Reflections and the Roles we Play: Interprofessional Supervision

1
Reflections and the Roles we Play
Interprofessional Supervision

• Shelly Russell-Mayhew, Ph.D., R. Psych.
• Division of Applied Psychology
• University of Calgary
• March 9, 2007

2
Agenda

• Definitions and Lingo
• Barriers and Disadvantages
• Facilitators and Advantages
• Experiential Activity
• What might interprofessional supervision look
  like?
• Recommendations and summary

3
Interprofessional Definition

• Occasions when two or more professionals learn
  with, from and about each other to improve
  collaboration and the quality of care.
• Centre for the Advancement of Interprofessional
  Education (CAIPE, 1997, revised 2002.)

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Supervision

• A formal process of professional support and
  learning which enables practitioners to develop
  knowledge and competence, assume responsibility
  for their own practice and enhance consumer
  protection and the safety of care in complex
  situations.
• Department of Health (1993) UK as cited in Bailey
  2004.

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Overarching Theme in Collaboration Literature

• Involves considering MORE THAN ONE PERSPECTIVE

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Lingo

• Clinical supervision is now called work based
  supervision as it seems to be more inclusive of a
  number of professions (Bailey, 2004)

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Lingo continued

• Mentor the professional who facilitates
  learning and supervises and assesses students in
  the practice setting (nursing)
• Facilitator (community nursing)
• Clinical supervisor (physiotherapy)
• Practice teacher (social work)
• Fieldwork educator (occupational therapist)
• Peer reviewer (mental health practitioners)
• Tutor (clinical education ward)
• Placement educator (proposed by Emerson, 2004 as
  neutral)

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Interprofessional Supervision

• Two or more people from different professional
  groups to achieve a common goal of protecting the
  welfare of the client
• Townend, 2005

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KEY FEATURES OF ANY INTERPROFESSIONAL
SUPERVISION DEFINITION

• 1) There is an INTERACTION between (at least) two
  people,
• 2) the supervisor is attempting to support the
  supervisee in becoming better at helping people
• 3) the process of supervision is about a
  relationship within which education, support and
  quality control can happen
• 4) there are two or more professional groups
  represented in the interaction

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Barriers

• Power
• Professional stereotypes
• Time/caseload issues
• Interprofessional rivalries and turf wars

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Disadvantages

• Role differences and misunderstandings
• Different training level (perceived professional
  status)
• Absence of shared theory and language
• Absence of empathy for organizational issues
• Anxiety
• Fear of revealing weaknesses

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Facilitators

• Trust
• Working alliance b/w supervisor and supervisee
• A developmental approach to improving practice
• Common documentation systems for team
• Joint supervision policies
• Role clarity
• A common approach to practice

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Advantages

• Different perspective
• Increased creativity
• Wider knowledge
• Prevents complacency
• Critical thinking
• Interprofessional supervision can contribute to
  the transfer of learning from training into
  practice

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Summary

• Both interprofessional collaboration and
  supervision are poorly understood (double
  trouble)
• Interprofessional supervision is one of the most
  confused issues in team organization and
  management
• Interprofessional supervision is just beginning
  to be explored
• Theoretical models of interprofessional
  supervision need to be developed

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The Roles We Play

• Experiential activity using scenerio
• Volunteers play a role
• (need 9 people)
• Observers watch to share observations

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THE ROLES WE PLAY Interprofessional Supervision
Experiential Exercise

• Your workplace has become a part of an exciting
  new initiative that includes a new model of
  supervision for student trainees. As part of your
  commitment to this initiative, all students will
  be trained in service delivery as part of a
  multidisciplinary student team supervised by a
  team of interprofessional supervisors.
• A student and supervisor have approached you
  about interprofessional supervision asking
• How does this really work?
• Why is it important for my professional
  development?
• What will my professional association say about
  my supervision being with someone from another
  profession?
• Because of the importance of giving both the
  student team and the supervisor team consistent
  messages, you have brought forward this topic for
  discussion at the team meeting for the
  Interprofessional Supervisors. Take up this
  discussion using the cards in front of you.
  Identify approaches and strategies you could take.

