Manchester Clinical Supervision Scale Research Articles

Supervision and Wellness: A Survey of Human Service Practitioners

ABSTRACT Organizationally provided workplace-based supervision is important for human services as it impacts service delivery, client outcomes, and organizational efficacy. Surveying human service practitioners in Ontario, Canada (N = 207), this study examined the relationship between supervision effectiveness and practitioner wellness using the Manchester Clinical Supervision Scale and the Professional Quality of Life – Health Scale, conducting a MANCOVA and fitting a Structural Equation Model. Of the participants, 37% received effective supervision as defined by MCSS-26 developers, 40% non-effective supervision, and 23% no supervision. Participants whose scores reflected non-effective supervision experienced the worst wellness outcomes, worse than no supervision. Results indicate effective supervision, particularly the strength of supervisory relationship and administrative (i.e. normative) function, predicts practitioner wellness, increasing perceived support and compassion satisfaction while decreasing burnout, secondary traumatic stress, and moral distress. Findings emphasize the need for organizations to dedicate resources to effective supervision to improve practitioner wellbeing and, in turn, client outcomes.

Clinical supervision effectiveness in NHS nursing, medical and allied health professionals: Exploring interaction with workplace factors, supervision factors and burnout.

The study aimed to (1) determine if a variety of workplace and supervision factors predict clinical supervision effectiveness; and (2) establish if clinical supervision effectiveness predicts burnout, amongst a variety of mental health staff (medical, allied health, and nursing staff). The study adopted a multicentre cross-sectional online survey design. Participants included 204 mental health staff (89 allied health staff, 81 nursing staff, and 34 medical staff). The Manchester Clinical Supervision Scale (MCSS-26) was used to measure clinical supervision effectiveness, and the Maslach Burnout Inventory (MBI-HSS) was used to measure burnout. Linear regression analyses and multiple regression analyses were conducted. The main findings suggested that supervision frequency, supervision duration, choice of supervisor, workplace setting, and supervisee profession, were all significant predictors of clinical supervision effectiveness. Additionally, clinical supervision effectiveness was a significant negative predictor of burnout. Workplace and supervision factors should be considered in supervision practice across professional groups. Policies need to promote effective clinical supervision practice.

The effect of clinical supervision model on nurses’ self-efficacy and communication skills in the handover process of medical and surgical wards: an experimental study

BackgroundThe handover process is a vital part of patient safety continuity, particularly conducted between nurses at the end of shifts. Nurses often face challenges in handover due to a lack of self-efficacy and inadequate communication skills. The clinical supervision model, by providing emotional, educational, and organizational support, aids in skill acquisition and instills confidence.ObjectiveThis study was conducted to investigate the effect of the clinical supervision model on nurses’ self-efficacy and communication skills in the handover process within medical and surgical wards.MethodThis experimental two-group (pre-and post-test) study was conducted in 2024 at selected hospital affiliated with Isfahan University of Medical Sciences, Isfahan, Iran. Convenience sampling was used, and participants were randomly assigned to either the intervention or control group. Data were collected using the ISBAR communication checklist, communication clarity, the Sherer General Self-Efficacy Scale (GSES), the Visual Analog Scale (VAS) for handover self-efficacy, and the Manchester Clinical Supervision Scale (MCSS). The clinical supervision model and routine supervision were implemented in six sessions for the intervention and control groups, respectively. Data were analyzed using SPSS version 16, employing independent t-tests, covariance analysis, paired t-tests, chi-square tests, and repeated measures ANOVA with a significance level of p < 0.05.ResultsNo significant differences were observed between the intervention and control groups in terms of baseline characteristics. Inter-group analysis indicated that there were no significant differences in the scores of self-efficacy, ISBAR, and communication clarity between the control and intervention groups before the intervention (P > 0.05). According to the intra-group analysis, the ISBAR and communication clarity scores in the intervention group significantly increased over time (p < 0.001), whereas no such increase was observed in the control group. The intervention group showed a significant increase in general self-efficacy (p < 0.001) compared to the control group. Although both groups showed a significant improvement in handover self-efficacy, the mean scores of the intervention group were higher than those of the control group (p < 0.001). The mean score of the Manchester Clinical Supervision Scale in the intervention group was 128.98, indicating the high effectiveness of implementing the clinical supervision model.ConclusionThe findings indicated that the use of the clinical supervision model improves self-efficacy and communication skills in the handover process of nurses in medical and surgical wards. Therefore, it is recommended to use this model in handover training to enhance the quality of care and improve patient safety.

