Clinical Supervision

For professionals working in the area of healthcare, clinical supervision offers an unrivalled opportunity to explore one’s strengths and weaknesses, learn more about their practice, and it encourages greater overall growth and development, both professionally and personally. In this blog, we will explore the benefits of clinical supervision and its overall impact on practice outcomes.

According to research, ‘clinical supervision of health professionals is associated with effectiveness of care.’[1]

While the definition of clinical supervision can vary between supervisor and supervisee, depending on the nature of the relationship and the desired outcomes, a comprehensive definition by the Royal College of Nursing Institute defines it as: ‘regular, protected time for facilitated, in depth reflection of clinical practice. It aims to enable the supervisee to achieve, sustain and creatively develop a high quality of practice through the means of focused support and development.’[2]


Acceptance of Clinical Supervision

 

Acceptance of clinical supervision is a barrier to its implementation. Some healthcare professionals take the view that once their training has been completed, clinical supervision is no longer needed, which is far from the truth. The healthcare arena is constantly changing and adapting as new approaches to care are being introduced and explored, and older approaches are being revisited and adapted to suit modern needs. Furthermore, modern healthcare is calling for an ‘increasingly team-based’[3] approach, which challenges the sense of professional independence that some older practitioners feel they have developed or even earned.

Others may be reluctant to further clinical supervision due to negative experiences with it in the past. While it is true that the presence of a supervisor in a clinical setting can cause some feelings of anxiety – perhaps relating to one’s concern over their competency, and which may cause some discomfort – this same anxiety can cultivate in the supervisee a state of alertness, and finer focus on compassionate attunement with the client. If the practitioner can apply learned relaxation in a clinical setting, that – when combined with a moderate level of anxiety – can result in what author and educator Zaretta Hammond calls ‘relaxed alertness’.[4]

 

The Benefits of Clinical Supervision for Practitioners

 

It is known that practitioners can benefit from clinical supervision, regardless of age or what stage they are at in their career.

For professionals working in isolation, clinical supervision can provide some much-needed support.[5]

‘Regular clinical supervision ensures that health professionals connect with their peers in safe, serious, and supportive ways.’[6]

 

Reduced burnout and work-related distress

 

Compassionate, trust-based clinical supervision can reduce feelings of burnout and distress in healthcare practitioners. One study conducted in 1997, known as the Clinical Supervision Evaluation Project (CSEP) reported a positive outlook on clinical supervision by nurses who praised ‘the structured opportunity to talk meaningfully to a trusted colleague about their circumstances at work.’[7]

According to a discussion paper entitled Clinical Supervision: A Structured Approach to Best Practice published by the National Council for the Professional Development of Nursing and Midwifery, ‘those who received clinical supervision suffered less psychological distress arising from their work and in areas where clinical supervision was not offered, there were measurable detrimental effects on the workforce.’[8]

 

Cost Effectiveness of Clinical Supervision

 

Clinical supervision is also a cost-effective means of improving care services. A 2001 study[9] published in the Journal of Nursing Management considered the costs of nurses’ time and that of the supervisor, and the benefits, like greater practical knowledge and satisfaction of patients, volume of complaints, extent of litigation, and frequency of sick leave. It was ultimately concluded that ‘clinical supervision was cost-effective as the number of sick days decreased and the number of patients treated increased, thus improving productivity.’[10]

A study published in the Journal of Psychiatric and Mental Health Nursing in 2017[11] reported that schizophrenic patients showed a greater decrease in severity of positive symptoms when being treated by a group of students ‘who were engaged in clinical supervision compared with a group not engaged in clinical supervision.’[12]

Though evidence is limited on the direct effect of clinical supervision on patient health outcomes, it may be associated with ‘a reduction in psychological symptoms of patients diagnosed with a mental illness’ when provided to mental health professionals.[13]

In terms of improving the knowledge and capability of working professionals, effective clinical supervision is beneficial in that it[14]:

  • increases competence and confidence in practice.
  • fosters professional development.
  • safeguards healthcare professional against work-related burnout.
  • improves teamwork and collaboration.
  • promotes measurable clinical outcomes.
  • ensures welfare of clients.

 

A Collaborative Effort

 

‘With accountability and governance being high on the policy agenda in healthcare, the introduction of systems like clinical supervision to support professional competence will contribute to an overall strategy to achieve safe, quality patient care.’[15]

In contrast to the common perception of clinical supervision, it is not so much a hierarchical structure whereby an authority figure judges the competency of a working professional, but is more ‘a process of guided reflection’[16] that aims to improve the overall professional efficacy of those working in the healthcare arena.

In conclusion, effective clinical supervision is fundamental in improving our approaches to treatment.

