Supervision Sessions Research Articles

Exploring internship nursing students' experiences regarding the effect of supervision model implementation on medication safety: A descriptive qualitative study.

Medication safety is one of the main aspects of safe care in the nursing profession, which leads to increasing patient safety and preventing medication errors. Clinical supervision is an integral part of nursing education that leads to the professional and social development of nursing students. This study was designed with the aim of revealing the experiences of nursing internship students from the implementation of the clinical supervision model on medication safety. This descriptive qualitative study was done in 2022. The participants were selected from nursing internship students (Last year undergraduate) of Isfahan University of Medical Sciences, Isfahan, Iran. Participants in this study were 15 nursing internship students selected using a purposeful sampling method. Data were collected using in-depth semi-structured interviews. The qualitative content analysis approach was used for data analysis. After analyzing the data, four categories, "promotion medication safety competence and knowledge," "development trust and respect climate," "outcome of feedback," and "role of clinical supervisor," and 10 subcategories were extracted from the participants' experiences. The implementation of the clinical supervision model led to an increase in the competence of nursing internship students in medication safety. The students believed that this educational method made them follow the principles of medication safety administration. The feedback provided in the clinical supervision sessions made students think about their clinical activities, understand the reason for their mistakes, and use the reliable nursing resources introduced by the supervisor to improve their performance.

집단상담 수퍼비전 경험에 관한 탐색적 연구

Objectives The purpose of this study is to explore both the intermediate-level group counselors’ helpful experiences in the group counseling supervision session and the essential meaning of what changes. Methods 11 group counselors were interviewed individually from September 2019 to March 2021. Some of them with a second-degree counseling license participated in the group counseling supervision at least five times. Others were in the process of obtaining a first-degree counseling certification. Data were analyzed through Giorgi’s phenomenological method and the analysis led to a total of 66 semantic units, 16 sub-categories, and 6 categories and 3 themes. The results are as follows. Results First, the participants joined the group counseling supervision session with expectations that they would be able to gain a deeper understanding of group work and receive the confirmation of the supervisor when functioning as a group counselor. Because training for certification for counselor does not comprehensively cover how group counseling is operated in actual, the participants reported they faced difficultes in carrying them out. Secondly, what the participants experienced were helpful of this supervision is that by adjusting to the previously-burdedsome supervision work and applying the supervisor’s feedback to real intervention, they could experience professional development. Finally, changes as a group counselor in this process were that the participants deeply trusted the group members and understood themselves, as well as they got to form the sense of identity as the supervisor. Conclusions These results are meaningful in that they provide specific implications on the professional learning process and development of intermediate-level group counselors by means of analyzing the helpful experiences gathered from counselors who participated in group counseling supervision session.

The Learning Effects of Children Curriculums by Using Cooperative Learning and Community Practice

