Placement Team Research Articles

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.

When Proximity May Not Be Destiny: The Role of Existing Relationships

Research on geography and knowledge spillovers is premised on the proposition that proximity reduces the cost of search and coordination. Thus, learning from proximate parties is easier than from more distant ones. As a consequence, nearby individuals, teams, and firms share overlapping knowledge and correlated outcomes. In this paper we theorize that spatial spillovers fundamentally depend on the presence of existing relationships. Using multi-dimensional network formation data from the random placement of teams at a startup bootcamp, we show that spatial spillovers decline if team members have existing ties within a particular social setting. For teams with preexisting ties within the bootcamp, localized spillovers appear small or non-existent. For teams without preexisting ties we find that outcomes improve if neighbors are high performing, but that outcomes worsen if neighboring teams are low performing. Our findings suggest that existing relationships do affect spillovers, primarily by capping downsides, but also by limiting the upsides of being near a high-performing team.

An education management information system with simultaneous monitoring of stress stimulators for students Mental Health management.

Education Management Information System (EMIS) is a widely acceptable and developing technology within the Information Technology field. The advancement in technology in this century is being collaborated with scientific invention or explorer and information strengthening or development. This paper presents the results and experiences gained from applying students oriented EMIS for monitoring and managing mental health. The Mental Health of students depends on the acquiring adequate knowledge on basic concepts within a time period or academic schedule. It's obviously significance to evaluate and appraise the stress stimulators as a challenge or threat. The theoretical framework for the study was designed for analyzing the stress stimulators, academic performance and EMIS accessibility. The sample examined in this study was stratified random sample from 75 students specifically all engineering college in Dindigul District of Tamilnadu. The primary factor is the academic stress stimulators that form one module of EMIS for each of the key variable such as curriculum & instruction related stressors, placement related, teamwork related and assessment related. The Mental Health related stress stimulators namely curriculum & syllabus, placement related, assessment related and team work related have a significant influence on academic performance by students in various institution. The important factor leading to the EMIS application in monitoring stress stimulators is curriculum & syllabus related and assessment related.

Reducing maternal morbidity and mortality in the developing world: a simple, cost-effective example.

ObjectivesTo determine the impact of volunteer obstetricians and midwife teams on obstetric services in a rural hospital in Ethiopia.MethodsThe intervention was undertaken in Mota district hospital, a rural hospital in the Amhara region of Ethiopia, which is the only hospital for 1.2 million people. Before the placement of volunteer teams it had a rudimentary basic obstetric service, no blood transfusion service, and no operative delivery. The study prospectively analyzed delivery data before, during, and after the placement of volunteer obstetrician and midwife teams. The volunteers established emergency obstetric care, and trained and supervised local staff over a 3-year period. Measurable outcomes consisted of the number of women delivering, the number of referrals of pregnant women, the number of maternal deaths, and the number of referrals of obstetric fistula patients.ResultsWith the establishment of the service the number of women attending hospital for delivery increased by 40%. In the hospital maternal mortality decreased from 7.1% to <0.5%, and morbidity, as measured by number of obstetric fistulae, decreased from 1.5% deliveries to 0.5% over the 3-year intervention period. The improvements were sustained after handing the project back to the government.ConclusionThe placement of volunteer teams was an effective method of decreasing maternal mortality and morbidity.

Risk Factors of Nonretrieval of Retrievable Inferior Vena Cava Filters

Optimal use of retrievable inferior vena cava (IVC) filters is an important health care issue, and despite an exponential rise in the use of retrievable IVC filters, national trends suggest that most of these filters are not removed. The purpose of this study was to identify risk factors associated with nonretrieval of retrievable IVC filters at our institution. A retrospective institutional review of all patients undergoing IVC filter placement from June 2010 to June 2012 was performed. A number of patient parameters were studied, including relevant demographics, indication for filter placement, clinical history, related hospitalization, and whether filter retrieval was performed. Patient parameters were compared by univariate and multivariate logistic regression analyses. There were 605 retrievable IVC filters placed over a 24-month period by vascular surgery, intervention radiology, and interventional cardiology. The follow-up retrieval rate was 25%. By indication, 272 (45%), 53 (9%), and 280 (46%) filters were placed for absolute, relative, and prophylactic indications, respectively. Independent predictors for nonretrieval by multivariate analysis were age >80 years (hazard ratio [HR], 5.0; 95% confidence interval [CI], 1.7-20; P < 0.001), acute bleed (HR, 2.5; 95% CI, 1.4-5; P < 0.001), current malignancy (HR, 2.0; 95% CI, 1.3-3.3; P = 0.011), postfilter anticoagulation (HR, 0.5; 95% CI, 0.28-0.9; P = 0.017), and history of pulmonary embolism and/or venous thromboembolism (HR, 0.5; 95% CI, 0.28-0.35; P < 0.001). Filter placement team and indication were not identified as independent predictors of nonretrieval of IVC filters. Patient variables identified by univariate and multivariate analyses as risk for nonretrieval of retrievable IVC filters have several implications: first, some of these patients may represent a group of patients with a low life expectancy or unresolvable underlying condition in which filter retrieval has diminishing returns and may indicate the clinical option for permanence of the filter; second, identification of risk factors for nonretrieval in patients before filter placement will help to optimize use of retrievable IVC filters and enhance retrieval rates.

