An Opportunity to Provide High-Quality Training and Care: Use of Telesupervision and Reflection on Practices.

BACKGROUND: Rural populations experience more health care disparities than urban populations, including higher rates of chronic conditions and limited access to health care practitioners and facilities. Because health care professional (HCP) training programs are largely based in urban areas and often shape where early-career clinicians practice, rural communities have fewer opportunities to attract individuals to build sustainable local workforces. As the largest provider of health professions training, the US Department of Veterans Affairs (VA) is well positioned to leverage telesupervision- clinical supervision delivered via synchronous audio and video-to strengthen rural training, support high-quality care, and enhance workforce retention. OBSERVATIONS: This 3-year quality improvement project analyzed 11 rural VA psychology training programs. A total of 3197 monthly questionnaires from supervisors and trainees showed that telesupervision upheld patient safety and supervision quality while increasing trainees' comfort with telehealth care. These findings illustrate how telesupervision can create new opportunities to maintain high-quality training and care by connecting geographically dispersed health care practitioners. The evolving use of telesupervision underscores that clinical supervision is a distinct competency requiring intentional relationship building, direct observation, and structured feedback. CONCLUSIONS: Thoughtfully implemented telesupervision can support safe, high-quality supervision while broadening access to rural training experiences and specialty expertise. For rural VA sites, telesupervision may strengthen supervisors' professional connection, increase trainees' engagement with veterans living in rural communities, and contribute to rural workforce sustainability and improved population health.