However, the present study first demonstrates that reflection leads to a new understanding and the intention to act differently in the future an iterative dimension. Secondly, it shows different levels of reflection on experience. In general, the surface level is more descriptive and less analytical than the deeper level, which appears more difficult to reach. Dewey  focused on the depth and quality of reflective thinking, which is termed a vertical dimension.
The work of Mezirow  indicates that the reflection process can operate at various levels of intensity: habitual action, thoughtful action, reflection or critical reflection. Studies by Callister et al. NSS are educated and trained to work in high-tech departments with a strong focus on PS. Nowadays PS is increasingly recognized as a key dimension of quality care and has been integrated into the education of healthcare professionals . Jha et al. In particular, surgery and anaesthesia present substantial safety risks. The relevance of PS has expanded internationally .
Many different types of healthcare professional are involved and it is difficult to ensure safe care unless the system is designed to facilitate timely and complete information and understanding by all. Accordingly, numerous factors such as understaffing and inadequate structures contribute to unsafe patient care . The strategy includes the specific goal of improving PS and the quality of the healthcare services. The main dimension in PS and safety culture domains is respectful communication, which implies sharing experiences.
Furthermore, the most important dimensions in the multidisciplinary capacity building domain are collaboration and teamwork, coordination and risk management, knowledge sharing and patient- centred communication . The study has a qualitative design .
In , we conducted a quantitative survey that included qualitative questions focusing on how NSS experienced CS from their supervisors in relation to PS . These qualitative questions constitute the empirical material in this study. The study included all the 56 nurse specialist students NSS from four healthcare contexts in the final phase of their postgraduate education at the University College in June and eligible to participate in the study.
The characteristics of the participants are presented in Table 1. A common component of qualitative interpretive content analysis methods is coding operations that translate one set of meanings into the other. The method presented by Graneheim and Lundman  consists. Table 1. Demographic characteristics of the students. In the analysis process of this study, both the first and the second author read the material repeatedly and identified the sense of the whole for each question. Meaning units were then identified through joint reflection and discussion, after which they were categorized into ten subthemes and five themes.
All the authors carefully discussed the tentative subthemes and themes. Having moved back and forth several times between the whole and the parts of the text, all the authors finally agreed on the condensing of the domains and key components in accordance with Baxter .
According to Baxter  , interpretive content analysis enables a deeper understanding of the meaning of the content. Finally, we compiled one main theme, two domains, of which one was on the latent level and one on the manifest level, and four key components as presented in Table 2. The guidelines for research set out in the Helsinki declaration  were followed.
The principles of confidentiality, voluntariness and informed consent were adhered to. Information about the aim of the study was provided both in writing and verbally. The participants indicated their consent by giving a completed consent form to their principal tutor.
Skills of Clinical Supervision for Nurses: A Practical Guide for Supervisees, Clinical Supervisors and Managers (Supervision in Context): Buy Skills of clinical supervision for nurses: A Practical Guide for Supervisees, Clinical Supervisors and Managers (Supervision in Context) 2 by Bond (ISBN.
The data were stored securely in a fireproof cabinet in accordance with university college regulations. The NSS also highlighted the importance of being understood in their role as a student.
They re-. Table 2. Most of the students reported that they are sufficiently competent to ensure PS and that CS and reflection are of great importance for PS. Most of the students were especially satisfied with the supervision and their supervisor. One main theme emerged: CS as a prerequisite for professional development and two domains; A reflective way of growing and learning through CS, manifest level with two key components and The meaning of being and acting in a reflective and professional manner to ensure PS latent level , also with two key components Table 2.
According to the students, learning to reflect and act in a professional and reflective way through CS is a prerequisite for professional development. The results also show that CS is of great importance for PS. The students reported the importance of reflection in practice, that CS is planned and well organized for them. Stability and continuity in the relationship with the supervisor is important in CS.
To achieve this they suggested the need for the same supervisor over time, or even two supervisors for each student, which would enable a more nuanced learning situation. Having the same supervisor during the clinical practice period created trust, safety, stability and a close relationship with the supervisor. Most of the students reported a desire for more time together with their supervisor.
One student stated:. I would have liked more time together with my supervisor, more time to reflect and discuss patient situations in a setting away from the patient. In this study, the need for time was consistently expressed as essential. The desire for time to reflect, discuss and summarize together with their supervisors at the end of each day demonstrates the need for both mental and physical reflection space.
A high level of nursing competence and expertise, evidence-based practice, user empowerment, good practical skills, in addition to sufficient resources, positive attitudes and good role models at the workplace are of importance. Being encouraged and feeling free to ask questions and call for help were also mentioned as essential. Another NSS expressed: I appreciate that the supervisor is patient, supportive and willing to teach me. They wanted to be seen, accepted, respected, appreciated and recognised, which could be interpreted as their need for confirmation.
Furthermore, they described the importance of mutual trust and feeling safe in the relationship with the supervisor. As a specialist nurse student, I want to be challenged by my supervisor and given the opportunity to work more independently with patients. The supervisor should have patience, provide support and see me as a person. The meaning comprises elements such as confirmation, affirmation, trust, being supported yet challenged, dialogue and identifying role models.
