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促进和阻碍工作场所有效临床监督的因素:快速证据回顾。

Enablers and barriers to effective clinical supervision in the workplace: a rapid evidence review.

机构信息

School of Medical Education, Newcastle University, Newcastle upon Tyne, UK

Health Professions Education Unit, Hull York Medical School, York, UK.

出版信息

BMJ Open. 2021 Sep 28;11(9):e052929. doi: 10.1136/bmjopen-2021-052929.

Abstract

OBJECTIVES

We aimed to review the international literature to understand the enablers of and barriers to effective clinical supervision in the workplace and identify the benefits of effective clinical supervision.

DESIGN

A rapid evidence review.

DATA SOURCES

Five databases (CINAHL, OVID Embase, OVID Medline, OVID PsycInfo and ProQuest) were searched to ensure inclusion and breadth of healthcare professionals.

ELIGIBILITY CRITERIA

Studies identifying enablers and barriers to effective clinical supervision across healthcare professionals in a Western context between 1 January 2009 and 12 March 2019.

DATA EXTRACTION AND SYNTHESIS

An extraction framework with a detailed inclusion/exclusion criteria to ensure rigour was used to extract data. Data were analysed using a thematic qualitative synthesis. These themes were used to answer the research objectives.

RESULTS

The search identified 15 922 papers, reduced to 809 papers following the removal of duplicates and papers outside the inclusion criteria, with 135 papers being included in the full review. Enablers identified included regular supervision, occurs within protected time, in a private space and delivered flexibly. Additional enablers included supervisees being offered a choice of supervisor; supervision based on mutual trust and a positive relationship; a cultural understanding between supervisor and supervisee; a shared understanding of the purpose of supervision, based on individual needs, focused on enhancing knowledge and skills; training and feedback being provided for supervisors; and use of a mixed supervisor model, delivered by several supervisors, or by those trained to manage the overlapping (and potentially conflicting) needs of the individual and the service. Barriers included a lack of time, space and trust. A lack of shared understanding to the purpose of the supervision, and a lack of ongoing support and engagement from leadership and organisations were also found to be barriers to effective clinical supervision.

CONCLUSIONS

This review identified several enablers of and barriers to effective clinical supervision and the subsequent benefits of effective clinical supervision in a healthcare setting.

摘要

目的

我们旨在回顾国际文献,了解工作场所中有效临床监督的促进因素和障碍,并确定有效临床监督的益处。

设计

快速证据综述。

资料来源

为确保纳入和涵盖广泛的医疗保健专业人员,对五个数据库(CINAHL、OVID Embase、OVID Medline、OVID PsycInfo 和 ProQuest)进行了搜索。

入选标准

在 2009 年 1 月 1 日至 2019 年 3 月 12 日期间,在西方背景下,针对医疗保健专业人员的有效临床监督的促进因素和障碍进行识别的研究。

资料提取和综合

使用详细的纳入/排除标准提取数据的提取框架,以确保严谨性。使用主题定性综合分析对数据进行分析。这些主题用于回答研究目标。

结果

搜索确定了 15922 篇论文,在去除重复项和不符合纳入标准的论文后,减少到 809 篇,135 篇论文被纳入全面审查。确定的促进因素包括定期监督、在受保护的时间内进行、在私人空间进行以及灵活提供。其他促进因素包括为监督对象提供选择监督者的机会;基于相互信任和积极关系的监督;监督者和监督对象之间的文化理解;基于个人需求、关注增强知识和技能的监督目的的共同理解;为监督者提供培训和反馈;以及使用混合监督模式,由几位监督者或接受过培训以管理个人和服务重叠(可能存在冲突)需求的人员提供。障碍包括缺乏时间、空间和信任。还发现缺乏对监督目的的共同理解,以及缺乏领导层和组织的持续支持和参与,也是有效临床监督的障碍。

结论

本综述确定了有效临床监督的几个促进因素和障碍,以及医疗保健环境中有效临床监督的后续益处。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a8e6/8479981/9d9e8383abfd/bmjopen-2021-052929f01.jpg

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