selection and allocation of postgraduate students to supervisors without consultation; the requirements for intensive guidance during the process of writing the thesis to meet the needs of under-prepared students; and the difficulties inherent in the ODeL model, which depended primarily on written communication, especially for academically weak students. The recommendation is that experienced supervisors should conduct workshops and mentor novice academics on effective ODeL supervision procedures. Keywords: higher education institutions; open distance e-learning; postgraduate studies; postgraduate supervision; South Africa; supervisee; supervisors

Leaping‐in and leaping‐ahead: A hermeneutic phenomenological study of being‐responsible in psychotherapeutic supervision

AbstractAimsPsychotherapeutic supervision is a human‐to‐human encounter in which counsellors and psychotherapists regularly present their client case work. There are multiple theoretical and practical perspectives about what supervision is and how to do it. Yet, little is known about the day‐to‐day lived experiences of psychotherapeutic supervisors. This article reports on a key finding from a Heideggerian hermeneutic phenomenological research study which was concerned with uncovering what it is really like being a psychotherapeutic supervisor. Participants told many stories about experiences of heightened responsibility. They recounted how experiences of anxiety in specific supervisory encounters were intertwined with burdensome experiences of responsibility. Existing theories, practices and prescribed ethical guidelines on managing supervisory responsibility were of limited assistance to supervisors grappling with troubling supervisory experiences. Instead, to cope with the burden of responsibility, psychotherapeutic supervisors had common human experiences of ‘leaping‐in and leaping‐ahead’ of their supervisees, leading to hidden and unintended consequences for supervisees and supervisors.ConclusionsResponsibility is inescapable in supervisory encounters and is fuelled by a mood of anxiety. The phenomenon of responsibility could be rendered more intelligible, in supervision consultation, by privileging, uncovering and dwelling in psychotherapeutic supervisors’ day‐to‐day lived experience of being‐responsible, while being mindful of what we already know about responsible supervisory practice.

Improving the Quality of Practicum Learning: Self-Study of a Faculty Member’s Role in Practicum Supervision

This self-study of activities as a practicum supervisor in several secondary schools focuses on the supervisor’s contribution to the quality of a teacher candidate’s professional learning in the context of a familiar tension between on-campus courses and in-school practicum experiences. Data from both formal and informal supervisory experiences are taken from notes recorded in classes with those supervised formally, records of notes taken in practicum observations, and email messages exchanged with teacher candidates about their supervision experiences. Analysis of formal supervision experiences generated a series of insights into candidates’ experiences of the practicum, a modest innovation in supervisory practice, and important reminders arising from a significant error in personal practice as a supervisor. Informal supervision experiences involved visits arising from invitations to observe extended by candidates in the author’s physics methods course. These experiences generated opportunities to test an alternative supervisory strategy focused on candidates’ perceptions of their learning from experience. Related literature includes the topics of learning from experience, reflective practice, and the potential significance of an epistemology of practice. In closing, attention is given to trustworthiness, the personal significance of the study and connections to the teacher education literature.

Making the transition from practitioner to supervisor: reflections on the contribution made by a post-qualifying supervisory course

ABSTRACTWithin Scotland, as elsewhere, there has been a resurgence of interest in the critical role of supervision within social work practice. However, those in transition from practitioner to supervisor still commonly report feeling unprepared for their changing role and uncertain about what it entails. This paper will explore our experiences of delivering an accredited post-qualifying supervision course since 2008 to professionals from different sectors, diverse professional backgrounds, and with varying levels of supervisory experience. The course provides time and space to think about the different elements of supervision, and to consider how these translate into day-to-day practice. We will argue that the opportunity to explore the complexity of the supervisory task, while learning from and with peers, is an important part of making the transition in professional role and identity. Moreover, in organisational contexts where the reflective space which supervision can provide may feel under threat, and where the focus on people who use services can at times be lost, professional staff undertaking supervision training describe feeling more confident and competent in their role, with renewed commitment both to uphold the value of reflective supervision, and to sustain a clear emphasis on people who use services.

