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The author examines the positive effect of Clinical Supervision (CS) on the well-being of supervisees in the British nursing and midwifery professions. Topics covered include how CS is often accepted as a formal relationship-based system of support and practice development provided by approved Supervisors to the staff in human service agencies in maximizing the best possible outcomes for their clientele and the organisational culture dimension of CS arrangements.

The historical development of clinical supervision has been variously interpreted in the international literature. Creditable evidence has accumulated, particularly over the past two decades, to show that clinical supervision has a positive demonstrable effect on supervisees. However, comparatively little research evidence has entered the public domain on any effect that clinical supervision might have on other nominated outcomes. In Australia, developments in clinical supervision were recently prompted by initiatives at national and state levels. Since 2010, lead agencies for these have sought feedback from professional bodies and organizations on a number of inter-related draft policy documents. The present article tracked changes over time between the draft and final versions of these documents in New South Wales, and reviewed the original sources of literature cited within them. The strength of evidence upon which the final published versions were reportedly predicated was scrutinized. Upon examination, claims to the wider benefits of clinical supervision were found to be unconvincingly supported, not least because the examples selected by the agencies from the international literature and cited in their respective documents were either silent, parsimonious, or contradictory. Many claims remain at the level of folklore/hypothetical propositions, therefore, and stay worthy of rigorous empirical testing and faithful public reporting. Such investigations have been acknowledged as notoriously difficult to conduct. The present article identified noteworthy examples in the contemporary literature that signpost robust ways forward for empirical outcomes-orientated research, the findings from which might strengthen the evidence base of future policy documents. [ABSTRACT FROM AUTHOR]

Eight active supervision scholars provide their perspectives on priorities for advancing research in clinical supervision. Based on proposals they presented at an invited symposium held during the 11th International Interdisciplinary Conference on Clinical Supervision, the authors propose research questions around multicultural identities, supervisor expertise, supervision models, and research methods. Although neither a comprehensive nor exhaustive list of priorities, the authors hope the article encourages dialogue across disciplines and countries that expand understanding of clinical supervision practice and supervisor education. [ABSTRACT FROM PUBLISHER]

The article presents the author's views on clinical supervision (CS). Topics discussed include a new tool (Manchester Clinical Supervision Scale (MCSS) promoted by government as the first validated tool designed specifically to measure the impact of Clinical Supervision; increase in so-called home-spun CS checklists; and argument that claims to the benefits of wider outcomes of CS should be further investigated.

The published literature on clinical supervision in relation to the helping professions, particularly nursing, has been essentially contained to the past two decades and has largely rested at the level of description. This article traces the origins back to the pioneering charity work of European and North American social reformers of the eighteenth century. Historical documents are reviewed to posit a discussion of the historical development of clinical supervision, linked across continents and within and among helping professions and human service agencies, to establish a contemporary international relevance for the associated professions and to help establish a convincing evidence base for practice. [ABSTRACT FROM AUTHOR]

Clinical supervision can improve staff satisfaction and reduce stress and burnout within the workplace and can be a component of organizational readiness to implement evidence-based practice. This study explores clinical supervision processes in alcohol and drug counselors working in telephone and online services, assessing how their experiences of supervision link to workplace satisfaction and well-being. Standardized surveys (Manchester Clinical Supervision Scale and the TCU Survey of Organizational Functioning) were completed by 43 alcohol and drug telephone counselors. Consistency of supervisors and good communication were the strongest predictors of satisfaction with clinical supervision, and satisfaction with supervision was a good predictor of overall workplace satisfaction. [ABSTRACT FROM AUTHOR]

white e. & winstanley j. (2010) Journal of Nursing Management  18, 689-696 Clinical supervision: outsider reports of a research-driven implementation programme in Queensland, Australia Aim The aim of the present study was to explore substantive issues related to the implementation of Clinical Supervision (CS). Background Historically, the treatment of mental illness in Australia has been inadequate. CS has shown promise as a positive contribution to the clinical governance agenda, as a structured staff support mechanism. Evaluation Within the wider context of a randomized controlled trial (RCT) of CS, semi-structured interviews ( n = 17) were conducted with staff who worked alongside colleagues that attempted to implement CS. Key issues Senior managers embraced CS and were disappointed when junior managerial colleagues did not hold a similar conviction, when tested by the realities of CS implementation. If CS was regarded as an additional activity, it stretched human resources and created inter-staff tensions. Conclusions The personal testimony of these 'outsiders' spoke about the practicalities of implementing CS and the prevailing culture into which they were introduced. When perceived as a tour de force for culture change, CS was polarized as an opportunity by many, but also as a threat by some. Implications for nursing management A single, cohesive and explicit management position on CS in each Health Service entity may obviate some of the impediments to CS implementation. [ABSTRACT FROM AUTHOR]

This article acknowledges an enduring debate about the nature of evidence and provides a context for the selective review of a literature on the outcomes of Clinical Supervision, a structured arrangement to support staff, which has been widely introduced into health service systems across the world. The literature revealed that many of the claims for the positive effects of CS have remained unsubstantiated. A contemporary pragmatic randomised controlled trial, summarised here, tested the relationships between Clinical Supervision, quality of care and patient outcomes, in mental health settings in Queensland, Australia. It confirmed that beneficial and sustainable CS outcomes accrued for Supervisors and Supervisees, as measured by a suite of research methods and instruments including The Manchester Clinical Supervision Scale©, and for patients in one private sector mental health facility. However the effect Clinical Supervision had on nominated outcomes still remained difficult to demonstrate across a broad front. Plausible explanations are offered for this and a new framework for future outcomes-related research studies is suggested, in the continuing attempt to strengthen an empirical evidence base for Clinical Supervision. [ABSTRACT FROM AUTHOR]