Risk Factors for Nonretrieval of Retrievable Inferior Vena Cava Filters

Optimal utilization of retrievable inferior vena cava (IVC) filters is an important healthcare issue and despite an exponential rise in the use of retrievable IVC filters, national trends suggest that the majority of these filters are not removed. The purpose of this study was to identify risk factors associated with nonretrieval of retrievable IVC filters at our institution. A retrospective institutional review of all patients undergoing IVC filter placement from June 2010 to June 2012 was performed. A number of patient parameters were studied, including relevant demographics, indication for filter placement, clinical history, related hospitalization, and whether filter retrieval was performed. Patient parameters were compared by univariate and multivariate logistic regression analysis. 605 (49% male) retrievable IVC filters were placed over a 24-month period by vascular surgery, intervention radiology, and interventional cardiology. One-hundred forty (23%) IVC filters were removed. By indication, 272 (45%), 53 (9%), and 280 (46%) filters were placed for absolute, relative, and prophylactic indications, respectively. By univariate analysis, we examined over 20 patient variables and identified 13 associated with nonretrieval (P < .05). Independent predictors for nonretrieval by multivariate analysis were age >80 (HR, 0.2; 95% CI, 0.05-0.6; P = .005), acute bleed (HR, 0.4; 95% CI, 0.2-0.7; P = .004), current malignancy (HR, 0.5; 95% CI, 0.3-0.8; P = .011), postfilter anticoagulation (HR, 2.0; 95% CI, 1.1-3.6; P = .017), and history of pulmonary embolism and venous thromboembolic event (HR, 2.0; 95% CI, 1.2-3.5; P = .007). Filter placement team and indication were not identified as independent predictors of nonretrieval of IVC filters. Patient variables identified by univariate and multivariate analysis as risk for nonretrieval of retrievable IVC filters has several implications: (1) some of these patients may represent a high-risk population in which filter retrieval has diminishing returns and may indicate the clinical option for permanence of the filter; and (2) identification of risk factors for nonretrieval in patients before filter placement will help to optimize utilization of retrievable IVC filters and enhance retrieval rates.

Student placement service: An exploratory investigation of employer retention and a “Priority Partner” intervention

PurposeThe purpose of this paper is to investigate the factors relating to retention of employers on an undergraduate work placement programme in a third level institution.Design/methodology/approachAn action research methodology involving problem diagnosis, intervention planning, action and evaluation is employed. The diagnosis involved a survey of 130 employers that had taken students on placement during the first two years of the placement programme. The action research also involved workshops with the work placement team and the making of an intervention with respect to enhancing the placement process through the introduction of a Priority Partner initiative for 26 of the employers.FindingsThe survey findings reveal differences in the ranking of importance of college selection criteria by employers, as well the impact of the placement manager's characteristics on the placement process. The intervention findings show that the employer retention percentage increased for the Priority Partners but remained the same for the other employers.Research limitations/implicationsThe study reports qualitative findings in the context of a placement programme in one institution which limits external validity.Practical implicationsEmployer retention would seem to be improved with the development of a customer relations management orientation with employers. The role of the placement manager is pivotal to enhancing the retention of employers as is the quality and professionalism of the work placement service.Originality/valueNew empirical data extends the very limited understanding of company retention on work placement programmes.

