Clinical Supervision On a Shoe String: d oing more with less

Clinical Supervision On a Shoe String:doing more with less

Margaret A. BramwellSocial Work ManagerSVH Sydney

12 June 2014

Footnote to go hereDay/Month/Year Page 2

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Cairns and FNQ

Regional SW covering travelling from Innisfail to TI to Normanton

Supervising staff in Cairns/ Atherton/ Mareeba

Day/Month/Year Page 3

Clinical Supervision: Our lens

We all come to Supervision as an instrument with experience

Context: professional background

Social Work : commitment to Clinical supervision

Positive and negative experiences

Respect for the principles of Adult Education

Educator / Pupil

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Social Work : Clinical Supervision

Alfred Kadushin 2002:

“The relationship is the communication bridge between people.”

Three Supervision components: Education Management

Support.


Clinical Supervision: Why do it?

Studies show that effective clinical supervision leads to improved well-being, confidence and self-awareness, reduces emotional strain and burnout, and individuals experience greater professional growth.

For the workforce it increases staff morale, job satisfaction, staff proficiency and retention of a more highly skilled workforce.

Studies also show that the positive impact that clinical supervision has is most likely a result of the training that supervisors receive, the quality of supervision they provide and the culture and managerial attitudes within the organisation. (White & Winstanley 2010).

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Clinical Supervision: Assets

Things that cost nothing but are critical components of Supervision:

You Engagement Dedicated time for Supervision - Protect it ! Mutual Aid Respect Agreed contract Reflective practice Active Listening Confidentiality/ Escalation Education Support Professional behaviour


Clinical Supervision:

Representative sample of work- are they safe today?

Use of critical reflection / feedback

Process recording- what they said, responses

Observe- One way screens

Face time/ Skype – city, rural, remote, international supervision

Finding a supervisor when resources are limited Draw upon other agencies – Community Health/ GP’s/ Clinical

Psychologists in Private Practice/ other specialists

Form an interprofessional group

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STAR Project 2013 SVH

Recent Student SVH 2013 survey

Students were asked the 3 most important attributes of a clinical supervisor

ApproachableSupportive

Good Communicator

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Students were asked which factors they thought affect clinical supervisors being

able to perform their role well

Lack of timeLack of appropriate trainingLack of interest in the role

Please note: these results reflect the most significant rate of responses and not all results are shown in these tables.

STAR Program 2013 SVH Sydney

Supervisees value: 2013 SVH

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0%

10%

20%

30%

40%

50%

60%

70%

80%

90%

100%

Not important at all

Not very important

Not sure

Somewhat important

Very important

Students were asked how important it is that clinical supervisors performed the following activities

Supervision:Peer group

Peer group supervision usually refers to reciprocal arrangements in which peers work together for mutual benefit where developmental feedback is emphasised and self directed learning and evaluation is encouraged (Benshoff, J.M. 1992).

Increased access / frequency of supervision

Reciprocal learning through the sharing of experiences

Increased skills and responsibility for self assessment and

Decreased dependency on expert supervisors

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Supervision:Peer supervision

7 factors for Effective Peer Group Supervision:

EqualitySupportive CultureStructure: ‘checking in’ and agenda set / supervisee

and supervisor roles Placeing a high value on turning upSuper + VisionSelf Directed – No Post mortems

( A. McNicoll, NZ Mentoring Centre- 2008)

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Supervision: Peer groups

Diverse modalities of presentation will be used; including case discussion, theoretical discussion, case- based learning, role plays and TED talks.

Non-hierarchical with a rotating facilitator

Focus on capacity building and being fluid rather than rigid in format

Ensure there is collegial listening and it is a safe environment


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Interprofessional Supervision

Definition of IPE:

“Occasions when two or more professionals learn from, with and about each other to improve collaboration and the quality of care”

(Thistlethwaite, 2012; Reeves et al 2012)


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Clinical Supervision: Interprofessional

World Health Organisation (2010) show that interprofessional teaching and supervision can prepare health professionals for team-based care or interprofessional collaborative practice (IPCP).

The benefits: increased staff motivation, well-being and retention decreases in staff turnover increased patient satisfaction increased patient safety increases in appropriate use of specialist clinical resources reductions in patient mortality and critical incidents increases in access to and coordination of health services enhances the learners understanding of other professionals roles and

responsibilities fosters mutual respect promotes teamwork and collaboration


Marie Heydon Project Officer CETI 2011 Page 17

Get Ready!A Course for Interprofessional Work-Place Readinessin the Health Service14 to 18 November 2011

Delivered by St Vincents & Mater Health Sydney in collaboration with our University partners:

University of New South Wales – St Vincent’s Clinical School The University of Sydney Australian Catholic University

University of Tasmania, School of Nursing and Midwifery

Get Ready

Day/Month/Year Marie Heydon Project Officer CETI 2011 Page 18

Results Excellent attendance and participation from 52 Nursing, Medical and Allied Health students

across the week of the 14th – 18th November 2011

Robust quantitative and qualitative data very strongly support the effectiveness of this one week program in addressing the core interprofessional competencies.

