The nursing profession is generally regarded as important and highly relevant to society, but in the public debate it is often associated with staff shortages, poor working conditions and low pay. The working days are often hectic, which creates stress within healthcare teams.

These demanding conditions can lead to conflicts within the teams that become entrenched and can only be resolved with external help. The traditional approach is to recommend so-called supervision by external consultants. “However, many carers and nurses have had bad experiences with supervision,” says Andre Terjung from the Frankfurt University of Applied Sciences. It is often perceived as condescending and as an unwanted interference from outside. Supervision also costs a lot of time and money, which the organisations usually don't have.

Terjung knows what he is talking about, as he has worked in the healthcare sector himself and is familiar with the particular stresses and strains that the profession entails. Therefore, he has been working on an alternative solution over the past few years after coming up with the idea for the POINTED project. Together with the Faculty of Design Computer Science Media at the RheinMain University of Applied Sciences, the Frankfurt researchers have developed a media-supported intervision concept and optimised it in close collaboration with various healthcare teams.

The teams organise the training independently

The intervision centres on the advice provided by team colleagues. “Unlike typical supervision, the intervision concept takes effect before conflicts even arise,” explains Prof Dr Ulrike Schulze, head of the project at the Frankfurt University of Applied Sciences and Managing Director of the Hessian Institute for Nursing Research. “It also enables nurses and carers to help themselves within the team and thus solve problems independently.”

To help participants get started – “Every minute can be too much in the tightly scheduled day-to-day care routine,” says Andre Terjung – the intervision begins with short digital individual training sessions that they can carry out using a specially developed app. This is followed by four team training sessions in which the team gets together to watch training videos. 

Andre Terjung and his colleague Sabrina Khamo Vazirabad have methodically and didactically underpinned, developed, and optimised the training videos step by step. Only a third of the training sessions consist of content for listening. The remaining two thirds are exercises and hands-on activities, starting with simple team-building activities and extending to the assessment of everyday care situations.  

The idea is that the participants learn to use their respective skills to support each other. “This form of self-empowerment can be enormously helpful not only within the team,” says Terjung. “It also helps nurses and carers to better represent their decisions and arguments to doctors and superiors.” The teams organise their team training sessions themselves, once again focusing on their own empowerment.

The challenges are similar everywhere

The POINTED team also accompanied the participatory development of the training courses from a scientific perspective. Therefore, the healthcare teams involved were chosen to be as diverse as possible: They came from 20 different institutions such as hospitals, outpatient care services, or special needs care. Nevertheless, the researchers found that the differences between the teams – regardless of the sector – were generally smaller than the differences between people within a team. 

In other words: All healthcare teams, regardless of their specialization, had to deal with similar interpersonal challenges. They were all characterised by different diversity features, such as a wide range of qualification levels, a different understanding of care and nursing, and individual approaches to their work.

In addition, the researchers were able to identify different communication types over the course of the project, which they ultimately summarised in a paper (Terjung et al., 2025). “These different communication types each have their own competences that they can use to support each other – which is another aspect that the teams learn during intervision,” explains Terjung.

It's the details that matter

The iterative approach of developing a concept in numerous feedback loops originates from media science. The team members who came from a nursing science background were unfamiliar with it at first, but ultimately it was the key to success: the researchers were able to optimise many details that they would never have thought about without feedback from the healthcare teams. “For example, how the remaining time for an exercise is displayed in the training videos: We found out that a time bar running down works much better than a time indication in the form of a number,” says Terjung.

The recent Covid pandemic might have severely impaired the project, but in the end, it turned out to be helpful: Since the whole care sector was isolated and heavily overstrained during this time and physical meetings were impossible anyway, the entire iteration process was carried out through digital meetings. “This allowed us to go through more iteration cycles than we initially planned and to proceed in smaller steps,” says Terjung. This led to significantly better results, as the training videos could be customised down to the smallest detail.

The team was able to finalise the training material in time for the end of the project in December 2024. The next step now is to publicise and disseminate the concept across healthcare facilities, since the material is ready for use: Any interested healthcare team can get started with intervision. 

However, Terjung believes that it still requires a bit of a push: even if the training courses are organised and carried out autonomously, each healthcare facility needs people who are enthusiastic about the concept and initiate the process. Terjung and his colleague Sabrina Khamo Vazirabad plan to support such “instigators” for a while. They want to accompany the intervision for one to three years with a few hours of work per week and thus establish the corresponding skills in the various facilities. “And then,” says Terjung, “the media-supported intervision will hopefully run all by itself.” Prof. Dr Schulze sums up: “Enabling nurses and carers to analyse problems in a team and find solutions themselves is fundamentally a central approach to professionalisation in nursing.”