Placement Learning Research Articles

Reflection on creating a coaching approach to student nurse clinical leadership development.

Coaching is an intervention that facilitates another person's learning, development and performance. Applied to student nurse practice placement learning, coaching has the potential to boost leadership learning that is student led, less focused on following the directions of a mentor and more focused on students taking responsibility for identifying their learning goals and objectives. This article gives personal perspectives about how a collaboration between four Greater Manchester (GM) universities and their partner practice organisations developed, implemented and evaluated a coaching approach to student nurse clinical leadership development and peer learning, while increasing practice placement capacity-the GM Synergy model. Perspectives are given on setting up a project team, testing the model before implementation and developing a robust evaluation framework. Coaching as a model for student support and clinical leadership development is in line with the Nursing and Midwifery Council's Future Nurse: Standards of Proficiency for Registered Nurses document, with the practice supervisor role complementing the role of the coach in clinical practice.

Developing student teachers’ approaches to group teaching in placement learning

The purpose of this research aims to develop teaching methodology of pedagogical students through small-group teaching practice in group of 4-5 students. All activities that have been conducted by researching the lesson to advance the teaching method of students are: (1) setting goals: identify specific student needs and formulate curricular goals, (2) plans: develop lesson plans; devise data -collection strategies; rationalize the approach; anticipate students’ responses, (3) implementation: one or two members of the team teach the public lessons in high schools where students from University of Education have placement learning, while other members observe and collect data, such as video documentation and working samples, (4) debrief: analyze collected data; discuss about students’ learning, teachers’ teaching, relative pedagogical content learning. We used Kobo software and Maastricht-Peer Activity Rating Scale in order to observe and evaluate the teaching – learning activities in small group of students. The results show that using reflection thinking while teaching by small group would help students to improve their teaching methods more efficiently.

Perceptions of occupational therapy threshold concepts by students in role-emerging placements in schools: A qualitative investigation.

Traversing threshold concepts has been identified as crucial in becoming an occupational therapist. To support this learning, previous research has emphasised the value of students engaging in practice-based learning, accompanying reflection, and a curriculum which makes threshold concepts explicit to students. Role-emerging placements form part of students' practice-based learning in many universities and could offer a valuable opportunity for students to learn threshold concepts. Understanding the value of threshold concepts to enhance role-emerging placement learning from both the students' and educators' perspectives warrants further research. The aim of this study was to examine how occupational therapy students on role-emerging placements in school settings experienced applying threshold concepts and how it impacted on their learning. An epistemological position of social constructionism and a qualitative research design was used. This included semi-structured focus group interviews and reflective logs that enabled exploration of 13 student's and one supervisor's perspectives of learning during the placement. Template analysis was used to analyse the data. Students spoke of their learning of the threshold concepts of client-centredness, occupation, and understanding and applying occupational therapy theory in practice. These are expressed within the three emergent themes; 'curriculum supports in placement', 'uncertainty when applying their own knowledge', and 'placement context and expectations'. Results suggest that learning happens within the liminal spaces which occurred from an intersection with the threshold concepts, the curriculum, knowledge generation and use, and the context and expectations of the role-emerging placement. Engaging with uncertainty may be considered a vital part of this process and something which should be valued.

Student teachers’ self-dialogues, peer dialogues, and supervisory dialogues in placement learning

ABSTRACTThis paper compares three types of dialogues as reflective tools in placement learning: supervisory dialogues (mentor to student-teacher), peer dialogues (student teacher to student teacher) and self-dialogues (student teachers to themselves). Forty-four Dutch student teachers utilised the procedure of guided reflection to talk about their teaching experience. Stimulated recall data were analysed through qualitative and quantitative methods. Most poignant result was that supervisory and peer dialogues seemed to have similar reflective power considering student teacher’s practical knowledge and richness of argumentation for appraisals. We suggest more frequent use of peer dialogues. Only when expert advice is needed, should one employ supervisory dialogues. As self-dialogues engendered most rules and resolves, they could arguably be employed for student teachers to consolidate their own knowledge and manage their learning behaviour.

