Supervision, support and mentoring interventions for health practitioners in rural and remote contexts: an integrative review and thematic synthesis of the literature to identify mechanisms for successful outcomes

Abstract

ObjectiveTo identify mechanisms for the successful implementation of support strategies for health-care practitioners in rural and remote contexts.DesignThis is an integrative review and thematic synthesis of the empirical literature that examines support interventions for health-care practitioners in rural and remote contexts.ResultsThis review includes 43 papers that evaluated support strategies for the rural and remote health workforce. Interventions were predominantly training and education programmes with limited evaluations of supervision and mentoring interventions. The mechanisms associated with successful outcomes included: access to appropriate and adequate training, skills and knowledge for the support intervention; accessible and adequate resources; active involvement of stakeholders in programme design, implementation and evaluation; a needs analysis prior to the intervention; external support, organisation, facilitation and/or coordination of the programme; marketing of the programme; organisational commitment; appropriate mode of delivery; leadership; and regular feedback and evaluation of the programme.ConclusionThrough a synthesis of the literature, this research has identified a number of mechanisms that are associated with successful support interventions for health-care practitioners in rural and remote contexts. This research utilised a methodology developed for studying complex interventions in response to the perceived limitations of traditional systematic reviews. This synthesis of the evidence will provide decision-makers at all levels with a collection of mechanisms that can assist the development and implementation of support strategies for staff in rural and remote contexts.

Linking communities to formal health care providers through village health teams in rural Uganda: lessons from linking social capital

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Registered nurse and midwife experiences of using videoconferencing in practice: A systematic review of qualitative studies

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Supporting our supervisors: sending out an SOS

“…While it represents part of an established approach to successful implementation of new practices, it needs to be conducted as one element within a systematic approach to innovation that takes due account of organizational factors (Beidas & Kendall, 2010). These factors include staff shortages, high clinical loads, limited access to support or supervision, and poor management relationships (Moran et al 2014). These authors reviewed 43 studies where training and support interventions had been introduced to overcome such barriers, with a focus on the factors that contributed to success.…”