Clinical supervisor’s experiences of peer group clinical supervision during COVID-19: a mixed methods study

BackgroundProviding positive and supportive environments for nurses and midwives working in ever-changing and complex healthcare services is paramount. Clinical supervision is one approach that nurtures and supports professional guidance, ethical practice, and personal development, which impacts positively on staff morale and standards of care delivery. In the context of this study, peer group clinical supervision provides allocated time to reflect and discuss care provided and facilitated by clinical supervisors who are at the same grade/level as the supervisees.MethodsTo explore the clinical supervisor’s experiences of peer group clinical supervision a mixed methods study design was utilised within Irish health services (midwifery, intellectual disability, general, mental health). The Manchester Clinical Supervision Scale was used to survey clinical supervisors (n = 36) and semi-structured interviews (n = 10) with clinical supervisors were conducted. Survey data were analysed through SPSS and interview data were analysed utilising content analysis. The qualitative and quantitative data’s reporting rigour was guided by the CROSS and SRQR guidelines.ResultsParticipants generally had a positive encounter when providing clinical supervision. They highly appreciated the value of clinical supervision and expressed a considerable degree of contentment with the supervision they provided to supervisees. The advantages of peer group clinical supervision encompass aspects related to self (such as confidence, leadership, personal development, and resilience), service and organisation (including a positive working environment, employee retention, and safety), and patient care (involving critical thinking and evaluation, patient safety, adherence to quality standards, and elevated levels of care).ConclusionThere are many benefits of peer group clinical supervision at an individual, service, organisation, and patient level. Nevertheless, there is a need to address a lack of awareness and misconceptions surrounding clinical supervision to create an environment and culture conducive to realising its full potential. It is crucial that clinical supervision be accessible to nurses and midwives of all grades across all healthcare services, with national planning to address capacity and sustainability.

Operational nursing managers' experiences of clinical supervision at a Johannesburg Hospital.

Clinical supervision is pivotal in supporting nurses in rendering quality, safe patient care. Therefore, it is essential to understand clinical supervision from operational nursing managers' context to define existing challenges and propose suitable recommendations. This study aimed to explore and describe operational nursing managers' experiences of clinical supervision within the context of an academic hospital in Gauteng province and propose evidence-based practice recommendations to improve patient safety and the quality of clinical supervision. An exploratory, sequential, mixed-method design was used and implemented over two phases to take advantage of the strengths of both the qualitative and quantitative research designs. Unstructured individual interviews were conducted to collect data in phase one, and an adapted Manchester Clinical Supervision Scale (MCSS) questionnaire was used to collect data in phase two. Operational nursing managers work in stressful conditions and environments with a gross shortage of staff and tools of the trade while being expected to deliver high-quality and safe nursing care. Of the sampled respondents, 36% (n= 17) were dissatisfied with the supervision they received, while 64% (n= 30) were indifferent in the sense that they did not think it was adequate or inadequate. Clinical supervisors should be trained and supported in clinical supervision, with regular workshops on interpersonal relations.Contribution:A clearer understanding of clinical supervision within the hospital context and evidence-based practice recommendations to improve patient safety and the quality of clinical supervision.

Interactive clinical supervision training added to self-education leads to small improvements in the effectiveness of clinical supervision of physiotherapists: a randomised trial

