Summary of - Access to and effectiveness of clinical supervision for allied health workers: A cross-sectional survey.

Title of Original: Access to and effectiveness of clinical supervision for allied health workers: A cross-sectional survey.
Authors: David A. Snowdon, Fiona Kent, Melanie K. Farlie, Nicholas F. Taylor, Owen Howlett, Sharon Downie & Marcus Gardner
Journal: Medical Teacher, 2024
DOI: https://doi.org/10.1080/0142159X.2023.2271158

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Why This Matters - Many allied health workers—especially senior, rural, and diagnostic staff—lack effective supervision, despite its proven role in wellbeing and patient care. This study offers detailed evidence on who misses out, how well supervision works across sectors, and what strategies can improve its delivery.

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Read Time - 5 Minutes

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This cross-sectional survey study investigates both access to and effectiveness of clinical supervision among allied health workers in Victoria, Australia. Clinical supervision is known to reduce burnout and improve care quality, yet little is known about its uptake across this diverse workforce.

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Using the Manchester Clinical Supervision Scale (MCSS-26) and open-ended qualitative questions, the study captured responses from 1,133 allied health professionals across disciplines, locations, and settings.

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1. Access to Clinical Supervision

• 28% of respondents reported receiving no clinical supervision.

• These workers were more likely to be:

  • In management roles

  • Based in regional or rural locations

  • From medical imaging disciplines

  • Male, longer in their role, and already supervising others

• Top reasons for not receiving supervision:

  • No supervisor available

  • Belief that supervision was not necessary

This suggests a cultural gap in valuing supervision at senior levels and in certain specialties, with implications for burnout risk and care quality.

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2. Effectiveness of Supervision (MCSS-26 Scores)
Of those receiving supervision (n=814), 720 completed the MCSS-26. Key findings:

• Overall average score: 78.7 (effective threshold ≥73)

• Psychologists reported the highest scores (84.8)

• Dietitians and Allied Health Assistants scored lowest

• Private practice settings rated highest, hospitals lowest

• Regional areas rated supervision more effective than metropolitan

Among Proctor’s domains:

• Formative (skills): highest rated (79.5/100)

• Restorative (emotional support): strong (77.2/100)

• Normative (accountability): weakest (70.9/100)

This indicates supervision is better at supporting reflection and skills than enforcing clinical standards.

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3. Quantitative Regression Analysis
Regression confirmed statistically significant differences in supervision effectiveness based on:

• Discipline:

  • Dietitians scored 8.4 points lower than psychologists

  • Allied health assistants scored 5.8 points lower

• Location:

  • Metropolitan workers scored lower than regional peers

• Setting:

  • Private practice outperformed hospitals, education, and community health

  • Hospital-based workers scored 10.2 points lower than those in private settings

This suggests that workforce structure, autonomy, and organisational culture impact supervision success.

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4. Qualitative Themes – Barriers and Solutions
From open-ended responses (n=352), six strategic themes emerged:

To improve effectiveness:

1. Alternative supervision models (e.g. peer/group supervision)

2. Dedicated supervision time during work hours

3. Education and training in supervision delivery and feedback

To improve access:

1. Formalised inter-service supervision relationships for rural staff

2. Managerial support and prioritisation

3. Funding for alternative supervision methods

Illustrative quotes revealed deep frustration among staff lacking access and a desire for more skilled, relational supervision structures.

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5. Implications

1. Senior clinicians may resist supervision due to outdated beliefs—missing the restorative and reflective benefits.

2. Medical imaging and diagnostic workers, often outside traditional supervision cultures, are under-served.

3. Private practice settings may excel due to smaller teams, higher autonomy, or self-selection of motivated staff.

4. Organisational investment is needed in supervisor training, funding, protected time, and model flexibility.

 

6. Limitations

• Qualitative data depth was limited by the survey format.

• Study was conducted during COVID-19, which may have affected access or perception of supervision.

• Response rate was unknown, though this remains the largest allied health supervision survey to date.