Unit 10

Clinical/field supervision

Ramila Maharjan
 Supervision
• Supervision is a teaching learning process which provides constant
observation, monitoring, evaluation, guidance to workers to enable
them to perform their activities effectively and efficiently maintaining
required standards.
• Supervision nowadays considered as a part of teaching- learning
function.
• Educators think of supervision is a guidance or working together for
common goals.
• Desirable ends are mutually decided .
Clinical Supervision
• Not just workplace assessment training
• Not just teaching
• Clinical supervision includes
ensuring the safety of the trainee and patient in the course of clinical care

as well as giving feedback on performance, both informally and through

appraisal
Clinical supervision cont………..
• Clinical supervision is critical to training (Proctor, 1986).
• Fosters trainee development.
• Protects client welfare.
• Ensures competence to serve the profession.
• Clinical supervision promotes ethical practice (Vasquez, 1992).
• Imparts knowledge.
• Teaches skills.
• Models behaviors.
• Supervision positively impacts client outcomes (Bambling et al., 2007).
Purpose of clinical supervision

The main purpose of supervision is to assist the subordinate to achieve the

common organizational goal efficiently by improving their performance
through some form of organizational improvement. This purpose is
achieved by meeting the objectives to follow:
1. To provide staff with a confidential, safe and supportive
environment,
2. To critically reflect on professional practice.
3. To improve quality patient services by improving mental health
practice, by encouraging reflection on attitudes towards people with
health problems and disorders, their family members and careers.
Cont…..
4. To assess the performance of subordinates with the intention of :
 Finding out how far they are meeting the set standards.
 Inspiring or motivating them through rewards for their good
performance.
 Improving their performance through the guidance, coaching,
and training as needed.
5. To help subordinates:
work efficiently by developing their skills
Develop critical thinking needed for solving the problem.
 Develop their potentialities to the fullest through counseling,
guidance, coaching, and training.
Improve team spirit by brining coordination among them.
Build up a sense of self-confidence among subordinates.
Clinical supervisor

• ‘A trainer who is responsible for overseeing a specified trainee’s clinical work

for a placement in a clinical environment and is appropriately trained to do so.

• He or she will provide constructive feedback during that placement, and inform
the decision about whether the trainee should progress to the next stage of their
training at the end of that placement and/or series of placements.’
• It is someone with experienced helping someone who is less experienced.
• The supervisor’s function therefore is one primarily of guidance
Cont.…………
• The clinical supervisor:
■ Is a person trained/experienced with clinical supervision and should
have a minimum of two years experience in the related field.
■ Is preferably from the same professional group,
■ Is from the same or another worksite
■ Can give feedback at the supervisee’s level of experience
■ Has at least the same or higher level of practice skills, in the areas
being addressed but this is not absolutely necessary.
Qualities of clinical supervisor:

• Motivated
• Open, honest, acceptance and tolerance
• Aware of own strengths and Weaknesses
• Self-reflecting
• Able to give and receive constructive feedback
• Empathy
• Supportive
• Challenge and has internal review skills
Cont…………..
• Courage to take risk for failure
• Competency in technical knowledge and skills.
• Communication skills: good listener
• Skill in human relations: mutual respect and trust.
• Problem solving and organizing abilities
• Creativity
• Alertness : ability to assess situation quickly
Supervisee

• The supervisee is:

■ any professional working within health in a clinical area
Cont……………
Qualities of clinical supervisee:
 Motivated
 Open, honest
 Aware of own strengths and weaknesses,
 Self reflecting,
 Able to generate ideas for action,
 Able to accept responsibility for own practice and able to give
and receive constructive feedback.
Criteria for clinical supervision
• Agreement is the formal written arrangement to participate in clinical
supervision with another person. A copy of the agreement should be
forwarded to supervisees/supervisors line manager for inclusion in
personnel file.

• Meeting is the time spent between supervisor and supervisee in clinical

supervision.