When the Boss Is Away: Manager–Worker Separation and Worker Performance in a Multisite Software Maintenance Organization

Distributed work is ubiquitous in modern organizations, as are situations where managers and workers interact remotely. Past research postulates the existence of costs of manager–worker separation, but empirical evidence is scant and inconclusive. Building on the literature on manager–worker separation and distributed work we claim that the effect of manager–worker separation on worker performance varies depending on three factors: task complexity, collocation of the worker with experienced peers, and manager supervisory experience. We investigate our arguments by developing hypotheses in the context of a multisite IT services organization, where we collected data encompassing 13,435 software maintenance tasks executed within a two years period. We find that the hypothesized interaction effects are significant and can give rise to costs of manager–worker separation. However, our results also pinpoint the existence of situations where benefits of manager–worker separation are present, that is, where remote supervision leads to superior worker performance. In practice, our findings suggest that organizations should consider task, work configuration, and manager characteristics when deciding whether workers and managers should be collocated.

Self-efficacy of the psychotherapist in the context of supervision

IntroductionIn the context of the importance of psychotherapy in mental health care the aim of our study is to highlight the importance of supervision as an integral part thereof.AimWe analyze the relationship between the assessment of the quality of supervision and the perceived self-efficacy of the psychotherapist as one of the antecedents of decision-making in the psychotherapeutic process. This framework is applied to an empirical study that focuses on psychotherapist's perception of clinical supervision in relationship to professional self-efficacy in the therapeutic process.MethodsThe study was operationalized using the Manchester clinical supervision scale (MCSS), containing a demographic questionnaire, counselor self-efficacy scale–modified version. One hundred and twenty-five psychotherapists with supervisory experience participated in the research, including 67 trainees and 58 graduates of psychotherapy training.ResultsThe results show a positive relationship between effective supervision and self-efficacy (r = 0.363; sig = 0.000; n = 125). The participants who attributed higher ratings to supervision and supervision work alliance also assigned higher scores to perceived self-efficacy–although there is a significant relationship among the participants of psychotherapeutic training (r = 0.444; sig = 0.000; n = 67), this relation is not significant among the actual graduates. Based on modeling, rapport was discovered to be the most important predictor of supervision effectiveness assessment.ConclusionsThe results support the merits of supervision in the education of psychotherapists and the importance of investing resources in its regular implementation.Disclosure of interestThe authors have not supplied their declaration of competing interest.

Cross‐cultural supervision in international settings: experiences of foreign supervisors and native supervisees in Cambodia

AbstractWith the global expansion of family therapy, it is vital to engage in culturally responsive methods of training and supervision. This is especially critical when international training involves Western‐based therapy models and supervision from non‐native supervisors. This study explores how native Cambodian therapists experience clinical supervision conducted by non‐native supervisors. In this responsive evaluation, data were triangulated across multiple stakeholders (N = 95) and collection methods, including focus groups, interviews, and live supervision observations. Emergent themes highlight the need for intentionally culturally responsive supervision and included challenges with non‐native supervisors, unresponsive methods of learning and power imbalances. Therapists emphasized that they were less likely to attend supervision and felt discouraged when it was not culturally responsive. Data‐driven suggestions for increasing cultural responsiveness in supervision are provided.Practitioner points Supervisors can challenge personal cultural assumptions and deepen contextual understanding by seeking local cultural knowledge Supervision contracts created with input from stakeholders can attend to likely cultural differences The supervisory relationship can be supported through open discussion and negotiation of cultural differences In cultures with high regard for those in authority, supervisors can use a strengths‐based approach to feedback and demonstration

Developing skilled doctor\u2013patient communication in the workplace: a qualitative study of the experiences of trainees and clinical supervisors

To inform the development of recommendations to facilitate learning of skilled doctor–patient communication in the workplace, this qualitative study explores experiences of trainees and supervisors regarding how trainees learn communication and how supervisors support trainees’ learning in the workplace. We conducted a qualitative study in a general practice training setting, triangulating various sources of data to obtain a rich understanding of trainees and supervisors’ experiences: three focus group discussions, five discussions during training sessions and five individual interviews. Thematic network analysis was performed during an iterative process of data collection and analysis. We identified a communication learning cycle consisting of six phases: impactful experience, change in frame of reference, identification of communication strategies, experimentation with strategies, evaluation of strategies and incorporation into personal repertoire. Supervisors supported trainees throughout this process by creating challenges, confronting trainees with their behaviour and helping them reflect on its underlying mechanisms, exploring and demonstrating communication strategies, giving concrete practice assignments, creating safety, exploring the effect of strategies and facilitating repeated practice and reflection. Based on the experiences of trainees and supervisors, we conclude that skilled communication involves the development of a personal communication repertoire from which learners are able to apply strategies that fit the context and their personal style. After further validation of our findings, it may be recommended to give learners concrete examples, opportunities for repeated practise and reflection on personal frames of reference and the effect of strategies, as well as space for authenticity and flexibility. In the workplace, the clinical supervisor is able to facilitate all these essential conditions to support his/her trainee in becoming a skilled communicator.

