Clinical Supervision: A Positive Thing For All Practitioners and Physicians

            So lots of social media about negative aspects of having to have clinical supervision and/or collaboration from individuals in states where nurse practitioners (NPs) are seeking full practice authority (FPA). I will state up front, there is no valid argument against those will lesser training to have clinical oversight and/or supervision and/or collaboration from those with more education and training. It’s not negative but rhetoric talking points are tying to take a good thing and spin it into a negative thing. This is wrong. There are weak arguments against it such that is a barrier somehow towards individuals practicing to the full extend of their education and training. This statement doesn’t even make sense. As a former NP, I never understood what this statement means. Look at the pictures above – when googled for images, nothing negative came up but we are being led to believe that now clinical collaboration is somehow a barrier. How I ask? Just how is having someone smarter, more educated, wiser giving us knowledge a barrier in one’s practice?  

            Social workers, psychologists, professional counselors, occupational therapists and other professional disciplines mandate clinical supervision to those with less education and training by those with more education and training:  This idea of supervision being linked to quality assurance1in other words, it is common knowledge in the literature that it is a good thing leading to better practices. 

The term “clinical oversight” was developed to describe patient care activities performed by supervisors to ensure quality of care.”2

            Ironically, even nursing literature reports as such:

“Despite acknowledging tensions, we argue that clinical supervision is both necessary and beneficial. It can be advantageous to individual practitioners and professional groups in enhancing practice and accountability, and promoting professional development.”3

            It is well supported in the medical education community:

“The results of this review indicate that enhanced attending supervision of trainees, especially in activities already supervised to at least the oversight degree, result in positive changes in patient- and education-related outcomes.”4

            There is much more literature out there on the topic that would warrant further review, but the brief literature search and review done here has as it’s consensus that clinical oversight is positive, beneficial, safe, and necessary. Any argument against clinical supervision/oversight is suspect and should be critically scrutinized. 

REFERENCES:

  1. http://citeseerx.ist.psu.edu/viewdoc/download?doi=10.1.1.736.9585&rep=rep1&type=pdf
  2. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2305735/pdf/11606_2007_Article_179.pdf
  3. https://onlinelibrary.wiley.com/doi/pdf/10.1111/j.1365-2648.2004.02986.x
  4. https://pdfs.semanticscholar.org/ec98/b9178fe0d81e89317ddeabd7390489a24ff3.pdf
  5. https://onlinelibrary.wiley.com/doi/abs/10.1046/j.1365-2648.2000.01329.x

Robert Duprey MD

Robert P. Duprey Jr studied medicine as a 2nd career medical student who went to medical school in his 40’s after honorable discharge and ‘retirement’ from 25 years in the US Military (USCG & US Army). He was a registered nurse (RN) with specialty training as a psychiatric RN in the US Army for 15 years. During this time he also became a Master’s level psychotherapist in 2002. While on US Army active duty he also became a Psychiatric Nurse Practitioner while working full time in 2011. He served as a Psych NP on active duty, to include a combat tour in Iraq, until his ‘retirement’ in 2014 and moved to Philippines with his 3 children. At this time he started medical school overseas at Oceania University of Medicine based out of Samoa accredited by Philippine Accrediting Association of Schools, Colleges and Universities (PAASCU). He continued to work as a Psych NP throughout medical school to support his children and to not have to take out loans for medical school tuition. Originally from Rhode Island, he completed medical school clerkship rotations throughout the USA with a graduation in May 2019 earning the esteemed credential of MD. He has successfully completed USMLE Steps 1, 2CS, and 2CK. He will take Step 3 this September as he applies for Psychiatry Residency. Having been and RN, NP and now MD, he is a believer of Physician led multidisciplinary healthcare teams 

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