<p>本研究目的為：瞭解運用合作學習及實作經驗在兒童遊戲治療及兒童發展與輔導課程，對大學生學習成效之研究。研究對象為大學生，採行動研究法設計行動方案及收集資料，用同理成份量表及學習動機量表，共收集有效問卷含前後測18及21份，個人作業18份及團體心得作業8份。量性研究資料使用描述性統計分析及相依樣本t檢定，質性資料使用內容分析。研究結果發現：運用合作學習及社區實作在兒童遊戲治療課程時，其同理成份量表之總分及認知驅力（Cognitive drive），後測較前測顯著增加（t=2.557；p=.020；t=7.444；p=.000）。在兒童輔導與發展課程顯示：大學生的學習動機及同理能力之前後測無顯著差異（t=1.295；p=.210；t=2.057；p=.053）。質性資料顯示：合作學習促進學業投入、增加同理兒童的認知及情感能力；社區實作促進覺察、理解與反映兒童內在能力及學習動機。結論：合作學習及社區實作可增加學生學習動機及同理能力。研究並根據研究結果修改課程行動方案，建議增加合作學習活動及密集督導實作過程。</p> <p> </p><p>The purpose of this study was to explore the learning effects of two courses (children play therapy and children development and guidance, respectively) by using cooperative learning and community practice. The research participants were college students. The research was action research. The Learning Motivation Scale (LMS) and Empathy Components Questionnaire (ECQ) were collected with 18 and 21 copies, including pre-test and post-test. Moreover, 18 personal assignments and eight texts of group reflection assignments were collected from students. The quantitative data were analyzed by descriptive method and paired t-test. The qualitative data were analyzed through content analysis. The results were as follows: The ECQ score and the subscale score of cognitive drive in the pre-test and post-test significantly differed (t=2.557; p=.020; t=7.444; p=.000) in the children play therapy course. By contrast, the children development and guidance course using cooperative learning and community practice indicated that LMC and ECQ score in the pre-test and post-test had no significant difference (t=1.295; p=.210; t=2.057; p=.053). From the quality analysis, Cooperative learning could improve the college students’ schoolwork involvement and prompt their cognitive and emotional empathy toward children; community practice could improve their awareness, understanding, reflection, and learning motivation abilities toward children. Conclusion: cooperative learning and community practice could increase the learning motivation and ability of empathy. Finally, the action project has been revised on the basis of the research results, suggesting that the cooperative learning-related activities and the intensive supervision sessions in practice duration be added accordingly.</p> <p> </p>

사례개념화 기반 독서치료 수퍼비전 경험에 대한 내러티브 연구

Objectives The study addresses in-depth exploration of a professional bibliotherapist’s experience via case conceptualization-based supervision, by way of the narrative study methodology. Methods The above-mentioned bibliotherapist has more than 10 years of experiences offering bibliotherapy and more than 50 hours of supervision experiences. Data were collected over a 3-month span, by way of three supervision and in-depth interview sessions. Results Analyzed out of the data were 3 domains and 9 lower categories that are related to temporality. Lower category for the first domain (‘pre-supervision pressure’) was ‘preparation of supervision at a loss.’ Lower categories for the second domain (‘shifting of perspective via supervision’) were ‘training for whole-hearted understanding,’ ‘completely melted bibliotherapist’s medium, not part of it,’ ‘going from winding alley to boulevard,’ ‘change of interactions with added trust trust,’ ‘proactive motivation of using media for bibliotherapy,’ and ‘bibliotherapy with shifting of perspective applied.’ Lower categories for the third domain (‘growth via supervision’) were ‘using bibliotherapy to improve counseling effect’ and ‘ruminating myself.’ Conclusions The results of this study will contribute to recognizing the meaning of the case conceptualization-based bibliotherapy supervision experience and preparing concrete evidence for how the case conceptualization training of bibliotherapy supervision is systematized and effectively carried out.

Examining the synergistic effects of a cognitive control video game and a home-based, self-administered non-invasive brain stimulation on alleviating depression: the DiSCoVeR trial protocol

Enhanced behavioral interventions are gaining increasing interest as innovative treatment strategies for major depressive disorder (MDD). In this study protocol, we propose to examine the synergistic effects of a self-administered home-treatment, encompassing transcranial direct current stimulation (tDCS) along with a video game based training of attentional control. The study is designed as a two-arm, double-blind, randomized and placebo-controlled multi-center trial (ClinicalTrials.gov: NCT04953208). At three study sites (Israel, Latvia, and Germany), 114 patients with a primary diagnosis of MDD undergo 6 weeks of intervention (30 × 30 min sessions). Patients assigned to the intervention group receive active tDCS (anode F3 and cathode F4; 2 mA intensity) and an action-like video game, while those assigned to the control group receive sham tDCS along with a control video game. An electrode-positioning algorithm is used to standardize tDCS electrode positioning. Participants perform their designated treatment at the clinical center (sessions 1–5) and continue treatment at home under remote supervision (sessions 6–30). The endpoints are feasibility (primary) and safety, treatment efficacy (secondary, i.e., change of Montgomery-Åsberg Depression Rating Scale (MADRS) scores at week six from baseline, clinical response and remission, measures of social, occupational, and psychological functioning, quality of life, and cognitive control (tertiary). Demonstrating the feasibility, safety, and efficacy of this novel combined intervention could expand the range of available treatments for MDD to neuromodulation enhanced interventions providing cost-effective, easily accessible, and low-risk treatment options.ClinicalTrials.gov: NCT04953208.