Enhancing learning in longitudinal clinical placements in community primary care clinics: undergraduate medical students’ voices

ABSTRACTLongitudinal clinical placements are increasingly adopted by medical training institutions. However, there seems to be little evidence regarding their implementation in primary care settings in the developing world. This paper explored medical students’ perceptions of their learning experiences in longitudinal placements in primary care clinics. The Manchester clinical placement index (MCPI) survey was offered to second-year medical students at the University of Botswana to determine perceptions of their 16 weeks clinical placement in primary care clinics. The MCPI provided data on eight aspects of clinical placements which were analysed to gain insight into students learning experiences while on placement. The eight items in the tool were grouped into four themes, namely, teaching and learning, learning environment, relationships and organisation of placements. Students cited the feedback they received whilst on placement and the learning environment in primary care clinics as aspects of clinical placements which could be improved to enhance their learning experience. For an enriched learning experience in primary care settings in a developing world context, there are critical aspects to be considered. Based on the students’ perspective we suggest an approach of how learning in such placements could be enhanced.

Achieving WIL placement and theoretical learning concurrently: An online strategy for Higher Education Institutions

The Australian Government requires Higher Education Institutions to demonstrate the work-readiness of graduates. Consequently, Work Integrated Learning (WIL) has been adopted to enhance the workplace skills and professional networks of students to improve graduate employability. While WIL can take many forms, experiences located in workplaces (placements, internships) have been popular. The introduction of the Australian Government’s Fair Work Act 2009 required that placements be tightly embedded within curriculum thereby presenting the challenge of how to enable WIL via placements and theoretical learning in already compact study programs. As a response, we present the pragmatic use of online theoretical instruction and online WIL assessment within an undergraduate core Capstone business subject, as an enabler of the WIL placement. We examine learner perspectives on, and grade outcomes from, undertaking online theoretical instruction concurrent with WIL placements to discuss the key WIL and online learning design implications for this cohort of learners. Our findings are increasingly pertinent given the 2017 Australian Government Higher Education Reform package incentivising the expansion of WIL into all degrees.

Using blackboard collaborate, a digital web conference tool, to support nursing students placement learning: A pilot study exploring its impact

Ensuring student nurses, when in clinical placement areas, receive good quality Higher Education Institution (HEI) lecturer support is challenging. This is because conventional HEI placement support, is resource intensive and arguably infeasible with growing student numbers.Evidence suggests, however, that online collaborative learning solutions (e.g., virtual classrooms, web conferencing tools) have the potential to ameliorate resource pressures. To test this idea, an online learning solution called Blackboard Collaborate was piloted. It virtually connected, students and their preceptors to a university lecturer. Its usefulness was explored by obtaining qualitative, focus group data, from the students and preceptor participants. The findings were thematically analysed.Collaborate ensured all three parties were connected. It was a time efficient, easy to use technology. Despite technical glitches, i.e. occasional time delay and audio echo, participants concluded Collaborate was an efficient medium when placement needs were routine. Face-to-face was preferable when more intensive support was required.In today's busy times, HEI's must explore time effective methods of placement collaboration. Online collaborative tools are one solution. Students will, however, need to develop their digital literacy in using this technology. The benefit being when qualified they are more likely to embrace this form of technology to promote their efficiency.

Illuminating undergraduate experiential and situated learning in podiatry clinical placement provision at a UK school of podiatric medicine

Purpose Situated and experiential learning methodologies are largely underresearched in relation to student experience and satisfaction. The purpose of this paper is to illuminate the perspectives of students studying on a BSc (Hons) Podiatry degree programme to establish perceptions of their experience in practice. Design/methodology/approach Using an interpretivist methodological framework, Free Association Narrative Interviewing was used to provide an insight into the perceived impact that experiential learning in clinical placements had on undergraduate podiatry students. Findings Students perceived that what could not be taught but what could be experienced, contributed much to the confidence that students had gained during their training and which they anticipated would be further developed during the initial years of their training in practice, particularly in the context of the NHS. Research limitations/implications This is a study from which it is acknowledged that within the underpinning research design and methodology there is no scope for generalisability. Practical implications The study highlights an appreciation for the implication and recognition of “tacit” knowledge, currently recognised in medical curricula as an asset which can aid a move towards higher order critical thinking skills. Social implications Student acknowledgement of the need for emphasis on “soft skills” can be posited, in the context of this small-scale study as an appreciation for affective domain learning in the context of podiatric academic and clinical curricula. Originality/value Limited information from the extant literature is available in relation to the illumination of podiatry student placement experiences, so this research contributes to an effectively underresearched field.

