Aims To establish regular peer review and reflective supervision for paediatricians at both sites of an NHS Trust for a six month period and evaluate participation and learning.
Methods An action research methodology was chosen. Morrison’s 4 × 4 × 4 reflective supervision model was selected because of its focus of improving safeguarding outcomes for children. New documentary output was developed for peer review sessions. To support participation, peer review and supervision sessions were scheduled during monthly clinical governance half-days. Attendance at clinical governance sessions is expected for all available paediatricians. Participation in the evaluation of learning was optional. There are 21 paediatricians permanently employed by the Trust. Their participation, any resultant learning and impact was to be explored through examination of documentary outputs from the sessions including attendance registers and from semi-structured interviews. This service evaluation project was registered with the NHS organisation. The evaluation of learning has approval from a university ethics committee.
Results Experienced supervisors were secured and a steering group established. Six sessions were planned at each site beginning with supervisee training for reflective supervision. Then there was to be alternating sessions of reflective supervision or peer review at each site. For the site with 13 paediatricians, six (6/13, 46.2%) were present for training. Of the subsequent five sessions, only one session has taken place. There were four attendees (4/13, 30.8%) at the reflective supervision session, only two of whom had attended the training. Four of the sessions did not take place. For the site with 8 paediatricians, three (3/8, 37.5%) attended training and none of the five planned sessions happened. Of the nine missed sessions, analysis indicates that unavailability of the Named Doctors for Child Protection accounted for four missed sessions, unavailability of other paediatricians for an additional four and an administrative error for one. The details of the barriers to participation will be presented.
Conclusions Scheduling peer review and reflective supervision during clinical governance half-days did not secure paediatricians’ participation. There has been insufficient participation to evaluate learning or impact on outcomes for children. Future options to support participation will be discussed.
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