Project SELfit: training socio-emotional skills in a school environment in Porto

Abstract Issue/Problem Mental disorders are the main cause of years lived with disability (YLD) in 5-14-year-old people around the world, in Western Europe, and particularly in Portugal. Young people who experience anxiety during childhood have a 3,5-fold likelihood of suffering from depression or anxiety during adulthood. COVID-19 has aggravated this situation, namely regarding socio-emotional competencies. Description of the problem SELfit, a project based on the Socio-emotional learning (SEL) methodology, aims promoting mental health, by training teachers and community nurses to develop socio-emotional skills in students from primary schools. The project includes a theoretical and a practical/training session, and monthly supervision sessions by a team that includes a psychologist, a public health doctor and public health nurses. The period of implementation is between February to July 2022. Results A total of 8 community nurses and 13 teachers from 3 primary schools in Porto enrolled in this project, which corresponds to a total around 272 students from 5 to 8-year-old. Knowledge of nurses and teachers regarding mental health literacy, and social emotional learning was assessed, before and after the theoretical session. The mean percentage of correct answers before was 49% (54% regarding nurses and 45% teachers) compared to 84% (92% regarding nurses and 78% teachers) after. Concerning socio-emotional skills of the primary school students, possible improvement will be evaluated at the end of the project (July 2022). Lessons Mental health literacy and social emotional learning knowledge increased 35%, which highlights the importance of these theoretical sessions promoting mental health literacy. By the end of this project, it is expected to exist an improvement on socio-emotional skills of the primary school students. This is a very important project, expected to be implement and replicated in other schools in Porto and in Portugal. Key messages • Mental disorders are the main cause of years lost due to disability (YLD) in primary school students in Portugal; hence, it was chosen for this mental health promotion project. • This is a pioneer project in Porto, involving both community nurses and primary teachers, in which all are involved in training and promoting social-emotional learning in a school context.

Assimilating problematic life script themes in clinical supervision: The case of Adam

ABSTRACT In transactional analysis theory, life script themes are archaic patterns of experience and interaction, which can emerge during clinical work and impact practice. This study examined whether a newly qualified therapist’s problematic life script themes were detectable in supervision, how they were addressed, and whether addressing them led to assimilation of these themes. Seven consecutive supervision sessions with a recently-qualified male therapist (pseudonym Adam) were transcribed and analyzed using a qualitative theory-building approach. The assimilation of problematic experiences sequence (APES) was used to track changes in Adam’s life script themes. Life script themes were evident in all seven supervision sessions. They centered on two interconnected themes of abuse and rejection. Discussions of these themes in supervision focused on over-identification, protectiveness, and self-disclosure. The supervisor’s interventions included didactic work appropriate for a beginning clinician and facilitative work in supporting development of assimilation of problematic themes. Reflective supervision including exploration of the therapist’s personal process when it is triggered can enhance practice development, and be an important part of the supervision process, providing it respect teach/treat boundary. Comparisons with previous research suggested that script themes emerged differently in supervision of relatively inexperienced supervisees as opposed to experienced ones.

The KomMent study: apilot project on structured interprofessional communication in uro-oncology

