Clinical Placement Model Research Articles

Exploring the impact of clinical placement models on undergraduate midwifery students

Learning undertaken through clinical placements provides up to 50% of the educational experience for students in pre-registration midwifery courses. However little is known about of the impact various models of clinical placement have on the learning experiences of undergraduate midwifery students. Two clinical placement models have been employed for undergraduate midwifery students at Monash University, including the block placement model and the continuous two days per week model. This project sought to explore the learning experiences of students in these two models of placement. Focus groups were held on two campuses with a total of 17 students from different cohorts and programs. No one type of placement was favoured over another both had benefits and disadvantages. Further, this study found that regardless of program and clinical placement model the major learning impact for students was related to the midwife they worked with each day on placement rather than to the model. No one type of placement was favoured over another both had benefits and disadvantages. Further, this study found that regardless of program and clinical placement model the major learning impact for students was related to the midwife they worked with each day on placement rather than to the model.

Outcomes of a clinical partnership model for undergraduate nursing students

Background: Over the last decade several innovative approaches to enhance students’ transition to graduate nurse year have been implemented or piloted. This paper describes a study that investigated how the social practices of clinical partnership placement model underpin workplace learning for undergraduate students as they transitioned to graduate. Methods: A mixed method approach was utilized comprising individual interviews with students, observation of clinical workplaces across six different areas of nursing practice, student surveys of the clinical learning environment and participant workshops. Results: Three themes were identified that influenced participants’ preparedness for work and enhanced the transition into the workplace: ‘organizational familiarity’, ‘continuity’ and ‘social participation’. Conclusion: A clinical partnership model offers a degree of work readiness for novices when commencing their professional practice role. It enables individuals to participate and engage in workplace activities which are a central component of their learning.

A Possible Alternative Model of Clinical Experience for Student Nurses

Commencing in February 2008, an alternative model for clinical placements was developed. Second- and third-year students were placed in a weekly clinical placement model and many provided valuable feedback. This article provides an overview of formal evaluations of the model. Recommendations from this study were based on perceptions from students and outline ways of significantly facilitating students in the learning environment along with the delivery of required theoretical knowledge.

An international study of clinical education practices in speech-language pathology

This study identified the clinical placement and supervisory models used within 45 speech-language pathology professional preparation programs in seven English-speaking countries and the drivers influencing the adoption of these models. University personnel completed an on-line survey about the placement and supervisory models used in their programs, their opinions regarding the effectiveness of the models in developing student competency, and the factors influencing the adoption of different models. Responses from the survey were analysed through descriptive statistics and thematic analysis. “Traditional” placement models such as block and weekly placements, as well as traditional supervisory models utilizing a speech-language pathologist as supervisor in a 1:1 student-to-supervisor ratio were the most widely used in the clinical education of speech-language pathologists. “Non-traditional” models, where the overall structure of the practicum experience or the delivery of supervision within the practicum experience has been altered from the traditional models, were used with differing frequency across countries. The major influences on the adoption of non-traditional models included attitudes about the effectiveness of the models, availability of placements, standards of professional associations, and student learning outcomes, particularly in relation to exposure to clinical sub-groups. Further evidence regarding the effectiveness of both traditional and non-traditional placement and supervisory models needs to be developed. To develop this evidence, consistent terminology and a shared understanding of terminology needs to be established.

