Innovative Placement Research Articles

Reflecting on Experiences of Senior Medical Students' External Clinical Teaching Visits in General Practice Placements: A Pilot Study.

Australian general practice training uses external clinical teaching (ECT) visits for formative work-based assessments. ECT visits appoint senior general-practitioners (GPs) observe trainee GPs' consultations, provide feedback, and make performance-enhancing recommendations. As ECT visits are one of the best assessment tools in Australian GP training, there is limited evidence of its use in undergraduate teaching. This study aims to introduce ECT visits and evaluate assessment tools during senior medical students' GP placement. This study included external and internal GP supervisors and twenty-five Chinese and Australian students during GP placements. The supervisors provided structured in-person feedback, while the ECT assessment tool used a standardised, validated feedback platform to assess every component of a consultation. Students' feedback was recorded and collected by both internal and external supervisors, and then semantically analysed by external supervisors. Twenty-five ECT visit feedbacks were collected and analysed semantically. All participating students rated ECT visits excellently and confirmed the relevance of assessment tools for discussions with supervisors to achieve the designed learning outcomes. Chinese students rated the assessment tools as innovative from a cultural perspective and recommended the ECT visit teaching model and assessment tools to their home university, whereas Australian students suggested more ECT visits during GP placements. Time management was a limitation for both the students and supervisors. ECT visit is an innovative placement teaching model and work-based assessment tool for senior medical students' GP placements, and is rated as the most preferred formative assessment tool. The limitations of this study include small group of students/supervisors and lack of patient feedback; however, all of these limitations can be overcome by involving multiple GP clinics in ongoing large-scale study. ECT visits can be introduced quantitatively into students' GP placement curricula to improve clinical reasoning, learning, and quality assurance with assessments during clinical placements.

Dietetics student contribution to addressing malnutrition in residential aged care facilities.

To test a model of malnutrition screening and assessment conducted by dietetics students on placement in residential aged care facilities. The secondary aim was to identify possible facilitators and barriers to the implementation of the model. The type 1 hybrid effectiveness-implementation trial study design and reporting outcomes were developed using the Consolidated Framework for Implementation Research. An innovative placement model was developed, where students on voluntary placement visited three residential aged care facilities to identify residents at risk of malnutrition using currently available screening tools for older people. Students completed malnutrition assessments for all residents using the subjective global assessment tool. Thirty-two students participated; 31 completed all three sessions, with malnutrition screening completed for 207 residents and malnutrition assessment for 187 residents (July and September 2022). Based on the subjective global assessment, 31% (n = 57) of residents were mildly/moderately malnourished, and 3% (n = 5) were severely malnourished. The Innovation Domain of the Framework was the most important consideration before implementation. Whilst previous research documented student learning opportunities in residential aged care facilities, this study provides the first available evidence of the direct contribution students can make to the health of aged care residents through malnutrition screening and assessment. The model enables students to conduct malnutrition screening and assessment feasibly and efficiently in facilities that do not routinely collate and act on these data. With a limited nursing aged care workforce to undertake this vital task, the potential role of student dietitians to fulfil this role must be considered.

Experiences of students and educators with simulated placements in allied health profession and nursing education: a qualitative systematic review

Reduced clinical placement capacity, the COVID-19 pandemic and growing training place numbers have resulted in the development of innovative placement design in healthcare education. Simulation is widely used in healthcare education; however, its use as a placement model is in its infancy. The experiences and perceptions of students and educators are important to shape simulated placements moving forward. A systematic search of the literature was conducted on eight databases to identify qualitative and mixed-methods studies exploring the experiences of students or educators in the nursing and allied health professions. Eight studies met the inclusion criteria and were assessed for methodological quality using the Joanna Briggs Institute (JBI) critical appraisal checklist for qualitative research. A meta-aggregative approach, in accordance with JBI guidelines for reviews of qualitative evidence, was used to synthesize the results. From the eight studies, a total of 69 findings were extracted. These were grouped into nine categories to form three synthesized findings of overall low quality. These findings were related to (1) reality of the simulated placement, (2) emotions evoked during the simulated placement, and (3) opportunities and challenges associated with implementing simulated placements. Simulated placements were considered a useful tool for the enhancement of communication skills, clinical reasoning skills, new knowledge generation, enhancing reflection and for preparation for clinical practice by students as well as educators.