Communication and interprofessional collaboration with patients diagnosed with cancer is challenging. Structured communication training has not yet been integrated into postgraduate medical education. The aim of this study was to evaluate the feasibility of an 80-teaching unit interprofessional communication training (ICT), as recommended in the National Cancer Plan, at aclinic with auro-oncological focus. Aneeds assessment was conducted using focus groups and individual interviews. Learning objectives were aligned with (inter)national learning objective catalogs. The ICT was developed using the six-step approach according to Kern and design-based research. Utilization and acceptance were evaluated. The ICT comprised six face-to-face workshops (50teaching units) and team supervision sessions (10teaching units). Six defined settings were identified for the individual workplace-based training (20teaching units): Ward rounds, handover, reporting of medical findings, admission and discharge interviews, and afreely choosable setting. Physician participation rates in the workshops were 83.0% and nursing participation rates were 58.3%. Utilization of the workplace-based training was 97%. The physicians evaluated the ICT very positively. All participants felt better prepared for discussions with patients and relatives. For continuity, physicians were trained as mentors. The implementation of an ICT with 80teaching units is successfully feasible in aurological clinic and leads to asustainable improvement of the communication culture, among other things through mentor training.

P17 - Group Clinical Supervision - its tops!

Clinical supervision is a supportive strategy that has been used successfully in myriad health disciplines, and is commonly used in psychology, social work, other allied health, mental health and palliative care nursing. For midwives, clinical supervision has: fostered feelings of re-energisation and invigoration; enhanced motivation for their jobs; and positively impacted interpersonal skills, situational responses, and careers. An audit of Sydney maternity units show that all organisations offer some degree of Clinical Supervision to midwives, but it is unclear how many actually attend the sessions. The presenter is currently undertaking an NHMRC-funded cluster randomised controlled trial with 12 maternity units in Sydney with Group Clinical Supervision as the intervention. It is hypothesised that midwifery burnout, as well as other health-related parameters will be lowered in relation to attendance at the sessions. As such, the presenters have a wealth of experience in running Group Clinical Supervision sessions. This workshop will demonstrate how Group Clinical Supervision is structured and run. First, background to Clinical Supervision will be outlined about what it aims to achieve for supervisees. The different models of Clinical Supervision that are used in healthcare and the research underpinning the strategy will be discussed. A Group Clinical Supervision session for willing participants will be demonstrated using the role development model. The role development model facilitates a deep reflective process on a work-related topic to unfold. Certain strategies such as using figurines (called ‘concretisation’) to enable a unique view of a situation will be used. Care will be taken to choose a demonstration topic that does not engender strong emotional responses for participants. The workshop has an overall aim to give delegates a chance to be part of a Group Clinical Supervision session and to see, firsthand, the benefits and processes involved.

Explorations on the use of lived experiences by psychiatrists: facilitators and barriers

PurposeThis study aims to explore the perspectives of psychiatrists with lived experiences and what their considerations are upon integrating the personal into the professional realm.Design/methodology/approachAs part of a qualitative participatory research approach, participant observations during two years in peer supervision sessions (15 sessions with 8 psychiatrists with lived experiences), additional interviews as part of member feedback and a focus group were thematically analysed.FindingsAlthough the decision to become a psychiatrist was often related to personal experiences with mental distress and some feel the need to integrate the personal into the professional, the actual use of lived experiences appears still in its early stages of development. Findings reveal three main considerations related to the personal (3.1), professionality (3.2) and clinical relevance (3.3) comprising 11 facilitators and 9 barriers to harness lived experiences.Research limitations/implicationsThis study was conducted locally and there are no similar comparable studies known. It was small in its size due to its qualitative nature and with a homogeneous group and therefore may lack generalisability.Practical implicationsFuture directions to further overcome shame and stigma and discover the potential of lived experiences are directed to practice, education and research.Originality/valuePsychiatrists with lived experiences valued the integration of experiential knowledge into the professional realm, even though being still under development. The peer supervision setting in this study was experienced as a safe space to share personal experiences with vulnerability and suffering rather than a technical disclosure. It re-sensitised participants to their personal narratives, unleashing its demystifying, destigmatising and humanising potential.

Enhancing the clinical supervision experience of staff members working within primary and community care: a best practice implementation project.

