Supervision: ‘a random bag of arrangements’? Perspectives from psychiatrists on how to improve clinical teaching

Abstract

Suggestions to improve clinical teaching and supervision included defining supervisor teaching competencies, instituting evidence-based faculty development, a feedback structure and strengthening leadership support for workplace-based education.

On being supervised: getting value from a clinical supervisor and making the relationship work when it is not

“…8 Given this, it is reasonable to question whether all supervision is necessarily good for trainees and their patients. 8,14 A small number of papers have considered the RANZCP training program's supervision requirements over the past 20 years, including qualitative explorations from the trainee 5 and supervisor 7,15 perspectives, and a survey of trainee satisfaction. 16 Two papers have considered the supervisory experience since the CBFP was introduced in 2012.…”

“…16 Two papers have considered the supervisory experience since the CBFP was introduced in 2012. 3,7 Cheung and Stephan explored supervisor perspectives of how clinical supervision can be improved using thematic analysis of responses from the 27% of New Zealand psychiatrists who completed an online questionnaire. 7 These psychiatrists described supervision as 'a random bag of arrangements', referring to a lack of conceptual framework and preparation for their pedagogical role.…”

“…Additionally, there is evidence that supervisors struggle to understand how to perform their role best 7,15 and may value feedback from their supervisees. 7 For these reasons, we propose that trainees should actively work to get value from their supervisors. A similar proposition was implicit in a well-articulated summary of the trainee perspectives on a previous iteration of the college training program by Shaw and Williams in 1994.…”

Gaming the system: using transactional analysis to explore dysfunctional processes in clinical supervision

“…3 Given this lack of focus, it is not surprising that RANZCP trainees and supervisors experience difficulties in understanding what is expected of them in supervision. [5][6][7][8] There is an inevitable power differential in the clinical supervisor-supervisee dyad. 3,[9][10][11] This arises from the hierarchical nature of the relationship and the associated expectations that the supervisor holds specialised knowledge, professional status and will provide direction and support.…”

Supervision contracts for mental health professionals: a systematic review and exploration of the potential relevance to psychiatry training in Australia and New Zealand

“…the[ir] educator role'. 1 One proposal to address problems emerging in clinical supervision has been advocacy for the use of formal written agreements between supervisors and supervisees that delineates their roles and responsibilities, as well as the boundaries of the relationship. 2,5 Supervision contracts aim to introduce transparency and accountability to the supervision process, 6 facilitating informed consent and mitigating the risks associated with power imbalances inherent to clinical supervision.…”