***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
    ***DOCUMENTATION*** 
    ***EXAMPLES*** 
    Input: In this article , we report findings from a study aim ed at developing the content and implementation of a manual for a research -based intervention on clinical supervision of mental health nursing staff . The intervention was design ed to strengthen already existing supervision practice s through educational preparation for supervision and systematic reflection on supervision . The intervention consists of three sessions and was implemented on two groups of mental health hospital staff . We present an outline of the manual and explain how the trial sessions made us adjust the preliminary manual . The effects of implementing the manual will subsequently be analysed in an independent r and omised controlled trial Aims : With the increase in the number of systematic review s available , a logical next step to provide decision makers in healthcare with the evidence they require has been the conduct of review s of existing systematic review s. Syntheses of existing systematic review s are referred to by many different names , one of which is an umbrella review . An umbrella review allows the findings of review s relevant to a review question to be compared and contrasted . An umbrella review 's most characteristic feature is that this type of evidence synthesis only considers for inclusion the highest level of evidence , namely other systematic review s and meta-analyses . A methodology working group was formed by the Joanna Briggs Institute to develop method ological guidance for the conduct of an umbrella review , including diverse types of evidence , both quantitative and qualitative . The aim of this study is to describe the development and guidance for the conduct of an umbrella review . Methods : Discussion and testing of the elements of methods for the conduct of an umbrella review were held over a 6-month period by members of a methodology working group . The working group comprised six participants who corresponded via teleconference , e-mail and face-to-face meeting during this development period . In October 2013 , the methodology was presented in a workshop at the Joanna Briggs Institute Convention . Workshop participants , review authors and method ologists provided further testing , critique and feedback on the proposed methodology . Results : This study describes the methodology and methods developed for the conduct of an umbrella review that includes published systematic review s and meta-analyses as the analytical unit of the review . Details are provided regarding the essential elements of an umbrella review , including presentation of the review question in a Population , Intervention , Comparator , Outcome format , nuances of the inclusion criteria and search strategy . A critical appraisal tool with 10 questions to help assess risk of bias in systematic review s and meta-analyses was also developed and tested . Relevant details to extract from included review s and how to best present the findings of both quantitative and qualitative systematic review s in a reader friendly format are provided . Conclusions : Umbrella review s provide a ready means for decision makers in healthcare to gain a clear underst and ing of a broad topic area . The umbrella review methodology described here is the first to consider review s that report other than quantitative evidence derived from r and omized controlled trials . The methodology includes an easy to use and informative summary of evidence table to readily provide decision makers with the available , highest level of evidence relevant to the question posed Clinical supervision plays an essential part in maintaining professional st and ards and in achieving the National Health Service 's objective of a modern workforce . Paradoxically , little is known about how supervisors themselves acquire competence , leading to lament that ' something does not compute ' . To contribute to a solution , a supervisor training manual that guided trainers in delivering continuing professional development to supervisors in an evidence -based approach to clinical supervision  was piloted nationally , in terms of the reactions of trainers ( N = 25 tutors from clinical psychology courses ) and their workshop delegates ( N = 256 clinical psychology supervisors ) . Trainers were allocated r and omly to either manual-alone or to a manual-plus consultancy group . The trainers all rated the manual favourably ( mean rating of 78 % ) , but there was no significant difference between the two groups . However , the supervisors within the consultancy group rated the sessions significantly more highly than their counterparts . It is concluded that brief training in an evidence -based approach appears feasible and acceptable , making more rigorous evaluations appropriate OBJECTIVE Recent studies have recognised that the communication skills learned in the training environment are not always transferred back into the clinical setting . This paper reports a study which investigated the potential of clinical supervision in enhancing the transfer process . METHODS A r and omised controlled trial was conducted involving 61 clinical nurse specialists . All attended a 3-day communication skills training workshop .  Twenty-nine were then r and omised to 4 weeks of clinical supervision  , aim ed at facilitating transfer of newly acquired skills into practice . Assessment s , using real and simulated patients , were carried out before the course , immediately after the supervision period and 3 months later . Interviews were rated objective ly using the Medical Interview Aural Rating Scale ( MIARS ) to assess nurses ' ability to use key skills , respond to patient cues and identify patient concerns . RESULTS Assessment s with simulated patients showed that the training programme was extremely effective in changing competence in all three key areas . However , only those who experienced supervision showed any evidence of transfer . Improvements were found in the supervised groups ' use of open questions , negotiation and psychological exploration . Whilst neither group facilitated more disclosure of cues or concerns , those in the experimental group responded more effectively to the cues disclosed , reduced their distancing behaviour and increasing their exploration of cues . CONCLUSIONS The study has shown that whilst training enhances skills , without intervention , it may have little effect on clinical practice . The potential role of clinical supervision as one way of enhancing the clinical effectiveness of communication skills training programmes has been demonstrated . PRACTISE IMPLICATION S : This study raises questions about the effectiveness of training programmes which do not incorporate a transfer element , and provides evidence to support the need for clinical supervision for clinical nurse specialist BACKGROUND It is cl aim ed that  clinical supervision  contributes to clinical governance of healthcare services , but many cl aims for its positive effects are unsubstantiated . AIM To test relationships between supervision , quality of nursing care and patient outcomes . METHOD A r and omised controlled trial was conducted across Queensl and , Australia , supplemented by qualitative data collection . RESULTS Supervision had sustainable beneficial effects for supervisors and supervisees . The individual performance of clinical supervisors was affected by the culture of the organisation . A positive relationship between supervision , quality of care and patient outcomes could not be established statistically , except in one location . DISCUSSION AND CONCLUSION Proposals are made for future supervision implementation and further research is required 
    Output:
    
Despite insufficient evidence to directly inform the selection and implementation of a framework , the limited available evidence can inform the design of a new model of clinical supervision for UK-based midwives