Getting good help: a guide for reflection, debriefing and feedback conversations about in-consultation supervision

Sturman, Nancy; Fitzmaurice, Liz; Ingham, Gerard; Lee, Cathy; Sheldrake, Michelle

doi:10.1080/14739879.2020.1864781

Cited by 3 publications

(12 citation statements)

References 24 publications

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“…A total of 11 articles met the inclusion criteria which described a specific clinical supervision model 48–58 …”

Section: Resultsmentioning

confidence: 99%

“…Within the 11 articles, six focused on general practitioners, four focused on practice nurses, and there was one article that focused on nurse practitioners 48–58 . All articles had a model that utilised a peer of the same profession for supervisor and supervisee; however, one of the models made use of general practitioners for clinical supervision of practice nurses.…”

Section: Resultsmentioning

confidence: 99%

“…All articles had a model that utilised a peer of the same profession for supervisor and supervisee; however, one of the models made use of general practitioners for clinical supervision of practice nurses. The clinical supervision models and/or cohorts were located in rural and metropolitan Australia, the United Kingdom and Denmark, and the USA 48–58 …”

Section: Resultsmentioning

confidence: 99%

“…57 The Trainee & Supervisor Reflection, Feedback & Debriefing Guides employed a method of mutual reflection on the clinical supervision session to prompt and feed into a feedback session. 54 In the Kalymnos model, feedback was given immediately postcase presentation in an indirect fashion to the supervisor and group. However, it was performed retrospectively with the presentation of a video case of a previous consultation.…”

Section: Feedbackmentioning

confidence: 99%

“…Modelling also had low representation in the majority of articles. [48][49][50][51][52][53][54][55][56] Modelling was inherent in Flags for Seeking Help model as the supervisor and supervisee negotiated and discussed how serious a trigger was and what the appropriate response would be. 57 The Kalymnos model used role play during the case presentation by the group members, to explore what the patient might be experiencing, which also demonstrated another paradigm of the clinical supervision process.…”

Section: Modellingmentioning

confidence: 99%

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Models of clinical supervision of relevance to remote area nursing & primary health care: A scoping review

Hildebrand,

Gray,

McCullough

2023

Australian J Rural Health

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IntroductionNurses in remote primary health care settings work in difficult conditions, in isolated and disadvantaged communities, and often must work beyond their scope to provide advanced assessments and treatments to support the community. Therefore, remote area nurses require support to develop their skills and knowledge to work safely within their full scope of practice. Clinical supervision is widely used in health professions for this purpose; however, models of supervision for nursing have not been implemented or evaluated within remote primary health care settings.ObjectiveThe purpose of this study was to search the literature to source suitable clinical supervision models that could pertain to the remote area nursing context.DesignAn initial search of the literature found no clinical supervision models developed for remote or isolated practice nurses so a scoping review was conducted searching for publications related to advanced practice generalist health practitioners in primary health care, including practice nurses, nurse practitioners and general practitioners. This was seen as a suitable substitute because the phenomena of interest were the model of supervision rather than the specific skills or knowledge being developed.FindingsThe scoping review search yielded 251 articles from 5 journal databases of which 11 articles met the inclusion criteria. Each clinical supervision model was described and synthesised using qualitative description. The 11 models of clinical supervision had differing formats including; individual and group clinical supervision, in‐person, telephone, medical records review and video case study.DiscussionWhilst several models were described in the literature, none were directly transferrable to the remote area context. The absence of supervision for cultural safety was significant. There was a variety of modes including face‐to‐face, virtual, individual and group proposed. Cultural considerations were lacking in all of the models.ConclusionOur study recommends a hybrid clinical supervision model suitable for consultation and validation through pilot testing with remote area nurses. There is potential for this model to be used globally in isolated contexts due to the option of virtual participation.

