Mental health pre-registration nursing students' experiences of group clinical supervision: A UK longitudinal qualitative study

Online Group Supervision as Pedagogy: A Qualitative Inquiry of Student Mental Health Nurses' Discourses and Participation

This study explored online group clinical supervision participation, as a component of pre-registration education following mental health nursing students' clinical placements. Clinical supervision has historically been valued as a supportive strategy by healthcare professionals to develop practice and competence and prevent burnout. As many student nurses do not have access to clinical supervision via practice areas as a standardised process, their experiences of engaging in or benefitting from clinical supervision are wide-ranging. In view of this, we are identifying a theory-practice gap between theoretical knowledge and practice experience. This study incorporated a qualitative inquiry using reflexive thematic analysis and applying poststructural theoretical perspectives. Online group clinical supervision was delivered to student mental health nurses whereby focus groups followed to discuss their views, understandings and experiences of online group clinical supervision. This was against a back drop of Covid-19 lockdown restrictions. Thematic synthesis identified two main areas for improving participation and pedagogy comprising; Improving Confidence and Trust in (Online) Participation and The Need for Familiarity in CS Participation and Understanding. Thematic and poststructural analysis demonstrated participants' positive outlooks on the values of clinical supervision, whilst also identifying the finer nuances of the differences in accessing group clinical supervision through an online format. This study adds to the literature on using group clinical supervision within the student mental health nurse population by identifying the benefits of group clinical supervision for student nurses. It has additionally found that the silences and inhibitions surrounding online participation are important areas for further research.

'What is it we are trying to achieve here'? Community maternal and child health nurses and clinical supervision: A qualitative descriptive study

AIMS

To explore clinical supervision practice by Victorian Maternal and Child Health nurses, identify the self-reported supervision needs of nurses and the facilitators and barriers to meeting those needs.

BACKGROUND

Community-based Maternal and Child Health nurses have responsibilities for the safety and wellbeing of children and specific clinical support needs. Clinical supervision has the potential to support nurses' clinical practice and reflective skills; however, little is known internationally about child and family health nurses' supervision practices.

DESIGN

Qualitative descriptive study.

METHODS

Twenty-three semi-structured interviews were conducted between October and December 2021 with nurses, managers and supervisors across metropolitan, regional/rural areas of Victoria, Australia. Inductive thematic analysis was applied to the data. The Consolidated Criteria for Reporting Qualitative Research guided this study.

RESULTS

Three main themes, with subthemes were generated; 'Understand what we do', 'It's the gathering of the nurses' and 'Bringing a case'. A lack of agreed purpose, aims and varied understandings of clinical supervision contributed to suboptimal clinical supervision. Although participants agreed about the importance of clinical supervision, the perceived benefits were inconsistently realized.

CONCLUSIONS

This study points to a need for greater organizational awareness of the conditions and leadership needed to build reflective skills and culture in community-based child and family nursing.

REPORTING METHOD

The Consolidated Criteria for Reporting Qualitative Research has guided this study.

NO PATIENT OR PUBLIC CONTRIBUTION

There was no patient or public contribution in the conduct of this study.

IMPACT

A stronger focus is needed to build reflective culture and skill in child and family nursing. Areas for improving child and family nurses' use of clinical supervision have been identified. This study can inform nurse education, policy and service leaders, to strengthen clinical supervision in child and family nursing contexts.

Reflections on Reflection: Clarifying and Promoting Use in Experienced Coaches

Background

We draw on the work of established scholars in the field of reflective practice who highlight its importance as a key cognitive skill for professionals to hold. While the substantive effect of engaging in reflective practice is emphasised in the literature, apparently coaches only spend a limited time learning about and engaging with it.

Objectives

This study was conducted in two parts: Part 1 examined coaches' knowledge of reflective practice and ascertained their perceived lack of value and use of reflective practice within their coaching. In response to the unexpected findings in Part 1, in Part 2, we instituted an educational intervention to further these participant coaches' knowledge of Reflective Practice (RP) and facilitate its integration into their coaching practice.

Design

The present study utilised a mixed method design with semi-structured interviews being conducted in Part 1. A coach development reflective programme inspired by Stimulated Recall approach was implemented in Part 2.

Participants

Twelve high level coaches were interviewed about their reflective practices in Part 1. In Part 2, the same coaches agreed to participate in the educational intervention for the duration of the project.