The project aimed to assess compliance with evidence-based criteria regarding the use of clinical supervision amongst district nurses and to improve knowledge and engagement in clinical supervision activities within the workplace. It is important to provide clinical support to all healthcare workers that provide opportunities to develop and be listened to in a supervised environment. Clinical supervision is seen as a key element to provide this support. It provides a professional working relationship between two or more members of staff where the reflection of practice and personal emotion can be discussed, which is outlined in many policies and guidelines. A baseline audit was carried out using the JBI Practical Application of Clinical Evidence System program involving 16 participants in one district nursing team in South Wales. The first step involved the development of the project and generating the evidence. Following this, a baseline audit was conducted, and educational training on clinical supervision was undertaken followed by clinical supervision sessions. A postimplementation re-audit was conducted following implementation. A total of 16 participants enrolled on the project. Receiving basic training and participating in clinical supervision was much higher than the baseline audit with both increasing to 100% compliance. Furthermore, 94% of participants were aware of clinical supervision activities and 88% knew of existing records on clinical supervision. The project results show a large increase in compliance with all of the criteria. Overall the implementation project achieved an improvement in evidence-based practice regarding clinical supervision in primary care.

Learning norms of science through laughter: a study of humour in life science supervision

ABSTRACT We explore how norms of science are given attention through laughter in life science doctoral supervision. Four supervision sessions were observed and video recorded. All laugh units were identified, and instances of humour were coded in relation to norms of science. Our analysis reveals tensions around how to do valid research, governance vs. administration and the willingness to make sacrifices. Balancing between validity and feasibility and between quality and quantity, not to mention the importance of scepticism in intellectual conversation, are other important norms of science highlighted in the interaction. We found that norms of science are a vital part of life science supervision and that supervisors play a critical role in the process of socialising PhD students into becoming researchers. We saw how PhD students are taught to navigate these norms, that is, how they are supposed to behave in these complex normative systems. We recognised that the norm of calling has many benefits for researchers in natural science but may pose a threat to good work–life balance for PhD students. Since humour is a powerful form of communication, we recommend that supervisors reflect on how laughter is used as well as which norms and values they teach.

A behaviour‐based coding tool for assessing supervisors' adherence and competence: Findings from a motivational interviewing implementation study

Supervision seems to be an essential part of therapist training and thus also of implementing evidence-based practices. However, there is a shortage of valid and reliable instruments for objective assessment of supervision competence that include both global measures and frequency counts of behaviour-two essential aspects of supervisory competence. This study tests the internal consistency and inter-rater reliability of an assessment tool that includes both these measures. Additionally, strategies and techniques used by 10 supervisors in 35 Motivational interviewing supervision sessions are described. Codings were conducted after two separate coding training sessions. The internal consistency across the global measures was acceptable (α = 0.70; 0.71). After the second training, the inter-rater reliabilities for all frequency counts were in the moderate to good range, except for two that were in the poor range; inter-rater reliability for one of the four global measures was in the moderate range, and three were in the poor range. A prerequisite for identifying specific supervisor skills central to the development of therapist skills, teaching these skills to supervisors and performing quality assurance of supervision, is to create instruments that can measure these behaviours. This study is a step in that direction.

‘The Golden Question’. Addressing supervisee self‐care in clinical supervision

AbstractObjectivesThe purpose of this study was to explore how supervisee self‐care is, or is not, addressed in the clinical supervision of counsellors and psychotherapists. The aims of the study were as follows: (1) to analyse the process and dialogue used to address supervisee self‐care in clinical supervision; (2) to explore supervisee and supervisor experiences and understanding of how self‐care is addressed in clinical supervision; and (3) to investigate how addressing supervisee self‐care can be enhanced or maintained and how this can be implemented into training and practice.MethodFour established supervision dyads with experienced practitioners took part. Twelve supervision sessions were analysed using a discursive psychology approach to discourse analysis. Participants were then interviewed; the data were analysed using interpretative phenomenological analysis.ResultsThe findings from the discourse analysis demonstrate how discourse can enhance or limit addressing self‐care. The findings from the analysis of the supervisor interviews resulted in the following superordinate themes: ‘I am here’, ‘Where are you?’ and ‘We're the instruments’. The findings from the supervisee interviews resulted in two superordinate themes: ‘Me, myself and I' and ‘You and I'.ConclusionsThere is an interplay between the experience of the supervisor and supervisee and the dialogue used to address self‐care in clinical supervision. The implications for practice and training are discussed via ‘The Golden Question’ that encapsulates the findings.