 


 
Sources:

 

[1] Snowdon, David A et al. “Does clinical supervision of healthcare professionals improve effectiveness of care and patient experience? A systematic review.” BMC health services research vol. 17,1 786. 28 Nov. 2017, doi:10.1186/s12913-017-2739-5

[2] RCN Institute (1997) Exploring Expert Practice Study Guide. RCN, London.

[3] Tomlinson, J., 2015. Clinical Supervision: The Key To Patient Safety, Quality Care And Professional Resilience – BMC Series Blog. [online] BMC Series blog. Available at: <https://blogs.biomedcentral.com/bmcseriesblog/2015/06/19/patient-safety-quality-care-professional-resilience/#:~:text=Preventing%20the%20feeling%20of%20isolation%20in%20the%20clinic&text=many%20healthcare%20systems.-,Regular%20clinical%20supervision%20ensures%20that%20health%20professionals%20connect%20with%20their,safe%2C%20serious%20and%20supportive%20ways.&text=Some%20professionals%20think%20that%20they,they%20have%20completed%20their%20training.> [Accessed 15 July 2020].

[4] Reina Remigio, P., 2018. Improving Clinical Supervision Through Collaboration – Time2track Blog. [online] Time2Track Blog. Available at: <http://blog.time2track.com/improving-clinical-supervision-through-collaboration/> [Accessed 15 July 2020].

[5] Clough A. 2003. Clinical supervision in primary care. Primary Health Care 13(9):15–18.

[6] Tomlinson, J., 2015. Clinical Supervision: The Key To Patient Safety, Quality Care And Professional Resilience – BMC Series Blog. [online] BMC Series blog. Available at: <https://blogs.biomedcentral.com/bmcseriesblog/2015/06/19/patient-safety-quality-care-professional-resilience/#:~:text=Preventing%20the%20feeling%20of%20isolation%20in%20the%20clinic&text=many%20healthcare%20systems.-,Regular%20clinical%20supervision%20ensures%20that%20health%20professionals%20connect%20with%20their,safe%2C%20serious%20and%20supportive%20ways.&text=Some%20professionals%20think%20that%20they,they%20have%20completed%20their%20training.> [Accessed 15 July 2020].

[7] Butterworth T., Carson J., White E., Jeacock J., Clements A. & Bishop V. (1997) Clinical Supervision and Mentorship. It Is Good To Talk: An Evaluation Study in England and Scotland. The School of Nursing Studies, University of Manchester, Manchester.

[8] 2008. Clinical Supervision: A Structured Approach To Best Practice. [ebook] National Council for the Professional Development of Nursing and Midwifery. Available at: <https://www.pna.ie/images/ncnm/Clinical%20Supervision%20Disc%20paper%202008.pdf> [Accessed 15 July 2020].

[9] Hyrkäs K., Lehti K. & Paunomen-Ilmonen M. (2001) Cost–benefit analysis of team supervision: the development of an innovative model and its application as a case study in one Finnish university hospital. Journal of Nursing Management 11, 48-58.

[10] 2008. Clinical Supervision: A Structured Approach To Best Practice. [ebook] National Council for the Professional Development of Nursing and Midwifery. Available at: <https://www.pna.ie/images/ncnm/Clinical%20Supervision%20Disc%20paper%202008.pdf> [Accessed 15 July 2020].

[11] Bradshaw T., Butterworth A. & Mairs H. (2007) Does workplace based clinical supervision during psychosocial intervention education enhance outcome for mental health nurses and the service users they work with? Journal of Psychiatric and Mental Health Nursing 14, 4-12.

[12] 2008. Clinical Supervision: A Structured Approach To Best Practice. [ebook] National Council for the Professional Development of Nursing and Midwifery. Available at: <https://www.pna.ie/images/ncnm/Clinical%20Supervision%20Disc%20paper%202008.pdf> [Accessed 15 July 2020].

[13] Snowdon, David A et al. “Does clinical supervision of healthcare professionals improve effectiveness of care and patient experience? A systematic review.” BMC health services research vol. 17,1 786. 28 Nov. 2017, doi:10.1186/s12913-017-2739-5

[14] Bambling, King, Raue, Schweitzer & Lambert (2006); Bernard & Goodyear (2004); The Bouverie Centre (Ryan, Wills et al., 2009); Kavanagh, Spence et al. (2002); Powell & Brodsky (1998); Roche, Chelsea et al. (2007).

[15] 2008. Clinical Supervision: A Structured Approach To Best Practice. [ebook] National Council for the Professional Development of Nursing and Midwifery. Available at: <https://www.pna.ie/images/ncnm/Clinical%20Supervision%20Disc%20paper%202008.pdf> [Accessed 15 July 2020].

[16] Clinicalsupervisionguidelines.com.au. 2013. Definition And Purpose. [online] Available at: <http://www.clinicalsupervisionguidelines.com.au/definition-and-purpose> [Accessed 15 July 2020].

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