Lost in translation: barriers to learning in health professional clinical education

AbstractThe perennial debate concerning the so‐called ‘theory‐practice gap’ pervades health professional education. It is uncertain whether this gap – the notion that knowledge gained in university does not translate well into the workplace – is unavoidable or if it is a manifestation of the learning approaches used and the cultures operative in the two locations. This paper examines how nursing students’ knowledge and skills gained within university clinical laboratories transfer into the reality of the clinical environment. A series of one‐on‐one interviews were conducted over a two year period with second and third year nursing students (n = 28) participating in a preceptorship clinical placement model at one healthcare organisation. This paper focuses on data from the students' first interview. Data were transcribed and imported into NVivo 8 for thematic analysis. Four key themes emerged, including: ‘How I learn’ which focuses on students’ perceptions of their learning preferences; ‘Lack of engagement – it’s not real’ which concerns a perceived lack of authenticity of clinical laboratories; ‘Lack of affordances’ relating to the learning opportunities available in the clinical setting; and ‘Teacher Impact’ which focuses on the influence of individual teachers on student learning. The ‘parallel universes’ of academia and the workplace create dissonance for students as they juxtapose the authenticity of the clinical laboratories with the reality of professional healthcare practice. Transfer is inextricably linked with the individuals’ learning preferences, the affordances the workplace offers to students, and the willingness of staff to provide exciting, engaging learning opportunities. The challenge for health professional education is to provide a model of clinical education that meets not only the needs of university and clinical staff, but most importantly, the needs of students.

Developing a practice-academic partnership logic model

This article will describe a testable logic model for practice-academic partnerships. The model can be used to build collaborative practice capacity between academic and practice partners. A deductive approach was used to construct a logic model based on the best theoretical evidence in the research literature. The model was tested and refined over the course of a year, based on the collection of inductive evidence to support the theoretical model's components and linkages. This article will describe how the logic model served to guide School of Nursing faculty and nurse leaders from a local, urban community hospital through the process of establishing a successful partnership. Specific examples of the model's inputs, activities, outputs, and outcomes are provided. The partnership is actively engaged 2 years after the initial pilot of the logic model. Significant outcomes have included a new clinical placement model, affiliate academic appointments for practice educators, and research collaborations.

Exploring continuous clinical placement for undergraduate students

Clinical placements are integral to health professional preparatory courses. These placements allow for the application of classroom-based learning into real patient care situations. In doing so, they provide opportunities for applying theoretical knowledge into practice contexts, skills development and socialisation into the chosen profession. However, despite its recognised importance across health professions, little has been written about optimal structures for supporting clinical learning. This paper presents one group of findings from a larger qualitative study aimed at exploring health professional student's clinical experiences and their impact on career intentions. Findings reported here present a group of undergraduate midwifery student's perspectives on a "home" hospital clinical placement model where continuous clinical placements were taken in the same agency (or hospital group) for 2 days per week over the final 2 years of their course. Two main themes emerged from the data analysis, these being, 'familiarity' and 'continuity'. It is concluded that continuous placements in the same clinical setting have the potential to offer greater opportunities for learning and early professional socialisation than traditional block (Monday to Friday) placements. They can offer a more integrated approach to classroom theory and its application into practice.

Students’ perception of the psycho-social clinical learning environment: An evaluation of placement models

Nursing is a practice based discipline. A supportive environment has been identified as important for the transfer of learning in the clinical context. The aim of the paper was to assess undergraduate nurses' perceptions of the psychosocial characteristics of clinical learning environments within three different clinical placement models. Three hundred and eight-nine undergraduate nursing students rated their perceptions of the psycho-social learning environment using a Clinical Learning Environment Inventory. There were 16 respondents in the Preceptor model category, 269 respondents in the Facilitation model category and 114 respondents in the clinical education unit model across 25 different clinical areas in one tertiary facility. The most positive social climate was associated with the preceptor model. On all subscales the median score was rated higher than the two other models. When clinical education units were compared with the standard facilitation model the median score was rated higher in all of the subscales in the Clinical Learning Environment Inventory. These results suggest that while preceptoring is an effective clinical placement strategy that provides psycho-social support for students, clinical education units that are more sustainable through their placement of greater numbers of students, can provide greater psycho-social support for students than traditional models.

