Student physiotherapists' perspectives of peer learning during multi-model placements

INTRODUCTION

Placements are a key component of physiotherapy courses; however, placement providers struggle to meet rising demands. To enhance placement capacity, multi-models are increasingly employed, where Universities place more than one student with one educator. Student support on placement is important, and studies exploring multi-placement models reveal educators welcome the peer support possible with this placement pattern. This research explored UK physiotherapy students' perspectives of peer relationships during placements, for which there is yet little research.

METHODS

Eight single, semi-structured interviews were conducted, exploring students' experiences of peer working on placement October to December 2020. Participants and researchers were undergraduate students at the same UK university. Interviews were virtual, recorded via Microsoft Teams and transcribed verbatim. Transcripts were analysed first individually, then collaboratively, sharing ideas and interpretations using a phenomenologically informed analytical lens.

RESULTS

Two main themes were identified: collaboration vs conflict and supportive vs hindering relationships. Students appreciated the emotional and academic support from peers, but there could be difficulties in generating constructive peer relationships, and sometimes a sense of competition from divided tutor attention.

CONCLUSION

Multi-model placements provide social and emotional support to students, increasing their confidence. Peer relationships present opportunities for collaborative working and academic support if they are adequately framed as such by the practice educator and wider team. Students may benefit from university-based support to prepare them to maximise the peer relationship. Practice educators may benefit from information about supporting students in multi-model placements. Student-led research can offer rich qualitative data and helpful educational solutions.

CONTRIBUTION OF THE PAPER

This small project from one UK University produced similar findings as research from other professions: placement peer relationships had the capacity to provide helpful social and emotional support to students, resulting in greater levels of confidence, collaborative working, and learning. However, there were indications that educational institutions could a) further support students to develop their capabilities in cooperative peer working, and b) assist educators to manage the challenges of multi-model placements.

Clinical placement models for undergraduate health professions students: a scoping review

BACKGROUND

Clinical learning is fundamental to undergraduate health professions students. There are several calls for the transformation of health professions education, which have direct implications on clinical learning. Clinical placement models provide structure to clinical learning. Therefore, this scoping review could contribute to supporting curriculum transformation to enhance learning in the clinical environments for undergraduate health professions students.

OBJECTIVES

This scoping review identified the characteristics of research evidence related to mapping the purpose, methodologies used, outcomes, and specific recommendations associated with clinical placement models in undergraduate health professions education.

DESIGN

A scoping review method was used in this study. A search string developed from the title of the review was used to search online databases to identify research published between January 2000 and March 2020.

RESULTS

Forty-eight articles reporting on ten clinical placement models were included in this review. The majority of these articles originated from Australia and predominantly report on nursing. The aims of these articles aligned with the evaluation of the implementation of a clinical placement model. Seven categories of outcomes of the clinical placement models are reported namely, relationships, influence, environment, facilitation, inputs, knowledge scores, and student perceptions.

CONCLUSIONS

As clinical learning is fundamental to undergraduate health professions education, clinical placement models should prioritise the development of competence among undergraduate students. Insights into outcomes reported in literature could guide educators in fostering optimal learning in students who may then be able to influence community health outcomes positively.

Peer learning and collaborative placement models in health care: a systematic review and qualitative synthesis of the literature

AIMS

To summarise the international empirical literature to provide a comprehensive overview of peer learning and collaborative practice placement models in health care and to synthesise their benefits and challenges.

BACKGROUND

Practical placements for students are in high demand due to the need for an increased nursing, midwifery and health professional workforce, thus collaborative placement models are an attractive solution to potentially increase placement capacity and enhance the student learning experience.

DESIGN

A systematic search of the literature and qualitative data synthesis using the PRISMA checklist and ENTREQ guidelines.

REVIEW METHODS

MEDLINE and CINAHL searched in March 2020. Quality appraisal of studies conducted. Collaborative models and empirical findings summarised. Reported benefits, challenges and implementation recommendations synthesised. Two tables developed for data representation.

RESULTS

172 studies were identified by the search strategy. Of these, 47 articles were included for appraisal and synthesis. 30 articles employed qualitative, seven quantitative and ten mixed-methods approaches. Research took place in eight countries. The majority of studies employed focus groups, interviews as well as questionnaire design. The total participant sample was 3462 consisting of students and educators.

CONCLUSIONS

This review confirmed that any peer learning is beneficial in supporting students' confidence and team working skills. It is especially helpful when pairing first year with third-year students. The latter can demonstrate their clinical skills and prepare for working in practice. Simultaneously, expert-led learning is important for role modelling and for the recognition of acquired skills. Evidence on the optimal placement experience is inconclusive; however, it can be concluded that any form of collaborative placement model requires careful planning and continuous preparation for staff and students.

RELEVANCE TO CLINICAL PRACTICE

Decision makers should consider implementing at least some form of peer learning to assist students with peer support, and ideally work towards a collaborative learning environment.

