Improving access to clinical supervision through action research with community nurses: what are the build and design criteria for an online virtual environment for clinical supervision?

Abstract

Access to clinical supervision is an enduring enigma to many nurses and other healthcare professionals. The aim of this action research study was to bring about the potential for a change in the practice of clinical supervision (CS) by developing a solution to the problem of access. This was achieved in collaboration with community nurses and a range of other staff from one NHS Primary Care Trust. The solution proposed was the development of a new mode of delivery: online clinical supervision.

Holter and Schwartz-Barcott’s (1993) Technical Collaborative Approach was used to identify potential user (Supervisee, Supervisors and Management) requirements for an online environment for CS. The research was conducted in three stages. The first stage ‘Conceptualisation’ involved the identification and exploration of the problem as well as the initial steps in discovering how the problem could be addressed. Central to this was the engagement with the stakeholders. The second stage ‘Designing the Solution’ was a synthesis of activities undertaken by focus groups in order to determine what a potential online environment might look and feel like, as well as how it might function. Analysis was through a continuous, iterative, cyclical process of member checking. Schach’s (1999) Life Cycle Model (adapted) and Lengel’s (2001) Website Design Principles were used as a theoretical frame to guide the solicitation of the required design and build criteria. The final stage was ‘Evaluation’, participants evaluated the design and build criteria they had developed using a SWOT analysis, and finally the experience of undertaking action research was captured through a self completion questionnaire.

In conclusion, this research has identified what an online environment for CS could look like, as well as how it might function, thus opening up the possibility of improving access to CS. The research also highlighted a potential tension between the users’ desire for privacy and the employers’ desire for access to information. Future negotiations are required to determine how this tension could be managed.

The likely impact of this development, if implemented, will be more community nurses and others undertaking CS at a time and place that is convenient to them, potentially making CS available (via a user-centred design) 24 hours-a-day, seven days-a-week a reality.

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