ADVANCING SEDIMENT SOLUTIONS IN THE SEVEN MILE ISLAND INNOVATION LABORATORY

In 2019, the U.S. Army Corps of Engineers (USACE) Philadelphia District partnered with the State of New Jersey, The Wetlands Institute, and the USACE Engineer Research and Development Center to launch the Seven Mile Island Innovation Laboratory (SMIIL). The initiative is designed to advance and improve dredging and marsh restoration techniques in coastal New Jersey through innovative research, collaboration, knowledge sharing and practical application. SMIIL efforts are enhancing the science and engineering that supports dredging and beneficial use placement practices by clearing shoals from the federal New Jersey Intracoastal Waterway for navigation and innovatively placing that sediment on multiple sites described herein. Regional Sediment Management and Engineering with Nature principles and practices serve as a strong foundation for SMIIL actions. Efforts are successfully evolving the practice and advancing techniques for beneficial use of dredged channel sediments with innovative placements that support coastal resilience for habitats and communities.

Increasing capacity by moving away from one-to-one clinical supervision: using peer-assisted learning and a group model of student placements in community paediatric speech and language therapy to enable student-led service delivery.

Health Education England (HEE) and the Royal College of Speech and Language Therapists (RCSLT) have identified the need to increase placement capacity. Speech and language therapy is a shortage profession in the UK, so services need to consider innovative placement models to increase their placement offers without increasing the time burden on speech and language therapists (SLTs). To increase capacity for pre-registration practice-based learning by using peer-assisted learning (PAL) in a group model of student placement to enable student-led service delivery which provides high standards of clinical care and student experience and is an efficient use of SLT time. A paediatric speech and language therapy service hosted eight student speech and language therapists (SSLTs) for their final pre-registration placement. SSLTs completed pre- and post-placement confidence ratings for a range of clinical skills; SSLTs and SLTs rated how useful different types of support were, and education settings provided feedback about working with the SSLTs. The number of clinical sessions completed by the SSLTs and the percentage of outcomes achieved for children with speech, language and communication needs were calculated. SLTs completed time-trackers for placement-related activities. The impact of the placements was assessed using a tri-vector methodology consisting of: self-reporting by the student (using an evaluation form), feedback from the placement sites (schools) and analysis of targets set for individual children. SSLTs reported increased confidence in all clinical areas in their post-placement evaluation form. SLTs reported increased confidence in SSLTs working independently and an increase in the perceived benefit to the service for having SSLTs in comparison with the time invested in supporting SSLTs. SSLTs and SLTs found all types of support provided during the placement useful. Schools reported high levels of satisfaction for working with SSLTs. SSLTs completed more clinical sessions than an SLT would have been able to in the time SLTs invested in placement-related activities. Children achieved 60% of the targets set by SSLTs. This placement model increased the capacity for SSLT placements by using PAL in a group model of student placement to enable student-led service delivery. The model provided high standards of clinical care and student experience and was an efficient use of SLT time. Wider use of this placement model would increase placement capacity and could also address vacancies in services. What is already known on the subject SSLTs and SLTs are positive about the benefits of paired placements in comparison with individual placements. Other allied health professions have demonstrated that larger placements can be an effective way to support students and have used students to deliver student-led services. What this study adds to existing knowledge This paper is the first to look at whether PAL in a group model of student placements can be used in speech and language therapy to enable student-led service delivery which provides high standards of clinical care, maintains high standards of student experience and is an efficient use of SLT time. What are the potential or actual clinical implications of this work? This paper demonstrates that PAL can be used effectively in a group model of student placements in a paediatric SLT service to increase student capacity and enable student-led service delivery. The proposed placement model provides a high-quality placement for SSLTs and the children they work with, and is also an efficient use of SLT time.

