Introduction: For healthcare organizations to adapt and improve, staff need to speak up for patient safety and quality improvement. Speaking up has been explored in nursing and medicine with little known about speaking up in allied health. This study is part of a larger project investigating speaking up in allied health new graduates. This paper is taking a realist position to look at the perspectives of supervisors of allied health new graduates and further develop the Initial Program Theory (IPT) developed from the new graduate study. Method: Data was collected from two focus groups. Inductive thematic analysis was employed to develop themes and further realist informed analysis was completed using context-mechanism-outcome configurations leading to a refined IPT. FINDINGS: This study reports on the causal mechanisms and contextual features which supervisors believe activate speaking up in new graduates. A further developed IPT which combines findings from both studies will be introduced. CONCLUSION: Supervisors of allied health new graduates are aware of the complexity of speaking up in healthcare. Taking a realist position, this study has highlighted the importance of professional supervision and cultural supervision in speaking up for allied health new graduates.

Author Bio(s)

Philippa Friary, BSLTHons and registered Speech-language Therapist, is the Director of Clinical Education for the Speech Science programme at The University of Auckland, New Zealand and currently completing her PhD.

Prof Suzanne Purdy (Te Rarawa, Ngāi Takoto), NZOM, PhD, MSc, DipAud, registered Audiologist, is currently Head of School of Psychology. The University of Auckland, New Zealand.

Prof Lindy McAllister, PhD, is Professor of Work Integrated Learning in the Work Integrated Learning (WIL) Unit and Assoc Dean of the Faculty of Health Sciences, University of Sydney, Australia.

Prof Mark Barrow, EdD, MSc, GDipTchg, was appointed Dean of the Faculty of Education and Social Work in 2018, The University of Auckland, New Zealand.

Dr Rachelle Martin, PhD, MHSc, DipPhys, registered Physiotherapist, works as a Lecturer with the Rehabilitation Teaching and Research Unit (RTRU) in the Department of Medicine at the University of Otago, Wellington, New Zealand.


Thank you to the participants who gave their time and energy to this study.





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