“Asking the ‘dumb’ questions”.

INTRODUCTION: Reflective social work supervision is essential to professional development, building resilience and client work. However, in child protection, supervision is preoccupied with managing risk and meeting outcomes at the expense of analysis and critical reflection. Oranga Tamariki (OT), the statutory child protection organisation in Aotearoa New Zealand, has recently been scrutinised for poor supervisory practice. The authors worked alongside OT social work supervisors and supervisees to explore ways to generate resilience, learning, self-awareness and develop practices that support reflective capability and well-being in supervision. METHODS: This article presents data from the pre/post online evaluation of an action research intervention study with OT supervisors and supervisees. The aim of the online survey was to measure participants’ supervision practices, and the extent to which perceptions of confidence, reflection, professional learning and resilience improved. FINDINGS: The findings are reported from key areas within OT supervision: the frequency of supervision sessions, the functions of supervision, engagement in reflection, supervision- changing practice, resilience and longevity in social work careers and the supervision of supervisors. CONCLUSIONS: The results from the survey showed social workers had increased confidence as they built reflective capacity, resiliency and improved their supervision practice. The study identified the importance of developing learning spaces that enhance reflective supervision for supervisors and supervisees in child protection.

Implementation of strengths model case management in seven mental health agencies in Canada: Direct-service practitioners' implementation experience.

Implementation of strengths model case management is increasing internationally. However, few studies have focused on its implementation process, and none have specifically addressed the implementation experience of direct-service practitioners. This paper presents factors that facilitate and impede the successful implementation of the strengths model, with a specific focus on practitioners who deliver the intervention directly to service recipients. To address this objective, a qualitative study of seven mental health agencies that implemented the model was conducted, involving a combination of participant observations and qualitative semistructured interviews with case managers, team supervisors, and senior managers. Qualitative data were analyzed using open coding followed by axial coding. Finally, the findings were aligned with an adapted Consolidated Framework for Implementation Research. Implementation of the strengths model involved a significant change in practice for case management practitioners. The results confirm that at the beginning of implementation, the strengths model was perceived as complex and not always adaptable to on-the-ground realities. With time, and with support from management, ongoing training and supervision sessions, and reflection and discussion, practitioners regained feelings of competence and resistance to the model diminished. The use of the model's structured team-based supervision tools was fundamental to supporting the implementation process by enabling an interactive and concrete training approach. The more an approach leads to changes in daily practice and is perceived as complex, the more concrete support is needed during implementation. This article highlights the importance of attending to a practitioner's sense of personal effectiveness and competence in the adoption of new practices.

Poverty in Arab-Palestinian society in Israel: Social work perspectives before and during COVID-19.

Arab-Palestinian families have one of the highest poverty rates in Israel. However, there is a lack of knowledge regarding this population from a social work perspective. This article presents an analysis of 64 supervision sessions held with Arab-Palestinian social workers with the aim of identifying context-specific knowledge on the barriers service users face in their daily lives. Our findings point to three types of barriers: economic, sociopolitical, and cultural/political. The article relates to the intersections of these barriers before and during the COVID-19 pandemic.

Tele-Balint under the microscope: What really happens in Tele-Balint groups?