Collaborative coaching and learning in midwifery clinical placements

The model of coaching and collaborative learning is based on the nursing model of collaborative learning in practice developed at University of East Anglia and supported by Health Education East of England. The model was adapted to fit the midwifery antenatal and postnatal ward, where it was trialled between September 2016 and August 2017. During the trial, students, coaches, mentors and other staff on the ward were supported by the clinical education midwife. Evaluation data were collected in the normal module evaluations and showed overall satisfaction with the model and the opportunities for sharing learning. The model is now being rolled out to other placement areas. Keys to success included good preparation of the clinical placement areas and supported from a practice educator.

Novel interprofessional learning for healthcare students: An escape room pilot

Introduction: Interprofessional practice is an important contributor to improved patient outcomes, yet interprofessional learning (IPL) has proven challenging to implement. With responsibility for a cohort of students from many universities and disciplines, attending placements of various lengths and dates, the Flinders Northern Territory Remote and Rural Interprofessional Placement Learning program needed a novel way to overcome barriers to IPL. Innovation: An “escape room”, an immersive team-based activity with puzzles and problem solving, was developed specifically for this program. The room has an interprofessional healthcare theme and can be transported in a suitcase to enable use in almost any placement site. What next? The next steps will focus on refining the learning objectives, developing the post-room debrief and exploring the escape room’s use for formative assessment. In addition, we plan to replicate the room across our sites, develop an additional scenario and undertake ongoing evaluation of the room and associated student learning outcomes. Evaluation: The room was run as a pilot in three stages – briefing, solving the room and debriefing. The pilot room was evaluated in multiple ways: observation of participants before, during and after the room; participant evaluation questionnaires; free-flow discussion after participation; and through written and verbal feedback received. A shortened version was presented to ANZAHPE conference attendees, with observers asked to provide feedback. The room was evaluated for participant engagement and perceived learning value. Outcomes: The evaluation findings indicate that the escape room activity was very enjoyable, encouraged participant engagement, suited many professions, was transportable and showed promise as an interprofessional learning platform. Additionally, it provided unexpected benefits, including networking opportunities, staff engagement and peer support possibilities. What next? The next steps will focus on refining the learning objectives, developing the post-room debrief and exploring the escape room’s use for formative assessment. In addition, we plan to replicate the room across our sites, develop an additional scenario and undertake ongoing evaluation of the room and associated student learning outcomes.

Using the notion of ‘gift exchange’ to explore effective mentoring relationships in the placement setting

ABSTRACTPlacement or work-based learning is an integral component of many HE programmes and mentors can play a pivotal role in a student’s learning experience. Studies have explored the characteristics of ‘good’ mentors or mentees, but there is limited research that fully considers the interpersonal dynamics within such relationships. The notion of ‘gift exchange’ and ‘gift giving’ was applied to the analysis of students’ views concerning placement learning in a healthcare setting, exploring particularly issues of power, identity, duty and reciprocity. Findings suggest that both mentor and mentee play an important role in the gift exchange but these roles may be more fluid than previously considered. Students may need to tread a fine line in maintaining a good relationship with their mentor and invest considerable ‘emotional work’. HEIs and placement providers should devote time to allow students to explore the interpersonal dynamics of mentoring relationships to prepare them for such work.

Occupational therapy international undergraduate students’ perspectives on the purpose of practice education and what contributes to successful practice learning experiences

IntroductionPractice placements (also referred to as fieldwork) are a significant component of occupational therapy education. For international students enrolled in occupational therapy education programmes outside their own country, completing practice placements can be challenging. There is scarce literature that examines the perspectives of international students undertaking practice placements. The study’s aim was to understand international students’ perceptions, what they believe to be the purpose of practice placements and what attributes contribute to successful practice education.MethodQualitative, semi-structured interviews were used to elicit the perspectives of seven fourth-year international undergraduate occupational therapy students enrolled at an Australian university.ResultsThematic analysis identified two key themes: ‘the purpose of practice placements’ (sub-themes: translating knowledge into practice, adapting to real life experiences and building our communication skills), and ‘a successful practice placement’ (sub-themes: the environment, the clinical educator and my responsibilities).ConclusionFindings identified what international occupational therapy students believed to contribute to a positive and quality practice placement. All students valued the opportunities that practice education afforded, including developing communication skills and integrating theory into practice. These findings will assist academic and practice educators in the delivery of high quality practice education placement learning experiences for international students.

