Snowdon David A, Kent Fiona, Farlie Melanie K, Taylor Nicholas F, Howlett Owen, Downie Sharon, Gardner Marcus
National Centre for Healthy Aging, Melbourne, Australia.
Peninsula Clinical School, Monash University, Melbourne, Australia.
Med Teach. 2024 May;46(5):640-647. doi: 10.1080/0142159X.2023.2271158. Epub 2023 Nov 22.
Clinical supervision supports patient care and health worker wellbeing. However, access to effective clinical supervision is not equitable. We aimed to explore the access and effectiveness of clinical supervision in allied health workers.
A cross-sectional survey design using the Manchester Clinical Supervision Scale (MCSS-26), including open-ended survey responses, to collect data on effectiveness. Multivariable regression was conducted to determine how MCSS-26 scores differed across discipline, work location and setting. Open-ended responses were analysed using content analysis.
1113 workers completed the survey, with 319 (28%) reporting they did not receive supervision; this group were more likely to hold management positions, work in a medical imaging discipline and practice in a regional or rural location. For those who received supervision, MCSS-26 scores significantly differed between disciplines and work settings; psychologists and those practising in private practice settings (i.e. fee-for-service) reported the highest levels of effectiveness. Suggested strategies to enhance effectiveness included the use of alternate supervision models, dedicated time for supervision, and training.
Targeted subgroups for improving access include senior staff, medical imaging professionals, and those working across regional and rural settings. Where supervision was least effective, strategies to address behaviours with organisational support may be required.
临床督导有助于患者护理和医护人员的福祉。然而，获得有效的临床督导并不公平。我们旨在探讨专职医疗人员获得临床督导的情况及其有效性。
采用曼彻斯特临床督导量表（MCSS - 26）进行横断面调查设计，包括开放式调查回复，以收集有关有效性的数据。进行多变量回归分析以确定MCSS - 26分数在不同学科、工作地点和环境中的差异。使用内容分析法对开放式回复进行分析。
1113名工作人员完成了调查，其中319人（28%）报告他们没有接受督导；这一组人员更有可能担任管理职务，从事医学影像学科工作，并在地区或农村地区执业。对于那些接受督导的人员，MCSS - 26分数在不同学科和工作环境之间存在显著差异；心理学家以及在私人执业环境（即按服务收费）中执业的人员报告的有效性水平最高。提高有效性的建议策略包括使用替代督导模式、专门的督导时间和培训。
改善获得督导机会的目标亚组包括高级工作人员、医学影像专业人员以及在地区和农村地区工作的人员。在督导效果最差的地方，可能需要采取在组织支持下解决行为问题的策略。