Supervisory experience and data points: implementation barriers, risk assessment and correctional professionals

Drawing on interviews with 24 correctional practitioners who use risk assessment instruments daily, we examine barriers to the use and implementation of these instruments. Findings reveal that practitioners have confidence in the state of risk assessment generally, but are skeptical about risk assessment on the job due to limited resources. They also point to barriers that inhibit their effectiveness including recognition of population heterogeneity, predictive misspecification due to data lags and overemphasis on stable predictors, and lacking guidance on appropriate use of vast available data. Instruments for measuring risk serve purposes beyond those intended by the social scientists who developed measures. We conclude with lessons for increasing the utility and legitimacy of risk assessments and with a call for incorporating latent uses of assessments into design.

“Like a marriage”: Partnering with peer mentors in child welfare

A growing number of child welfare programs have incorporated peer mentors – individuals in long-term recovery from substance use disorders – into their service delivery models. Whereas existing literature suggests the collaboration between peer mentors and child protective service workers brings both opportunities and challenges, few studies have described these experiences from the perspectives of mentors, caseworkers, and supervisors. Understanding how these team members experience partnership is critical for the further evaluation and development of mentor models in child welfare. The purpose of this study was to understand the experiences of mentors, caseworkers, and supervisors working through an integrated team model in Kentucky. A qualitative approach was used, combining a phenomenological lens with constructivist grounded theory analysis techniques. Our results indicate that successful partnerships between mentors, caseworkers, and supervisors involve four processes: sharing a common vision, developing working relationships, learning with open-mindedness, and identifying the benefits of partnership. These findings have implications for practitioners in a variety of child welfare settings, particularly those interested in developing and training teams for peer mentor integration.

Professional Supervision as Storied Experience: Narrative Analysis Findings for Australian-Based Registered Music Therapists.

Limited research exists to inform a music therapist's supervision story from their pre-professional training to their practice as a professional. Evidence is needed to understand the complex nature of supervision experiences and their impact on professional practice. This qualitative study explored the supervisory experiences of Australian-based Registered Music Therapists, according to the: 1) themes that characterize their experiences, 2) influences of the supervisor's professional background, 3) outcomes of supervision, and 4) roles of the employer, the professional music therapy association, and the university in supervision standards and practice. Seven professionals were interviewed for this study. Five stages of narrative analysis were used to create their supervision stories: a life course graph, narrative psychological analysis, component story framework and narrative analysis, analysis of narratives, and final integration of the seven narrative summaries. Findings revealed that supervision practice is influenced by a supervisee's personal and professional needs. A range of supervision models or approaches is recommended, including the access of supervisors from different professional backgrounds to support each stage of learning and development. A quality supervisory experience facilitates shifts in awareness and insight, which results in improved or increased skills, confidence, and accountability of practice. Participants' concern about stakeholders included a limited understanding of the role of the supervisor, a lack of clarity about accountability of supervisory practice, and minimal guidelines, which monitor professional competencies. The benefits of supervision in music therapy depend on the quality of the supervision provided, and clarity about the roles of those involved. Research and guidelines are recommended to target these areas.

Should we assess clinical performance in single patient encounters or consistent behaviors of clinical performance over a series of encounters? A qualitative exploration of narrative trainee profiles

Background: A variety of tools have been developed to assess performance which typically use a single clinical encounter as a source for making competency inferences. This strategy may miss consistent behaviors. We therefore explored experienced clinical supervisors’ perceptions of behavioral patterns that potentially exist in postgraduate general practice trainees expressed as narrative profiles to aid the grading of clinical performance.Methods: We conducted semistructured interviews with clinical supervisors who had frequently observed clinical performance in trainees. Supervisors were asked to describe which behavioral patterns they had discerned in excellent and underperforming trainees, during different stages of training, in their careers as clinical supervisor. We analyzed the interviews using a grounded theory approach.Results: The analysis resulted in a conceptual framework that distinguishes between desirable and undesirable narrative profiles. The framework consists of two dimensions: doctor–patient interaction and medical expertise. Personal values appear to be a moderating factor.Conclusions: According to experienced clinical supervisors, consistent behaviors do exist in GP trainees when observing clinical performance over time. The conceptual framework has to be validated by further observational studies to assess its potential for making robust and fair assessments of clinical performance and monitor the development of consultation performance over time.

