Sloan G, Watson H
Ayrshire and Arran Primary Care Trust, and Doctoral Research Student, Glasgow Caledonian University, Glasgow, UK.
J Adv Nurs. 2001 Sep;35(5):664-73. doi: 10.1046/j.1365-2648.2001.01898.x.
AIM(S) OF THE PAPER: This paper gives a description of illuminative evaluation and argues for its use in process-focused research investigating the reciprocal interpersonal interactions between clinical supervisors and their supervisees. Experiences from conducting an initial pilot study, which is a part of larger qualitative project concerned with individual clinical supervision in mental health nursing, are highlighted.
Research investigating fundamental process issues in clinical supervision and their influence on outcomes for nursing is uncommon. Previous work in this area has stopped short of exploring the supervisory relationship and illuminating the importance of this interpersonal process in the delivery of gains. At the heart of the present project are questions about which supervisor interventions facilitate and constrain the supervisee's use of individual clinical supervision.
Data were collected using individual in-depth interviews, critical incident journals, session documents and audio recordings of supervision using illuminative evaluation and a case study approach.
Supervisor interventions included taking the lead, suggesting an option, exploring the supervisee's work, reflecting back, conveying an understanding of client issues, being supportive and giving information. Using Heron's framework, catalytic, prescriptive, informative and supportive interventions were identified. Interestingly, informative interventions related mainly to the sharing of team policy issues and were derived from the clinical supervisor's agenda. Although undoubtedly relevant to the supervisee's practice, such organizationally focused information giving may be at odds with progressing the therapeutic integrity and professional development of the supervisee. Degenerative interventions were also illuminated.
Following the pilot study, it was concluded that the research approach known as illuminative evaluation using multiple case studies is an appropriate design to explore the supervisory process and the particular clinical supervisor and supervisee interactions which influence this. Potential outcomes from the supervisory experience will be contextualized with how mental health nurses engage in the supervisory process and the particular supervisor interventions delivered during supervision sessions.
本文目的：本文描述了启发性评估，并主张将其用于以过程为重点的研究，该研究旨在调查临床督导与其被督导者之间相互的人际互动。文中突出了开展初步试点研究的经验，该试点研究是一个关于心理健康护理中个体临床督导的大型定性项目的一部分。
研究临床督导中的基本过程问题及其对护理结果的影响并不常见。该领域以前的工作未能深入探讨督导关系，也未阐明这种人际过程在取得成效方面的重要性。本项目的核心问题是，哪些督导干预措施促进或限制了被督导者对个体临床督导的利用。
采用启发性评估和案例研究方法，通过个人深度访谈、关键事件日志、会议文件以及督导的录音来收集数据。
督导干预措施包括带头、提出建议、探究被督导者的工作、反馈、表达对客户问题的理解、给予支持和提供信息。运用赫伦的框架，确定了催化性、规范性、信息性和支持性干预措施。有趣的是，信息性干预措施主要涉及团队政策问题的分享，且源自临床督导的议程。尽管这些信息无疑与被督导者的实践相关，但这种以组织为重点的信息提供可能与推进被督导者的治疗完整性和专业发展不一致。还发现了退化性干预措施。
经过试点研究得出结论，使用多案例研究的启发性评估这一研究方法是探索督导过程以及影响该过程的特定临床督导与被督导者互动的合适设计。督导经历的潜在结果将与心理健康护士参与督导过程的方式以及督导期间所实施的特定督导干预措施相结合。
