What are the outcomes for team supervision?

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14 Feb 2024

Clinical supervision is one part of a complex pie of workplace sustainability and wellbeing in healthcare. Practical and financial considerations for rolling out clinical supervision in the workplace suggest that team supervision is an efficient use of time and resources. But what does the evidence say? Please see below for an overview of potential outcomes that organisations might expect when implementing clinical supervision in the workplace.

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Well supported staff provides optimal care for their clients.

As previously discussed, (see here and here), clinical supervision is an important part of ensuring best outcomes for patients, clients and service users, as well as being crucial for continued growth, wellbeing and learning for clinicians in the workplace.

There is a growing evidence base for supervision. However, with issues relating to terminology, disagreement regarding the nature of supervision, a lack of consistency and queries into the rigour of processes involved, supervision research is clearly in its formative years.

Despite these challenges, it is important to consider what the research confirms thus far.

Outcomes in team supervision

Much of the literature divides outcomes across three core domains of the functions of supervision according to the work of Proctor:

  1. Formative (educational): relating to education, skill and knowledge development
  2. Normative (administrative): pertaining to standards of care, quality control, and professional accountability
  3. Restorative (supportive): referring to collegial and emotional peer support; personal wellbeing

There is overlap across these areas of functioning, but it is helpful to understand outcomes in these three parts.

Formative / educational outcomes in team supervision

Educational outcomes involve'...teaching about relevant population groups, their special needs and challenges relating to the context/setting; models of practice and strategies for intervention and theoretical frameworks' (Berger & Quiros, 2014).

Formative outcomes may include:

  • increased understanding around models of care
  • development of clinical, practical or interpersonal skills particular to a specific client group
  • enhanced understanding of operational tasks
  • deepening theoretical knowledge or practical application of skills
  • development of creative and innovative thinking, problem solving and generating new ideas and perspectives
  • increased awareness of a clinician's own needs, responses and / or behaviours
  • feeling more competent and empowered in the role

(Brunero,& King, 2012; Brunero & Lamont, 2011 )

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Normative / administrative outcomes in team supervision

According to Berger & Quiros, an administrative focus in supervision includes '... monitoring adherence to organizational policies, delegating tasks and evaluating work performance', potentially resulting in:

  • greater clarity regarding clinical role and professional identity
  • an enhanced understanding of professional and ethical issues and challenges
  • increased team communication and understanding of organisational needs
  • an enhanced sense of confidence, competence and self-efficacy
  • clarifying issues around staffing, professional boundaries
  • managing complex cases
  • assessing and managing quality control and professional accountability
  • improved patient care and efficiency

(Brunero & Lamont, 2011; Lindahl & Norberg, 2002; Love, 2014).

Themes uncovered in healthcare teams in supervision

The research shows common themes that emerge during supervision for healthcare workers.

For example, the following themes were found in supervising a group of healthcare workers in a rural mental health service in Victoria, Australia:

  • "Organisational culture
  • Exploring possibilities
  • Leadership
  • Education and training
  • Reflection
  • Culture change
  • Sustainability"

(Lynch, L., & Happell, B. (2008). Implementing clinical supervision: Part 1: Laying the ground work. International journal of mental health nursing, 17(1), 57-64, p. 60).

A place for reflection, mutual support and debriefing is often a central theme:

"The core category of safe reflection was seen as the key to ‘unscramble’ what was going on in a midwife’s head".

(Love, Sidebotham, Fenwick , Harvey & Fairbrother, 2017, p. 276).

Supportive / restorative outcomes in team supervision

'... emotional support to assist the supervisee with work related challenges/ stresses; identifying personal issues impacting their ability to work effectively with clients and strategies to address them (without shifting into individual therapy)'.

Restorative outcomes in the literature are well documented and may include:

  • increased connection to colleagues and reduced sense of isolation
  • improved sense of team stability and morale
  • increased sense of trust and community amongst team members
  • reduced team conflict
  • enhanced sense of competency, personal accomplishment and compassion satisfaction
  • improved team communication and approaches to collaboration
  • feeling a valued part of the team
  • enhanced sense of self awareness and
  • a sense of sharing the emotional load through empathy and validation
  • reduced sense of stress and symptoms of burnout
  • increased ability to separate home from work
  • greater sense of sustainability in working in healthcare

(Barnes, White, Winstanley & Reed, 2013; Brunero,& King, 2012; Brunero & Lamont, 2011; Cook, Hua & Yegameh, 2020; Lindahl & Norberg, 2002; Love, 2014; Love, Sidebotham, Fenwick , Harvey & Fairbrother, 2017; Reschke, Dawber, Millear & Medoro, 2021).

The core category of safe reflection was seen as the key to ‘unscramble’ what was going on in a midwife’s head.

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Header image: Dushyant Kumar