Interprofessional learning for

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JSWEC Conference 2005
Interprofessional learning for supervision Liz
Beddoe
The University of Auckland
New Zealand
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Themes of presentation

• Resurgence of interest in clinical supervision in
  health and human services
• New opportunities for interprofessional
  supervision education
• Critical issues for learning
• Critical  reflection approach
• Question  taken- for- granted professional
  assumptions
• Cultural and socio-political dimensions

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Why Interprofessional learning for supervision?

• Resurgence of interest in supervision mid 90s
• Supervision being taken up by new professional
  groups
• Shortage of expertise in supervision education
• Programme history-from only social workers to 12
  different professions

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Definitions

• it is now widely accepted that
  multiprofessional best describes those
  occasions on which several professions come
  together to learn about the same topic but do not
  necessarily interact with each other, whilst
  interprofessional is reserved for those
  occasions where interactive learning takes place
  between members of different professional groups
• Owens ,Goble Gray(1999)

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Supervision

• Supervision is understood as a specific
  learning, developmental and supportive method of
  professional reflection and counselling, enabling
  professional workers .to acquire new
  professional and personal insights through their
  own experiences. It helps them to integrate
  practical experiences with theoretical knowledge
  and to reach their own solutions to the problems
  they meet at work, to face stress efficiently and
  to build up their professional identity. By this,
  supervision supports professional as well as
  personal learning and development.
• orga, (2002)

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Whats different about interprofessional
supervision education?

• Absolute newbies
• No baseline of knowledge and experience
• Some participants have never experienced
  supervision session
• Know it all social workers
• Wide variety of assumptions and expectations
  about supervision

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The preparation of professional supervisors
key elements

• Focus on the learning not just the managerial
  role (Payne, 1994 Morrison 1993,2000 Beddoe
  Davys, 1994).
• The importance of processes to support reflective
  practice (Bond, 1998, Davys Beddoe, 2000
  Davys, 2001) .
• The transition from practitioner to supervisor
  (Heid ,1996 Beddoe, 2001).

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Continued

• Supervision in diverse cultural contents
  (Autagavaia, 2000 Bradley, Jacob, Bradley,
  1999 Davys,2005, Webber-Dreardon, 1999, Eruera,
  2005
• Mafileo ,2005) .
• The particular ethical parameters of the
  supervisory role (Hughes Pengelley, 1997).

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Critical issues for Interprofessional supervision
education

• The acquisition of specialist knowledge and
  skills for supervision
• The management of authority and power
• Decolonising supervision
• Ethical practice in complex multi-disciplinary
  contexts

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1. Specialist knowledge and skills for supervision

• Three main elements
• Working at arms length and with worker
  ideas/perceptions/reactions forming much of
  content
• Centrality of learning and teaching
• Clear differentiation of role and process of
  supervision

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Challenges

• Need to explore interventions for learning e.g.
  reflective frameworks rather than didactic
  methods
• Differences between the professions
• No common baseline of engagement/questioning/
  reflection
• Need to provide an explicit refresher of basic
  skills ( Heron/Loganbill interventions useful
  here
• Steering for a balance between content
  rich/process poor

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2. Managing authority and power

• Distinguishing between role authority,
  professional authority and personal authority
  (Hughes Pengelly)
• Too much use of legitimate authority leads to
  distortions and stifles learning
• Too little can lead to collusion and unsafe
  practice
• Again a struggle for balance impact of contexts
  difference.
• Selling supervision to reluctant supervisees

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3. Decolonising supervision

• Supervision dominated by Western world view
• Part of our target group works in Iwi (tribal)
  social services and in Pasifika (Pacific origins
  in NZ)
• Growth in social/ health services which are
  culturally specific-need appropriate supervision
  models.
• Deconstruct and reconstruct- challenge our
  participants to do this
• Professional differences- nursing for example
  has a cultural safety approach, social work
  approach more about structural (institutional
  )racism
• Challenge for us as educators not to water down
  content

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Kaupapa supervision

• All cultures have conceptions of the world
  which contain explanations of their experience of
  the world. These conceptions of life form what
  is termed the worldview of a culture (Royal,
  199942). While there are common themes and
  principles in a Maori worldview it also creates
  tensions in summarizing what is a particularly
  diverse and evolving culture. It must be
  acknowledged that all Maori have diverse
  experiences, realities, and tribal differences
  Eruera (200561)

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Cultural supervision

• Cultural supervision is about facilitating the
  cultural development and capacity of the
  supervisee through reflection, critique and
  action. The realm of both the focus and impact
  of cultural supervision is not confined to the
  specifics of a case scenario but ripple
  throughout the personal, family, community,
  cultural and professional domains .Cultural
  supervision is also about supporting Pasifika
  social workers to operate in predominantly
  non-Pasifika contexts. (Mafileo 2005120)

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Reconstruction
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Requirements for 'cross cultural ' supervision
in non-oppressive practice
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4. Ethical practice in complex
multi-disciplinary contexts

• Supervision is often seen as the site for ethical
  teaching.
• This would be fine if ethics was a simple thing.
• There are some broad issues about the role of the
  professions that have significance in thinking
  about ethics.

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Ethics

• The professions are less confident in the full
  gaze of a critical media and public
• There is an enhanced appreciation of difference
  and diversity in our society
• We are more able to cope with irony and
  contradiction in the moral dimensions of our
  professional and personal lives
• That the rulebook of ethical codes has become
  marginalized and to some extent replaced by a
  view of ethics as contextualised and situated
• Situational ethics tend to be grounded in a
  particular cultural context in contrast to the
  past universal claims for moral rightness
• Bagnall (1998

)
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Challenges for supervision education

• Managing this complexity
• Managing the issues within diverse cultural
  perspectives
• Managing the issues within diverse professional
  perspectives
• Critical thinking around balancing risk and
  empowerment (parallel process)
• Case studies enable constructive positive
• use of difference in learning activities

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Conclusions

• Interprofessional education for supervision full
  of challenges
• Adds excitement and diversity to the learning
  (and teaching ) environment
• Need for further development of strategies
• Challenging (disturbing) professional assumptions
  comfort zones
• Challenging the boundaries of supervision
• Need for research into learning experiences
  value for participants