Professional Experience Placement

To follow on from last weeks blog about the history of  clinical supervision, this paper by Fowler (1996) focuses on the meaning of clinical supervision, as the author indicates it has different meanings for different groups. Fowler (1996) traces the inception of clinical supervision back to the time of Nightingale where senior nurses directed junior nurses.   Fowler (1996) found that  early (1980s)  clinical supervision literature considered it to be ‘a good thing’ (p472) implying that it was rarely formal, however this would be an advantage to the profession and patient care. There was a lack of evaluation or measurement of the value of clinical supervision at this time.

The concept of clinical supervision spread during the 1990s and crept into the nursing vocabulary, but had little impact on the reality of nursing practice or education. The author found in the literature that mentorship developed as task-based nursing declined. Fowler (1996) focused on the terminology used to describe clinical supervision, including preceptorship and mentoring and later discusses the role and function of each. The article moves onto the widespread acceptance of clinical supervision and the idea of supervisors being practitioners in their own right in the UK. There is discussion about the theoretical underpinnings associated with clinical supervision and the concept of developing a formal structure.

Perceptions of good supervision and models of supervision are also addressed in this paper. Elements are espoused and there are: role and function; identification of the elements of the supervisory relationship ;  the process of the relationship; and acknowledgement of the practical nature of both of supervision and nursing. Preparation and training of supervisors at the time of writing indicated preparation for the role at a local level was established, however, national guidelines were vague. Fowler (1996) argues that there was a lack of opportunity for preparation of clinical supervisors and lists four essential skills required to fulfil the role.  These were: skills to identify learning objectives; interpersonally competent; coaching skills; and ability to enable the student to self-evaluate. So it seems although there has been progress in some aspects of supervision, while others are yet to be resolved. The concluding remarks of this author are a call for enabling transition from clinician to supervisor by transfer of established skills in one area to another – clinical supervision.

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