Masters of Science - Msc (Physiotherapy) / The roles of doctors and nurses in clinical supervision and clinical education are well defined in literature. However, the role of the physiotherapist in clinical education has not been clearly defined. This could be because the understanding of a clinical supervisor varies from discipline to discipline.

Clinical supervision is integral to promoting the professional development of counselors-in-training and gatekeeping the counseling services provided by counselor trainees (Bernard & Goodyear, 2014). Despite the value of studying participants’ retrospective perceptions about or reflections upon supervision, the supervisory process in which supervision transpires is infrequently quantified and measured (Holloway, 1982; Holloway, 1987). As described by most developmental supervision models, clinical supervision is “a process with sequential and qualitatively distinct stages through which supervisors and trainees progress” (Littrell, Lee-Borden, & Lorenz, 1976, p. 134). In order to capture these stages and phenomena with observable and measurable units, the author used six states of interest to measure the supervision process, which exhibit the progressively complex nature of clinical supervision. The six states include: (a) social interfacing (non-skills phase), (b) reflecting on foundational competencies, (c) deepening case conceptualization, (d) processing the relational management, (e) overcoming personal and multicultural barriers, and (f) furthering professional development. These states underpin the codebook of this study and are used to conceptualize the supervision process. Although the interactions between the supervisor and supervisee are transient and difficult to grasp, supervisory interactions move from one state to another. Indeed, state-transitional dynamics of clinical supervision are subject to a constellation of factors that supervisors and supervisees initially bring in and constantly reinforce, such as supervisory styles, supervisee developmental levels, supervisory working alliance, and supervisee satisfaction with clinical supervision. By using Markov chain analysis, this study detects the overall transitional dynamics of supervisory dyads and investigates how transitional dynamics vary based on the aforementioned variables that manifest themselves as supervision dynamics unfold and closely interface with other supervision variables. Results of this study provide implications for clinical supervisors, counselor educators, and counselors-in-training.

Introduction The purpose of this study was to enhance the prac experience of undergraduate nursing students and registered nursing staff. An innovative model of clinical education, the Clinical Education Unit (CEU) model was developed, implemented and evaluated. Background to the study Clinical education is a vital component of the undergraduate nursing curriculum. 'Real world' practice provides students with the opportunity to develop the knowledge, attitudes and skills needed to function effectively as a registered nurse. Despite the commitment of universities to produce competent graduates, there has continued debate regarding the preparedness of new graduates for practice as registered nurses. This has focussed continued attention on the adequacy of students' clinical education and, in particular, on the models used for clinical facilitation/supervision. There is little published evidence that clearly demonstrates the effectiveness of any of the current models of clinical education or that any particular model is better than any other in achieving quality outcomes (Wellard, Williams and Bethune 2000; Clare, White, Edwards and Van Loon 2002). Hence, as recommended in the recent National Review of Nurse Education (2002), ongoing evaluation of nursing curricula and teaching practice, including clinical education, is clearly warranted. Methods The study utilised action research methodology to examine the effects of the Clinical Education Unit (CEU) on the quality of clinical prac as experienced by undergraduate nursing students and registered nurses working with the students in wards where they were placed for their practicums. It was undertaken in two iterations or phases: Phase 1 - Development, implementation and initial evaluation of an innovative model of clinical education (the CEU model) and Phase 2 - Refinement and re-evaluation of the CEU model of clinical education. Using focus group discussions and survey questionnaires, qualitative and quantitative data were collected from undergraduate nursing students and clinical nursing staff in conjunction with each iteration of the study. Results Phase 1 results indicated that the CEU model was evaluated more positively by students and registered nurses than were the non-CEU models that were used for comparison. This result was demonstrated in the comments of students and registered nurses with regard to the respective models of clinical education and supported by their ratings of the quality of clinical experience through the QPE-Phase questionnaires. A similar trend was found in the results from Phase 2. The CEU-2 model was again evaluated more positively by students and registered nurses than were the non-CEU models that were used for comparison. Conclusion In summary, the results of this study indicate that the CEU model had a positive impact on the prac experience of students and registered nurses. In both phases of the study, students and registered nurses in wards where the CEU model was being used evaluated the prac experience more positively than did students and registered nurses in wards where non-CEU models were being used. Two key factors were found to be important in achieving this outcome: the collaborative nature of the CEU model and nursing staff ownership of students' clinical education. These factors provided an operating framework which enabled the development of positive learning environments in the wards where students were placed for prac. Equally important were arrangements for the supervision of students' practice which involved local clinical facilitation and the explicit inclusion of other nursing staff in the ward. Further, continued support from the university to allow the clinical facilitators to take a supernumary role when facilitating students, to provide staff development for clinical education and to support staff on a day-to-day basis during the prac was also important, if not essential. It is proposed that these factors, acting synergistically, promoted enhanced access to learning opportunities for students and improved learning outcomes for students and staff. The study makes an important contribution to nursing education by providing evidence that can inform future developments in the area of undergraduate clinical education. It has potential benefits for nursing education not only in the local context, but within the international arena as well.