• Relationship is the connection between supervisor and supervisee for

the purposes of clinical Supervision.
Role and responsibilities of clinical/field supervisor:

• To ensure venue and mode availability

• Personal availability
• Record-keeping
• Confidentiality
• Awareness of limitations in knowledge
• Commitment to the process of clinical supervision
• Be accountable to the employing organization by promoting safe clinical
practice.
• To accept responsibility for own professional development by seeking out
additional resources for professional development and training as necessary
Responsibility of the supervisee

■ To ensure venue and mode availability

■ Personal availability
■ Preparing issues to discuss
■ Record-keeping
■ Confidentiality
■ Commitment to the process of clinical supervision
Factors of Effective Supervision

1. Human relation skill:

• different individuals may have different emotions, statements and
attitudes.
• As a supervisor s/he has to realize human emotion and sentiments.
According to the perception and experience of employees they
conduct their behavior.
• Thus supervisor must treat the subordinates as human being and
must develop good human relations.
2. Technical and managerial knowledge

• Familiarity with the technical aspect of work increases the supervisory

competence.
• Without the technical knowledge about the work, whether such work
relates to production, sales or office activities, no supervision can
become thorough and satisfactory.
• Guidance implies a complete understanding for all work problems.
• Besides the technical knowledge, the supervisor must have
managerial vision to comprehend company policies and practices in
their correct setting.
• The greater the management experience and skill of a supervisor, the
more effective will be the result of supervision.
3. Improved upward relations
• Top management must pay adequate attention and thought on
supervisory jobs to ensure a good quality of supervision.
• Problems of supervision usually arise from omissions, mistakes and
negligence on the part of superior mangers.
• Hence, for any improvement in supervisory position, the supervisors'
upward relations must be well established.
4. Relief from non-supervisory duties:
• To make the supervisory duties purposeful, the supervisors are to be
relieved of many routine activities that divert their attention from the
real job.
• Submission of numerous reports and returns by supervisors is, to say
the least, unnecessary for the job of supervision.
• On the one hand, the number of returns of reports can be reduced
and on the other, essential reports can be secured by top
management through the employment of staff assistance.
5. Leadership skill: –
• Supervision is the function of leading, coordinating and directing the
work of others to accomplish the objectives.
• Therefore, without leadership skill supervision may not be effective.
• So she/he should possess leadership qualities in order to achieve the
goals.
• Means she/he should be able to guide, coordinate, control and
supervise the subordinates effectively.
6. Managerial knowledge:
• Supervisors must have the knowledge and skill of management that helps
to make the policies, planning, rules, regulations and other objectives.
• It is necessary to use the power and to handle all the problems of
subordinates.
7. Communication skill: –
• Another important factor that ensures effective supervision is
communication skill.
• In the absence of communication skill no effective supervision is possible
in the organization.
• The supervisor must the capability of communication.
• When s/he is not able to convey the information or do not understand the
information supervising cannot be effective.
8. Motivating power: –
• The supervisors must have the skill of motivation.
• she/he must be able to motivate the subordinates and subordinates
effort are effectively used for the organization
9. Proper working conditions:
• Proper working condition is necessary for effective supervision.
• When there is lacking of proper working condition the direction of
supervisor does not play effective role
10. Clear instructions:
• Supervisor must give clear instructions to the employees.
• It is the duty of the supervisor to provide clear instruction for the effective
supervision.
11. Thinking of participation:
• The supervisor makes the decision in his/her level.
• In the process of decision making supervisor must ensure participation of the
subordinates.
• Employees’ vision must be accepted.
• There should be two way communications.
12. Work load of the supervisor:
• The purpose of supervision is to inspect, evaluate, and improve the work
performance.
• Many times supervisors are unable to give time for supervisions as they are
overloaded with other duties and responsibilities.
• At times, the span of supervision is so broad that it becomes virtually
impossible for the supervisors to cover it , and supervision becomes
neglected, but not on purpose.
• Unless supervisors are relieved from some of the routine work, it is
impossible for them to provide meaningful supervision, which means the
purpose of supervision will be defeated.
13. Support system:
• Availability of the resources to carry out the work and the effectiveness of
the communication system play important role in meeting the purpose of
supervision.
• Also the support a supervisor receives from the authority makes
supervision effective.
• We must remember that supervisors also need supervision form their boss
to ensure that they are carrying out their supervisory jobs effectively.
14. Control system:
• Supervision has the controlling function as well.
• How well the quality of performance is assessed very much depends upon
how assessment tools are standardized and how they are used.
• If the assessment tools are objective and the method of assessment is
ongoing in nature, and the results of assessment are used for the purpose
of feedback and reward, supervision becomes effective.
PRINCIPLES OF SUPERVISION

