Supervision Tips

Establish open communication channels - communication is key in a successful placement.
  • Discuss your student's communication and learning styles during the first few days.
  • Discuss the types of caseload your student will be expected to carry, how that will change during the placement as well as the amount and type of supervision the student will require.
  • Set boundaries early on as to what is expected from the student and the instructor
  • Try to establish daily wrap-ups even if only for a few minutes, to consolidate the days events
  • Encourage active participation from the student in the discussion
For example: I plan to have you shadow me for the first day and then start involving you in parts of care that I am providing to my current caseload. By the end of the week I hope to be able to give you a new patient. Does that work with your learning style?
Learning plans/SMART goals- Goal setting forms the framework for the learning experience. It also enables adult learners to be more actively involved in the direction and focus of their learning and give clear guidelines as to what is expected from both the student and the CI. Goals should be: SMART (Specific, Measurable, Action Oriented, Realistic and Timelined)

  • Students are expected to establish 2-4 SMART goals but will likely need your input to tailor them to your specific service or population
  • Goals help to outline expectations and can be adjusted during the placement - typically weekly or at midterm.
  • Goals can assist in framing/objectifying your evaluation, especially if the student is struggling.
Examples: I will complete a shoulder assessment with minimal CI input by midterm. I will be able to consistently complete a Berg balance assessment without any safety concerns by the end of week 3.

Feedback - important in moulding practice by reinforcing positive behaviour and addressing areas for improvement. Establish a climate of trust so the student will welcome the feedback, and negotiate with student about which areas they would like feedback on.
  • Ask the student to reflect on an event or their progress through the placement
  • Give honest, specific and timely feedback. Give verbal feedback as often as possible; don't wait for formal midterm and final evaluations.
  • Try to provide feedback in private, especially when related to direct patient care
  • Start by reinforcing positive behaviour and then address areas for improvement. Encourage the student to problem solve for solutions.
  • Clearly outline behaviours that are or could be unsafe. Novice students usually require more detailed feedback
Feedback should be tailored to the student, junior students will require frequent (perhaps daily) specific feedback that may focus on skills and knowledge, intermediate students may require more exploratory questioning to help with clinical decision making and self evaluation. Senior students may direct their feedback and ask for specific feedback that they need and when they need it.

Example: The standing pivot transfer was well done, you stood close to the patient and had good hand position. You did use some jargon in your instructions to the patient, how might you rephrase your instructions next time?

 

Documentation/Evaluation:

  • The Assessment of Clinical Performance (ACP) is designed to evaluate a number of criteria and a full evaluation is usually completed twice, once at midterm and once at final.
  • Significant situations (good and bad) occurring at any time during the placement should be documented under the relevant heading in the ACP when they occur. Date the encounter; include a brief description of the situation, the behaviours observed and the resulting consequences.
  • If, following specific incidents, behaviours have improved, this can be documented alongside the incident with a new date or at final evaluation.
  • Notify the student of the specific event, give them feedback and tell you them you will document it in the ACP and have the student initial the comment.
  • Documented events will provide a framework for evaluation
  • Please review the tips sheet for evaluating students and what the relevant "credits" mean.
Example: Under heading 1. Safety: 09/09/2006.Student X has twice failed to apply the brakes during a wheelchair transfer. Both transfers were stopped prior to the patient being moved. Both incidents have been discussed with the student and the need for brakes with every transfer stressed.

02/10/2006 - All subsequent transfers have been safe and have gone smoothly. Student X is more conscious of safety precautions.

If you are new to clinical supervision it may be helpful for you to sit down with a more experienced therapist to discuss your ideas for the placement or go over troubling students.

Thank you for contributing to and continuing to support the education of our future colleagues.