A análise funcional tem sido considerada o instrumento básico do analista de comportamento. Entretanto, a literatura denuncia a escassez de pesquisas sobre o processo de desenvolver e usar a análise funcional em clínica dificultando a tarefa dos supervisores de estágio ao ensinar seus alunos a se tornarem terapeutas, justamente por não terem disponíveis os métodos que eles usam e como determinam em que ordem usá-los. Com o objetivo de preencher essa lacuna foi feito um levantamento dos relatos de casos publicados pelos terapeutas analíticocomportamentais para identificar o que fazem quando atendem seus clientes. Parece que o consenso entre eles é que sua atividade básica é a análise funcional, embora haja muitas controvérsias sobre tal termo, que é discutido neste trabalho concluindo-se por sua substituição pelo termo análise de contingências. Com base no levantamento feito, elaborou-se um programa de ensino dessa prática, do qual participaram oito estagiários que foram treinados a elaborar análises de contingências. O programa foi constituído de três módulos: revisão de princípios básicos do Behaviorismo Radical, elaboração de análises por escrito de casos relatados na literatura, de acordo com critérios elaborados por Sturmey (1996) e análise de pelo menos um caso atendido pelo terapeuta estagiário que foi gravado em vídeo e assistido pela supervisora e pelos colegas. Os procedimentos utilizados foram modelagem (reforçamento diferencial logo após a elaboração das análises por escrito e das sessões de atendimento) e modelação (observação das sessões de atendimentos dos colegas e da supervisora, observação do próprio comportamento de atender o cliente pela fita de vídeo e vivência da própria análise do seu comportamento de analista durante as sessões de supervisão). Os resultados demonstraram a eficácia do programa pela diferença significativa das notas dadas às análises por escrito antes e depois do treino. Para avaliar a efetividade do programa, as sessões de quatro dos oito participantes foram novamente observadas e as ações ao vivo durante o processo da análise de contingências puderam ser categorizadas. Foi possível definir treze categorias de falas dos terapeutas e analisar as porcentagens de freqüências delas, descrevendo os comportamentos dos terapeutas quando atendiam seus clientes, culminando numa proposta de sistematização da tarefa do terapeuta analíticocomportamental, que poderá ser usada como um dos critérios orientadores para a formação desse profissional. / Functional analysis has been considered the behavioral analyst\'s basic instrument. However, the literature denounces the shortage of researches on the process of developing and using functional analysis in clinics, which makes the task of professional training supervisors more difficult as they teach their students to become therapists, exactly because the methods which they use are not available, neither how they determine in what order these methods are used. To fulfilling this gap a search in literature was performed to identify by case reports what the analytical-behavioral therapist does when he is in attendance of his clients. It seems that there is a consensus among them considering functional analysis their basic activity, although there are many controversies about such terminology, which is discussed in this paper, leading to its substitution to contingency analysis term. Based on this research, a program for the teaching of this practice was conceived, in which eight trainees were taught to elaborate contingency analysis. The program had three modules: revision of basic principles of Radical Behaviorism, written analysis of cases found in the literature according to Sturmey\'s criteria (1966), and analysis of at least one case treated by the trainee therapist, which was recorded in video and observed by the professional supervisor and other trainees. The teaching used procedures were shaping (differential reinforcement right after written analysis as well as therapeutical sessions), and modelling (observation of therapeutical sessions performed by his peers and his supervisor, observation of his own behavior in session by watching the videotape, and his own experience in analyzing his own behavior as an analyst during supervision sessions). The results show the efficacy of the program by the significant difference of the grades given for the written analysis before and after training. To assess the effectiveness of the program, the sessions of four out of the eight participants were again observed and their actual actions during the process of contingency analysis could be categorized. It was possible to define thirteen therapists\' talk categories, whose frequency percentages demonstrated trainees behavior when attended their clients, what led to a proposal for the systematization of the analytical-behavioral therapist\'s task, which could be used as one of the orientation criteria for professional formation.