A picture tells 1000 words: learning teamwork in primary care

Teamwork and patient centredness are frequently articulated concepts in medical education, but are not always explicit in the curriculum. In Ireland, recent government policy emphasises the importance of a primary care team approach to health care. We report on an appraisal of a newly introduced community-based student attachment, which focused on teamwork. To review students' experience of teamwork following a community clinical placement by examining student assignments: essays, poetry, music and art. Year-2 graduate-entry students (n = 45) spent 2 weeks with a primary care team. Attachments comprised placements with members of the primary care team, emphasising team dynamics, at the end of which students submitted a representative piece of work, which captured their learning. Essays (n = 22) were analysed using a thematic content analysis. Artwork consisted of painting, collage, photography, poetry and original music (n = 23). These were analysed using Gardner's entry points. Three core themes emerged in both written and visual work: patient centredness; communication; and an improved appreciation of the skills of other health care professionals. Students identified optimal team communication occurring when patient outcomes were prioritised. Metaphors relating to puzzles, hands and inter-connectedness feature strongly. The poems and artwork had a high impact when they were presented to tutors. Primary care team placements focus student attention on teamwork and patient centredness. Student artwork shows potential as a tool to evaluate student learning in medical education.

Improving outcomes for ‘failing’ students through the use of presentations

Over recent years there has been an increasing use of presentations for students who are struggling in, or have failed a practice placement on the qualifying social work programmes. This has often been set up following the student having attended a practice consultation panel at the request of member of the students’ placement team. The presentations are aimed at improving the students’ understanding of the issues that have led to their difficulties on placement and are therefore specific to that student. Some students have been asked to prepare just one presentation whilst others have been given up to 4 titles. The experience of the university placement team, and the practice agencies that offer a repeat placement is that it has led to an improvement in the outcome for many students as this has led to greater understanding of issues and therefore preparation for the repeat placement. Some of the students concerned have chosen at the end of the process of undertaking presentations that they will not complete the professional award and this decision has been clearer and based on better quality evidence and thinking. This paper considers the process, outcomes and potential gains of this system.

Using Interviewing to Explore Clinical Learning at Team Placements: A Pilot Study

This paper reports the development of a pilot study which aims to identify a medical student’s experience and perceptions towards team placement learning and how closely those experience and perceptions link to the author’s main project--a longitudinal, multiple-method case study, which is designed to investigate how medical students learn in a multiprofessional clinical context, and how multi- and inter-professional contact influences the transition from ‘thinking as a student’, to ‘thinking like a doctor’, to ‘thinking as a doctor’, as an issue of identity construction. By using a reflexive account, the author delineates the strengths and limitations; practicalities and difficulties of in-depth interviewing, one of the qualitative data collection methods to be use in her further study.

Improving outcomes for ‘failing’ students through the use of presentations

Over recent years there has been an increasing use of presentations for students who are struggling in, or have failed a practice placement on the qualifying social work programmes. This has often been set up following the student having attended a practice consultation panel at the request of member of the students’ placement team. The presentations are aimed at improving the students’ understanding of the issues that have led to their difficulties on placement and are therefore specific to that student. Some students have been asked to prepare just one presentation whilst others have been given up to 4 titles. The experience of the university placement team, and the practice agencies that offer a repeat placement is that it has led to an improvement in the outcome for many students as this has led to greater understanding of issues and therefore preparation for the repeat placement. Some of the students concerned have chosen at the end of the process of undertaking presentations that they will not complete the professional award and this decision has been clearer and based on better quality evidence and thinking. This paper considers the process, outcomes and potential gains of this system.

Fostering a Child’s Recovery: Family Placement for Traumatized Children

Fostering a Child’s Recovery: Family Placement for Traumatized Children

Student and professional attitudes and interests in working with people with complex communication needs

Speech-language pathology interest in working with people with complex communication needs was investigated in this study. Participants were third year speech-language pathology undergraduates and recent graduates who had participated in a unit on AAC. Undergraduates (n = 85) completed an Interaction with Disabled Persons attitudinal scale and a questionnaire about interest in various client groups before and after the unit. Some undergraduates (n = 34) repeated the attitudinal scale and completed another questionnaire 2 years after graduation. Recent graduates (n = 56) completed a questionnaire about working with people with complex communication needs and factors influencing work choices; 10 also participated in interviews or focus groups. We found a small but positive attitudinal shift for the undergraduates, but, along with previous disability experience, this was a weak predictor of working with this group. Working in developmental disability ranked low amongst undergraduate preferences. Most graduates were influenced in their job choices by a desire to work on a particular team and previous clinical placements. Questionnaires and interview/focus group data indicated the strong influence of clinical placements on later work choices. Participants who worked in disability appeared passionate about the work involved and offered suggestions for engaging more professionals with this group. Implications for speech-language pathology services in disability are discussed.

