Supervision

Question 1

Models of supervision

Answer 1

Developmental models
Discrimination models
Reciprocal engagement model (R.E.M.-S)

Question 2

Bernard’s discrimination model

Answer 2

Role based model.
Roles that supervisor is taking on:
-teaching (this is what I saw, this is what I would do), consulting (collaborative, working together to assess and come up with a plan), counselling (addressing personal perspectives of student - what seem more comfortable giving information, can we explore that further?), evaluation (figuring out where a students skills are in relation to expectations and communicating that)

Supervision areas of focus:

• process skills (skills and knowledge a student has)
• conceptualization (how a student thinks about a case, preparation, how it is framed)
• personalization (personalizing the session to the patient and also the students experience)

Strength of the model is getting supervisor to thinks about roles they use often and ones they can work on or use more based on student’s need.

Question 3

Developmental models

Answer 3

Supervisees at different stages of training have different characteristics, and therefore need different types of supervision/feedback, often non-linear

-experience level, dependence on supervisor, anxiety, motivation, personal responsibility, professional self-concept, supervision needs, clarity of supervision goals

Interventions and strategies need to be tailored to the developmental level

Question 4

REMS

Answer 4

Specific to GC school
Developed to mirror GC process and supervision process
5 tenets in 3 categories:
-education: learning and applying genetic information are key
-individual attributes: student autonomy must be supported, student’s are capable and their emotions matter
-relationship: relationship is integral to genetic counselling supervision

All work together towards supervision outcomes: students understand and apply information to: independently provide effective services, develop professionally, engage in self-reflective practice

Question 5

Supervision competencies

Answer 5

• Personal traits and characteristics: demonstrate skills and competencies, comfort, patience
• Relationship building and maintenance: show empathy w student, engage w student to establish working alliance, deal with resistance in productive ways, attend conflict
• Student evaluations
• Student centered supervision: encourage autonomy
• Ethical and legal aspects of supervision: seek appropriate consultation in situations of ethical uncertainty, define boundaries of supervisory relationship
• Guidance and monitoring of patient care: elicit students perceptions of patient psychosocial dynamics, adapting to patient, assist student in determining whether the objectives for patient have been met

Question 6

Strategies for effective supervision

Answer 6

Establish clear goals
Disclose expectations 
Describe the evaluation process
Maintain professional boundaries
Create a supportive atmosphere 
Use self-disclosing and self-involving statements when appropriate 
Make feedback constructive

Question 7

Compassion fatigue

Answer 7

Lacking emotional strength, loss of energy
Reduced capacity to provide empathy
Function of bearing witness to the suffering of others

Related: burnout, higher patient volumes, greater variety of types of distressing clinical experiences, more likely to self-criticize/ give up hope

26% of GCs at high risk
57% of GCs at moderate risk

Question 8

Burnout

Answer 8

Negative impact of systemic problems over time
Prolonged exposure to demanding interpersonal situations leading to:
-emotional exhaustion
-depersonalization
-reduced personal accomplishment

Burnout is related to compassion fatigue but not the same