The use of long-arm (indirect) supervision for nursing, midwifery and allied health professionals in health and social care settings: A systematic literature review

Background: Internationally, critical shortages of healthcare workers have been reported. Indirect supervision is one educational approach which has the potential to expand placement opportunities for the future healthcare workforce. However, its use across healthcare professions is yet to be systematically reviewed. Objectives: To evaluate the use of indirect supervision across nursing, midwifery and allied health professionals in health and social care settings. Design: Systematic review. Review methods: Searches in six databases (CINAHL, MEDLINE, APAPsych Info, Web of Science, Scopus and PubMed) were conducted. Grey literature and handsearching were also conducted. Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines were used for this review. A total of 493 titles and abstracts were screened. The quality of the included studies was evaluated using the Quality Assessment with Diverse Studies (QuADS) tool. Results: A total of 25 articles were included. Three overarching themes were identified: (1) Professional identity, (2) Educational approaches and (3) Educational outcomes. Approaches to what constitutes indirect supervision varied widely and inconsistencies were found in the reporting of the placement model. Supervision, support and preparation were perceived as vital for positive outcomes of these placements. Higher levels of learning were reported, although challenges were also discussed. Conclusions: This review highlights the variability in approaches to indirect supervision. Positive perceptions around using indirect supervision in health and social care settings has been widely reported, however further research is warranted to explore this across professions. Systematic review registration PROSPERO: CRD42023418302.