Results

Findings from Part 1 revealed an interesting paradox: coaches demonstrated a lack of appreciation for reflective practice yet recounted the positive influence that specific events and individuals had on their practice. In Part 2, to fully develop RP with the present cohort, an educational intervention was conducted. While watching videos of their own practice, coaches initially required lots of prompts from the lead interviewer to facilitate a deep and meaningful discussion of their practice. During the latter stages of the intervention, however, participants were less dependent on questions and prompts.

Conclusion

In part 1, the coaches in this study did employ reflection, although they did not label it as such. The qualitative evidence we have gathered enables us to suggest that it is the combination of how to reflect, and against what criteria that makes RP a powerful tool to develop expertise which it has the potential to be. Importantly, however, additional coach education input is necessary for these benefits to be fully realised.

Elements of group dynamics that influence learning in small groups in undergraduate students: A scoping review

BACKGROUND

Learning in small groups is a frequent activity in undergraduate programs to enrich learning, as well as in nursing programs during clinical experiences. Being in a small group adds elements of group dynamics that influence learning. Research into the influence of these elements on learning in small groups is not clear in the literature. This makes it challenging for educators to promote the optimal environment for learning.

OBJECTIVE

To explore the literature on elements of group dynamics that influence learning in small groups among undergraduate students.

DESIGN AND DATA SOURCES

A scoping review was performed, inspired by the five-stage approach of Arksey and O'Malley and the methodology outlined by the Joanna Briggs Institute. Various databases were used including CINAHL, ERIC, psycINFO, PubMed and Science Direct.

REVIEW METHOD

Our research question was: What are the elements of group dynamics that influence learning in small groups among undergraduate students? At least two authors analyzed the relevant studies and data were extracted to describe the elements of group dynamics that influence learning in small groups among undergraduate students.

RESULTS

Thirty papers were included in our review. Five elements emerged: engagement, openness, support, quality of communication and style of dominant behavior.

CONCLUSIONS

The results suggested the utilization of these elements in establishing a group dynamic favorable for learning in small groups. Since little research has been done into group dynamics in nursing education, it was useful to explore this concept in other disciplines. Further research is needed with a focus on clinical education for nursing students.

The importance, impact and influence of group clinical supervision for graduate entry nursing students

This paper will report on an evaluation of group clinical supervision (CS) facilitated for graduate entry nursing (GEN) students whilst on clinical placement. The literature suggests educational forums which enable GEN students to engage in critical dialogue, promote reflective practice and ongoing support are an essential element of GEN curricula. The model of supervision employed was informed by Proctor's three function interactive CS model and Inskipp and Proctor's Supervision Alliance. Both emphasise the normative, formative and restorative functions of CS as task areas within an overarching humanistic supervisory approach. The three-function model informed the design of a questionnaire which intended to measure their importance, impact and influence through both structured and open-ended questions. Findings suggest the restorative function of supervision is most valued and is facilitated in an environment where humanistic principles of non-judgement, empathy and trust are clearly present. Also the opportunity to learn from others, consider alternative perspectives and question personal assumptions regarding capability and confidence are a priority for this student group. It is suggested that the restorative function of CS should be prioritised within future developments and models which view this function as a key purpose of CS should be explored.

Understanding supervision in health and social care through the experiences of practitioners in Scotland

Purpose

The purpose of this paper is to describe a collaborative study on supervision with health and social care practitioners in Scotland. The study attempted to gain a better understanding about the use and benefit of supervision from a multiprofessional perspective.

Design/methodology/approach

Consultation events with health and social care staff and 12 informant interviews were undertaken. Data analysis was via the Framework Method.

Findings

Managers were more likely to conceive of supervision as a positive intervention than those in lower pay bands. The practice of supervision was variable. Not all staff appeared to take part in regular supervisory activities even when it was mandated. A lack of professional, organisational or local commitment to implement robust supervisory structures and processes was seen as the major barrier to effective supervision.

Research limitations/implications

This was a small study, thus findings would need to be confirmed by health and social care staff working across a wider spectrum of disciplines and regions across Scotland.

Practical implications

A combination of factors would seem to determine effective supervisory practice. Supervision was perceived to be of benefit when individuals were willing to participate fully, when there was reflection and planned action, constructive challenge, respectful relationships, regular and protected sessions and processes were appropriate to an employee’s circumstances.

Originality/value

This study situates supervision in the current context of health and social care and finds it to be an irregular practice. The findings confirm the existing literature about the importance of supervisor-supervisee relationships but explain differing perceptions of supervision in terms of staff seniority.