Development of a Tool to Monitor Paramedic Clinical Placements: A Case Study of Innovation Overcoming Tradition

Introduction This paper discusses a trial of the use of CompTracker© – an online platform used to link the student, preceptor and academic in a time sensitive manner during student clinical placement – within a cohort of 330 first and second year paramedic students studying at an Australian university. CompTracker© allows for preceptors to identify and assess clinical competencies, and for the student to reflect after each case is completed on placement. The tool was initially piloted, and then remodeled on several attempts to improve its overall functionality and relevance for the placement learning experience. The study aims to educate and inform other health disciplines that may have an interest in using online tools for competency tracking and education in diverse workplaces. Methods Multiple surveys were conducted over a 3-year period, using both Likert 5-point scales and open-ended questions, to evaluate 330 first and second year students’ and 261 preceptors’ experiences. Results Of the 54 student responses, 92% felt the tool was useful and 67% felt it was easy to use. Within the preceptor results, 63 ± 2% preferred CompTracker© over traditional paper-based methods. Conclusion CompTracker© can be used to support students and preceptors in clinical placement. The flexibility of this online tool makes it adaptable to most clinical workplaces, and should be considered in any workplace that requires the use of competency-based clinical assessment and used in place of traditional paper-based portfolios.

Global Health Competency Self-Confidence Scale: Tool Development and Validation.

Global health education in tertiary institutions worldwide is at an all-time high. Until recently, most evaluations of student learning from a global exposure was in the form of a reflective paper with little information that would enable standardized assessment of the competencies gained. In 2015, the Consortium of Universities for Global Health (CUGH) published a set of interprofessional global health competencies that were drawn upon to create a Global Health Competency Self-Confidence Scale and workbook. This study reports the development and validation of the scale and its implications for global health education. In total, 126 graduate students from a university in New York State participated in the validation process of the Global Health Competency Self-Confidence Scale-an 11-domain, 22-item competency self-assessment to measure the level of confidence of students before and after undertaking a global learning experience. The team used factor analysis to compare the scale to the Global Health Competency Survey for content validity and reliability. Reliability and validity of the scale was determined. An exploratory factor analysis identified 4 standalone components as: (1) Ethical and Professional Practice, (2) Capacity Strengthening and Planning, (3) Structural and Social Determinants of Health, and (4) Strategic Analysis. The scale showed excellent internal consistency (Cronbach's alpha=0.92) and test-retest reliability (reliability (r)=0.455; P<.001). Concurrent validity was established. The Global Health Competency Self-Confidence Scale contributes to a further consolidation and refinement of competency groupings into components of global health education and offers a scale to assess student learning in global placements.

Belongingness: Student ODPs' learning experiences in clinical placements.

The aim of this qualitative study is to explore student operating department practitioners' (ODPs') experiences of belongingness in clinical placements. Belongingness has been shown to be significant for learning in clinical placements for student nurses and midwives. This study was designed to look specifically at student ODPs' experiences. Semi-structured interviews were conducted with eight student ODPs. The interviews were transcribed and coded. All student ODPs could describe clinical placement experiences where they felt they belonged and those where they felt they did not belong. Both had a significant impact on students' learning experience. Students also described their own sense of responsibility for belonging while in placement. This study provides qualitative data to help understand how belongingness can positively or negatively affect the learning experiences of student ODPs in clinical placements.

Learning from students: Facilitators’ learning in interprofessional placements

ABSTRACTFew studies have examined experiences and learning from the viewpoint of interprofessional facilitators of student placements, and limited research has investigated this learning enacted across traditional service boundaries or between health and education practitioners. This study aimed to address these gaps by exploring perceptions about the learning and experiences of Early Childhood Educators (ECEs) who facilitated placements in childcare settings for speech-language pathology students from a health professional background. Lave and Wenger’s theory of Legitimate Peripheral Participation was utilised to design and interpret this study. Seven ECEs from two childcare centres and four Centre Directors participated in focus groups and individual semi structured interviews respectively. Thematic analysis revealed five themes that described how the ECEs came to accept the students as legitimate members of their practice community, and how this subsequently facilitated the ECEs’ learning. The themes of power described in previous studies that explored status and hierarchical differences between facilitators and students from differing professions were not identified in this study. This absence of observed power differential, in addition to the embedded nature of the placement design, and the students’ participation in the ECEs’ everyday activities and routines contributed to the ECEs’ positive interprofessional learning.

