Clinical learning and supervision for allied health professionals in Singapore: current framework, facilitators, barriers and the way forward

Abstract

Background: Clinical supervision for allied health professionals is vital to develop clinical skills within an acute hospital. With the ageing population that the country faces and the exponential increment in the number of younger professionals, clinical supervision is even more paramount to ensure the continuity of professionalism and to maintain clinical standards, resulting in a quality-assured service that protects patients’ safety. There has been minimal research conducted to investigate clinical supervision in the workplace, facilitators and barriers of clinical supervision and how we can assist in making improvements in the workplace. The following research questions have therefore been derived to investigate clinical supervision in the local context: 1) What are the current frameworks and outcome measures for clinical supervision in allied health professions in Singapore? 2) What are the facilitators and barriers to learning within the current framework of clinical supervision? 3) What are the facilitators and barriers to supervising within the current clinical supervision framework? 4) How can we improve the current framework to assist in improving the quality of healthcare standards in Singapore?

Method: A two-round Delphi technique was employed. In the first round, 77 participants participated in answering an open-ended anonymous online questionnaire targeting the research questions. Their responses were then analyzed with thematic and content analysis. The themes were then categorized and used for the second round of the survey. A total of 55 participants participated in round two. Participants were requested to rate their level of agreement according to a five-point Likert scale. The results were then analyzed according to the percentage consensus achieved. A level of 68% was set for the percentage consensus in the study.

Results: Analysis of data from round one revealed similar themes for both supervisees and supervisors across all questions. Analysis revealed current supervision practices that included a focus on clinical teaching, development of skills, emotional support, administration and organization. Analysis of facilitators and barriers of clinical supervision fell within the themes of clinical, developmental, emotional and administration. Suggestions for improvement were identified as having protected time set aside for clinical supervision, a dedicated clinical supervisory unit and a more conducive work environment for learning. In round two, 63 out of 77 themes from round one were considered to be important for both supervisors and supervisees.

Conclusion: The findings of both rounds of the survey revealed that in this workplace, the supervisors and supervisees have a common understanding of clinical supervision. This allows a smoother implementation of clinical supervision. The outcome measures that are implemented so far largely relies on objective measures which can show the effectiveness of clinical supervision. The facilitators and barriers of learning and supervising within this current framework were all mostly in line with the literature so far. This indicates that across professions, the areas surrounding clinical, professional, administrative, emotional and developmental aspects are similar. This can also indicate that the suggestions of improvement for clinical supervision for allied health professionals can potentially be used across other disciplines that require clinical supervision. In order to enhance and provide a more conducive environment for learning and supervision, some of these suggestions for improvements for the current framework for clinical supervision can be considered.