O presente estudo percorre questões que envolvem o homem no trabalho: práticas de desenvolvimento humano em Recursos Humanos, Gestão de Pessoas e Psicologia. Aponta para a necessidade de pesquisar aqueles que se submetem ao coaching, o que foi possibilitado por narrativas de executivos em situação de internacionalização de suas carreiras, permitindo pensar coaching no âmbito da globalização atual. Lança luzes, ainda a compreender a prática do coaching através da experiência do ser humano/trabalhador, pelas percepções reveladas pelos próprios executivos durante entrevistas de coaching com eles realizadas. Interessa poder resgatá-la como um meio pelo qual os executivo/trabalhadores possam estar encontrando modos outros de ação ao nível gerencial. Nessa direção, estaria sendo proposta uma leitura de coaching numa perspectiva fenomenológica existencial. Ao buscar a historicidade do coaching, via etimologia, aflorou-se a necessidade de direcionar o coaching para dirigir-se como cuidado ao trabalhador, considerado factível via Psicologia Social Clínica. Pela análise das narrativas foi possível compreender o coaching como prática psicológica, via Aconselhamento, possibilitando aos trabalhadores ressignificar sua experiência no trabalho, percebendo-se humanos afetados, contextualizados e demandantes por atenção e cuidado, para dirigem-se ao desenvolvimento profissional e coletivo em organizações. Assim, coaching se apresentaria como facilitação para o sujeito social repensar sua carreira, autorizando-se a encontrar sentido ao projeto profissional por demanda própria e não da organização ou empresa: uma prática para gestão de carreira mais eticamente orientada. / The present study deals with questions concerning the man in his work: human development practice in Human Resources, Management of Persons and Psychology. It points to a need to research how coaching is perceived by those who were submitted to it during a situation for internationalizations of their careers at the globalization world. Executives\' narratives allowed thinking coaching as a practice through the human worker\'s experience. Executives\' perceptions were revealed during coaching interviews and process realized with them. The purpose is to re-signify it as a means by which the executives/workers may find other ways for management actions. It is proposed other comprehension for coaching, base on a phenomenological existential perspective. By etymologically re-visiting the historicity of coaching, it appeared to direct coaching practice as care toward the worker, factitive through the Social Clinical Psychology. The narrative analysis allows to comprehend coaching as a Counseling Psychology practice, by which the workers could re-signify their experience at work. Perceived as affected human beings, contextualized and demanding for attention and care, they may direct themselves to a professional and collective development in organizations. Thus, coaching would present itself as facilitation for the social subject to reflect about his careers, authorizing himself to find a sense for his professional project by his proper demand and not by the organization: a more ethical oriented practice for career management.