Vein Preservation: An Algorithmic Approach to Vascular Access Placement in Patients With Compromised Renal Function

Peripherally inserted central catheters (PICCs) have become ubiquitous in the current management of chronic inpatient and outpatient conditions. Many hospitals have developed practice patterns that allow placement ofPICC lines by teams of nurses at the bedside. This practice has led to a proliferation of these central venous access devices, and their use has expanded. One of the consequences of a nurse-based placement team is the decrease in physician involvement in decisions regarding the placement of PICC lines. In some settings, PICC placement can become so routine that the type of access needed or the other clinical conditions affecting an individual patient may be overlooked. One example of this problem is the situation in which a patient with chronic kidney disease or end-stage renal disease needs venous access for a nondialysis reason, such as antibiotics, cancer therapy, or total parenteral nutrition. The author discusses ramifications of this problem as well as ways to reduce the chances of mistakes.

Pericardial Tamponade in Patients With Central Venous Catheters

Cardiac (pericardial) tamponade occurs when the pressure of the fluid within the pericardial sac is high enough to impair the venous return to the heart. Cardiac tamponade can occur during central venous catheter placements. Nursing members of a central vascular catheter placement team benefit from quickly recognizing this clinical situation and understanding the appropriate clinical response. A methodical approach to this potentially fatal condition can greatly increase patient safety. This article reviews this condition, its clinical presentation and diagnosis, and strategies for avoiding central vascular access-associated tamponade.

See the client not the addiction

A drug team placement opened Kerry Stott’s eyes to non-judgemental care. As a nursing student I had no experience of working with addiction or the complex social issues connected to it before my placement with the community drug team.

Universities preparing health professionals for the 21st century: Can something new come out of the traditional establishment?

To address clinical education in chronic disease management, the University of Alberta partnered with the local health authority to develop interprofessional team placements in diabetes chronic disease management. The objectives were to determine a meaningful and sustainable approach to interprofessional team placements. Pre-licensure students from medicine, nursing, nutrition and pharmacy participated in a project-based team experience designed to increase their discipline-specific knowledge of diabetes while enhancing their team process skills. Quantitative and qualitative research methods were used to evaluate project implementation and student outcomes. The majority of students reported learning “a great deal” about the roles of other health professionals and knowledge regarding the management of diabetes from the perspective of other health disciplines. However, several key learning outcomes were not fully accomplished; to enhance student's interprofessional team skills, increase their knowledge of interprofessional team functions and learn how to modify team function in a clinical setting. Creativity concerning relevant projects, varying settings, and differing models of service delivery should be encouraged, and flexibility within the project and process is essential for self-directed learning of student teams. New models of interprofessional clinical education, such as the chronic disease management model used in this study, have potential, if supported by the shift in health science programs culture.

Trait configurations in self-managed teams: A conceptual examination of the use of seeding for maximizing and minimizing trait variance in teams.

In this article, the authors argue that there is no one best way to make placement decisions on self-managed teams. Drawing from theories of supplementary and complementary fit, they develop a conceptual model that suggests that (a) maximization principles should be applied to extroversion variance (i.e., complementary fit), (b) minimization principles should be applied to conscientiousness variance (i.e., supplementary fit), and (c) extroversion variance and conscientiousness variance interact to influence team performance. They also argue that previous research has underestimated the effect of extroversion and conscientiousness variance on performance because of suboptimal design. The authors, therefore, present an alternative method for making team placement decisions (i.e., seeding) that can be used to maximize or minimize variance in teams.

It will go swimmingly

You need to prepare to fit in with your placement team, say Melanie Gasston-Hales and Dawn Kelly.

The Special Education Referral and Decision-Making Process for English Language Learners: Child Study Team Meetings and Placement Conferences

The purpose of this study was to examine the special education referral and decisionmaking process for English language learners (ELLs), with a focus on Child Study Team (CST) meetings and placement conferences/multidisciplinary team meetings. We wished to learn how school personnel determined if ELLs who were struggling had disabilities, to what extent those involved in the process understood second language acquisition, and whether language issues were considered when determining special education eligibility. We observed CST meetings and placement conferences for 19 students who were considered ELLs when they were referred. Findings revealed that in practice, only cursory attention was given to prereferral strategies. Most students were pushed toward testing, based on an assumption that poor academic performance or behavioral difficulties had their origin within the child and indicated a need for special education. Although some school personnel were quite knowledgeable about language issues, many were not. There was tremendous variation in the quality of what transpired during meetings. These differences were influenced by the intentions, knowledge, skills, and commitment of CST or multidisciplinary team members. All the factors we describe point to aspects of the process that should be improved.