• A supervisor must follow certain principles of supervision, which find

its basis on the assumptions that supervision is interaction between
the supervisor and the followers; therefore, if a supervisor has to
influence people's thinking and ways of doing, he/she must be able to
win the heart of people.
1. The supervision should be well planned beforehand.
2. Participatory approach should be used throughout the planning
of supervision by involving employees as much as possible.
3. The lines of communication should be open and clear.
4. The effects of informal communication should not be ignored and rather
should be used for the benefit of supervision.
5. The personal and social needs of employees must not be overlooked.
6. There should exit a sense of mutual trust and respect among people to
make the climate within the organization warm and stimulating.
7. In order to facilitate supervision, collegial relationships should exist between
the supervisor and the follower, and the supervisor and his/her superiors.
8. Supervision should be used for counseling the employees, if and when
needed.
9. Supervision should focus on continuous growth and development of
individual employee.
10. The span of supervision should be reasonable to make it physically possible
for supervisor to do his job honestly.
11. In order to feel adequate for supervision, supervisors must be
knowledgeable about the subjects of their field and must possess the
technical and human skills.
12. Supervisors must possess the leadership skill in order for him/her to
give the guidance needed by the followers.
13. Supervisors should not be given non-supervisory responsibilities at the
cost of his/her supervisory functions.
14. Supervisors must be delegated adequate authority for giving them
needed power and status to carry out their supervisory responsibilities
effectively.
15. Supervisors must have tolerance for the mistakes and be open to
constructive criticism.
16. There should be continuity in supervision.
17. Supervision should be just and fair.
18. In order to motivate people to give their best performance, they
should be given the due positive rewards timely, but supervisor
should us the "equity theory" in giving rewards.
19. The preset tools for assessment of the performance should be
standardized, objective, and practical.
20. Supervision should rather help people to improve their work-
performance through coaching and guidance than just to find fault
in people.
METHODS/PROCESS OF
SUPERVISION
Supervisory process follows main three steps:
1. Planning:
• If plans are clear, subordinates will know what is expected of them
without frequently having to check with their supervisor. In the
planning stage supervisors must carry out the tasks as follows:
Clarify the goals and objective of the organization and what is
expected of the people as an individual or as a group.
Specify the work standards or norms of performance as well as the
method of appraising the performance.
 Decide on allocation of tasks and plan the work schedule.
Prepare the job descriptions.
Decide the authority and responsibility that workers would need to
carry out the given task.
Specify whose job is to be supervised by whom.
Specify what is to be communicated by whom and when, and plan
to keep the two-way communication channel open.
Explore and plan the resources required, and specify who is
responsible to secure it.
Implementing:
• This is the dynamic phase in which the plan is put into action.
• The supervisor is responsible for maintaining the quantity and the
quality of the work performance, exercises his leadership capability in
helping and guiding the subordinates to give their best performance
by using their technical knowledge and skills, by using the resources
efficiently, and by developing a team spirit.
• For this, supervisors are responsible to carry out the tasks as follows:
Orient employees about the objectives and policies of
organization, the job they are expected to carry out, and the
supervisor and other people they will be working with.
Maintain the quality and quantity of the work by allocating the job
on the basis of person's capability and capacity.
Assist subordinates to carry out their tasks through guidance and
teaching needed.
Identify the factors that reduce the quality and quantity of the
work performance by people and try to resolve them by using a
participatory approach.
Meet the staff's needs for knowledge and skills needed to carry out
the task entrusted to them.
Provide necessary help and guidance in proper utilization of
material resources.
Hold formal meeting periodically to keep the channel of
communication open and, for the feedback.
Explore the ways to increase effectiveness in organizational
communication.
 Act as mediator to resolve the dysfunctional organizational conflict.
 Listen to staff's personal problem and grievance and help them to
cope with them and provide necessary assistance it is not
contradictory to the organization's policies.
 Maintain the discipline in the organization.
 Coordinate the efforts of the subordinates to converge it towards
meeting the common organizational goal.
 Develop the relationship of mutual trust by honoring people's
individual rights for respect and confidence, and treating them fairly.
 Motivate people by giving the positive reward for good performance.
Evaluation and feedback:
• In this stage, supervisor assesses the quantity and the quality of work
performance by judging it against the preset criteria.
• The formal job description and associated performance standard provide the
model against which to judge performance.
• The tasks for supervisors to carry out at this stage are:
 Assess the work performance through the application of specialized records
and reports.
 Use standardized evaluation tools (rating scale or check list) to measure the
work performance to be fair and objective.
 Use the performance measures to give due rewards to employees and
inspire them.
 Provide feedback to the employees on their weakness so that they can work
towards improving their performance by seeking necessary help and
guidance.
Thank You