Rethinking student placement to enhance efficiency and student agency

Placement tests are used to support a particular need in a local context—to determine the best starting place for a student entering a specific programme of language study. This brief report will focus on the development of an innovative placement test with self-directed elements for our local needs at a university in Canada for students studying English or French as a second language. Our goals are to produce a more efficient assessment instrument while allowing students more agency through the process. We hope that sharing these details will encourage others to consider the potential of incorporating self-directed elements in low-stakes placement decision-making.

Comparing Preferred and Actual Clinical Learning Environments and Perceptions of First-Year Nursing Students in Long-Term Care: A Cross-Sectional Study

The clinical learning environment, which includes the culture of clinical units, the mentoring process, and the different health organizations, influences the learning process of nursing students. However, scarce literature has been published on the impact of the clinical learning environment on first-year nursing students in long-term care. We aimed to assess first-year nursing students 'preferred' and 'actual' clinical learning environments when conducting their first placements in nursing homes within an innovative placement model that comprised the active participation of academic mentors. The validated Spanish version of the Clinical Learning Environment Inventory (CLEI) instrument was used in our study, and 99 first-year nursing students participated. The highest mean scores for the CLEI-Actual were found for the Satisfaction (22.7) and Involvement scales (19.09). The lowest mean scores were found for the Personalization (17) and Individualization (17.27) scales. The multiple correlation (R) between the Satisfaction and the other CLEI scales was 0.61 (p > 0.001), which means that in this study the association between student satisfaction and their perception of the clinical learning environment was strong. First-year students conducting their first clinical placements in nursing homes can have a positive learning experience considering a well-designed and organized pedagogical strategy, including constant support and feedback from academic and clinical mentors.

Survey of clinical placements within pre-registration diagnostic radiography programmes in the UK and Ireland

IntroductionPlacement capacity is a challenge in supporting the clinical education of diagnostic radiography students within the UK at a time where growth in the workforce is required if service delivery needs are to be met. COVID-19 has been one of the catalysts in the growth of innovative and simulated clinical placement models. This survey seeks to understand the current picture of clinical education models and the drivers for it. MethodsA short online MS Forms survey with mixed question types was distributed to higher education institutions (HEIs) delivering pre-registration diagnostic radiography programmes in the UK and Ireland. Descriptive and thematic analysis of data was undertaken to gain insight into the clinical placement models used. ResultsResponses related to 24 programmes from 17 HEIs were collated. Capacity issues, increased student numbers and ability to achieve the learning outcomes were the drivers for the model and arrangement of clinical placements. Clinical practice hours varied widely across programmes as did the proportion of simulation-based education. Respondents felt an increase in the use of placements in modalities and other settings could further increase training capacity. ConclusionOpportunities to further change the clinical placement model have been identified which may alleviate some pressure points on capacity. Guidance around clinical practice hours may facilitate a sustainable approach to workforce training. Innovative placement models will require assessment strategies that align in order that students demonstrate relevant capabilities in a range of settings and value varied learning opportunities. Implications for practiceThe collective engagement and innovation of higher education institutions and service providers will be needed to create sustainable quality models of clinical training and assessment to meet diagnostic radiography workforce requirements.

Enablers, markers, and aspects of quality innovative placements across distance: insights from a co-operative inquiry