Evaluation of Physiotherapy Clinical Educational Models: Comparing 1:1, 2:1 and 3:1 placements

Summary Nationally there is an increasing problem of clinical placement shortages for physiotherapy which is likely to become worse with the implementation of Government National Health Service plans. The purpose of this study was to compare experiences of clinical educators and students using three different clinical placement models. Method Eight clinical educators volunteered to experience 1:1, 2:1 and 3:1 placement models; 48 third-year physiotherapy students volunteered to attend these placements. Data were collected by face-to-face interviews with educators and students at the end of each placement. Department managers and visiting tutors were also interviewed when all the placements were completed. All interviews were recorded on audiotape, transcribed verbatim and assessed for accuracy. The data were analysed thematically using NVIVO software and assessed for reliability and validity. Results Themes emerged that had an effect on the success of a placement. These included the time the educator spent with individual students, size of department, number of patients and availability of accommodation. The experiences of the interviewees suggest that each of the models has advantages and disadvantages, but they all provide valuable learning opportunities. The results indicate that the success of any placement model depends heavily on how the placement is planned. Conclusion It is evident from the findings that all three models investigated have a place in physiotherapy clinical education. The 2:1 and 3:1 models provide different learning opportunities from the 1:1, but are no less important; they can now be promoted in the clinical setting with more evidence to support their use. If implemented these models will contribute to increasing placement numbers while still maintaining high quality learning environments for the students and rewarding experiences for the educators.

The 2:1 Clinical Placement Model: Perceptions of clinical educators and students

Summary Background and Purpose The need to increase availability of practice placements for undergraduate physiotherapists is now critical, particularly since higher student numbers have been commissioned with the implementation of the National Health Service Plan ( DoH, 2000 ). Exploration of non-traditional placement models which promote peer learning and accommodate more students has been proposed ( Baldry Currens and Bithell, 2000 ). This paper examines perceptions of clinical educators and students regarding the 2:1 model (two students placed with one educator), both as a learning experience and with regard to practical aspects of its management. Methods Thirty-four 2:1 placements in 12 National Health Service trusts were studied. Clinical educators new to the 2:1 model, and students from six academic institutions participated. Qualitative in-depth interviews and questionnaires were conducted in the final placement week. Interviews were audio-taped and transcribed verbatim. Data (original words and phrases from interviews and questionnaires) were subjected to a six-part content analysis and coded into emerging themes and issues. Findings were checked with peers from six groups of clinical educators and one group of students. Findings Thirty-seven clinical educators and 61 students were interviewed; questionnaires were returned from 34 clinical educators (91.9%) and 59 students (96.7%). At interview 35 clinical educators were willing to use the 2:1 model again, and in questionnaires almost all students valued peer discussion (98.3%) and peer support (81.4%). 2:1 models were considered feasible in all clinical specialties studied and for all student years. Interaction with peers was perceived to enhance the quality of placement learning, although clinical educators expressed uncertainty regarding relevant teaching and learning strategies. Although clinical educators expected difficulties in managing competition and difference between students, these aspects were rarely problematic in practice. Placements were most successful and time management most efficient when students treated more than 50% of the clinical educator's caseload. Conclusions The 2:1 model was perceived as successful by clinical educators and students in all years of study. It has potential to enhance student learning, and is appropriate for use in a variety of clinical settings.

The 2:1 Clinical Placement Model: Perceptions of clinical educators and students

The 2:1 Clinical Placement Model: Perceptions of clinical educators and students

Dedicated Education Units: 2 An Evaluation

This paper reports on an evaluation of a new concept in clinical nurse education: the Dedicated Education Unit (DEU). Developed by the School of Nursing, The Flinders University of South Australia, the DEU aims to optimise under-graduate student learning through enhancement of the clinical learning environment and collaboration between clinicians, academics and students. Three DEUs involving 91 students were evaluated, using primarily summative methods to elicit positive and negative attributes of the DEUs. Outcomes indicated that the DEU is a highly appropriate clinical placement model. (Part one of this paper explained the rationale for the DEU and its key features.)