Mapping effective interprofessional supervision practice

Factors that influence the quality of the clinical supervision experience in a first contact physiotherapy (FCP) role - The perspectives of supervisors and supervisees - A qualitative analysis

PURPOSE

First contact practitioner (FCP) roles have been developed to supplement the primary care workforce in managing the burden of musculoskeletal conditions. In order to quality assure and standardise capability of these clinicians an educational framework was developed by NHS England. The Roadmap to Practice (2020) was the curriculum designed to support and develop capability for FCP roles. This secondary analysis of a broader research project aimed to understand the factors affecting the supervisory experience from both a supervisor and supervisee perspective.

METHODS

A qualitative design using group interviews and an online survey was utilised to examine the experiences of these clinicians on their journey navigating and supporting the Roadmap to Practice portfolio process.

FINDINGS

Three principal themes were identified that affected the supervisory process; preparation of both supervisors and supervisee; the person (supervisor) and the practicalities associated with supervision.

CONCLUSION

There were numerous factors influencing the quality of clinical supervision. Adequate preparation of the supervisor and supervisee is critical to success. The attributes of the supervisor were important in the enhancing the quality of supervisory process. Time afforded to undertake supervision and access to appropriate supervisors need to be adequate and accounted for in workforce planning. A paradigm shift in workplace culture is required so clinical supervision is seen as an integral component in maintaining quality and assuring patient safety.

Are the stars aligned? Healthcare students' conditions for negotiating tasks and competencies during interprofessional clinical placement

BACKGROUND

Healthcare students must learn to collaborate across professional boundaries so they can make use of each other's knowledge and competencies in a way that benefits the patient. One aspect of interprofessional collaboration implies negotiating what needs to be done and by whom. Research, focused on the conditions under which students perform this negotiation when they are working together during interprofessional clinical placement, needs to be further developed. The study therefore aimed to explore students' negotiation of tasks and competencies when students are working together as an interprofessional team during clinical placement.

METHODS

The study was designed as a focused ethnographic observational study. Two Nordic sites where final-year healthcare students perform clinical interprofessional education were included. Data consists of fieldnotes, together with informal conversations, group, and focus group interviews. In total, 160 h of participating observations and 3 h of interviews are included in the study. The analysis was informed by the theory on communities of practice.

RESULTS

Students relate to intersecting communities of practice when they negotiate what they should do to help a patient and who should do it. When the different communities of practice align, they support students in coming to an agreement. However, these communities of practice sometimes pulled the students in different directions, and negotiations were sometimes interrupted or stranded. On those occasions, observations show how the interprofessional learning practice conflicted with either clinical practice or one of the student's profession-specific practices. Conditions that had an impact on whether or not communities of practice aligned when students negotiated these situations proved to be 'having time to negotiate or not', as well as 'feeling safe or not'.

CONCLUSIONS

Final-year healthcare students can negotiate who in the team has the competence suited for a specific task. However, they must adapt their negotiations to different communities of practice being enacted at the same time. Educators need to be attentive to this and make an effort to ensure that students benefit from these intersecting communities of practice, both when they align and when they are in conflict.

Enhancing the quality of allied health clinical supervision in a regional setting: An action research study

OBJECTIVE

To explore and describe strategies to enhance the implementation of an organisational clinical supervision framework and subsequently inform the development of a model of implementation of clinical supervision for allied health professionals in a regional health care setting.

SETTING

A large regional health service in Victoria, providing hospital, rehabilitation, community, mental health and aged care services.

PARTICIPANTS

Allied health managers employed at the health service were members of an action research group.

DESIGN

This longitudinal study used an action research approach. The action research group informed the repeated cycles of planning, action and reflection. Data from recorded action research meetings were analysed using content analysis.

RESULTS

The action research group met 11 times over a 5-year period informing four action research cycles. Six main themes relating to factors that enhanced the quality of clinical supervision emerged from the analysis of the action research group data: purpose and value of clinical supervision; clinical supervision characteristics; differences between disciplines; framework development; training and support and implementation of clinical supervision.

CONCLUSION

The findings from this comprehensive longitudinal study provide evidence-based approaches to the implementation of allied health clinical supervision. The action research approach used ensures that the strategies described are realistic and sustainable. A model has been developed to inform the implementation of clinical supervision for allied health.

Allied health clinical supervision: An opportunity lost

This study investigated clinical supervision with Allied Health professionals in a public health setting. Staff perceptions and experiences were explored through focus group discussions. Key themes identified that supervisees "tip-toe into complexity" by engaging in reflective practice for incremental personal and professional development. In contrast, supervisors identified that reflexivity was required for the opportunity to "develop at a deeper level". Offering a choice of supervisor and providing supervisor training enhanced supervision experiences. Challenges to effective supervision were identified. Competing priorities, inconsistent modes of delivery, major organisational change and the role of clinical supervision in line with professional development confounded the experiences. Health managers could improve the processes and outcomes by implementing consistency with approach, timing, documentation, language, and structure of Clinical Supervision.