This paper reports on selected findings from a novel randomised controlled trial (RCT) conducted in mental health settings in Queensland, Australia. Several national and state reports recently revealed the sub-optimal state of Australian mental health service provision which have direct implications for mental health nursing, including the privately experienced cost of working and coping in these settings. Clinical supervision (CS), a structured staff support arrangement, has shown promise as a positive contribution to the clinical practice development agenda and is now found reflected in health policy themes elsewhere in the world. However, CS is underdeveloped in Australia and the empirical evidence base for the informed implementation of CS, per se, has remained elusive. Within the overall context of a RCT design, therefore, and supplemented by other data collection methods, this large and generously funded study attempted to make an incremental contribution to better understanding this demanding substantive domain. Whilst the substantive insights and theoretical propositions reported here were derived from, and may be limited by, a sub-specialty of nursing and a single geographic location, they were earthed in the personal self-reported experience of those directly involved with a clinical practice innovation. They may resonate with counterparts beyond mental health nursing and Queensland, Australia, respectively, therefore, and may assist in both conceptualising and operationalising CS research, education, management, policy and clinical practice development decision making in the future. [ABSTRACT FROM AUTHOR]

Several national and state-based inquiry documents have reported longstanding and major concerns about mental health service provision in Australia. In particular, accounts of the difficult circumstances that surround the recruitment and retention of high-quality mental health nurses have clearly emerged, independent of jurisdiction. However, the privately experienced cost of working and coping in contemporary mental health settings, especially when the resilience of nursing staff is tested remains poorly understood. Clinical supervision (CS), a structured staff support arrangement, has shown promise as a positive contribution to the clinical governance agenda and is now found reflected in central policy themes elsewhere in the world. However, the concept of CS remains underdeveloped in Australia. The background to a unique randomised controlled trial (RCT), currently in progress in Queensland, Australia, has been described in this study. The efficacy of the most widely adopted model of CS that may address the promotion of standards and clinical audit issues, the development of skills and knowledge and the personal well-being of the supervisee will be tested. This study, funded by the Queensland Treasury/Golden Casket Foundation, will focus not only on the outcomes for individual mental health nurses but also examine the quality of care they provide and the effects of both on patient outcomes. This study will seek to establish a sustainable, strategically significant contribution to the knowledge base both for the mental health nursing workforce in Queensland (and beyond) and the patients they seek to serve. [ABSTRACT FROM AUTHOR]

This exploratory two-stage study, funded for two years by the English National Board for Nursing, Midwifery and Health Visiting, sought to reveal the prevailing circumstance of teaching, support, supervision and role modelling for students in clinical areas, within the context of Project 2000 courses, in three centres in England. Evidential data collection methods were developed which included personal interviews, non-participant observation and the scrutiny of documents. Findings revealed confusion and misunderstanding between students, practitioners and tutors about clinical supervision arrangements and competing explanations were reported. Further controlled research is required to assess and cost the comparative impact clinical supervision may make to student learning experience and to the well-being and skill base of qualified nurses, and the effect of both on the quality of patient care. [ABSTRACT FROM PUBLISHER]

A letter to the editor is presented wherein the author offer a rejoinder on two recently published articles that have attempted to test the psychometric properties of translated versions of the Manchester Clinical Supervision Scale (MCSS) into Swedish and Norwegian and into Danish.

A response from the authors of the article "The MCSS-26©: revision of The Manchester Clinical Supervision Scale© using the Rasch Measurement Model," in the December 1, 2011 issue is presented.

Abstract: Background: Developing a therapeutic relationship with consumers is considered as the central aspect of nursing work in mental health. The importance of this relationship stems from its association with enhanced patient care and improved patient outcomes. Factors within the practice environment may influence the nurse''s ability to engage effectively in this relationship. Objective: This study explored a model that added characteristics of the individual and practice environment to a central framework incorporating therapeutic commitment: a nurse''s ability and willingness to engage in a therapeutic relationship. Setting and participants: Data were collected at six mental health nursing units in five public general acute hospitals in New South Wales, Australia for 14 days per unit, between 2005 and 2006. All nurses in participating wards were invited to partake in the study. Seventy-six (51%) responses were analyzed. Method: The data were collected using a Nurse Survey inclusive of the Practice Environment Scale of the Nursing Work Index (NWI-PES), and the Mental Health Problems Perception Questionnaire (MHPPQ). A Unit Profile form was used concurrently to collect staffing, skill mix and patient turnover data. Partial least squares path modeling (PLS-PM) was chosen as the analytical method to test the model and identify the most influential factors. Results: Experienced nurses who perceived themselves to be competent and supported were more likely to express a willingness to engage therapeutically with patients. Environmental factors associated with these perceptions included foundations of quality nursing care, opportunities to participate in hospital affairs and clinical supervision. Not all elements in the proposed model were supported. Conclusion: Positive hospital practice environments can improve the capacity of nurses working in mental health to engage therapeutically with patients. Specific approaches may include access to preceptorship, continued education and career development opportunities, together with clinical supervision, improved continuity of care, and the involvement of mental health nurses in the governance of the hospital. [Copyright &y& Elsevier]