JCPSLP Vol 19 No 2 2017

access to continuing professional development for allied health practitioners is vital in providing quality health service delivery based on contemporary practice” (Mason & DHA, 2013, p. 310). Supervision can support SLPs to deal with these increasing pressures, develop the relationship and communication skills required in contemporary practice, and support their ongoing development as professionals. High-quality supervision contributes to the development of the workforce and helps equip staff to negotiate the ever- changing, increasingly complex work environment. This paper shows how these aims may be achieved. What is supervision? Recently supervision has received increased attention in the literature across a range of disciplines and there are a number of definitions of supervision. For the purposes of this paper, we will use the definition of supervision developed for SLPs by SPA: a contractual, relational, collaborative process, which facilitates the ethical and professional practice of the supervisee…an opportunity for the supervisee to reflect on their practice to gain a broader perspective, opening up opportunities for personal and professional growth…a means to ensure the supervisee is accountable to the personal and professional standards of their profession. (SPA, 2014b, p. 4) Supervision may take many forms, such as individual, group or peer supervision. What are the benefits of supervision? Supervision has been found to improve client outcomes across a range of disciplines including medicine, social work, teaching, psychotherapy and nursing (Butterworth, Bell, Jackson, & Pajnkihar, 2008; Kilminster & Jolly, 2000; Lyth, 2000). Further, practitioners under supervision have been shown to improve their skills more rapidly compared to those who are unsupervised (Kilminster & Jolly, 2000). In nursing, supervision has facilitated both personal and professional development of supervisees, increasing creativity, self-confidence, knowledge and participation in reflection (Lyth, 2000) – all factors which contribute to the development of professional expertise (King, 2009a). In social work, Pack (2009) notes supervision is a “co-created space in which a sustained reflection on practice can occur from a mutual understanding of process and a shared experience of learning” (p. 666) allowing supervisees to “tell their story in new ways that promote personal and professional growth” (p. 658). In terms of developing communication and relationship skills, supervision has been shown to improve practitioner– patient relationships and reduce patient complaints (Lyth, 2000). Improvements in the supervisees’ awareness of their own emotional responses to clients, impacting their ability to build and maintain relationships, and manage the dynamics of relationships are noted (Wheeler & Richards, 2007). Supervision can reduce stress in workers, increase morale, job satisfaction and retention, and support staff in the pressure of the complex workplace (Lyth, 2000). Supervision has also been shown to improve self-care, promote personal well-being and resilience and be a protective factor against vicarious trauma (Pack, 2009; Wheeler & Richards, 2007). Therefore, supervision may be said to be vital for sustaining staff in the provision of quality health care.

Supervision can assist in improving client outcomes, developing the knowledge, skills and attitudes of supervisees, increasing communication and relationship skills, and reducing stress and burnout (Kilminster & Jolly, 2000; Lyth, 2000; Pack, 2009). What is the evidence base for supervision? While there is very little published on supervision specific to SLP, several literature reviews have examined the evidence across a range of disciplines including allied health (Fitzpatrick, Smith & Wilding, 2012; Dawson, Phillips & Leggat, 2013), nursing (Lyth, 2000), social work (Pack, 2009), counselling and psychotherapy (Wheeler & Richards, 2007) and across several disciplines (Kilminster & Jolly, 2000; Milne, Aylott, Fitzpatrick, & Ellis, 2008). Although there is broad agreement regarding the benefits of supervision, these reviews highlight some of the complexities in researching supervision including a lack of clear definitions of supervision, with significant overlap with other terms such as mentoring, and variability in the supervisory models employed. A lack of agreement regarding what constitutes effective supervision, the functions and features of supervision, and what training and skills are required for effective supervision, still exists. In considering best practice for supervision in SLP the following areas will be discussed: the process of supervision, the organisational context, the supervisory relationship, reflection in supervision, and models of supervision. Best practice for supervision The process of supervision Pack (2009) recommends that supervision has a clear purpose and contract that addresses the nature of feedback, relationship evaluation, support strategies, and negotiation of clear roles and responsibilities. This can include specific learning objectives, clear plans for supervision sessions (regular agreed times, agenda) and recordkeeping (Kilminster & Jolly, 2000; Milne et al., 2008; Wheeler & Richards, 2007). Supervisors require training for their role (Kilminster & Jolly, 2000; Milne et al., 2008) and both supervisors and supervisees need to be committed to the process (Lyth, 2000; Milne et al., 2008). Organisational context Endorsement and recognition of the value of supervision for staff is important. Optimal supervision begins with the broader organisational context including professional and administrative support for supervision, incentives and training for supervision, and a needs led, system-wide team approach (Milne et al., 2008). King (2009b) also highlighted the importance of the organisational context in considering effective client-centred practice and the development of clinical expertise (King, 2009a) with a focus on support, relationships, and learning required. The development of expertise requires “an environmental context that provides supports, resources and opportunities for optimal experiences and the processing of experience” (King, 2009a, p. 187). It is recognised in SLP that competencies develop on a continuum, continuing a developmental trajectory throughout the career (McAllister, Lincoln, Ferguson & McAllister, 2013). Novices need more direction, explicit instruction, structured learning situations and scaffolding for reflection (King, 2009a) which requires additional

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JCPSLP Volume 19, Number 2 2017

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