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“…A total of 11 articles met the inclusion criteria which described a specific clinical supervision model 48–58 …”

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Feedbackmentioning

confidence: 99%

Section: Modellingmentioning

confidence: 99%

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Models of clinical supervision of relevance to remote area nursing & primary health care: A scoping review

Hildebrand,

Gray,

McCullough

2023

Australian J Rural Health

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Perceptions of the effectiveness of using patient encounter data as an education and reflection tool in general practice training

Klein

Bentley²,

Moad

et al. 2023

J. Prim. Health Care

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Introduction Patient encounter tools provide feedback and potentially reflection on general practitioner (GP) registrars’ in-practice learning and may contribute to the formative assessment of clinical competencies. However, little is known about the perceived utility of such tools. Aim To investigate the perceived utility of a patient encounter tool by GP registrars, their supervisors, and medical educators (MEs). Methods General practice registrars, supervisors and MEs from two Australian regional training organisations completed a cross-sectional questionnaire. Registrars rated how Registrar Clinical Encounters in Training (ReCEnT), a patient encounter tool, influenced their reflection on, and change in, clinical practice, learning and training. Supervisors’ and MEs’ perceptions provided contextual information about understanding their registrars’ clinical practice, learning and training needs. Results Questionnaires were completed by 48% of registrars (n = 90), 22% of supervisors (n = 182), and 61% of MEs (n = 62). Most registrars agreed that ReCEnT helped them reflect on their clinical practice (79%), learning needs (69%) and training needs (72%). Many registrars reported changing their clinical practice (54%) and learning approaches (51%). Fewer (37%) agreed that ReCEnT influenced them to change their training plans. Most supervisors (68%) and MEs (82%) agreed ReCEnT reports helped them better understand their registrars’ clinical practice. Similarly, most supervisors (63%) and MEs (68%) agreed ReCEnT reports helped them better understand their registrars’ learning and training needs. Discussion ReCEnT can prompt self-reflection among registrars, leading to changes in clinical practice, learning approaches and training plans. Reaching its potential as an assessment for learning (as opposed to an assessment of learning) requires effective engagement between registrars, their supervisors and MEs.

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Utilisation of in-consultation supervisor assistance in general practice training and personal cost to trainees: a cross-sectional study

Sturman

Tapley

Holliday

et al. 2023

J. Prim. Health Care

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Aim The aim of the study was to establish whether two previously described barriers to effective in-consultation assistance-seeking by general practice (GP) vocational specialist trainees (ie concern about patient impressions of their competence, and discomfort presenting to supervisors in front of patients) influenced the frequency of trainee in-consultation assistance-seeking from their supervisor. Methods This was a cross-sectional study nested in the Registrar Clinical Encounters in Clinical Training ongoing cohort study of Australian GP trainees. Trainee participants completed contemporaneous records of 60 consecutive patient consultations, including whether supervisory assistance was sought. Trainees also completed a cross-sectional survey including items eliciting their beliefs about patient impressions and their own discomfort in seeking in-consultation supervisory assistance. These were factors of interest in multivariable logistic regression analyses; the outcome factor in both regression models was the seeking of in-consultation supervisory assistance. Results In 2018, 778 trainees (778/876, response rate 89%) completed the cross-sectional survey. No association was found between the odds of in-consultation help-seeking and perceived decrease in patient impressions of trainee competence (OR = 1.09; 95% CI: 0.91, 1.31; P = 0.36) or higher comfort presenting outside patients’ hearing (OR = 0.9; 95% CI: 0.77, 1.05; P = 0.19). Discussion Contrary to expected utility models of help-seeking, trainees may not consider personal discomfort or impression management to be important enough, compared to patient safety and other considerations, to influence decisions regarding in-consultation help-seeking. Clinical supervisors should, nevertheless, consider the potential personal costs to trainees and maintain trainee self-esteem and confidence by providing in-consultation assistance in front of patients as comfortably and effectively as possible.

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Getting good help: a guide for reflection, debriefing and feedback conversations about in-consultation supervision

Cited by 3 publications

References 24 publications

Models of clinical supervision of relevance to remote area nursing & primary health care: A scoping review

Models of clinical supervision of relevance to remote area nursing & primary health care: A scoping review

Perceptions of the effectiveness of using patient encounter data as an education and reflection tool in general practice training

Utilisation of in-consultation supervisor assistance in general practice training and personal cost to trainees: a cross-sectional study

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