Providing the right environment to develop new clinical nurse leaders.

Jacqueline Leigh, Reader, Teaching and Learning, School of Health and Society, University of Salford, J.A.Leigh4@salford.ac.uk , and Lisa Littlewood, Director of Placement and Practice Learning, School of Health and Society, University of Salford, evaluate the changes in the delivery of nurse education as a result of the devolution of health and social care decision-making from Westminster to Greater Manchester.

Rapid actions of oestrogens and their receptors on memory acquisition and consolidation in females.

Increased attention has been paid in recent years to the ways in which oestrogens and oestrogen receptors rapidly affect learning and memory. These rapid effects occur within a timeframe that is too narrow for the classical genomic mode of action of oestrogen, thus suggesting nonclassical effects as underlying mechanisms. The present review examines recent developments in the study of the rapid effects of 17β-oestradiol and oestrogen receptor (ER) agonists on learning and memory tasks in female rodents, including social recognition, object recognition, object placement (spatial memory) and social learning. By comparing studies utilising systemic or intracranial treatments, as well as pre- and post-acquisition administration of oestradiol or ER agonists, the respective contributions of individual ERs within specific brain regions to various forms of learning and memory can be determined. The first part of this review explores the effects of systemic administration of 17β-oestradiol and ER agonists on memory when administered either pre- or post-acquisition. The second part not only focuses on the effects of pre- and post-acquisition infusions of 17β-oestradiol or ER agonists into the dorsal hippocampus on memory, but also discusses the contributions of other brain regions, including the medial amygdala, medial prefrontal cortex and paraventricular nucleus of the hypothalamus. The cellular mechanisms mediating the rapid effects of 17β-oestradiol on memory, including activation of intracellular signalling cascades and epigenetic processes, are discussed. Finally, the review concludes by comparing pre- and post-acquisition findings and effects of 17β-oestradiol and ER agonists in different brain regions.

Survey of disability-related content in Australian dietetics programs.

Nutrition and dietetic services are an important component of healthcare for people living with a disability. The introduction of the National Disability Insurance Scheme (NDIS) in Australia is providing more opportunities for individuals to access these services from an Accredited Practising Dietitian (APD). The aim of this research was to identify how students in Australian tertiary dietetics programs are being prepared to provide these services to people with a disability. A purpose-built questionnaire with eight open-ended questions was developed by the researchers to describe the disability-related content of university and professional placement learning opportunities and was distributed to all course conveners (or their nominated representative) of dietetics programs accredited by the Dietitians Association of Australia. The qualitative data were analysed using a descriptive approach. Responses were sorted into response category themes and counted to identify common themes. A representative from 14 of 18 programs (78% response rate) participated in the survey in September and October 2016. Results indicated that although 12 programs incorporate disability-related topics into the curriculum, content was inconsistent and of varying depths. Four programs offered a disability-specific placement opportunity and nine discussed the NDIS to varying degrees. It is important that graduates are provided with adequate learning opportunities in the area of disability to ensure that they are prepared for entry-level practise in this area. Further research may provide insight into the skills, knowledge and behaviours used by APDs working in disability to identify those that need to be strengthened in dietetics programs.

Fitting in with the team: Facilitative mentors in physiotherapy student placements’

Clinical placements are central to physiotherapy students’ education, providing an environment in which students can apply learning they have been introduced to in academic settings. However placement learning has been identified as fraught with problems and resultant stress, and there is limited evidence available on what exactly makes a good placement for physiotherapy students. This paper reports on selected findings from a study exploring narratives of physiotherapy students over three years, relating to their overall experiences of being a student. A narrative prompt provided an opportunity for the students to speak about ‘episodes’ of their learning experiences. A number of these ‘episodes’ related to the students’ experiences of clinical placements; thus it was decided to extract these from the narratives and undertake a separate qualitative analysis of these placement experiences. The majority of the students reported positive experiences of placements overall; however, it was clear that some placement teams and mentors did not support students appropriately. A welcoming team and a mentor who facilitated learning from an individual student perspective were considered to be key to a good placement experience, whilst an unwelcoming team and a mentor who objectified the student resulted in bad placement experiences.