QuestionDoes adding an interactive clinical supervision training program to self-education improve the effectiveness of clinical supervision of physiotherapists, reduce burnout, decrease intention to leave and increase participation in clinical supervision? DesignRandomised controlled trial with concealed allocation, assessor blinding and intention-to-treat analysis. ParticipantsPhysiotherapists (n = 58) working at a publicly funded health service. InterventionParticipants in both groups received a self-education clinical supervision training package. In addition, participants in the experimental group received interactive clinical supervision training consisting of three 90-minute workshops. Outcome measuresThe primary outcome measure was effectiveness of clinical supervision 4 months after training measured using the Manchester Clinical Supervision Scale (MCSS-26). Secondary outcomes were the Maslach Burnout Inventory, the Intention to Leave Scale, and participation in supervision. Focus groups were also used to gauge impressions of the intervention. ResultsThe addition of interactive clinical supervision training slightly improved effectiveness of clinical supervision, with a between-group mean difference of 6.3 units (95% CI 0.3 to 12.3) on the MCSS-26. The estimate of the effect on the proportion of physiotherapists reporting effective clinical supervision (ie, MSCC-26 score ≥ 73) was unclear (OR 1.97, 95% CI 0.50 to 7.81). Physiotherapists in the experimental group reported slightly lower levels of depersonalisation (MD –3.0 units, 95% CI –4.6 to –1.3). There were negligible or uncertain effects on the other burnout domains, intention to leave and participation in clinical supervision. Qualitatively, participants reported that the workshops made them realise that supervisees could take greater ownership of where supervision focused. ConclusionAdding interactive clinical supervision training to self-education leads to small improvements in the effectiveness of clinical supervision of physiotherapists. Registrationosf.io/yz3kx.

Access to and effectiveness of clinical supervision for allied health workers: A cross-sectional survey

Introduction Clinical supervision supports patient care and health worker wellbeing. However, access to effective clinical supervision is not equitable. We aimed to explore the access and effectiveness of clinical supervision in allied health workers. Methods A cross-sectional survey design using the Manchester Clinical Supervision Scale (MCSS-26), including open-ended survey responses, to collect data on effectiveness. Multivariable regression was conducted to determine how MCSS-26 scores differed across discipline, work location and setting. Open-ended responses were analysed using content analysis. Results 1113 workers completed the survey, with 319 (28%) reporting they did not receive supervision; this group were more likely to hold management positions, work in a medical imaging discipline and practice in a regional or rural location. For those who received supervision, MCSS-26 scores significantly differed between disciplines and work settings; psychologists and those practising in private practice settings (i.e. fee-for-service) reported the highest levels of effectiveness. Suggested strategies to enhance effectiveness included the use of alternate supervision models, dedicated time for supervision, and training. Conclusion Targeted subgroups for improving access include senior staff, medical imaging professionals, and those working across regional and rural settings. Where supervision was least effective, strategies to address behaviours with organisational support may be required.

Getting a grip on Safewards: The cross impact of clinical supervision and Safewards model on clinical practice.

The Safewards model is used across various mental health settings to reduce incidents of conflict and containment and its efficacy in reducing the use of seclusion and restraint, improving patients' experiences of care, and enhancing safety within clinical settings is well documented (Bowers, Journal of Psychiatric & Mental Health Nursing, 21, 2014, 499). However, there are barriers to successful implementation, including level of staff buy-in (Baumgardt etal., Frontiers in Psychiatry, 10, 2019, 340; Price etal., Mental Health Practice, 19, 2016, 14). This mixed-method study assessed the impact of adopting a Safewards model within a clinical supervision framework in an approach, named Group Reflective integrated Practice with Safewards (GRiP-S), which integrates Safewards theory within the clinical supervision framework. Both quantitative and qualitative data were collected using the questions derived from the Manchester Clinical Supervision Scale -26© (Winstanley & White, The Wiley International Handbook of Clinical Supervision. John Wiley & Sons Ltd, 2014). A total of 67 surveys and eight interviews were completed by nursing staff. Overall, the results showed that the GRiP-S approach improves the implementation of Safewards and nurses' clinical practice. Nursing staff satisfaction with clinical supervision and Safewards improved post GRiP-S pre-GRIP-S- 69.54 (SD 16.059); post-GRIP-S 71.47 (SD 13.978). The survey also identified nursing staff's perception of GRiP-S in the restorative and formative domains of clinical supervision improved. The restorative mean score pre-GRiP-S was 28.43 (SD 5.988) and post-GRiP-S 29.29 (SD 3.951). The formative mean score pre-GRiP-S was 20.10 (SD 5.617) and post-GRiP-S 20.63 (SD 13.978). The qualitative results further explained the satisfaction levels and the changes seen in perception domains. The GRiP-S approach reported (i) improved therapeutic relationships and patient centred care, (ii) improved staff communication and teamwork, (iii) barriers to GRiP-S engagement, and (iv) assistance with the change process. The results indicate that the GRiP-S approach had a positive impact on Safewards delivery and supports ongoing change of practice.