ABSTRACT Internationally, COVID-19 has forced educational reform and disrupted already strained social work field education systems. This inquiry began pre-pandemic, responding to placement scarcity, which was only exacerbated by the pandemic as agencies migrated to online service delivery and universities responded to sudden placement cancellations. Educators found themselves navigating two interlinked global trends: 1) workplace learning that was changing radically; and 2) the immediate need to identify and develop placement opportunities. This article presents themes from a co-operative inquiry that interrogated four innovative international placement scenarios from Australia, Canada, Ireland, and New Zealand, highlighting enablers, markers, and aspects of quality learning. The four exemplars evidence the pedagogical challenges and opportunities presented by placement innovation and online learning. These placements reveal how tensions regarding placement scarcity, rapid placement innovation, and the concurrent need to mitigate risk while preserving placement quality were managed. The authors propose that creativity and innovation guided by well-articulated educational principles, learning outcomes, and pedagogical practices, promote the construction of quality placements that transcend potential risks. The challenge moving forward is upholding contemporary approaches to placement teaching and learning that ensure social work students’ acquisition of professional knowledge, values and skills that are necessary for practice.

Effective Use of Extended Dwell Peripheral Intravenous Catheters in Neonatal Intensive Care Patients.

Implementing innovative approaches to vascular access can be challenging in the newborn intensive care unit (NICU). The purpose of this project was to describe the implementation of extended dwell peripheral intravenous (EPIV) catheters, a vascular access device not widely used in the NICU. The implementation involved (1) designing clinical criteria for EPIV catheter use, (2) education of vascular access NICU nurses, and (3) comparing clinical outcomes between vascular access devices (ie, PIV and EPIV catheters). We developed evidence-based clinical criteria guiding the use of vascular access devices. We then developed an educational plan for NICU nurses focused on vascular access. Finally, we collected and compared demographic characteristics and clinical data on catheter type and placement attempts, dwell time, and clinical complications associated with each catheter. EPIV catheters were implemented according to evidence-based criteria by a vascular access NICU nursing team. Fifteen percent of PIV catheter placements required 3 or more attempts compared with just 1% of EPIV catheter placement attempts. EPIV catheters had a longer median dwell time (3.5 vs 1 day) and fewer complications than PIV catheters (P < .001). Implementation of an evidence-based approach to vascular access by a team of NICU nurses may improve clinical outcomes. EPIV catheters may be an appropriate alternative device to PIV catheters due to fewer placement attempts, longer dwell times, and overall fewer complications during use. Future vascular access research in the NICU may include a greater focus on innovative placement strategies, optimal maintenance and infection control, and prevention of complications.

Learning to Teach Diverse Learners Together: Results from an Innovative Placement Structure

We explore the ways in which preservice teachers (PSTs) develop a practice in practice (Darling-Hammond, 2010) with diverse learners when placed in classrooms with college writing mentor teachers. Analyzing survey data and instances of stated confidence in PSTs’ activity logs, we share results that reveal a significant increase in the novice teachers’ perceived ability to teach diverse learners when placed in this context. Results also demonstrate a model of Teacherly Reflective Inquiry Practice (TRIP). These results suggest that placements with college writing instructors acting as mentor teachers can facilitate the development of collective efforts to teach diverse learners.

A nursing student’s reflections in the office of the coroner

ABSTRACTThis article is a reflection of a student’s experience in a new and innovative placement in the office of a coroner in rural and remote areas of northwestern Ontario. It is a reflection on the significance of the registered nurse in this role, and how it has evolved to consider the deeply holistic, relational, and moral nature of death investigation practice for nurses. It intertwines narrative and focused literature review to enhance discussion of the significance of the role nurses can play in death investigation specifically to serve communities in Northwestern Ontario.

The P-ART framework for placement of virtual network services in a multi-cloud environment

