Introduction Of Clinical Supervision Research Articles

Clinical supervision: a review of the evidence base

This article examines the concept of clinical supervision in nursing and considers how it is defined. It reviews the evidence supporting clinical supervision and discusses whether the introduction of clinical supervision may have been an example of a nursing 'fashion' or 'fad'. It also discusses whether reflection, as part of clinical supervision, has drawbacks as well as benefits. The author concludes that clinical supervision was implemented by the nursing profession without a sound evidence base.

Clinical Supervision in a High Secure Hospital

Preparation and implementation plans are crucial to the successful introduction of clinical supervision. This paper identifies key elements in the implementation and improved uptake of clinical supervision for nurses in a high-secure setting and through the use of a descriptive quantitative survey using questionnaires, evaluates the quality and effectiveness of supervision received.

Primary-care mental-health workers’ views of clinical supervision

AbstractClinical supervision is an essential component of psychological work with clients. This article presents views of a group of primary-care mental-health workers on the introduction of clinical supervision. A focus group interview was analysed. The key themes extracted were: the supervisor's approach that provided an educative, safe, boundaried space that allowed exploration, support and validation; the advantages and disadvantages of group supervision; helpful and unhelpful ingredients of supervision; the governance and facilitative functions of supervision; and the dangers inherent in not having supervision for both client and worker. Key recommendations are made encompassing: training in supervision and a psychological approach; encouraging theory–practice consolidation; balancing competency with curiosity; and reviewing supervision regularly. Limitations of the study are also discussed.

A selective review of mental health nursing in New South Wales, Australia, in relation to clinical supervision

Recent reports have suggested that mental health staff have added stress, which arose from poor working conditions, heavy workloads, and lack of resources, within a culture in which there was a large degree of burnout, low morale, lack of job satisfaction, poor status, insensitivity and indifference. This is particularly so for mental health nurses, who create the ambience in clinical settings. Previous research has shown that the introduction of clinical supervision, as a central plank of clinical governance arrangements, has a positive effect in some of these respects, but remains underdeveloped in Australia. The present scoping study examined the extent to which this was so in mental health nursing services in the state of New South Wales. Individual mental health nurses (n = 601) and Area Health Services (n = 17) provided data about their local circumstances. Findings revealed that mental health nursing in New South Wales was a committed, late middle-aged workforce, working in services about which there was a width of opinion with the prevailing management arrangements, yet to fully exploit their therapeutic potential, or engage the educational opportunities that would assist them in their endeavour. More specifically, it remained a workforce that has yet to engage clinical supervision in a systematically coherent manner. The study concluded, therefore, that clinical supervision offered a possible practical remedy to address the causes and the effects of suboptimal service provision and that the ready availability of dedicated funding and the immediate access to service development and research expertise was a rare and timely confluence.

Learning from experience: Constructing critical case reviews for a leadership programme

A previous paper described the development of a leadership programme for critical care and highlighted that one of the strengths of the programme was the critical case review. This paper sets out in some depth the major theoretical influences in the construction of the case review. Case reviews have been used in education for some time but often have predetermined outcomes. The education approach favoured here was based on action learning, which in itself belongs to the broad church of reflective practice. While reflective practice has been advocated in nursing since 1986 together with the introduction of clinical supervision neither have met with unqualified success in their own right. This paper concludes that while the concept and construction of the critical case review may be new it is in essence no more than a jigsaw of already well-established practices of reflection, clinical supervision and action learning woven into the foundations of clinical risk management and whole systems working.

Evaluating clinical supervision in community homes and teams serving adults with learning disabilities.

Evaluating clinical supervision in community homes and teams serving adults with learning disabilities This paper provides a discussion of some of the professional and policy outcomes associated with implementing clinical supervision within a community service for adults with learning disabilities. It is based upon a small qualitative study whose aim was to examine how clinical supervision was operating, its strengths, its weaknesses and where improvements might be made. The study followed the introduction of clinical supervision 9 months earlier for nurses and carers employed in three community homes and one community multiprofessional team. The method consisted of direct observation of individual and group supervision and staff completing critical incident questionnaires, followed by semi-structured, audio-taped interviews with seven registered nurses and four community team members, including a social worker, psychologist and physiotherapist. Outcomes were expressed in two ways: in terms of the benefits of clinical supervision or of its ambivalence. The range of matters brought for discussion, or resolution, in supervision reflected some of the difficulties or dilemmas staff faced working in this area, for example promoting empowerment and assisting clients to make choices, and dealing with clients' challenging and inappropriate behaviours. As for the role of supervisor there was some evidence of nurses expressing apprehension or unpreparedness, also a perceived general concern over the relatively low status of clinical supervision, thought to be due to absence of visible management approval or failure to articulate properly the objective of supervision. A limitation of the study was its small subject sample although considerable data were gathered in each of the units through relatively long-term contact.

Parallel process in clinical supervision: enhancing learning and providing support

The introduction of clinical supervision in nursing is gaining momentum and is proposed as having numerous benefits for nurses, organizations, and ultimately patient care. The necessity for such supervision has arisen partly from a fundamental shift in the nature and definition of nursing work. The emphasis on individualized, holistic care has led to a change in role from one characterized by professional distance to one in which interpersonal involvement is seen as central. Such a shift, though seen as positive, may lead to increased vulnerability as nurses negotiate the blurred boundaries between the personal and the professional in their relationships with patients. Such boundary negotiation is a legitimate focus for learning and support in clinical supervision. However, as with many aspects of nursing, the subtle processes involved in relationship development are often hidden from consciousness, thus missing potential learning opportunities. One way that such hidden aspects of practice may be explored in clinical supervision is through attendance to the way that such processes are parallelled in the supervisory relationship. Drawing on theory and practice from the fields of counselling and mental health nursing, this paper explores the nature of ‘parallelling’ in clinical supervision. The implications for clinical supervision in nursing more generally are examined in relation to enhancing learning and providing support for supervisees and supervisors.