Who supervises the supervisors? And how do you make sure clinical supervision enhances best practice, is effective, safe, and how if you’re a supervisor do you know you’re facilitating good supervision?
A PhD study by social worker Sarah Hamilton is not only providing answers to those questions but will improve care of patients across the health sector as a result.
The guidance she received herself early on in her own career sparked a passion for the area of supervision, leading initiatives to ensure others also received quality supervision in their roles.
Social Worker Sarah Hamilton
“Throughout the early days of my career I would say I wouldn’t have stayed in the profession and in mental health if it wasn’t for clinical supervision,” she said.
“When I found good clinical supervision, then I was able to grow as a professional and felt supported and safe to practice to my full scope of practice, which ignited my passion for embedding good supervision practices within every role during my career whether that be through supervising, mentoring, policy or education.
“I had been delivering and developing supervision education for a while, becoming increasingly conscious that though supervision was considered to be a distinct professional activity, there was real inconsistency in resourcing and training and in defining what competent supervision entailed. I was driven to better understand the breadth of supervision competency and methods for evaluating the supervisor’s development of the related competency skills.
“I found varied opinions about supervision training and limited accessible and effective evaluation resources for enhancing reflection and feedback in training. Often tools that were available had been developed for one profession or only allowed reflection on a specific area, for instance, the alliance, or through one perspective. I was seeking a multiple perspective tool that could assist supervisors and supervisees to understand all the competencies and capabilities they should be aware of when undertaking supervision regardless of their profession or practice area.”
Collaboration with other colleagues identified that existing supervision tools lacked information on key competencies, failed to capture multiple perspectives and were not well validated.
Through her PHD studies, Sarah has developed and psychometrically validated a generic supervision assessment tool (GSAT) that can be used across the allied health professions. Sarah believes the GSAT will be of great benefit to anyone who is asked to take on a supervisory role.
Validation of the GSAT which includes three methods for reflection with a supervisor self-assessment (GSAT-SR), a supervisee feedback version (GSAT-SE) and a third-party assessor version (GSAT-A), involved the participation of 1258 supervisors and supervisees from 12 professions. It is hoped these tools and the associated user manual will optimise supervisory evaluation processes and lead to better supervision of healthcare professionals and ultimately better outcomes for patients.
“When we looked into this, one of the things we found was that most tools are developed because someone had a passion in the area and they were predominantly looking at their area of practice or profession and the resulting work wasn’t easily transferable across professions, or easily usable in training or everyday supervision practice to enhance feedback processes,” Sarah said.
“We wanted to identify the core capabilities a supervisor needs in their toolkit to facilitate supervision regardless of whether you work in health, mental health, community practice, public or private practice, and regardless of your profession.
“If you look at any national or international health service guideline, workforce strategy or professional practice framework, supervision is always listed as one of the essential mechanisms for ensuring clinical excellence, safe and supported workforces and better outcomes for patients, their families, and carers. What I wanted to do was contribute to the efficacy of this by ensuring supervision is given the same level of attention, resourcing, and accountability as other clinical practices.”
“Because for our services, it’s a financial commitment to ensure that the workforce has the time and access to good supervision for their professional development and wellbeing, so we need to make sure we’ve got that return on investment and we are undertaking that activity at a quality that drives best outcomes.”
“For me, it’s a parallel into clinical care. When we do this right in supervision, we have clinicians that are more comfortable and capable in seeking evaluative feedback from patients around their experience of our delivery of care.”
For the Griffith University student, getting support from the PA Research Foundation through its higher degree support initiative to complete her studies was recognition that her work is impactful and desired within the health service.
“More than the financial support, it was the recognition that your research is visible, and it will mean improvements for the workforce and service, it’s the health service and the Foundation saying we’ve got your back,” she said.
“I’ve got to say, Metro South Health (MSH) has been really supportive from the very beginning with the ethics department supporting me with my complex ethical approval, through to the data collections phases, across multiple departments in MSH . I experienced genuine encouragement with leadership and clinicians being interested, engaged and generous with their feedback.”
Sarah’s research paper has now been published and can be read here https://doi.org/10.1111/papt.12369
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