Professional Documents
Culture Documents
You are invited to participate in this confidential survey, which aims to evaluate the effectiveness of Clinical
Supervision provided to you at your workplace. There are two sections that will take about 10 minutes to
complete. This investment of your time will provide unique and valuable insights, to help inform the future
development of Clinical Supervision.
Drawing on your current experience of receiving Clinical Supervision at your workplace, please indicate your
level of agreement with the following 26 statements, by selecting the box which best represents your answer.
Do not spend too long thinking about each question; your first response is probably the best one.
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SECTION A Strongly Disagree No Agree Strongly
disagree opinion agree
1
3
Other work pressures interfere with CS sessions
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19 Sessions with my supervisor widen my clinical knowledge ⃘ ⃘ ⃘ ⃘ ⃘
base
20 CS is unnecessary for experienced/established staff ⃘ ⃘ ⃘ ⃘ ⃘
21
22
23
sessions
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24 I can widen my skill base during my CS sessions ⃘ ⃘ ⃘ ⃘ ⃘
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25 My supervisor offers me guidance with patient/client care ⃘ ⃘ ⃘ ⃘ ⃘
26 I think receiving clinical supervision improves the quality of ⃘ ⃘ ⃘ ⃘ ⃘
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care I give
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Which of the following terms best describes your overall level of satisfaction with the Clinical Supervision you
currently receive?
o Very dissatisfied
o Moderately dissatisfied
o Neither satisfied, nor dissatisfied
o Moderately satisfied
o Very satisfied
You have reached the end of Section A; please continue with Section B.
Section B: This section relates to different aspects of your current Clinical Supervision arrangements.
Please answer the questions by selecting the appropriate option, or by entering a number.
About yourself:
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o Other [Please describe] _________________________________________
8. Is your Supervisor: ⃘ Male ⃘ Female 9. Approximately, how old is your Supervisor? [Years] ________
13. How long have you been receiving Clinical Supervision? Years ___ Months___
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o Away from the workplace
o In and away from the workplace
18. Please rank order the following themes between 1 and 4, by how frequently they usually arise during
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your Clinical Supervision sessions. 1 means Most frequent; 4 means Least frequent.
Rank order
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Staff-related ______
Patient/client-related ______
Self-related ______
Work environment-related ______
19. What is the name of the model of Clinical Supervision used in your sessions? If you are not sure, leave blank.
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20. Please enter any additional comments, which are related to your current experience of Clinical Supervision.
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