An assessment of the effectiveness of supervision in preventive healthcare institutions under the purview of the Regional Directorate of Health Services, Kalutara

Background: Supervision is an essential element in primary healthcare. It is not only the number that matters but the quality and effectiveness of supervision as well. Ineffective supervision is a cause of poor performance that can lead to sub-optimal health outcomes.Objective: To assess the effectiveness of supervision in preventive healthcare institutions under the administrative purview of the Regional Directorate of Health Services (RDHS), Kalutara.Method: A descriptive cross-sectional study was designed and carried out in all preventive sector healthcare institutions under the administrative purview of the RDHS, Kalutara. The entire population of the supervisors (Regional Director and Deputy Regional Director of Health Services, Consultant Community Physician, Medical Officer-Maternal &amp; Child Health, Regional Epidemiologist, District Dental Surgeon, Supervisory Public Health Nursing Officers, Supervisory Public Health Inspector, Medical Officers of Health, Additional Medical Officers of Health, Supervisory Public Health Inspectors, Public Health Nursing Sisters, and Supervisory Public Health Midwives) and supervisees (Public Health Inspectors and School Dental Therapists) in the RDHS division except the Public Health Midwives (PHMs) was included in the study as their actual numbers are low. The selection of PHMs, the major category of supervisees, was subjected to random sampling. Self-administered questionnaires, focus group discussions, and observatory visits were used to collect the data. Data were analyzed both quantitatively and qualitatively. The effectiveness of supervision was assessed utilizing Manchester Clinical Supervision Scale (MCSS-26). Knowledge, attitudes, and practices of supervisors were assessed through a self-administered questionnaire and to some extent through observations.Results: The overall response rate was 67.8%. The knowledge related to supportive supervision among the supervisors was moderate. The level of knowledge was not significantly different among the different categories of supervisors. The level of attitudes towards supervision was also moderate. However, it was significantly different among the supervisory categories. As per the scale devised through the questionnaire, the supervisory practice was moderate as well, but it was not significantly different among the different categories of supervisors. The mean score of MCSS-26 was 65.67 indicating that overall supervision was ineffective by its threshold limit of 73. Apart from the administrative function of supervision, the supportive and educational functions were largely ineffective.Conclusion and recommendations: The effectiveness of supervision was suboptimal in preventive care health institutions of the RDHS division Kalutara. Appropriate measures that focused on enhancing supportive and educational functions of supervision are therefore required to improve the effectiveness of supervision among different categories of supervisors in the division. Designing and implementing more focused training and development activities to improve knowledge, attitude, and practices in supportive supervision; facilitating, encouraging, and empowering the supervisors to implement their post-supervisory recommendations; and utilizing the MCSS-26 as a tool of measuring supervisory effectiveness for the purpose of monitoring and evaluating the supervisory activities, are therefore recommended to improve the effectiveness of supervision in the division.

Learner and supervisor perspectives on factors that influence the effectiveness of educational supervision in postgraduate pharmacy education