Carriers’ network services are distributed, dynamic, and investment intensive. Deploying them as virtual network services (VNS) brings the promise of low-cost agile deployments, which reduce time to market new services. If these virtual services are hosted dynamically over multiple clouds, greater flexibility in optimizing performance and cost can be achieved. On the flip side, when orchestrated over multiple clouds, the stringent performance norms for carrier services become difficult to meet, necessitating novel and innovative placement strategies. In selecting the appropriate combination of clouds for placement, it is important to look ahead and visualize the environment that will exist at the time a virtual network service is actually activated. This serves multiple purposes — clouds can be selected to optimize the cost, the chosen performance parameters can be kept within the defined limits, and the speed of placement can be increased. In this paper, we propose the P-ART (Predictive-Adaptive Real Time) framework that relies on predictive-deductive features to achieve these objectives. With so much riding on predictions, we include in our framework a novel concept-drift compensation technique to make the predictions closer to reality by taking care of long-term traffic variations. At the same time, near real-time update of the prediction models takes care of sudden short-term variations. These predictions are then used by a new randomized placement heuristic that carries out a fast cloud selection using a least-cost latency-constrained policy. An empirical analysis carried out using datasets from a queuing-theoretic model and also through implementation on CloudLab, proves the effectiveness of the P-ART framework. The placement system works fast, placing thousands of functions in a sub-minute time frame with a high acceptance ratio, making it suitable for dynamic placement. We expect the framework to be an important step in making the deployment of carrier-grade VNS on multi-cloud systems, using network function virtualization (NFV), a reality.

ВПРОВАДЖЕННЯ СПЕЦІАЛІЗОВАНИХ РЕАБІЛІТАЦІЙНИХ ПОСЛУГ У ГОТЕЛІ СІМЕЙНОГО ТИПУ

Purpose. The purpose of the article is to justify the feasibility of introducing specialized packages with rehabilitation services for children with special needs in a family-type hospitality establishment. Indeed, statistics show that in recent years in Ukraine and the world the number of cases of autism is increasing. Methodology. The methodological basis of this work is the work of domestic and foreign scientists in the field of inclusion, scientific periodicals, Internet resources. The methodology includes statistical data of the State Statistics Service of Ukraine and others, which reflect the prevalence of psychophysical diseases and their number. The methodology also includes the work of foreign scientists on the evidence of the effectiveness of a special diet. Results. As a result of the research, world experience was analyzed regarding the introduction in Ukraine of comfortable conditions for rehabilitation, as well as relaxation in institutions for placement of family-type children with special needs. It was revealed that in our country there is no experience in introducing such services in hotels. Specialized services for children have been developed that can be implemented in an innovative placement institution. The results will help move the problem of effective specialized rehabilitation of children with autism in combination with quality rest. Scientific novelty. The necessity of introducing services for the rehabilitation of children with developmental disabilities is identified. The world experience is systematized regarding the introduction of comfortable conditions for rest and rehabilitation in hotel complexes of children with autism in Ukraine with an analysis of the available methods for the possibility of their application in the development of the hotel business. Specialized services are provided that will enhance the institution's competitiveness, as well as allow families with special children to travel, relax and improve their health. Practical significance. Coverage of the problem of providing specialized rehabilitation services for children in Ukraine and the development of practical ways to solve it will improve the situation in the hotel market of the country. In the future, packages of services that can be used in hospitals by specialists for working with special children will be developed. This will lead to the development of wellness programs for children, involving classes by specially trained personnel, while parents will be able to devote their free time to outdoor recreation. The introduction of such services will help to increase public awareness, as well as the development of inclusion.

A National Survey of Australian Social Work Field Education Programs: Innovation with Limited Capacity

ABSTRACTSocial work field education programs globally are struggling to meet the demands of providing suitable placements for students and need to consider new and innovative placement models to both meet professional accreditation requirements and deliver high quality field education opportunities for social work students. This article reports on the qualitative responses of a national survey of Australian social work field education programs, which explored current challenges, innovative responses, and recommendations for the Australian Social Work Education and Accreditation Standards (ASWEAS) review, as well as hopes for the future of field education, and their capacity to undertake research into this area. Findings suggested that field education programs have been using incremental innovation in field education, including collaboration, partnerships, and new ways of responding to the changing student body. However, it is argued that radical structural change and additional resources will be needed for innovation to be more than merely incremental.IMPLICATIONSSocial work field education as a distinct pedagogy needs to be supported through evidence-based research in order to respond to current pressures.Collaboration in field education practice and research is valuable, but may be challenged by program competition.Structural innovation and accepting diversity in models could offer opportunities for social work education.

