Supervision may occur in any of the following ways, or in combination10:
- On a day-to-day basis
- Structured one-to-one sessions
- In a group environment.
Direct – supervision is required when students are undertaking clinical skills and care for the first time, with higher risk patients or where their confidence/competence suggests they require it. Direct supervision involves direct observation of skills and practice in real life contexts. Direct supervision can be delegated to other appropriate members of the care team.
Day-to-day supervision – Is conducted where the student has access to their supervisor in “real time” to facilitate the delivery of patient care. The supervisor may provide physical or “hands on” assistance if required to build clinician conﬁdence and to support the delivery of safe patient care.
Structured supervision - Is for more advanced students. It involves allocating placement activities and roles and having structured time together. The supervision session time should be protected and prioritised by both the student and the supervisor. Supervision should be conducted in an appropriate environment that facilitates patient care/case discussion, reﬂective practice, and the setting and monitoring of learning goals and objectives. In the case of rural or sole/isolated clinicians, structured supervision may be done by telephone, videoconference or online.
Group supervision – The purpose of group supervision is to provide a forum for facilitated open discussion and learning from each other’s experiences. This may include clinical case discussions, topics of interest, interprofessional collaboration and team work. Group supervision is lead by a clinical supervisor and can be conducted face to face or via the use of telehealth and online technology, particularly for rural, remote or sole practising clinicians.
For supervision to be effective, it is recommended as a minimum that day-to-day supervision is provided in conjunction with one-to-one structured supervision sessions at a frequency relative to the students experience and years of practice.
Supervision in a shift work environment – For some placements, particularly nursing in ward environments, a consistent supervisor may not possible due to shift work requirements. In these situations it is even more important to ensure there has been good planning. Ideally a ‘prime’ supervisor should be nominated for each student who can oversee the placement. Ensure a placement plan is developed and encourage the student to take responsibility for ensuring they work with their ‘shift supervisor’ each shift to progress attainment of their learning objectives.