Abstract Introduction Educational supervision underpins the Centre for Pharmacy Postgraduate Education’s (CPPE) publicly funded national training pathways for pharmacy professionals working in primary care in England, mirroring arrangements for postgraduate medical specialty training. The educational supervision provided by CPPE comprises both one-to-one support and group learning to enable pharmacy professionals transitioning into primary care roles to progress with their education, manage workplace challenges and practise safely.1 However, little is known about its effectiveness. Aim The aim of this study was to explore learner and supervisor perceptions of factors that influence the effectiveness of educational supervision. Methods The study used a concurrent embedded mixed methods design. Following institutional ethical approval, data were collected using a validated online survey comprising items adapted from the Manchester Clinical Supervision Scale (MSCC-26®)2 and the Academy of Medical Educators’ (AOME) framework. The survey, comprising a 25-item questionnaire, together with open-ended questions inviting respondents to explain their ratings, was sent to all 902 learners enrolled on a CPPE primary care training pathway and 52 CPPE education supervisors in July 2020. Statistical data were analysed with SPSS®, using non-parametric tests due to negative data skewing. Responses to open-ended questions were analysed with NVivo® using framework analysis and then compared with the statistical data. Results 187 learners (20.7%) and 51 supervisors (98%) responded to the survey. Overall, 82.5% learners and 100% of supervisors rated the educational supervision provided by CPPE as effective. Framework analysis of responses to open-ended survey questions identified three main factors perceived by learners and supervisors to influence the effectiveness of educational supervision: supervisor-learner relationships; a safe learning environment; and peer support. Within the theme of supervisor-learner relationships, trust and rapport was awarded the highest mean score of any survey item. Trust and rapport and the ability of supervisors to establish a safe learning environment showed significant positive correlations (ρ(8) = .48, p &amp;lt; .001 and ρ(8) = .74, p &amp;lt; .001 respectively) with overall scores for the effectiveness of educational supervision. Peer support did not form part of the survey yet was mentioned spontaneously in many learner and supervisor responses. Learners described the benefits of educational supervision in providing opportunities to learn from peers, to receive peer feedback and to obtain peer and supervisor support for personal issues such as workplace challenges. Discussion/Conclusion Consistent with the literature on factors that influence the effectiveness of clinical supervision in other healthcare professions3, the results indicate that educational supervision provided by CPPE was more effective when levels of trust and rapport between learners and supervisors were high and when supervisors were able to create a safe learning environment. However, peer support has not previously been identified as an influencing factor. This is an important finding, reflecting that unlike other disciplines, the educational supervision provided by CPPE encompasses both one-to-one and group learning sessions. Limitations of the study include the relatively low learner response rate, the effect of the COVID-19 pandemic which required provision of online supervision and the potential bias from insider research.

Effective Clinical Supervision in Nursing: Systematic Review

BACKGROUND: Clinical supervision is part of the leadership function to observe and evaluate the nursing care process, affecting service delivery and improving employee skills.&#x0D; AIM: This systematic review was designed to evaluate effective clinical supervision in nursing.&#x0D; METHODS: Databases were searched for relevant studies: Google Scholar, PUBMED, ScienceDirect, and ProQuest to study screening tools used to identify effective clinical supervision in nursing that were published within 2011-2022. Information about purpose, method, and result. The quality of the study was assessed using equipment from the Manchester Clinical Supervision Scale (MCSS). Validation and reliability were performed on all instruments. Data reliability using Cronbach's coefficient.&#x0D; RESULTS: Data from retrieved studies were reviewed and tabulated according to purpose, study design, characteristics of the population, and result. Eight hundred twenty-nine identified references and 12 full-text articles were reviewed, and 8 for eligibility which has been tested and included in a systematic review, and articles have instruments with included criteria.&#x0D; CONCLUSION: Limitations of effective clinical supervision of the head of the department. The organization is very important because a private hospital can work effectively if there is a healthy and supportive working environment between management and employees. Therefore, future research should focus on using clinical supervision in the health care system to identify effective supervision.

Effectiveness of allied health clinical supervision following the implementation of an organisational framework

BackgroundClinical supervision makes an important contribution to high quality patient care and professional wellbeing for the allied health workforce. However, there is limited research examining the longitudinal implementation of clinical supervision for allied health. The aim of this study was to determine the effectiveness of clinical supervision for allied health at a regional health service and clinicians’ perceptions of the implementation of an organisational clinical supervision framework.MethodsA cross-sectional study was conducted as a phase of an overarching participatory action research study. The Manchester Clinical Supervision Scale (MCSS-26) tool was used to measure clinical supervision effectiveness with additional open-ended questions included to explore the implementation of the clinical supervision framework. MCSS-26 findings were compared with an initial administration of the MCSS-26 5 years earlier. MCSS-26 data (total scores, summed domain and sub-scale scores) were analysed descriptively and reported as mean and standard deviation values. Differences between groups were analysed with independent-samples t-test (t) and one-way between groups ANOVA.ResultsThere were 125 responses to the survey (response rate 50%). The total MCSS-26 score was 78.5 (S.D. 14.5). The total MCSS-26 score was unchanged compared with the initial administration. There was a statistically significant difference in clinical supervision effectiveness between speech pathology and physiotherapy (F = 2.9, p = 0.03) and higher MCSS-26 scores for participants whose clinical supervisor was a senior clinician and those who chose their clinical supervisor. Seventy percent of participants perceived that the organisation’s clinical supervision framework was useful and provided structure and consistent expectations for clinical supervision.ConclusionsClinical supervision was effective for allied health in this regional setting and clinical supervision effectiveness was maintained over a 5 year period. The implementation of an organisational clinical supervision framework may have a positive effect on clinical supervision for some professions.