95% of all combined repeated measure items across four tools were statistically significant demonstrating an objective indicator of positive program impact

Qualitative feedback strongly supported these findings. Sample student comments from across professions include: ‘absolutely enjoyed the program, ability to work in a multidisciplinary team has improved a lot’; ‘concept great, very needed....simulation and Human Factors DVD excellent’; ‘terrific, informative and enjoyable, thanks’;

92% students endorsed this program for other pre-graduates with either unqualified support or a range of constructive suggestions

Students actively contributed suggestions for program refinement and enhancement and these comments have been incorporated into revised program recommendations

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Interprofessional Supervision

Studies suggest that in the interprofessional context, supervision from educators whose profession differs from that of the students can be a beneficial and rewarding experience for students and that a supportive, clinician-focused, content-oriented supervision offered by knowledgeable and skilled clinical experts has been perceived as beneficial, regardless of the supervisor’s profession (Townend 2005, Chipchase 2012).

Draw upon the strengths of your interprofessional colleagues

Diversification of staff supervision

Collaboration, communication and consultation


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Clinical Supervision: STAR Program

The pilot program at SVH Sydney focused on delivering the project objectives of developing an interprofessional education program to increase clinical supervisor competence and confidence.


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STAR Program covered diverse topics including:

balancing the clinical workload and the supervision role, balancing education, support and managerial functions in supervision, setting supervision contracts/agreements & learning goals, building relationships and identifying learning styles, understanding adult teaching skills, developing effective communication skills, reflective practice & advanced reasoning skills, managing conflict and challenging conversations, providing constructive feedback to over and under performers


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STAR : training new supervisors

STAR program: HWA Pilot Program to expand clinical supervision capacity and competency. Supervision, Training and Readiness (STAR) Program Provided an interprofessional developmental mentoring program for new

clinical supervisors Aims - to develop and enhance the quantity and quality of clinical supervisors

across the interprofessional domains - Confident and competent clinical supervision - Collaboration in the supervision of clinical practice activities - Enhance capacities and skill of experienced supervisors through

implementation of education modules such as e-learning, role playing, simulation and face to face sessions and peer mentoring groups,

- Evaluated

We designed an innovative program that can be utilised across other health

care facilities for a consistent and collaborative approach in enhancing the quality and capacity of interdisciplinary clinical supervision.


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Evaluation:

A five level ‘Likert Scale’ was used for the first four questions of the session evaluation to quantitatively measure the relevance of the content and whether appropriate teaching methods were utilised.

The scale was set as outlined below:

1.Strongly disagree

2.Disagree

3.Neither agree nor disagree

4.Agree

5.Strongly agree


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STAR : evaluation


Clinica

l Sup

ervis

ion &

Ove

rsigh

t

Adult

Lear

ning

Princip

les &

Sty

les

Debrie

fing

& Con

stru

ctive

Fee

dbac

k

Reflec

tion

IP P

eer M

ento

ring

Group

s0

1

2

3

4

5

Wednesday

Saturday

Q4. The content of the training program was relevant to my needs and provided knowledge and skills that can be utilised in my role as a clinical supervisor

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Evaluation:


Clinica

l Sup

ervis

ion &

Ove

rsigh

t

Adult

Lear

ning

Princip

les &

Sty

les

Debrie

fing

& Con

stru

ctive

Fee

dbac

k

Reflec

tion

IP P

eer M

ento

ring

Group

s0

0.5

1

1.5

2

2.5

3

3.5

4

4.5

5

Wednesday

Saturday

Q2. I was actively involved in the learning process which stimulated my interest

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STAR:

The opportunity for interprofessional supervision was ‘appreciated’ and the several participants think the STAR program will assist them to be a more structured supervisor, be more approachable, flexible and effective as a supervisor to provide the best learning experiences for their supervisees.

The majority of participants found the interactive activities most beneficial. The videoed scenarios, case studies, role plays and group discussions were considered the most effective and constructive. Many commented that being able to share experiences and hear from others was enjoyable and promoted IP collaboration


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Questions????

Thank you


Documents

Clinical Supervision On a Shoe String: d oing more with less