All of the students wanted more time for dialogue and to reflect together with the supervisor. It was essential to reflect together with the supervisor in order to learn from adverse events and identify alternative ways of acting. One student illustrated this as follows:. Supervision increases my self-awareness in new patient situations that I did not experience before. Reflecting together with my supervisor increases my understanding and is of great importance for patient safety. Supervision increases my learning, my self-awareness and develops my professional competence and team-working skills.
One of the students expressed:.
Two research questions were addressed: 1. The NSS stated that a prerequisite is educated professional supervisors who can influence their development of a professional identity . Most NSS were pleased with the supervision they received and they were satisfied with their supervisor. Nevertheless, they strongly emphasized the desire for even more time to reflect with their supervisor. However, finding time and room for supervision and reflection is a challenge. Moreover, NSS particularly pointed out the need for additional time to reflect outside of patient situations.
Do you want to help others advance their professional practice? It's the only online qualification of its kind in the UK. Attend a webinar Attend a webinar Contact details Contact details. On this page. Online course description What you will study How you will learn Entry requirements Fees and funding How to apply Careers.
Online course details Study options Part-time: 1 year. Course level Postgraduate. Qualification PG Cert. Start dates January, September, May. Location Online. Postgraduate certificate Postgraduate certificate. Core modules. Concepts and Theories within Supervisory Practice. Issues and Debates in Supervisory Practice.
Skills in Supervisory Practice. Skills in Supervisory Practice Providing a contextualised framework for practice, this module will examine the development of the supervisory relationship within clinical practice. The module will develop your understanding of the skills required for a clinical supervisor with particular focus on the development of the supervisory relationship.
It will facilitate you to understand some of the issues that may arise with conducting clinical supervision and the skills required to offer a high quality supervision. Module learning outcomes On successful completion of the module, students will be able to: Critically examine the development, maintenance, and limitations of the supervisory alliance within individual and group frameworks Critically evaluate the supervisory role, skills, and performance within the supervisory relationship Module content The module will focus on the personal and clinical skills required and underlying theories in relation to supervisory practice.
The following are indicative content: The development of the supervisory alliance Barriers to developing the supervisory alliance Ruptures within the supervisory alliance The context of supervisory practice within the clinical setting Communication skills within supervisory practice Facilitating supervisory practice Enabling group supervision Assessment within supervisory practice Critical review on the use of supervision Sensitivity within the supervisory alliance Personal development as a clinical supervisor Goal setting within clinical supervision Developing supervisory networks Evaluating effectiveness within clinical supervision Structuring supervision Managing the supervisory experience.
More information 20 Credits. Concepts and Theories within Supervisory Practice This module will introduce you to the theories and concepts that are relevant to supervisory practice. This module provides you with the opportunity to critically consider the available models and concepts that are relevant to your area of practice. It then encourages you to consider the application of these models and provides you with the opportunity to create a model of clinical supervision that is bespoke to your own practice area.
Module learning outcomes On successful completion of the module, students will be able to: Critically analyse major theoretical positions and their explanation of the relational and process aspects of supervision Synthesise supervisory and educational theories, and apply them creatively to complex supervisory processes and practice Module content The module will focus on the personal and clinical skills required and underlying theories in relation to supervisory practice. The following are indicative content: Theories of supervisory practice Learning theories in the supervisory process Enhancing learning through supervisory theories Epistemological viewpoints within clinical supervision Historical concepts of clinical supervision Development of theory within clinical supervision Theory to practice application in individual settings Theory application to group supervision.
Issues and Debates in Supervisory Practice This module will introduce you to some of the issues and debates that may arise as you practice as a clinical supervisor. You will participate in reflection on your own values and beliefs systems and deliberate the ethical and legal dilemmas that may occur within clinical supervisory practice. Clinical skill is especially poor. Some of them do not even have enough clinical skill and knowledge in their history because of the shortage of clinical records.
Usually, for various reasons, supervisors do not have enough training and learning and this is the cause that supervisors do not have adequate and appropriate supervision of all clinical areas. Participants said in this regard as follows:. Process of content analysis illustrated by examples of code, subcategories, and categories about acquisition of scientific competence. However, according to statements from supervisors, they need to identify, state, and solve the problem for planning, decision-making, and knowing how to deal with conflict.
Participants said in this regard:. We perform something natural or tentative, but we do not know if it is right or not. Some classes about hospital decisions that I should be informed before. There are a few things we have on our own experience that we do not know is true or not. Also, supervisor needs capabilities such as negotiation, coordination, collaboration, and facilitating teamwork. Nurse 1. The supervisor needs to participate in educational programs to improve their knowledge and performance. In your opinion, supervisors , do you not need training class?