Satisfaction with supervision of healthcare workers in relation to job satisfaction and selected characteristics of supervision

Aim: The aim of the study was to find out whether there was a correlation between satisfaction with supervision and job satisfaction among healthcare workers, and, in addition, whether there is a correlation between satisfaction with supervision and selected demographic data. Design: Cross-sectional study. Methods: The research sample consisted of staff in healthcare facilities who took care of patients / clients, and underwent supervision (n = 234). The McCloskey / Mueller Satisfaction Scale and Manchester Clinical Supervision Scale questionnaires were used. Results: In the case of job satisfaction, a statistically significant correlation was demonstrated between the effectiveness of the provided supervision and level of job satisfaction. When comparing selected demographic characteristics, a significant difference was demonstrated between satisfaction with supervision of psychiatric staff and hospice care staff. No statistically significant difference between the groups of respondents was demonstrated in satisfaction with supervision according to level of education. Conclusion: Our research demonstrated a correlation between satisfaction with supervision and job satisfaction. Satisfaction with supervision, in turn, depends on the workplace of the respondents. It is important to further educate staff in this area and promote the benefits of supervision in nursing practice.

Improvement in the Short-Term Effectiveness of the Clinical Supervision of Physiotherapists Who Have Taken Part in a Clinical Supervision Training Programme.

Purpose: The purpose of this study was to evaluate change in the effectiveness of clinical supervision of physiotherapists who took part in a clinical supervision training programme. Method: Our pre-post study design used both quantitative and qualitative methods. The programme consisted of three interactive sessions held with physiotherapists from a metropolitan public health network in Melbourne, Victoria, Australia. The effectiveness of clinical supervision of supervisees was measured using the Manchester Clinical Supervision Scale (MCSS-26). The effectiveness of clinical supervision from the supervisors' perspective was measured using a clinical supervisor questionnaire. The physiotherapists' experience of participating in the training programme was then explored in focus groups. Results: A total of 36 physiotherapists participated in the training programme. Twelve weeks later, the physiotherapists (35) reported a moderate improvement in the effectiveness of clinical supervision, with a mean improvement of 5.4 units (95% CI: 2.0, 8.9; p=0.003) on the MCSS-26 (score range 0-104). After training, a higher proportion of physiotherapists reported receiving effective clinical supervision (97% after vs. 53% before; p=0.001). In the focus groups, the physiotherapists reported greater flexibility in their approach to clinical supervision and a more effective supervisory relationship. However, difficulty finding time for supervision remained a barrier. Conclusions: Physiotherapists reported an improvement in the effectiveness of clinical supervision after a clinical supervision training programme.

Clinical supervision in a high secure hospital: a service evaluation

Few environments demand a higher level of emotional competences than forensic care settings, and the importance of clinical supervision to mitigate against the risks of such an environment cannot be underestimated. This paper explores the efficacy of clinical supervision provided to nursing staff within a high secure hospital using the Manchester Clinical Supervision Scale. Results indicated that the nursing workforce were overall very satisfied with their clinical supervision, specifically clinical team leaders are most likely to be very satisfied. Results also showed the significance of time: clinical supervision is more effective when it lasts between 30–60 minutes, but correspondingly, time is one of the key barriers to accessing clinical supervision.

Physiotherapists Prefer Clinical Supervision to Focus on Professional Skill Development: A Qualitative Study.

