Fundamental Themes in Clinical Supervision

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We should seek to value and enhance all the various forms of peer support that are already in place. We should draw on the huge fund of educational expertise that exists in other areas of postgraduate education, including consultation skills training, as well as the wisdom and experience of the Balint movement.

Rather than lamenting the demise of Balint groups, there is an urgent need to develop and research other approaches, and their effects on patient care.

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John Launer is organising tutor of supervision seminars at the Tavistock Clinic and clinical supervision lead at the London GP Deanery. He has received payment from other deaneries, primary care trusts, and universities in Britain and abroad, for workshops and courses in clinical supervision. National Center for Biotechnology Information , U.

Fundamental Themes in Clinical Supervision

Br J Gen Pract. Author information Copyright and License information Disclaimer. E-mail: ku. This article has been cited by other articles in PMC. Morton-Cooper and Palmer 6 define these as: clarifying human values; acquiring emotional literacy; recovering meaning in social relationships; providing skill rehearsal and role models; evaluating and disseminating best practice in health care; and protecting against disorientation, disillusionment, and burnout. Fundamental themes in clinical supervision. London: Routledge; RCN Institute.

Routledge Handbook of Clinical Supervision: Fundamental International Themes

Realising clinical effectiveness and clinical governance through clinical supervision. Oxford: Radcliffe; Burton J, Launer J, editors. Supervision and support in primary care. Proctor B. Training for the supervision attitude, skills and intention. Launer J. Supervision, mentoring and coaching: one-to-one learning encounters in medical education. Edinburgh: Association for the Study of Medical Education; Morton-Cooper A, Palmer A, editors.

Mentorship, preceptorship and clinical supervision: a guide to professional support roles in clinical practice. Oxford: Blackwell; Bond M, Holland S. Skills of clinical supervision for nurses. Buckingham: Open University Press; Feltham C. Meaning units were then identified through joint reflection and discussion, after which they were categorized into ten subthemes and five themes. All the authors carefully discussed the tentative subthemes and themes. Having moved back and forth several times between the whole and the parts of the text, all the authors finally agreed on the condensing of the domains and key components in accordance with Baxter [31].

According to Baxter [31] , interpretive content analysis enables a deeper understanding of the meaning of the content. Finally, we compiled one main theme, two domains, of which one was on the latent level and one on the manifest level, and four key components as presented in Table 2.

The guidelines for research set out in the Helsinki declaration [32] were followed. The principles of confidentiality, voluntariness and informed consent were adhered to.

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Information about the aim of the study was provided both in writing and verbally. The participants indicated their consent by giving a completed consent form to their principal tutor. The data were stored securely in a fireproof cabinet in accordance with university college regulations. The NSS also highlighted the importance of being understood in their role as a student.

They re-. Table 2.

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Most of the students reported that they are sufficiently competent to ensure PS and that CS and reflection are of great importance for PS. Most of the students were especially satisfied with the supervision and their supervisor. One main theme emerged: CS as a prerequisite for professional development and two domains; A reflective way of growing and learning through CS, manifest level with two key components and The meaning of being and acting in a reflective and professional manner to ensure PS latent level , also with two key components Table 2. According to the students, learning to reflect and act in a professional and reflective way through CS is a prerequisite for professional development.


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The results also show that CS is of great importance for PS. The students reported the importance of reflection in practice, that CS is planned and well organized for them.

Skills for Clinical Supervision

Stability and continuity in the relationship with the supervisor is important in CS. To achieve this they suggested the need for the same supervisor over time, or even two supervisors for each student, which would enable a more nuanced learning situation. Having the same supervisor during the clinical practice period created trust, safety, stability and a close relationship with the supervisor. Most of the students reported a desire for more time together with their supervisor.

One student stated:. I would have liked more time together with my supervisor, more time to reflect and discuss patient situations in a setting away from the patient. In this study, the need for time was consistently expressed as essential.


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  7. The desire for time to reflect, discuss and summarize together with their supervisors at the end of each day demonstrates the need for both mental and physical reflection space. A high level of nursing competence and expertise, evidence-based practice, user empowerment, good practical skills, in addition to sufficient resources, positive attitudes and good role models at the workplace are of importance. Being encouraged and feeling free to ask questions and call for help were also mentioned as essential. Another NSS expressed: I appreciate that the supervisor is patient, supportive and willing to teach me.

    They wanted to be seen, accepted, respected, appreciated and recognised, which could be interpreted as their need for confirmation. Furthermore, they described the importance of mutual trust and feeling safe in the relationship with the supervisor. As a specialist nurse student, I want to be challenged by my supervisor and given the opportunity to work more independently with patients.


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    The supervisor should have patience, provide support and see me as a person. The meaning comprises elements such as confirmation, affirmation, trust, being supported yet challenged, dialogue and identifying role models. All of the students wanted more time for dialogue and to reflect together with the supervisor. It was essential to reflect together with the supervisor in order to learn from adverse events and identify alternative ways of acting. One student illustrated this as follows:. Supervision increases my self-awareness in new patient situations that I did not experience before.

    Reflecting together with my supervisor increases my understanding and is of great importance for patient safety. Supervision increases my learning, my self-awareness and develops my professional competence and team-working skills. One of the students expressed:. Two research questions were addressed: 1. The NSS stated that a prerequisite is educated professional supervisors who can influence their development of a professional identity [38]. Most NSS were pleased with the supervision they received and they were satisfied with their supervisor.

    Nevertheless, they strongly emphasized the desire for even more time to reflect with their supervisor.