This study addresses the fit between social work education and practice in health care. A random sample of NASW members identifying with health care (N = 179) responded to a mail survey about the utility of core knowledge and roles that we had identified by reviewing seven commonly used health care social work texts. Quantitative data revealed knowledge and roles most frequently used in health care settings as well as differences in roles used dependent upon department name; and different professionals supervising social workers. Qualitative data from four open-ended questions provided suggestions for what knowledge and skills should be taught in social work programs, the best forums/methods for teaching this content, and topics for continuing education. Findings are discussed in relation to six key areas of the peer-reviewed literature: vulnerable populations/diversity, ethical dilemmas, interdisciplinary collaboration, mental health, managed care/accountability, and advocacy. Implications for social work practice, education, and research are discussed.

Goodness of fit: social work education and practice in health care.

Context
Clinical supervision has a vital role in postgraduate and, to some extent, undergraduate medical education. However it is probably the least investigated, discussed and developed aspect of clinical education. This large-scale, interdisciplinary review of literature addressing supervision is the first from a medical education perspective.

Purpose
To review the literature on effective supervision in practice settings in order to identify what is known about effective supervision.

Content
The empirical basis of the literature is discussed and the literature reviewed to identify understandings and definitions of supervision and its purpose; theoretical models of supervision; availability, structure and content of supervision; effective supervision; skills and qualities of effective supervisors; and supervisor training and its effectiveness.

Conclusions
The evidence only partially answers our original questions and suggests others. The supervision relationship is probably the single most important factor for the effectiveness of supervision, more important than the supervisory methods used. Feedback is essential and must be clear. It is important that the trainee has some control over and input into the supervisory process. Finding sufficient time for supervision can be a problem. Trainee behaviours and attitudes towards supervision require more investigation; some behaviours are detrimental both to patient care and learning. Current supervisory practice in medicine has very little empirical or theoretical basis. This review demonstrates the need for more structured and methodologically sound programmes of research into supervision in practice settings so that detailed models of effective supervision can be developed and thereby inform practice.

https://onlinelibrary.wiley.com/doi/pdf/10.1046/j.1365-2923.2000.00758.x

Effective supervision in clinical practice settings: a literature review

Many individuals are motivated to exert effort because they care about their jobs, rather than because there are monetary consequences to their actions. The intrinsic motivation of bureaucrats is the focus of this paper, and three primary results are shown. First, bureaucrats should be biased. Second, sometimes this bias takes the form of advocating for their clients more than would their principal, while in other cases, they are more hostile to their interests. For a range of bureaucracies, those who are biased against clients lead to more efficient outcomes. Third, self-selection need not produce the desired bias. Instead, selection to bureaucracies is likely to be bifurcated, in the sense that it becomes composed of those who are most preferred by the principal, and those who are least preferred.

The Motivation and Bias of Bureaucrats

This paper reviews the status of the social work labor force engaged in supervision as a primary or secondary function based on 1995 data drawn from the full membership of the National Association of Social Workers (NASW). Changing patterns are illustrated through comparisons to 1988 and 1991 NASW data. The demographics, areas of practice, auspice of practice, and career development patterns of this sub-set of social workers are explored. Significant trends include the decrease in the proportion of NASW members holding supervisory positions and the dearth of supervisors in the for-profit sector. These labor force trends are then discussed within the context of actual and potential changes in the purposes and practice of social work supervision, particularly in a managed care environment, and the implications of such changes for the profession.

Supervision in Social Work

Social work as a profession

Preface Acknowledgments1. History, Definition, and Significance2. Administrative Supervision3. Administrative Supervision: Problems in Implementation4. Educational Supervision: Definition, Differentiation, Content, and Process5. Principles and Problems in Implementing Educational Supervision6. Supportive Supervision7. Problems and Stresses in Becoming and Being a Supervisor8. Evaluation9. Group Supervision10. Problems and InnovationsBibliographyIndex

Supervision in social work

Supervision in social work, 5th ed.

This investigation examined skills and relationships in supervised practice to test Shulman's interactional helping theory on the basis of client outcomes. A correlational design was used to determine association among weekly worker ratings of supervisory skills and relationships, and client goal attainment and generalized contentment across sixteen weeks of practice in a community mental health setting. One pattern of findings lent modest and conditional support to subsets of Shulman's theory, but a challenge to the general theory was established by evidence that supervisory skills and relationships have independent associations with client outcomes. Implications were discussed for theory, research, and practice.

The art of helping in supervised practice: Skills, relationships, and outcomes.

This investigation used multiple regression in a cross-lagged panel analysis to test Interactional Social Work (ISW) theory in a challenging replication. ISW is a causal model of change which asserts that workers' practice skills help create positive working relationships, which are the medium through which workers influence practice outcomes. The empirical support for ISW theory comes from research using cross-sectional designs. This replication used a longitudinal design to expose Interactional Social Work theory to causal tests of association, temporal order, and independence. The replication varied the focus of social work supervision governing supervised practice with 161 clients in a community mental health setting, and examined the causal order among skills and relationships of supervised practice and client outcomes over time. The findings support, alter, and introduce links in the chain of Interactional Social Work theory.

Daniel Harkness

Papers

Supervision in social work

Supervision in social work, 5th ed.

The art of helping in supervised practice: Skills, relationships, and outcomes.

Testing Interactional Social Work Theory

The Social Construction of Co-Dependency in the Treatment of Substance Abuse