Do Supervisors Agree With A Competency-Based Approach to Clinical Supervision?

Abstract Introduction Workplace-based assessment in competency-based medical education employs entrustment-supervision scales to suggest trainee competence. However, clinical supervision involves many factors and entrustment decision-making likely reflects more than trainee competence. We do not fully understand how a supervisor’s impression of trainee competence is reflected in their provision of clinical support. We must better understand this relationship to know whether documenting level of supervision truly reflects trainee competence. Methods We undertook a collective case study of supervisor-trainee dyads consisting of attending internal medicine physicians and senior residents working on clinical teaching unit inpatient wards. We conducted field observations of typical daily activities and semi-structured interviews. Data was analysed within each dyad and compared across dyads to identify supervisory behaviours, what triggered the behaviours, and how they related to judgments of trainee competence. Results Ten attending physician-senior resident dyads participated in the study. We identified eight distinct supervisory behaviours. The behaviours were enacted in response to trainee and non-trainee factors. Supervisory behaviours corresponded with varying assessments of trainee competence, even within a dyad. A change in the attending’s judgment of the resident’s competence did not always correspond with a change in subsequent observable supervisory behaviours. Discussion There was no consistent relationship between a trigger for supervision, the judgment of trainee competence, and subsequent supervisory behaviour. This has direct implications for entrustment assessments tying competence to supervisory behaviours, because supervision is complex. Workplace-based assessments that capture narrative data including the rationale for supervisory behaviours may lead to deeper insights than numeric entrustment ratings.

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Competency-based Clinical Supervision: Status, Opportunities, Tensions, and the Future

Australian Psychologist ◽

10.1111/ap.12265 ◽

2017 ◽

Vol 52 (2) ◽

pp. 86-93 ◽

Cited By ~ 8

Author(s):

Carol A. Falender ◽

Edward P. Shafranske

Keyword(s):

Clinical Supervision ◽

The Future ◽

Competency Based

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Gaming the system: using transactional analysis to explore dysfunctional processes in clinical supervision

Australasian Psychiatry ◽

10.1177/1039856219848830 ◽

2019 ◽

Vol 27 (6) ◽

pp. 645-650 ◽

Cited By ~ 2

Author(s):

Tony Muller ◽

Shuichi Suetani ◽

Jimsie Cutbush ◽

Stephen Parker

Keyword(s):

Clinical Supervision ◽

Face Validity ◽

Game Playing ◽

Transactional Analysis ◽

Fellowship Program ◽

Supervision Practice ◽

Competency Based

Objective: This paper discusses the ongoing relevance of concepts derived from transactional analysis to understanding the challenges that can emerge in clinical supervision under the Competency Based Fellowship Program. Conclusions: Defensive game playing has face validity as a framework for understanding dysfunctional processes in clinical supervision. Being aware of these concepts may aid trainees and supervisors in promoting effective clinical supervision practice.

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Limitations of Multicultural Supervision in Clinical Neuropsychology

Archives of Clinical Neuropsychology ◽

10.1093/arclin/acz029.70 ◽

2019 ◽

Vol 34 (7) ◽

pp. 1303-1303

Author(s):

M J Cohen ◽

M Fredrick-Keniston ◽

D Jain

Keyword(s):

Clinical Supervision ◽

Self Awareness ◽

Limited Information ◽

Culturally Competent ◽

Clinical Neuropsychology ◽

Multicultural Supervision ◽

Multicultural Practice ◽

Competency Based ◽

General Aspects ◽

And Training

Abstract Multicultural awareness, competency based clinical supervision, and the clinical neuropsychology subspecialties are areas of growing importance in the psychology field. Specific guidelines exist for multicultural practice, clinical supervision, as well as training in clinical neuropsychology. However, there are significantly fewer resources and training procedures that focus on multicultural supervision, very limited information regarding neuropsychology supervision, and almost non-existent resources that address multicultural considerations in clinical neuropsychology supervision. Objective: This Poster highlights the most important literature regarding general aspects of multicultural supervision in psychology, supervision in clinical neuropsychology, while also introducing ideas and considerations regarding the dire need of multicultural supervision in clinical neuropsychology. Method The authors reviewed the literature regarding general aspects of multicultural supervision in clinical psychology, supervision in clinical neuropsychology, and additionally highlighted the gaps related to supervision in multicultural neuropsychology. Finally, they introduced ideas to address some of the needs in the arena of supervision in multicultural neuropsychology. Discussion Available resources that explore, delineate, or evaluate competent multicultural supervision in clinical neuropsychology are absent. Partially, the limited understanding of - and research that focuses on - the influence of diversity in neuropsychological assessment and interventions might explain the lack of resources allotted to competent multicultural supervision in clinical neuropsychology. It is proposed that in clinical, neuropsychology supervisory process (as in therapy supervision) should include a culturally competent supervisor who can assist in the development of self-awareness, knowledge, and skills in order to provide interventions that understand, honor, and respect the clients’ multiple diversity dimensions.

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