Balint groups provide a safe space for clinicians to discuss difficult cases, with the aim of deepening the clinician-patient relationship and providing space for self-introspection and personal development. During this COVID-19 period, mental health clinicians need a platform to undergo professional supervision and peer learning sessions, which can be provided for by Tele-Balint sessions. This study aims to understand the workings of Balint groups in a multi-disciplinary team, through exploring the experience and perceptions of mental health clinicians in a tertiary obstetrics- and paediatrics-focused hospital in Singapore towards Tele-Balint groups, and examining if these groups can address their professional needs. A mixed-methods study was conducted. 26 mental health clinicians who had participated in Tele-Balint groups since March 2020 completed a semi-structured questionnaire, and 12 of them were interviewed. Qualitative analysis of interview transcripts was performed. Qualitative analysis revealed 5 themes. The first 4: professional and personal growth of clinicians, providing emotional support to clinicians, burnout in clinicians: what contributes and what helps, and psychological safety, address whether Tele-Balint groups meet clinicians' needs. The last theme, evolution of nature of Balint groups, addresses whether Tele-Balint groups meet clinicians' needs during the time of a pandemic. Tele-Balint group participation was found to be beneficial in facilitating personal and professional growth, providing emotional support and preventing burnout, despite some limitations. Members should maintain flexibility towards the Balint process, in order to accommodate others who have differing needs, especially in a multi-disciplinary group.

Education for Sustainable Development: How Seminar Design and Time Structure of Teacher Professional Development Affect Students’ Motivation and Creativity

Teachers need to adapt teaching styles to the goals of modern education. The Starwalker project has developed an approach for strengthening students’ self-efficacy and has provided professional development (PD) to teachers. The present study measured the effectiveness of PD indirectly by changes in students’ motivation and creativity as indicators. Two PD designs with the same time budget were examined: (1) a traditional lecture with a single feedback session; (2) repeated supervision sessions. Students completed questionnaires on school motivation, self-reported creativity and personality measures at the beginning and end of the school year. Four classes each were selected for both treatments and a control group (N = 281; Mean-Age = 10.82). At baseline, with no difference, the second PD design showed a significant increase in motivation and creativity, while the first PD design showed no differences compared to the control group. Spearman’s correlations of personality with motivation and creativity confirmed the presumed role of Agreeableness and Conscientiousness, while Grade Motivation and Flow were independent of personality. Structural equation modelling (SEM) confirmed the importance of creativity for motivation. The study proves that PD can be evaluated indirectly through its effects on students and confirms the Starwalker approach. Frequent brief interventions are recommended for attitude change.

Group Clinical Supervision for midwives and burnout: a cluster randomized controlled trial

BackgroundThere are major shortfalls in the midwifery workforce which has been exacerbated by the COVID 19 pandemic. Midwives have high levels of burnout and many, often early career midwives, are planning to leave the profession. There are reports of a poor workplace culture in maternity units, including bullying. Support is essential for the welfare of the workforce to be able to cope with the demands of their jobs. Supportive strategies, such as Clinical Supervision, a recognised approach in healthcare, enable reflection in a facilitated, structured way, and can enhance professional standards. The purpose of this research is to study burnout levels in midwives, those exiting their workplace and perceptions of workplace culture in relation to access to, and attendance of, monthly Clinical Supervision.MethodsThis study will be a cluster randomised controlled trial of maternity sites within Sydney and the surrounding districts. Twelve sites will be recruited and half will receive monthly Clinical Supervision for up to two years. Midwives from all sites will be requested to complete 6-monthly surveys comprising validated measurement tools: the Copenhagen Burnout Inventory (CBI), the Australian Midwifery Workplace Culture (AMWoC) tool and the Clinical Supervision Evaluation Questionnaire (CSEQ) (the latter for intervention sites only). Primary outcomes are the levels of burnout in midwives (using the CBI). Secondary outcomes will be the quality of the intervention (using the CSEQ), perceptions of workplace culture (using the AMWoC tool) and midwives’ intention to stay in their role/profession, as well as sick leave rates and numbers of exiting staff. We will also determine the dose effect – ie the impact in relation to how many Clinical Supervision sessions the midwives have attended, as well as other supportive workplace strategies such as mentoring/coaching on outcomes.DiscussionThrough attending monthly Clinical Supervision we hypothesise that midwives will report less burnout and more positive perceptions of workplace culture than those in the control sites. The potential implications of which are a productive workforce giving high quality care with the flow-on effect of having physically and psychologically well women and their babies.Trial registrationThe ACTRN Registration number is ACTRN12621000545864p, dated 10/05/2021,