This qualitative systematic review aims to identify the supervision models physiotherapists engage in, identify the barriers and facilitators, and propose best practice recommendations based on a synthesis of available literature.
A systematic search of five electronic databases (Scopus, ProQuest, MEDLINE, CINAHL, and APA PsycInfo) was conducted using a pre-determined search strategy to capture relevant studies published from 2000 to March 2024. Studies were screened and selected using Covidence software, following PRISMA guidelines. Data was extracted and synthesised using thematic synthesis to identify key themes and subthemes. Relevant findings were grouped and analysed to inform best practice recommendations.
The search yielded 1957 studies, and 37 were included in the final analysis after screening. Four key themes and ten subthemes for practice were identified, including organisational factors, supervision systems, supervision styles and individual factors. The subthemes highlighted the interrelated barriers and facilitators to effective supervision, emphasising the need for tailored and flexible approaches to meet the diverse needs of physiotherapists.
The focus on direct skills and the ability for informal sessions emerged as a priority for physiotherapists. Time constraints, workload issues, resource limitations, lack of formal training, and insufficient support from healthcare organisations were major barriers to effective supervision. Building a successful supervisory relationship that fostered trust and mutual motivation was critical. Best practice recommendations emerged, emphasising the importance of the supervisees' goals underpinning the supervision process, supported by a flexible approach tailored to physiotherapy's practical, hands-on nature. Organisations are pivotal in cultivating a supportive environment and providing training and resources.
The review highlights the critical role of supervision in promoting workforce retention, emotional well-being and advancing professional practice in physiotherapy. Physiotherapists need training and education on supervision to improve the individual and organisational value of the practice while engaging in flexible models based on their needs and goals. Further research is required to develop and implement supervision models for physiotherapists based on best practice recommendations, investigating the frequency and duration of supervision with the balance of formal and informal sessions.
This review uniquely synthesises existing supervision models for physiotherapists, identifying critical barriers and facilitators to effect engagement. It offers practical best practice recommendations tailored to the needs of physiotherapists, advocating for flexible, individualised models that cater to varying career stages and goals. This review contributes new insights that could improve workforce retention and the emotional well-being of physiotherapists, which is crucial in anticipated global healthcare worker shortages.
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