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Clinical Supervision Handbook
Toward an evidence-base for clinical supervision in nursing
Does the research on clinical supervision in nursing provide evidence to support the
diverse conceptualizations? Two reviews of the empirical research on clinical supervision
in nursing, one spanning 1990–1999 (Williamson & Dodds, 1999), and the other
spanning 1996–2004 (Jones, 2005) found that different aspects of clinical supervision
are widely studied and described in the nursing literature. This growing interest in
clinical supervision, however, derives mainly from Europe (U.K. and the Scandinavian
countries) and from Australia and New Zealand. There is a paucity of research from
North America (Cutcliffe, 2005; Jones, 2005). The studies reviewed employ surveys
and exploratory interviews with descriptive and systematic qualitative designs and
have begun to contribute to an empirical base. However, investigators note that these
studies address the concept of clinical supervision in nursing while lacking a consensus
about the definition of the term or its components (Yegdich, 1999).
The existing studies contribute to the formation of a definition and all provide
support for its utility. For example, Kelly and colleagues (2001) found that managers
(87.5 per cent), supervisors (85.2 per cent), and the great majority of clinical
psychiatric nurse respondents supported the view that supervision can lead to
personal development.
Studies examined the process of clinical supervision. In one study, it was found that
a focus on the nurse “doing” (defined as the nurse-patient relationship) and not on
the nurse “being” (defined as the nurse as a person) made it easier for nurses to talk
about their feelings and actions (Berg & Hallberg, 1999). A number of studies found
that clinical supervision helps nurses gain knowledge and competence, a sense of
security in nursing situations, and a feeling of personal development (Arvidsson et al.,
2001; Jones, 2003; Magnusson et al., 2002). Additionally, Arvidsson and colleagues
(2001) found that supervision gave nurses a sense of feeling independent, increased
energy, fellowship with others and greater job satisfaction.
Format of clinical supervision
The format of clinical supervision has been investigated by a number of researchers.
In a study of nurses in an acute inpatient mental health setting, Cleary and Freeman
(2005) found nurses preferred ad hoc coping methods such as informal sharing and
support of trusted colleagues rather than a more formal approach. These nurses felt
that one-on-one clinical supervision was impossible due to unit constraints. Clinical
supervision in open groups was difficult to arrange due to staff leaves, rotations and
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