A randomised controlled trial of clinical supervision: selected findings from a novel Australian attempt to establish the evidence base for causal relationships with quality of care and patient outcomes, as an informed contribution to mental health nursing practice development

Abstract

This paper reports on selected findings from a novel randomised controlled trial (RCT) conducted in mental health settings in Queensland, Australia. Several national and state reports recently revealed the sub-optimal state of Australian mental health service provision which have direct implications for mental health nursing, including the privately experienced cost of working and coping in these settings. Clinical supervision (CS), a structured staff support arrangement, has shown promise as a positive contribution to the clinical practice development agenda and is now found reflected in health policy themes elsewhere in the world. However, CS is underdeveloped in Australia and the empirical evidence base for the informed implementation of CS, per se, has remained elusive. Within the overall context of a RCT design, therefore, and supplemented by other data collection methods, this large and generously funded study attempted to make an incremental contribution to better understanding this demanding substantive domain. Whilst the substantive insights and theoretical propositions reported here were derived from, and may be limited by, a sub-specialty of nursing and a single geographic location, they were earthed in the personal self-reported experience of those directly involved with a clinical practice innovation. They may resonate with counterparts beyond mental health nursing and Queensland, Australia, respectively, therefore, and may assist in both conceptualising and operationalising CS research, education, management, policy and clinical practice development decision making in the future.

The influence of clinical supervision and its potential for enhancing patient safety - Undergraduate nursing students’ views

“…In addition, this study reveals that CS definitely influences the development of skills important for patient safety care (see Table 2). The links between CS and patient safety are discussed in the literature [38,44,45] and Dawson [38] suggested that the former has some positive impact on the latter. Sullivan et al [29] highlighted that nurses need to be prepared for their future professional practice with tools in the form of knowledge, skills and attitudes, enabling them to continuously improve the quality and safety of care.…”

Clinical supervision, burnout and intent to leave: an Australian mixed methods study of community-based allied health professionals

“…It has been suggested that clinical supervision practice, in its present variable form, may not represent good value or good practice when it is applied across-the-board within health services (White & Winstanley, 2010). Consistent with all health service practice, clinical supervision implementation needs to be based on sound evidence.…”

“…It may be that findings of supervision ineffectiveness derive from studies where supervisors lacked the expertise to fulfill the educational function, resulting in the delivery of sub-standard supervision. Some researchers have suggested that ineffective supervision may be harmful for supervisees and service recipients (Ellis, 2010;Gaitskell & Morley, 2008;White & Winstanley, 2010), highlighting this potential risk and the need to establish the antecedents of effective supervision (Watkins & Milne, 2014).…”

“…(Crow, 2008;. Also, until recent times, clinical supervision training when provided, was frequently only made available to supervisors (For example, see Collins-Camargo et al, 2009;Hyrkas, 2005;Roche et al, 2007;White & Winstanley, 2010). Providing training for both supervisees and supervisors is recommended (Cutcliffe, 2011;Hyrkas et al, 2006) and evidence suggests that providing clinical supervision training to both supervisees and supervisors at the same time is likely to produce better outcomes (Kavanagh et al, 2008).…”

Supervision for treatment of depression: An experimental study of the role of therapist gender and anxiety

“…Within such research, results are often mixed. While some studies indicate that supervision can have a positive impact on patient outcomes (Bambling, King, Raue, Schweitzer, & Lambert, 2006;Ost, Karlstedt, & Widen, 2012), other research finds no impact (White & Winstanley, 2010). …”