Perspectives of Supervision
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Transcript of Perspectives of Supervision
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Perspectives about andModels for Supervision in the
Health Professions
Violet H. Barkauskas, PhD, RN, MPH, FN
!he "niversit# of Michi$an
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Focus of the Presentation
!he conte%t of health care
Fra&e'orks for supervision in health
care
(%a&ples of fra&e'ork application
(vidence of effectiveness
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)onte%t of Health )are * +estern
Hierarchical s#ste& of oversi$ht)linical supervision is a &aor
e&phasis because of-
)oncern for patients)urrent re*e&phases on patient safet#
Rei&burse&ent certification re$ulations
)oncerns about liti$ation
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)o&&on (%a&ples
!rainin$ education / students in allprofessional discipline
Professional develop&ent re0uire&ents
1versi$ht of assistant2ancillar#personnel)o&&on 3al&ost ubi0uitous4 in &ost
settin$s, especiall# for nursin$(%a&ples / nursin$ assistants in hospitals
nursin$ ho&es, ho&e health aides,co&&unit# health 'orkers
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Proctor5s Model of Supervision 367894
Nor&ative / d&inistration :ualit# ssurance Mana$e proects (nsure patient safet# ssess assure 0ualit# ;&prove practice
Restorative / Support ssistance 'ith )opin$ ;dentif# solutions to proble&s in practice lleviate stress
For&ative / (ducation Professional Develop&ent Skills kno'led$e
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pplications of the Model
Nor&ative 3&ana$e&ent, safet#, assurance4 Meetin$s 1bservation of care For&al evaluation !elephone consultation
Docu&entation in hard electronic &edia Patient records ctivit# lo$s
Restorative 3support assistance 'ith copin$4
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Heron5s Model of Supervision 367874
uthoritative Supervision ;nterventionsPrescriptive / direct behavior
;nfor&ative / $ive infor&ation2instruct
)onfrontin$ / challen$e
Facilitative Supervision ;nterventions)athartic / release tension2stron$ e&otion
)atal#tic / encoura$e self*e%plorationSupportive / validate2confir&
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Po'ell5s Model of Supervision 3677=4
)o&ponents d&inistrative
(valuative
)linical
Supportive
)onceptuali>ation of supervisor as a servant leader 'ho ;s self*a'are
1perates 'ith focus ener$#
;s proficient in &an# aspects of the ob
Makes the or$ani>ations &ission vision clear b# standin$ aheadof the follo'ers 'hile standin$ behind their actions
Shares po'er
Values people b# carin$ for the&
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ssu&ptions of Po'ell5s Model of
)linical Supervision 3Po'ell, 677=4
People have the abilit# to brin$ about chan$e in theirlives 'ith the assistance of a $uide.
People do not al'a#s kno' 'hat is best for the& asthe# &a# be blinded b# their resistance to denialof the issues.
!he ke# to $ro'th is to blend insi$ht behavioralchan$e in the ri$ht a&ounts at the appropriate ti&e.
)han$e is constant inevitable. ;n supervision, as in therap#, the $uide concentrates
on 'hat is chan$eable. ;t is not necessar# to kno' about the cause or
function of a &anifest proble& to resolve it. !here are &an# correct 'a#s to vie' the 'orld.
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Structure of Supervision
;ndividual / 6 to 6 6 supervisor 6 supervisee
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Supervision Venues
Routine interactions on the ob;nfor&all#;n scheduled &eetin$s
;ndirectl# / e.$., b# talkin$ to patients!hrou$h re&ote co&&unication!elephone
)o&puter +ritten docu&entation, e.$., lo$s, records,
reports
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)urrent Supervision Debates
:ualifications of the supervisors Fro& the sa&e discipline different discipline peer collea$ue
(%pertise )ontent of care Processes of develop&ent
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(vidence * Supervision (ffectiveness3Cil&inster oll#, A, p. 8==4
Supervision has a positive effect on patientoutco&e lack of supervision is har&ful topatients.
Supervision has &ore effect 'hen the
trainee is less e%perienced.Self*supervision is not effective.!he 0ualit# of the relationship bet'een
supervisor supervisee is probabl# the
sin$le &ost i&portant factor for effectivesupervision.Behavioral chan$es can occur 0uickl# /
chan$es in thinkin$ attitude take lon$er.
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!ips
)o&bine supervision 'ith focusedfeedback
)ontinuit#
Reflection b# both participants
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)haracteristics of (ffective
Supervisors
(&pathetic Supportive Fle%ible ;nterested in supervision
!rack supervisees effectivel# Eink theor# 'ith practice (n$a$e in oint proble&*solvin$ ;nterpretative Respectful Focused Practical Cno'led$eable
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)haracteristics of ;neffective
Supervisors
Ri$id Eo' e&path# Eo' support Failure to consistentl# track supervisee concerns
Failure to teach or instruct ;ndirect intolerant )losed Eack respect for differences
Non*colle$ial Eackin$ in praise encoura$e&ent Se%ist (&phasi>e evaluation, 'eaknesses, deficiencies
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Reco&&ended )ontent for
Supervisor !rainin$
Supervision fra&e'orks
ssess&ent of learnin$ needs
!eachin$ the adult learner )ounselin$
Provision of feedback
;ssues of po'er social stratification!ranscultural relationships
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References
Heron, . 367874. Six category intervention analysis.
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