New Evidence in the Implementation and Evaluation of Clinical Supervision
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Purpose: Clinical Supervision [CS] is a formally structured arrangement to support staff employed in human service agencies and has an established history in many health care professions, including nursing. It has shown promise internationally as a positive contribution to the health governance agenda. Two recent CS-specific research studies have made incremental progress towards establishing an evidence base for best practice development and the robust evaluation of Clinical Supervision outcomes. Methods: Described as "one of three studies conducted over the last 30 years, that provide the best and clearest directions for further thought about conducting future successful research in the supervision-patient outcome area" [Watkins 2011], the first study is the pragmatic randomised controlled trial of CS [White and Winstanley 2010]. This showed that, where certain identifiable conditions in the practice environment were met, positive causal relationships could be demonstrated to show an increase in the quality of care provided by nurses and an improvement in patient outcomes. Results: The second study tested the original factor structure and response format of the Manchester Clinical Supervision Scale & copy, for goodness of fit to the Rasch Model, using RUMM 2030 software [developed in Western Australia] and rigorously investigated the validity of this unique instrument. Using data from eight selected licensed CS evaluations conducted recently in Australia and New Zealand, detailed Rasch analyses confirmed the established psychometric properties and indicated that the original 36-item version could be reduced to 26 items, and from seven to six subscales, with improved fit statistics. The latest version has been named the MCSS-26 & copy; [Winstanley and White 2011]. Conclusion: This presentation will draw on both interrelated Clinical Supervision research studies and discuss fresh theoretical insights which have emerged, to address the methodological and substantive challenges that face the development of effective nursing practice, worldwide, in the constant quest to improve patient outcomes.