Nursing Student Collaborative With Meals on Wheels: Home Visits for At-Risk Senior Adults.

Nursing students at Washington State University Tri-Cities Campus are taking part in a program to provide care for homebound senior adults enrolled in home delivery meal services. Students perform home safety, functional, and cognitive assessments while learning the challenges of meeting nutritional needs of an at-risk senior adult population. This article outlines the program and its outcomes after two years of collaboration. Meals on Wheels is identified as an innovative placement for meeting nursing program outcomes and clinical practice hours. Areas for future growth include interdisciplinary collaboratives and partnering with local hospitals to study the program's impact on hospital readmission.

A Case of Difficult RV Lead Placement of Single Chamber Implantable Cardioverter-Defibrillator (ICD) with Atrial Septal Defect (ASD) Amplatzer Septal Occluder Device Delivery System

Introduction: A case of difficult RV lead placement of single chamber ICD with (ASD) Amplatzer septal occluder device delivery system. Implantation of pacemaker leads can be challenging sometimes. Various non-conventional tools have been used in such difficult cases. Case report: We report a case of single chamber ICD implantation in a patient with severe LV dysfunction as primary prevention strategy where RV lead placement was done with the use of 80 cm 10 F delivery system of ASD septal occluder amplatzer device. Conclusion: Innovative lead placement strategies with the use of appropriately selected tools is helpful in facilitating difficult cases.

Reflections from an innovative placement in Malawi: Understanding ‘Umoza’ in the context of older people’s services

Reflections from an innovative placement in Malawi: Understanding ‘Umoza’ in the context of older people’s services

Preparing the Dietetic Workforce of the Future – Developing Innovative Placements in Social Care Settings

Practice placements are key to the training of an allied health professional, supporting the integration of theoretical and practical knowledge, allowing the development of key skills and enculturation to a professional role. Practice placements in dietetic pre-registration training have largely focussed on clinical/health care settings, with the students based in dietetic departments. Current developments in integrated health and social care provision in the United Kingdom mean there is a compelling need to develop a workforce equipped to work across sectors to effectively support people’s nutritional needs. Against this background, a partnership group of healthcare and managerial professionals, representing NHS Education for Scotland (NES), NHS Highland (NHSH), a private care home group based in the North of Scotland and Robert Gordon University worked together to pilot and develop a model for the placement of student dietitians within social care settings (initially care homes). This novel approach embeds students in a social care setting for part of their placement rather than having them based within a dietetic department. The placements were positively evaluated and widely shared via Allied Health Profession (AHP) blogposts and in publications such as the Care Inspectorate newsletter, and other Scottish Health Boards are now developing local models of dietetic social care placements. There is a recognition that practice placement models should prepare the dietitians of the future for working beyond NHS environments, and that alternative models of placement should be explored from the perspective of raising the profile of the profession and ensuring sustainability of placement provision.

Implementation of a new model of clinical education for regional occupational therapy student clinical placements.

Expansion of occupational therapy education programs has resulted in increased student numbers and demand on clinicians to host clinical placements while also maintaining the delivery of high-quality, safe clinical services to patients. Much of the research about innovative placement models, including student contributions to service delivery, has been conducted in metropolitan areas. Therefore, there is a need to develop models that are suited to regional settings that face diversity of caseload, more generalised occupational therapy roles and variations in patient flow. The aim of the present study was to describe the initial application of the Calderdale Framework in student education in a regional context and look at lessons learnt. The Calderdale Framework provided a structured, clinically governed process whereby occupational therapists were able to determine which tasks could be allocated to students and provided a framework to support student training and competency development. The Calderdale Framework has been used successfully to implement allied health models involving professional skill sharing and delegation of tasks to allied health assistants, but it has not been used in clinical education. Pilot implementation of the Calderdale Framework showed that the model supports quality and safety of student-provided occupational therapy services and that the teaching method provides a platform for student skill development. These results warrant further investigation and are potentially transferrable to student education in other health professions.