Swedish clinical supervisors improvised across professions, qualitative study finds

Clinical supervisors in four Swedish interprofessional training wards described their work as improvised, negotiated and unevenly distributed, according to a qualitative study of 16 nurses, physicians, physiotherapists and occupational therapists. The participants generally entered interprofessional supervision with little preparation and developed their approaches through learning by doing, the researchers reported.

The exploratory study examined how supervisors from different health professions conceptualise and enact interprofessional supervision. In interprofessional training wards, students from several professions learn with, from and about one another while providing patient care together. Supervisors play a pivotal role in this arrangement, but the study focused on a supervisory practice that crosses the boundaries of their individual professions.

Researchers purposefully sampled 16 supervisors representing four health professions across four training wards in Sweden. They conducted interviews, transcribed them verbatim and analysed the transcripts using reflexive thematic analysis. Because the study was qualitative, it was designed to explore how participants understood and described interprofessional supervision rather than to measure an intervention, compare professional groups or determine effects on students or patients.

Three themes emerged from the interviews. The first, described as “learning to swim in uncharted waters,” captured participants’ limited preparation and reliance on learning through practice. The second concerned the tension between profession-specific and interprofessional supervision, with supervisors balancing their own areas of expertise against shared interprofessional goals. The third theme, “just call the nurse,” highlighted what the researchers characterized as the unchosen responsibility and unbalanced leadership of nurses. Across the accounts, interprofessional supervision emerged as a practice shaped by continual negotiation, individual improvisation and structural conditions rather than a uniformly defined role.

Nurses’ continuous presence on the wards positioned them as central coordinators of student teams, but participants described this role as demanding and under-recognised. The “just call the nurse” theme reflected the tendency for others to turn to nurses because of their availability, despite the uneven distribution of supervisory responsibility. The findings do not show that any professional group performed better than another, nor did the interviews establish how the practice affects learners or patient care. The results also cannot establish how commonly these tensions occur outside the four Swedish wards studied.

The authors concluded that interprofessional supervision is a distinct but under-supported pedagogical practice embedded in everyday clinical work and shaped by individual, organisational and structural factors. Without clear frameworks and institutional support, supervisory responsibilities can be unevenly shouldered, while tacit improvisation may become the primary approach. They called for supervisor preparation, shared pedagogical frameworks and organisational support to make interprofessional supervision more intentional and shared. Their evidence identifies gaps in support and describes how participants enacted supervision; it does not test whether a particular preparation programme or framework would improve learning outcomes.

Subject of Research: Qualitative study of interprofessional clinical supervision in Swedish training wards

Article Title: Supervising across professions: insights into the art of interprofessional clinical supervision

Article References: Zelić, L., Laksov, K. B., & Sondén, A. (2026). Supervising across professions: insights into the art of interprofessional clinical supervision. BMC Medical Education, 26(1), Article 1450. https://doi.org/10.1186/s12909-026-10355-y

Image Credits: AI Generated

DOI: 10.1186/s12909-026-10355-y

Keywords: interprofessional supervision, clinical education, Sweden, training wards, health professions, nurses, qualitative interviews, reflexive thematic analysis, supervisor preparation, organisational support, Supervising, across