A narrative literature review: Growing the workforce through increased fieldwork capacity in genetic counseling training programs

In response to mounting concerns regarding a perceived shortage of genetic counselors, the Genetic Counselor Workforce Working Group (WFWG) was established in 2013 to identify barriers to growth of the genetic counseling workforce. After completing a workforce analysis and confirming a shortage, the WFWG convened a strategic planning session in 2017 to identify goals and strategies that would increase the number of certified counselors to meet the current and future workforce demands and ensure access to genetic counselor services. Subcommittees were formed and charged with achieving assigned goals; one such subcommittee included a curriculum working group to build a dynamic and effective educational infrastructure to increase the number of genetic counselors graduated from accredited training program. This paper reports of progress of the WFWG Curriculum Subcommittee toward achieving this goal through a narrative literature review that identifies innovative education methods that help to increase capacity of fieldwork training, both in genetic counseling training programs and in other health professions. Of the five thematic areas identified in this study, four are analyzed for insight into building clinical capacity: systems/infrastructure, rotation structure/models, skill building, and novel techniques. While additional studies are needed to establish best practices in these thematic areas, there are several take-aways that training programs can begin to utilize as they look to expand training opportunities. While growth of the genetic counseling workforce will continue to be a long-term issue, programs should begin to think creatively and innovatively about how to reach beyond traditional fieldwork training formats to build capacity. The strategies explored in this paper offer feasible and untapped solutions that can help support efforts to establish a sustainable genetic counseling workforce.

A mapping review of models of practice education in allied health and social care professions

Introduction

Practice education is fundamental to pre-registration learning for many health and social care professions, yet finding sufficient opportunities for students is challenging. One-to-one student–educator pairings are common, and while different models could increase placement opportunities, the associated terminology is inconsistent and an overview of advantages, challenges and available evidence is missing. This mapping review identifies, categorises and critically considers the evidence for different models of practice education used by health and social care professions.

Method

Papers from 2008 onwards reporting on practice education approaches in allied health or social care profession courses were identified in three databases. Data was extracted, methodological quality categorised and a typology of practice education models developed.

Findings

Fifty-three papers were reviewed and developed into a typology of 14 models. Mapping indicated issues with a lack of high-quality research and limitations in available outcome indicators. Pre-requisites for the effective operation of different models include preparation, communication and allowing sufficient time for new ways of working.

Conclusions

Practice education discourse is characterised by varied terminology and practices. Various models for structuring practice education exist, though the evidence for their effectiveness and impact on capacity is limited. Using consistent language and considering wider impacts and outcomes is recommended in future study.

Supervision models in physiotherapy practice education: student and practice educator evaluations

Objectives: To establish the supervision models used during physiotherapy practice placements and to determine student and practice educators' evaluations of the quality of these placements.Design: Cross-sectional study set in clinical sites providing placements for physiotherapy students in Ireland.Participants: Practice educators and students completing placements in 2015/16.Outcome Measure: Questionnaire which measured 18 indicators linked to quality assured placements. Eight additional indicators in the practice educator questionnaire addressed the overall feasibility of the supervision model. Two open-ended questions captured comments on the benefits and challenges of each model.Results: The overall response rate was 72% (112/155). The majority (75%, n = 84) of participants reported a 1:1 (one student: one educator) model of supervision. Fourteen percent (n = 16) reported a 1.2 (one student: two educators) model and 9% (n = 10) a 2.1 (two students: one educator) model. There was generally positive agreement with the questionnaire indicating that all placements, irrespective of supervision model were positively evaluated by participants. Students, however, indicated a more negative evaluation of the placement than practice educators in indictors related to communication, the provision of feedback, establishing an effective relationship with their educator and diversity of available learning opportunities. Indicators relating to productivity and the placement representing an efficient use of resources and personnel received more negative or equivocal ratings by educators.Conclusions: While the 1.1 model remains the most widely used supervision model in physiotherapy practice education, other models also score positively, offering choice to placement providers when determining the model that best suits their service.

Collaborative learning: Application of the mentorship model for adult nursing students in the acute placement setting

Traditionally mentorship of pre-registration student nurses in clinical practice has followed a 1:1 model. Students are allocated a named mentor for the duration of the placement and they are responsible for supporting and assessing the learner. Many studies have identified problems with this approach to mentorship, including lack of time to facilitate learning on a 1:1 basis. In response to some of these challenges, a collaborative model of mentorship is being adopted both internationally and nationally. This involves placing a range of 1st, 2nd and 3rd year students on placement together, with students being allocated specific patients to care for collaboratively, under supervision. This model has already become established in Amsterdam, as an effective approach to mentorship (Lobo et al., 2014). In addition collaborative learning in practice has also been introduced in Ireland, Australia and the United States of America. This paper discusses the implementation of a collaborative model of learning by a district hospital and higher education institute (HEI) in the South West of England, commencing with a preliminary study in one placement area. Following success of this project this model is being implemented in other placement areas within the Trust.