Magister Curationis - MCur / The purpose of this qualitative explorative study is to explain individualized lived experiences of registered nurses working and participating in clinical supervision for nursing students within the clinical environment at selected hospitals. The study explores the challenges faced by registered nurses on a daily basis on how to structure clinical activities for the nursing students and provide high quality care to patients. / South Africa

Bakgrund: Sjuksköterskeyrket är in i sin kärna ett emotionellt arbete, vilket skapar behov av stöd. Professionell grupphandledning är en stödmekanism där reflektionen är en central komponent. Reflektion inom ramen för en professionell handledningsgrupp innebär förutom stöd även en möjlighet till ny kunskap för deltagarna. Syfte: Syftet med studien är att undersöka sjuksköterskors upplevelser av professionell grupphandledning. Metod: En kvalitativ litteraturstudie genomfördes, där materialet bestående av tolv kvalitativa studier analyseras med innehållsanalys. Resultat: Analysen resulterade i tre teman, vardera uppbyggt av två kategorier: Temat grupphandledningens påverkan med kategorierna påverkan på jaget och gruppen samt påverkan på yrket, temat grupphandledningens struktur med kategorierna grupphandledningens innehåll och utförande och gruppens sammansättning samt temat grupphandledningens funktion med kategorierna få stöd och sätta ord på känslor. Både positiva och negativa upplevelser av professionell grupphandledning framkom och dessa diskuteras i relation till Proctors trefunktionsmodell. Konklusion: Resultatet visar att professionell grupphandledning kan, då den är tillräckligt välstrukturerad, vara ett uppskattat stöd för sjuksköterskor. / Background: The nursing profession is into its core an emotional labor, which creates a need for support. Clinical group supervision is a support-mechanism where reflection is a central component. Reflection within the context of a clinical supervision group apart from support also implies an opportunity to new knowledge for its participants. Aim: The aim of the report is to examine nurses' experiences of clinical group supervision. Method: A qualitative literature review was performed, where the material consisting of twelve qualitative studies was analyzed with content analysis. Result: The analysis resulted in three themes, each built up by two categories: The theme implications of the clinical group supervision with the categories implications on the self and the group and implications on work, the theme the structure of clinical group supervision with the categories the content and execution of clinical group supervision and the composition of the group as well as the theme the function of clinical group supervision with the categories get support and put words on emotions. Both positive and negative experiences from clinical group supervision emerged, and these are discussed in relation to Proctor’s three-function model. Conclusion: The result shows that clinical group supervision may, if structured well enough, be an appreciated support for nurses.

Clinical education is a key element of graduate school training in the field of speech-language pathology. Graduate students are required to obtain 375 supervised clinical practice hours in order to earn their provisional license and begin their career. Supervision of clinical hours is most often provided by experienced speech-language pathologists with minimal, if any, training in effective supervision practices. Within the field of speech-language pathology, Anderson’s Continuum of Supervision (Anderson, 1988) is the most widely accepted model and provides a structure and sequence for supervisors to follow in order to facilitate the clinical development of their student clinician. Anderson’s model suggests that the collaborative supervision style should be used to transition student clinicians from directive supervision (where they are reliant on the supervisor for direction) to self-supervision, which represents independence. Despite this, and because of a lack of evidenced-based methods and a lack of training opportunities, many supervisors have difficulty implementing the collaborative supervision style. This study examines the effectiveness of an external tool, the Clinician’s Hierarchy for Advancing Treatment (CHAT) (Duthie, 2008), in helping supervisors to implement the collaborative supervision style. This is an exploratory quantitative, quasi-experimental non-equivalent groups study. Students and supervisors were surveyed about their perceptions of the supervisory process following their participation in a semester-long clinical practicum in a university speech-language pathology clinic. Prior to working with a second cohort of students, the supervisor group was trained on the CHAT. This method features a chart which objectively defines levels of client performance and corresponding levels of clinical supports needed for the client to advance in treatment. Supervisors were trained to use this tool to guide student clinicians in the clinical decision-making processes. Implementation of the CHAT occurred across the following semester in the same university clinic with a new group of student clinicians. Supervisors and students were again surveyed at the end of the semester on their experience of the supervisory process to determine if the perception of collaborative supervision had increased with the implementation of the CHAT. The Supervisory Relationship Measure (Pearce et al., 2013) and the Supervisory Relationship Questionnaire (Palomo et al., 2010) were used to survey the student clinicians and supervisors, respectively. Independent-samples, one-tailed t-tests were conducted to determine if there was a significant increase in the perception of collaborative supervision. These analyses were conducted using the Safe Base Subscale score from the surveys, of which items focus on the interactions and relationship between the supervisor and the student clinician as they relate to collaboration. Analysis resulted in insufficient evidence to suggest an increase in the perception of collaborative supervision from the first semester (without CHAT) to the second semester when CHAT was implemented. Additional analyses were also conducted on items that were considered particularly salient to collaborative supervision. Results of item-level analyses were marginally significant for two items from the supervisor surveys, both of which queried the supervisor’s perception of the student’s level of openness and honesty in supervisory conferences. These findings suggest that using an external tool such as the CHAT, may result in student clinicians being more open and honest about their experience of the clinical process in the supervisory conference. It is argued that the objectivity of the external tool prompts more objective conversation between the supervisor and student clinician. The increase in objective conversation, in turn, decreases the judgment and evaluation that students often associate with supervision, thereby creating a safer environment in which to voice their honest reflections.