Purpose: We explored physiotherapists' perceptions of clinical supervision. Method: Individual semi-structured interviews were conducted with a purposive sample of 21 physiotherapists from a public hospital. Qualitative analysis was undertaken using an interpretive description approach. The Manchester Clinical Supervision Scale (MCSS-26) was administered to evaluate the participants' perceptions of the effectiveness of the clinical supervision they had received and to establish trustworthiness in the qualitative data by means of triangulation. Results: The major theme was that the content of clinical supervision should focus on professional skill development, both clinical and non-clinical. Four subthemes emerged as having an influence on the effectiveness of supervision: the model of clinical supervision, clinical supervision processes, supervisor factors, and supervisee factors. All sub-themes had the potential to act as either a barrier to or a facilitator of the perception that clinical supervision was effective. Conclusions: Physiotherapists reported that clinical supervision was most effective when it focused on their professional skill development. They preferred a direct model of supervision, whereby their supervisor directly observed and guided their professional skill development. They also described the importance of informal supervision in which guidance is provided as issues arise by supervisors who value the process of supervision. Physiotherapists emphasized that supervision should be driven by their learning needs rather than health organization processes.

Effective clinical supervision of allied health professionals: a mixed methods study

BackgroundClinical supervision is recommended for allied health professionals for the purpose of supporting them in their professional role, continued professional development and ensuring patient safety and high quality care. The aim of this mixed methods study was to explore allied health professionals’ perceptions about the aspects of clinical supervision that can facilitate effective clinical supervision.MethodsIndividual semi-structured interviews were conducted on a purposive sample of 38 allied health professionals working in a metropolitan public hospital. Qualitative analysis was completed using an interpretive description approach. To enable triangulation of qualitative data, a quantitative descriptive survey of clinical supervision effectiveness was also conducted using the Manchester Clinical Supervision Scale (MCSS-26).ResultsThree main themes emerged from qualitative analysis: Allied health professionals reported that clinical supervision was most effective when their professional development was the focus of clinical supervision; the supervisor possessed the skills and attributes required to facilitate a constructive supervisory relationship; and the organisation provided an environment that facilitated this relationship together with their own professional development. Three subthemes also emerged within each of the main themes: the importance of the supervisory relationship; prioritisation of clinical supervision relative to other professional duties; and flexibility of supervision models, processes and approaches to clinical supervision. The mean MCSS-26 score was 79.2 (95%CI 73.7 to 84.3) with scores ranging from 44 to 100. MCSS-26 results converged with the qualitative findings with participants reporting an overall positive experience with clinical supervision.ConclusionsThe factors identified by allied health professionals that influenced the effectiveness of their clinical supervision were mostly consistent among the professions. However, allied health professionals reported using models of clinical supervision that best suited their profession’s role and learning style. This highlighted the need for flexible approaches to allied health clinical supervision that should be reflected in clinical supervision policies and guidelines. Many of the identified factors that influence the effectiveness of clinical supervision of allied health professionals can be influenced by health organisations.

Predictors of Nurse’s Caring Behavior towards Patients with CriticalIllness

Background: Caring for a critical ill patient are challenges for nurses. The nurse is required to deliver comprehensive nursing care including mental, psychological and physical. Caring behavior of nurse is influenced by several factors both internal and external. Objectives: This study aimed was to examine the relationship between nursing supervision, spirituality, caring efficacy, emotional quotation, work stress and working periods with caring behavior while deliver care for a critical patient.&#x0D; Methods: Cross-sectional design was used with the number of participants were 66 nurses. Data were collected in July 2018 in three wards: emergency room, HCU, and ICU in dr. DradjatPrawiranegara Hospital, Banten. Instruments used were the Spiritual Orientation Inventory questionnaires, Manchester Clinical Supervision Scale, Caring Behavior Assessment, and Caring Efficacy Scale which were modified and tested for validity and reliability. Data were analyzed using multivariate linear regressions.&#x0D; Results: The results showed that there were significant relationships between nursing supervision(r=0.511;p&lt;0.01),spirituality(r=0.448;p&lt;0.01),caringefficacy(r=0.433; p&lt;0.01) and emotional intelligence (r = 0.419; p&lt;0.01) with nurse caring behavior in care critical patients (p&lt;0.001). There was no significant relationship between Work Periodandworkstresswithcaringbehavior(p&gt;0.05).&#x0D; Final statistical analysis by using multiple regression showed that nursing supervision Beta=0.434;p&lt;0.01),spirituality (Beta = 0.312; p&lt;0.01) and caring efficacy (Beta = 0.297; p&lt;0.01) were recognized as predictors of nurse’s caring behavior in care critical patient ward.&#x0D; Conclusion: The Increasing of nursing supervision as an external effort and developing activities are expected to improve spirituality and caring efficacy of nurse is needed to improve nurse’s caring behavior in caring for a critical patient.