Modelling and numerical analysis of seru loading problem under uncertainty

As a flexible manufacturing system, seru seisan has been proven to be more competitive in a volatile market than traditional assembly line. In this system, seru loading plays an essential role to deal with the fluctuating demands and uncertain product types. Unfortunately, in practice, seru loading decision-making is mainly based on the supervisor's experience instead of the theoretical research. In this situation, seru loading in a single period under uncertainty is considered in this paper, meanwhile, a fuzzy random bi-objective model is developed to minimise the makespan and the total tardiness penalty cost. To deal with the fuzzy random variables, these uncertain parameters are transformed into the trapezoidal fuzzy variables, which are subsequently de-fuzzified by the optimistic-pessimistic adjustment index Me. After obtaining the equivalent crisp model, a heuristic algorithm based on enumerating feasible solutions is designed. Finally, to demonstrate the practicability, a numerical example is applied, and the generated results verify the efficiency of the proposed model and algorithm for seru loading problem. [Received: 28 April 2016; Revised: 28 July 2016; Accepted: 13 September 2016]

Ethics, relationships and pragmatics in the use of e-technologies in counselling supervision.

International literature and local anecdotal evidence report increasing use of video and other e-technology in counselling supervision. In this small-scale study, five experienced supervisors were interviewed about their use of e-technology within supervision. The research was part of a postgraduate paper in professional supervision and worked to introduce and engage researcher-students, all of whom were experienced counselling practitioners, in a supervised collaborative project. It also generated new knowledge for the researchers and participants for their supervision practice. This article offers a review of literature, and ideas about safe and ethical practice for the wider professional counselling community engaged in offering supervision using e-technology. While the use of e-technologies is an effective means of providing supervision, this study found that inquiry should be encouraged within supervision conversations to nourish the quality of supervisory relationships, and thereby enhance the effectiveness of supervision. [ABSTRACT FROM AUTHOR] Copyright of New Zealand Journal of Counselling is the property of New Zealand Association of Counsellors and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Perioperative Complications in 155 Patients Who Underwent Oblique Lateral Interbody Fusion Surgery

A retrospective multicenter survey. To investigate the perioperative complications of oblique lateral interbody fusion (OLIF) surgery. OLIF has been widely performed to achieve minimally invasive, rigid lumbar lateral interbody fusion. The associated perioperative complications are not yet well described. The participants were patients who underwent OLIF surgery under the diagnosis of degenerative lumbar diseases between April 2013 and May 2015 at 11 affiliated medical institutions. The collected data were classified into intraoperative and early-stage postoperative (≤1 mo) complications. The intraoperative complications were then subcategorized into organ damage (neural, vertebral, vascular, and others) and other complications, mainly related to instrumental failure. The collected data were also divided and analyzed based on whether the surgeon was certified to perform the surgery and the incidence of complications in the early (April 2013-March 2014) and late stages (April 2014-May 2015) of OLIF introduction. In the 155 included patients, 75 complications were reported (incidence rate, 48.3%). The most common complication was endplate fracture/subsidence (18.7%), followed by transient psoas weakness and thigh numbness (13.5%) and segmental artery injury (2.6%). Almost all these complications were transient, except for three patients who had permanent damage: one had ureteral injury and two had neurological injury. Postoperative complications included surgical site infection (1.9%) and reoperation (1.9%). Whether the primary operator was experienced did not affect the incidence of complications. Regarding the introductory stage, the incidence of complications was 50% in the early stage and 38% in the late stage. The overall incidence of perioperative complications of OLIF surgery reached 48.3%, of which only 1.9% resulted in permanent damage. Our analysis based on surgeon experience indicated that the OLIF procedure could be performed without increasing incidence of complications, under the guidance of experienced supervisors. 3.