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Recommendations

• Be familiar with your own role and others roles
• Put yourself in the others shoes regarding
  previous training and background
• Acknowledge power differences
• Acknowledge and negotiate preferred ways of
  working

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What might interprofessional supervision look
like? (Gillig Barr, 1999)

• Semi- annual chart review and face-to-face
  discussions held with clinicians by an
  interprofessional team (in addition to regular
  supervision)

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What might interprofessional supervision look
like? (Thomasgard Collins, 2003)

• A case-based peer supervision model
• A continuingeducation program, involving
  collaborative peer supervision

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What might interprofessional supervision look
like? (Ponzer et al., 2004)

• Interprofessional training in the context of
  clinical practice clinical education wards
• 2 week interprofessional clinical course

21
What might interprofessional supervision look
like? Emerson, 2004

• How common or profession-specific are the
  competency requirements of the different
  professions for members who supervise students?
• If commonality, how feasible is it to develop an
  integrated interprofessional development and
  support program for placement educators?

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Common Competencies for Placement Educators
(Emerson, 2004)

• Enabling learning
• Knowledge of theories of learning
• Ability to manage learning environment
• Ability to impart and model a sense of
  professional responsibility
• Current knowledge of professional practice
• Current knowledge of relevant curricula

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Summary of Literature

• Pilot projects and initiatives tend to be
  temporary so no long term data
• Positive features shown initially tend to temper
  as demands of real practice increase
• Consistent problem seems to be working in
  parallel not collaboratively (at the level of
  individual projects as well as at the level of
  professional bodies)
• Empirical reports of team supervision are
  extremely rare although often discussed
  theoretically

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Summary of Literature

• Little empirical evidence about the EXTENT of
  interprofessional supervision
• Little empirical evidence about advantages or
  disadvantages
• No clearly articulated theory, models, or
  protocols
• In short, people are engaging in
  interprofessional supervision without research,
  theory or knowledge base pertaining to
  interprofessional supervision competence.

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References

• Bailey, D. (2004). The contribution of work-based
  supervision to interprofessional learning on a
  masters programme in Community Mental Health.
  Active Learning in Higher Education, 5(3),
  263-278.
• Clouder, L., Sellars, J. (2004). Reflective
  practice and clinical supervision An
  interprofessional perspective. Journal of
  Advanced Nursing, 46(3), 262-269.
• Davies, E.J., Tennant, A., Ferguson, E., Jones,
  L.F. (2004). Developing models and a framework
  for multi-professional clinical supervision. The
  British Journal of Forensic Practice, 6(3),
  36-42.
• Emerson, T. (2004). Preparing placement
  supervisors for primary care An
  interprofessional perspective from the UK.
  Journal of Interprofessional care, 18, 165-182.
• Gillig, P.M., Barr, A. (1999). A model for
  multidisciplinary peer review and supervision of
  behavioral health clinicians, Community Mental
  Health Journal, 35(4), 361-365.
• Hyrkas, K., Appelqvist-Schmidlechner, K.
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  teams Team members descriptions of the effects
  as highlighted by group interviews. Journal of
  Clinical Nursing, 12, 188-197.
• Hyrkas, K., Appelqvist-Schmidlechner, K.,
  Paunonen-Ilmonen, M. (2002). Expert supervisors
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  promoting and inhibiting the achievements of
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• Larkin, C. Callaghan, P. (2005). Professionals
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• ODonoghue. K. (2003). Unpublished.
  Uniprofessional, multiprofessional, field of
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• Peacock, J.R., Bradley, D.B., Shenk, D. (2001).
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• Ponzer, S., Hylin, U. Kusoffsky, A., Lauffs, M.,
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• Summers, M., Childs, A., Corney, G. (2005).
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• Thomasgard, M., Collins, V. (2003). A
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• Townend, M. (2005). Interprofessional supervision
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  and other professionals in the field of cognitive
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