Ip Supervision

Reflections and the Roles we Play: Interprofessional Supervision

Shelly Russell-Mayhew, Ph.D., R. Psych.Division of Applied PsychologyUniversity of CalgaryMarch 9, 2007

Agenda

Definitions and ‘Lingo’ Barriers and Disadvantages Facilitators and Advantages Experiential Activity What might interprofessional

supervision look like? Recommendations and summary

“Interprofessional” Definition

“Occasions when two or more professionals learn with, from and about each other to improve collaboration and the quality of care.”

Centre for the Advancement of Interprofessional Education (CAIPE, 1997, revised 2002.)

Supervision

“A formal process of professional support and learning which enables practitioners to develop knowledge and competence, assume responsibility for their own practice and enhance consumer protection and the safety of care in complex situations.”

Department of Health (1993) UK as cited in Bailey 2004.

Overarching Theme in ‘Collaboration Literature

Involves considering MORE THAN ONE PERSPECTIVE

Lingo

‘Clinical’ supervision is now called ‘work based’ supervision as it seems to be more inclusive of a number of professions (Bailey, 2004)

Lingo continued

Mentor – the professional who facilitates learning and supervises and assesses students in the practice setting (nursing)

Facilitator (community nursing) Clinical supervisor (physiotherapy) Practice teacher (social work) Fieldwork educator (occupational therapist) Peer reviewer (mental health practitioners) Tutor (clinical education ward)

Placement educator (proposed by Emerson, 2004 as neutral)

Interprofessional Supervision

Two or more people from different professional groups to achieve a common goal of protecting the welfare of the client

Townend, 2005

KEY FEATURES OF ANY ‘INTERPROFESSIONAL SUPERVISION”

DEFINITION

1) There is an INTERACTION between (at least) two people,

2) the ‘supervisor’ is attempting to support the ‘supervisee’ in becoming better at helping people

3) the process of supervision is about a relationship within which education, support and quality control can happen

4) there are two or more professional groups represented in the interaction

Barriers

Power Professional stereotypes Time/caseload issues Interprofessional rivalries and turf

wars

Disadvantages

Role differences and misunderstandings Different training level (perceived

professional status) Absence of shared theory and language Absence of empathy for organizational

issues Anxiety Fear of revealing weaknesses

Facilitators

Trust Working alliance b/w supervisor and

supervisee A developmental approach to improving

practice Common documentation systems for

team Joint supervision policies Role clarity A common approach to practice

Advantages

Different perspective Increased creativity Wider knowledge Prevents complacency Critical thinking Interprofessional supervision can

contribute to the transfer of learning from training into practice

Summary

Both interprofessional collaboration and supervision are poorly understood (double trouble)

Interprofessional supervision is one of the most confused issues in team organization and management

Interprofessional supervision is just beginning to be explored

Theoretical models of interprofessional supervision need to be developed

The Roles We Play

Experiential activity using scenerio

Volunteers play a role (need 9 people)

Observers watch to share observations

THE ROLES WE PLAY: Interprofessional Supervision Experiential Exercise

Your workplace has become a part of an exciting new initiative that includes a new model of supervision for student trainees. As part of your commitment to this initiative, all students will be trained in service delivery as part of a multidisciplinary student team supervised by a team of interprofessional supervisors.

A student and supervisor have approached you about interprofessional supervision asking:“How does this really work?”“Why is it important for my professional development?”“What will my professional association say about my supervision being with someone from another profession?”

Because of the importance of giving both the student team and the supervisor team consistent messages, you have brought forward this topic for discussion at the team meeting for the Interprofessional Supervisors. Take up this discussion using the cards in front of you. Identify approaches and strategies you could take.

Recommendations

Be familiar with your own role and others’ roles

Put yourself in the others’ shoes regarding previous training and background

Acknowledge power differences Acknowledge and negotiate

preferred ways of working

What might interprofessional supervision look like? (Gillig & Barr, 1999)

Semi- annual chart review and face-to-face discussions held with clinicians by an interprofessional team (in addition to ‘regular’ supervision)

What might interprofessional supervision look like? (Thomasgard & Collins, 2003)

A case-based peer supervision model

A continuing–education program, involving collaborative peer supervision

What might interprofessional supervision look like? (Ponzer et al., 2004)

Interprofessional training in the context of clinical practice – clinical education wards

2 week interprofessional clinical course

What might interprofessional supervision look like? Emerson, 2004

How common or profession-specific are the competency requirements of the different professions for members who supervise students?

If commonality, how feasible is it to develop an integrated interprofessional development and support program for placement educators?

Common Competencies for Placement Educators (Emerson, 2004)

Enabling learning Knowledge of theories of learning

Ability to manage learning environment Ability to impart and model a sense of

professional responsibility

Current knowledge of professional practice

Current knowledge of relevant curricula

Summary of Literature

Pilot projects and initiatives tend to be temporary so no long term data

Positive features shown initially tend to temper as demands of ‘real practice’ increase

Consistent problem seems to be working in parallel not collaboratively (at the level of individual projects as well as at the level of professional bodies)

Empirical reports of team supervision are extremely rare although often discussed theoretically

Summary of Literature

Little empirical evidence about the EXTENT of interprofessional supervision

Little empirical evidence about advantages or disadvantages

No clearly articulated theory, models, or protocols

In short, people are engaging in interprofessional supervision without research, theory or knowledge base pertaining to interprofessional supervision competence.

ReferencesBailey, D. (2004). The contribution of work-based supervision to interprofessional learning on a masters programme

in Community Mental Health. Active Learning in Higher Education, 5(3), 263-278.Clouder, L., & Sellars, J. (2004). Reflective practice and clinical supervision: An interprofessional perspective.

Journal of Advanced Nursing, 46(3), 262-269.Davies, E.J., Tennant, A., Ferguson, E., Jones, L.F. (2004). Developing models and a framework for multi-

professional clinical supervision. The British Journal of Forensic Practice, 6(3), 36-42.Emerson, T. (2004). Preparing placement supervisors for primary care: An interprofessional perspective from the

UK. Journal of Interprofessional care, 18, 165-182.Gillig, P.M., & Barr, A. (1999). A model for multidisciplinary peer review and supervision of behavioral health

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Larkin, C. & Callaghan, P. (2005). Professionals’ perceptions of interprofessional working in community mental health teams. Journal of Interprofessional Care, 19(4), 338-346.

O’Donoghue. K. (2003). Unpublished. Uniprofessional, multiprofessional, field of practice, Discipline: Social workers and cross-disciplinary supervision.

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Ponzer, S., Hylin, U. Kusoffsky, A., Lauffs, M., Lonka, K., Mattiasson, A., & Nordstron, G. (2004). Interprofessional training in the context of clinical practice: Goals and students’ perceptions on clinical education wards. Medical Education, 38, 727-736.

Summers, M., Childs, A., & Corney, G. (2005). Education for sustainable development in initial teacher training: Issues for interdisciplinary collaboration. Environmental Education Research, 11(5), 623-647.

Thomasgard, M., & Collins, V. (2003). A comprehensive review of a cross-disciplinary, case-based peer supervision model. Families, Systems, & Health, 21(3), 305-319.

Townend, M. (2005). Interprofessional supervision from the perspective of both mental health nurses and other professionals in the field of cognitive behavioral psychotherapy. Journal of Psychiatric and Mental Health Nursing, 12, 582-588.