The association between effectiveness of clinical supervision of allied health professionals and improvement in patient function in an inpatient rehabilitation setting

Purpose: Clinical supervision is widely accepted as an important element of practice for allied health professionals to ensure a high quality of patient care. However, it is unknown whether effective clinical supervision of allied health professionals improves patients’ outcomes. This study investigated whether effective clinical supervision of allied health professionals is associated with improved patient functional independence. Methods: A prospective longitudinal study design and multi-level regression analysis were used to explore the association between effective clinical supervision and patient functional independence. The effectiveness of clinical supervision was assessed using the Manchester Clinical Supervision Scale. Functional improvement in patients treated by allied health professionals was measured utilising the mobility and self-care subscales of the functional independence measure.Results: Physiotherapists (n = 27) and occupational therapists (n = 26) in inpatient rehabilitation were recruited and the medical records of their patients (n = 1846) audited. The effectiveness of clinical supervision of physiotherapists was positively associated with improvement in personal care. Therapist variables accounted for less than 2.5% of the variation in patient improvement in functional independence.Conclusions: Effectiveness of a reflective model of clinical supervision of physiotherapists and occupational therapists was not associated with an improvement in their patients’ mobility or personal care, respectively.Implications for rehabilitationEffective clinical supervision of physiotherapists and occupational therapists using a reflective model of practice is a poor predictor of improved functional independence in rehabilitation inpatients.Patient variables, such as the intensity of therapy, were more important predictors of patient functional improvement than effective clinical supervision.Initiatives aimed at increasing intensity of therapy will likely have a greater effect on improving patient functional independence compared with initiatives aimed at improving the effectiveness of clinical supervision using a reflective model of practice.Initiatives to improve the effectiveness of clinical supervision in improving quality of care could explore the use of a direct model of practice where supervisors directly observe and support supervisees during patient treatment sessions.

Effect of an Educational Program about Clinical Supervision for First Line Nurse Managers on Quality of Their Clinical Supervision An Educational Program about Quality of Clinical Supervision for First Line Nurse Managers

Background: Clinical supervision (CS) is becoming standard practice for health professionals, and has been considered to be an important component of comprehensive clinical governance. Also CS has been promoted as a key clinical governance component to ensure the provision of and accountability for the quality of care provided to patient and to minimize the risk of adverse outcome for patient. Aim: to investigate the effect of an educational program about clinical supervision for first line nurse managers on quality of their clinical supervision. Setting: The study was carried out at Minia University Hospital; Gynecology, Obstetric and Pediatric University Hospitals. Subject: A convience sample of first-line nurse managers' (no.= 50) and staff nurses (no.= 300) were included in the study. Tools: Three tools were used in this study; Clinical supervision knowledge questionnaire, Clinical Supervisor self-assessment questionnaire and Manchester Clinical Supervision Scale (MCSS). Results: The total knowledge score and levels of CS, and its subscales among first line nurse managers were low before the program implementation; after the program implementation they had high scores with statistically significant differences; also the staff nurses perception about first line managers were low before program and became higher after the implementation. Conclusions: statistically significant increase in the knowledge test scores have been found after program implementation and during the different periods of testing. Recommendations: Clinical supervision program should be periodically conducted for all head nurses, integrate the clinical supervision in the philosophy of the hospital, and first line managers should periodically have nursing group meeting to verbalized, vitalize and support peer and social interaction develop supportive working conditions and relationship that encourage trust, empathy and mutual regard; put and identify the work policies and routine in place and allow supervisees to know their limitations.