Aims and objectives: To describe newly graduated nurses’ experiences of the intervention practitioner training nurse.  Background: Newly graduated nurses need support to establish the profession. Several studies have shown that the first years in the profession, is the most challenging time. Method: The intervention practitioner training nurse was initiated to empower, and support newly graduates nurses in their professional role. Data were collected through semi-structured interviews with ten newly graduate nurses having experience of the intervention. The data were analysed using qualitative content analysis. Results: The analysis results in the overarching theme; “Organizational prerequisites” The theme consisted of three categories, "Activator" comprised the subcategories compiliating and attractive workplace. This involved that the practitioner training nurse were the activator creating a clear structure and the wards became more attractive workplaces. “Supportive nursing" comprised the subcategories present assistance, emotional support, and patient safety. This involved that practitioner training nurse constituted an important support function and helped to ensure patient safety. “Professional development” comprised the subcategories nurse's competence, feeling of security, and learning. This created the opportunity for professional development. Conclusion: The newly graduate nurses' experience of the intervention shows that the creation of an organisational structure enabled the practitioner training nurse to be an important support and to contribute to professional development. This was accomplished by strategic decision of the hospital management. Relevance to practice: The results of the current study can be transferred to other similar healthcare organizations and can be a support for managers who plan to initiate interventions to empower and support newly graduated nurses.

Research in the area of clinical supervision has historically been limited, especially in the field of speech-language pathology. Furthermore, those few studies that do exist were primarily published during the decade of the 1980's. Clinical supervision, and specifically its critical component of supervisory feedback, is crucial to all clinical training programs. However, supervision research only mentions the topic of supervisory feedback and neglects the relationship between supervisory feedback preferences and actual supervisory practices. This study was designed to identify and compare supervisor and supervisee preferences and perceptions regarding supervisory feedback, to relate these preferences to a continuum-based model of clinical supervision, and to compare the feedback preferences of all participants to actual supervisory practices. Supervisory feedback preferences and perceptions were obtained by using a 31-item Supervisory Feedback Preferences and Perceptions Questionnaire (SFPPQ) developed for this study. Supervisory practices relevant to feedback were examined and described by collecting written feedback from participating supervisors at three different points within a six-week period of supervisory interaction. Participants included 37 speech-language pathology graduate students and 10 supervisors from two ASHA-accredited university training programs. Results revealed that both supervisors and student clinicians prefer verbal, in-person feedback, which is provided immediately and consistently after each treatment session. Additional preferences supported the continuum-based model of clinical supervision; however, actual practices did not reflect adherence to this model. Findings regarding supervisory practices revealed that supervisors gave mainly direct feedback to their supervisees and that this feedback did not change over time, unlike that suggested by the continuum model. Although no link was found between level of supervisory experience and nature of feedback given, clinicians with advanced experience levels received a higher percentage of direct feedback. This finding again contradicts the recommended model of supervision. This research expands and extends the limited amount of supervision literature, delineates areas for future research, and discusses implications for future clinical and supervisory training. These implications include information related to specialized supervisory training and styles of adult learning.