Healthcare and Medicine Reference
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entire message and the receiver from responding; silence or inactivity
between typed sentences can be interpreted as others not paying atten-
tion or being uninterested; distractions from other people nearby
including family members or other workers.
￿ Advantages: Simplicity; convenience, since group supervision can be
done anywhere at any time including when workers are at home;
some things are easier to write than to say, particularly if you sense
that others in the group will disapprove non-verbally in face-to-face
group conference; the meeting is permanent since it can be saved and
referred to in the future.
Miller, Miller, Burton, Sprang, and Adams (2003) evaluated the use of
interactive TV in the training and supervision of health and mental health
professionals in rural areas. They found the use of telecommunications
technology providing information and care across distance to be an
appropriate, cost-effective means of supporting patients and providers in
the changing health care system. The authors studied a new clinical
internship program in a rural setting, attempting to provide supervision
for allied health interns in related specialties including speech pathology,
physical therapy, occupational therapy, and psychology. The use of inter-
active technologies was augmented by face-to-face supervision, but when
that wasn't possible because of distances and problems in traveling, super-
vision was done by secure email messages and interactive telephone calls
(cameras hooked up to computers that allowed supervisors and students
to talk to and see one another).
Eighty students were supervised by four professionals for 30 weeks.
The supervision consisted of monthly group teleconferences (audio or,
when necessary, video), weekly individual telephone supervision, and
daily or as needed email supervision. Supervisors and clinicians had dupli-
cate copies of tapes of the previous week's clinical encounters to facilitate
supervision. Considering just the interactive portion of the experience,
there were over 20,000 emails, 450 secured fax information forms, and
500 hours of psychotherapy videotape. Communications were catalogued
in a searchable, analyzable database.
While there were many advantages to the use of interactive techno-
logies, not least of which was to provide supervision to workers in rural
or remote areas who might not otherwise be trained, the cost was not less
than if supervisors were present onsite. However, the quality of the
experience was highly rated by workers, and client care seemed consistent
with onsite
supervision. There were, however,
some drawbacks.
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