CTiBS Blog

June 7, 2023

New Research: A Primer for Understanding and Utilizing Telesupervision with Healthcare Trainees

Take a look at this Journal of Technology in Behavioral Science (JTiBS) article examining telesupervision practices within healthcare published by Perle and Zheng (2023).

Introduction

The COVID-19 pandemic has led many professions to reflect on the appropriate use of technology within supervision and training. This article highlights special considerations for supervisory practices around technology within healthcare. Authors define telesupervision as “supervision of a trainee from a distance through the use of technology”.

Targets of Supervision

The article highlights specific skills that may be targeted within supervision in a healthcare setting.

• Trainee’s clinical skills
• Interpersonal skills
• Documentation skills
• Ethical/legal adherence
• Telehealth-specific skills

Methods of Telesupervision

The article also highlights a variety of options for providing supervision services using technology.

• Live-Monitoring Only: Supervisor observes in real-time without intervening in patient care.
• Live-Monitoring with Intervening: Supervisor observes in real-time while supplementing information and assessment as needed.
• Live-Bug-in-the-Ear: Supervisor observes in real-time while providing audible feedback to trainee through a one-way receiver in the trainee’s ear.
• Live- Step Out: Supervisor observes in real-time and trainee will “step out” of the appointment to receive feedback before returning to the appointment with the patient.
• Scheduled- Case Review: Trainee shares information with supervisor in advance of feedback being received.
• Scheduled- Audio and/or Video Review: Trainee provides audio/video recordings of appointments that are reviewed by supervisor before feedback.

Benefits of Telesupervision

The article highlights various benefits of telesupervision in practice. Benefits of telesupervision include access to more specialized supervisors, promotion of equity and inclusion, greater breadth of knowledge from supervisors, reduced costs to trainee and supervisor due to reduced travel time, increased scheduling flexibility, and the potential to reduce perceived impacts of hierarchical issues between trainee and supervisor.

Challenges or Special Considerations of Telesupervision

Challenges include potential data breaches and confidentiality concerns, need for further planning, need to develop a backup plan should the initial supervision plan not be possible, planning for patient emergencies, need for further self-monitoring to reduce supervisor distractions during supervision, possible re-budgeting of time to allow for additional discussion of the impact of technological factors in service, and consideration of interjurisdictional factors with the possibility of practicing across state lines.

Approach to Telesupervision

The article highlights a possible 4 pronged approach to completing telesupervision. These components include:

1. Review, assess, and provide feedback on trainee’s clinical activities
2. Discussion of technological factors (e.g., issues that presented and how they were addressed)
3. Discussion on how technological factors interacted with clinical services to enhance or hinder healthcare services.
4. Develop a plan for future appointments.

Qualities of Effective Telesupervisors

• Strong clinical skills
• Ability to adapt skills across technological modalities
• Good organizational abilities
• Refined note-taking skills
• Recognition of the need to enhance specific teaching methods via different mediums of technology
• Appropriate understanding of technology to assist the trainee in troubleshooting
• High level of patience

This article highlights important considerations in providing telesupervision within healthcare. The article acknowledges that further training may be necessary for supervisors to understand the complexities of adapting skills over technology and ensuring competent practice.