What is supervision for?
Supervision can be used to address many aspects of work in medical and healthcare education. In the day-to-day clinical context, educational supervision necessarily includes some aspects of clinical supervision because issues discussed by the educational supervisor and trainee/student often include aspects relating to clinical practice. Although educational supervision may cover some of the technical aspects of the work, clinical supervision is the place where a wider range of issues around specific patients or dilemmas tend to be raised and addressed.
Most supervision addresses three domains:
- contexts (such as workplace teams or professional networks)
The role of the educational supervisor is clearer in some of these domains than others. Supervision conversations should aim to move back and forth between these three domains.
- As you read the next section think of examples from your own practice that fit these categories. You may wish to jot some of these down using the ‘reflections area’.
Benefits of supervision
Both clinical and educational supervision develop and use the same skills used in consultations:
- use of open questions
- being non-judgemental.
There is evidence from studies related to nursing (e.g. Begat et al., 1997; Butterworth et al., 1996; Cutliffe et al., 2001) that good clinical supervision improves morale and job satisfaction and may prevent stress and burnout.
It may be an example of the Inverse Care Law (Hart, 1971) that those practitioners who are the most isolated and deprived are the least likely to receive any supervision. In other words, doctors who are least able to reflect on their work, either because they work alone or because their psychological skills are less well developed, are the very practitioners who may most benefit from the opportunity to have supervision.
It would seem to be common sense that looking after practitioners can help them to look after patients. However, the difficulty of designing appropriate studies that can take into account the many variables involved and the problem of defining measurable outcomes means that there is little evidence available to support this assertion.
Supervision helps to promote reflective practice and contributes to professional development. In many professions (such as psychotherapy and social work) practitioners at all stages of their careers are required to have ongoing professional supervision.
Doctors and other health professionals are increasingly required to demonstrate evidence of reflective practice and/or clinical supervision as part of professional revalidation.