Supervisors are required to get training certificates for promoting employment. What's a certificate? How do you evaluate employees at year end? It seems certificates would be issued. I will not let my wife go to work tonight. He had an awful temper with supervisor, He had shouted, but the supervisor never spoke about it with me and nowhere she said about it. It is necessary that rather than simply report problems, simultaneously education reforms are applied.
Supervisors also need to offer support to supervisee or play a supporting role so as to provide empathy, take part in active listening, give confidence and assurance. The supervisor must, with respect to the competencies and capabilities of the personnel under their supervision, offer support to supervisee in times of need.
Nurse 9. Clinical supervisor has a very important role in ensuring the quality of care, and improves patient care and follows personal professional development of staff nurses. According to the experiences of participants in this study, both the themes, i. Due to the special role of supervisors in hospitals, it is very important that the process of training and preparation be done for supervisors. Grealish and Carrall found that supervisors do not have enough preparation for their role and felt that their supervising is done non-intelligently.
Thus, formal and informal preparation of clinical supervisors is important for their supervisory role. Based on the findings of the research, establishment of supervisory infrastructure, making the appointments and retention of supervisors, clarifying the duties and authority of supervisor, developing supervisory culture, specializing supervision, and conducting practice-based training should be done for training supervisors.
Hore et al. Content of supervision should be agreed upon and the aims specified before beginning supervision. The findings this study and the studies published by another researcher determined the importance of supervision goals, clarified the roles and responsibilities, and delegated responsibilities to the supervisor. For the implementation of effective supervision, it is very important to give attention to organizational culture, and the organizational climate and atmosphere should be prepared in compliance with the culture of supervision.
Gonge and Buus found that characteristics of the work environment, including organizational status, shift work, and environmental factors in the workplace affect the outcome of clinical supervision. Based on the findings, supervisors have to acquiring scientific, managing, communicative, professional, ethical, pedagogical, and supporting adequacy.
Supervisors need enough clinical and administrative knowledge and skills for their roles and it should be considered in their training and preparation. Sivan et al. Blomberg puts clinical supervision as an approach that can be used to support nurses for complying with the workplace. According to the studies mentioned above and based on the present research findings, having sufficient competence in all aspects of scientific knowledge and clinical skills, management, communication, ethical and professional behavior, teaching and support, competence in the supervision process, is very important, but no compiled program has been planned or collected yet.
So, it is necessary to plan a program for supervisor preparation. But unfortunately, program in this context has not been designed and developed. It is, therefore, necessary that a program be provided for the preparation of supervisors. Supervisors participating in this study had requested for special training methods that enhance their competence. Mather et al. It is necessary to enable supervisors to play a worthy role of clinical supervision at work.
So, for the chief nursing officers and directors of nursing services, it is suggested that in order to achieve this objective, first supervised infrastructure should be provided, such as making the appointments and retention of supervisors, clarifying the duties and authority of supervisor, developing supervisory culture, specializing supervision, and conducting practice-based training; then the competent supervisors should be provided comprehensive and integrated training in aspect of acquiring scientific, managing, communicative, professional, ethical, pedagogical, and supporting adequacy.
The chief nursing officers should provide training readiness and application practice-based teaching to supervisors for performing the supervisory role in an excellent way. Clinical supervision is an effective way to improve the quality of health care. It is necessary to enabling supervisors to play a worthy role of clinical supervision at work.
Therefore, for the chief nursing officers and directors of nursing services, it is suggested that in order to achieve this objective, first supervised infrastructure should be provided, such as making the appointments and retention of supervisors, clarifying the duties and authority supervisor, developing supervisory culture, specializing supervision, and conducting practice-based training; and then the competent supervisors should be provided comprehensive and integrated training in the aspect of gaining scientific, managing, communicative, professional, ethical, pedagogical, and supporting adequacy.
Recent Activity. Findings included two main themes: Firstly, establishment of a supervisory infrastructure that includes "making the appointments and retention of supervisors, clarifying the duties and authority of supervisor, developing supervisory culture, specializing supervision, and conducting practice-based training" and secondly, comprehensive supervisory competencies that include "acquiring scientific, managing, communicative, professional, ethical, pedagogical, and supporting adequacy.
This leads to improvements in patient care and nurses' personal and professional development. The snippet could not be located in the article text. This may be because the snippet appears in a figure legend, contains special characters or spans different sections of the article. Iran J Nurs Midwifery Res. PMID: Address for correspondence: Miss. E-mail: moc. Received Dec 10; Accepted Jul 7. Abstract Background: Supervisors should have certain characteristics and adequate preparation for their roles.
Materials and Methods: This research is an inductive content analysis. Conclusions: Clinical supervisor has a major role in ensuring the quality of nursing care. Keywords: Clinical supervisor, education, inductive content analysis, qualitative research, supervisory nursing, training. R ESULTS Analysis of data showed that there were two themes in order to train a nurse as a supervisor: Establishment of supervisory infrastructure and comprehensive supervisory competencies.
Open in a separate window. Figure 1. A summary of themes and categories of nurse supervisor training. Table 1. Leach L. Clinical supervision: Doing it for themselves. Nurs Stand. Cohen RI.