Improving the supervision of therapy assistants in Western Australia: the Therapy Assistant Project (TAP)

Introduction: Multidisciplinary therapy assistants (TAs) are increasingly seen as a model suited to the provision of allied health services in rural and remote areas. Supervision is a key aspect of therapy assistant practice. The rural context presents many challenges in supervising TAs including: a multidisciplinary TA role, outreach service delivery models, inexperienced allied health professionals (AHPs) and a high turnover of AHPs. At present there are no accepted standards for supervising TAs in this context. This study aimed to improve the supervision of TAs by AHPs in a rural setting. Improving supervision formed one aspect of the Therapy Assistant Project (TAP).Methods: Minimum standards for supervision were developed, a process for recording TA supervision introduced, and training in supervision skills was delivered to AHPs. A mixed method study design was used to determine the impact of introducing minimum standards and supervisor training on supervision practices.Results: Minimum supervision standards included: program and administrative discussion, observation, and demonstration of therapy sessions. Methods recommended for supervising allowed regular supervision of TAs in small, distant rural towns. Developing minimum standards for supervision, a process for recording supervision, and training in supervisory skills resulted in increased supervision between AHPs and TAs. AHP and TA participants expressed satisfaction with minimum supervision standards. The frequency and amount of supervision increased although videoconferencing for supervising TAs in distant towns was not widely used for supervision.Conclusion: This study provides a new resource for supervision practices for rural TAs. The minimum standards for supervision would be a suitable resource to assist health services seeking to improve supervision of TAs or commencing a TA program. Further exploration of the use of videoconferencing for supervising TAs in distant rural towns is suggested. Training in supervision skills for AHPs should include introductory and complex supervision methods. This study represents one step in defining standards for rural and remote TA practice.