International Journal of Practice-Based Learning in Health and Social Care

Sustainable growth in the Allied Health Professions (AHP) workforce is an ambition of the United Kingdom’s NHS Long Term Plan. However historically, access to good quality placements has been a barrier to increasing pre-registration training numbers. This article focuses on work carried out by Health Education England (HEE) to gain insights on the impact of the COVID-19 pandemic on capacity. Using a pragmatic, embedded mixed-methods approach, insights were gathered using an online workshop, crowdsourcing, open for two weeks in the summer of 2020. AHP placement stakeholders could vote, share ideas or comment. Descriptive data were extracted, and comments made were analysed using inductive thematic analysis. Participants (N = 1,800) made over 8,500 comments. The themes identified included: diversity of placement opportunity, improved placement coordination, a more joined-up system, supervision models and educator capacity. Alongside considering the challenges to placement capacity, several areas of innovative practice owing to the pandemic were highlighted. Generated insights have shaped the aims and objectives of the Health Education (HEE) pre-registration AHP student practice learning programme for 2020/2021 and beyond. The COVID-19 pandemic has disrupted the delivery of AHP placements. In the absence of face-to-face activities, crowdsourcing provided an online data collection tool offering stakeholders an opportunity to engage with the placement capacity agenda and share learning. Findings have shaped the HEE approach to short-term placement recovery and long-term growth.

Janice St. John-Matthews

Charlotte Hobbs

Paul Chapman

David Marsden

Ruth Allarton

Austin Booth

Fiona Martin

Julie Woodley

Beverley Harden

International Journal of Practice-based Learning in Health and Social Care

Ensuring an Essential Supply of Allied Health Professions (AHP) Placements: Using Crowdsourcing to Develop a National Call to Action

确保盟友健康职业（AHP）实习的基本供应：利用众包开发全国行动呼吁

Virginia King

Front Matter

前言

Maggie Bartlett

Stella Howden

Alison Jones

Linda Martindale

Editorial: Innovation and Creativity in a Time of Crisis

编者按：危机时期的创新与创造力

As with many OECD countries, graduating medical students have been choosing specialist careers at a greater rate than ever before. Generalism in the form of family (general practice) and more generalist medical specialties have been trending down resulting in distributional geographic challenges. With the advent of COVID-19 in March 2020, medical schools and in particular the Joint Medical Program situated in a regional and rural area in NSW Australia had the unique opportunity to rethink the penultimate year curriculum when the previous rapid rotation model through numerous medical specialities became untenable. The need to vision a new practical pragmatic curriculum spurred a rapid revaluation of assessment, placement length and model with a pivot to an “embedded senior student placement” agnostic of discipline and supported by a competency-based learning portfolio. This article explores the barriers and enablers and identifies the potential elements of this type of placement which can be adapted to community and smaller rural sites. The positive student and supervisor experience also enabled an employment model to be woven into the students learning and ensured on hand medical student workforce for hospitals throughout the rural footprint. The capacity of these placements to celebrate variation in experience and support students to learn on the job have now caused a revision of the penultimate year with expectation of gains in students’ satisfaction and in employability. It has also opened up options to deliver and increase the inherent value of generalist placements with likely long term workforce benefit.

Jennifer May

Miriam Grotowski

Tim Walker

Brian Kelly

Rapid Implementation of a Novel Embedded Senior Medical Student Program, as a Response to the Educational Challenges of COVID-19

快速实施新型嵌入式高年级医学生项目，以应对COVID-19带来的教育挑战

The first phase of the COVID-19 global pandemic had a significant impact on nursing students studying in the United Kingdom, heralding changes to every aspect of their lives. Practice Education Facilitators (PEFs) and academics had to respond quickly and work in close collaboration with their wider system partners, Health Education England (HEE) and the Department of Health (DH). Changes in emergency measures implemented by the Nursing and Midwifery Council (NMC) provided nursing students in their final six months of study with the opportunity of completing a paid placement. The objectives of this study were to explore the experiences of academics and PEFs supporting the nursing students and to identify examples of good practice. A phenomenological approach was used seeking to understand the lived experience of PEFs and academics within one case study site. A purposeful sample of ten participants was chosen using semi-structured interviews and focus groups to collect the data via a virtual platform. The results highlighted three themes: communication, innovative learning opportunities and the importance of support mechanisms. PEFs and academics reported how they had increased their competence and confidence in using virtual platforms. They suggested that changes they implemented during the pandemic to support staff and students would become embedded in their future practice. This study provides insights into how PEFs and academics transformed their practice to support students and clinicians during the COVID-19 pandemic. Having robust virtual platforms for the development of continuing learning opportunities and enhanced communication approaches across health and academic environments was essential to this success.

Noreen Cushen-Brewster

Annie Barker

Paul Driscoll-Evans

The Experiences of Practice Educator Facilitators and Academics Supporting Adult Nursing Students Completing a Paid Placement During the COVID-19

COVID-19期间支持成人护理学生完成有偿实习的实践教育促进者和学术人员的经验

This article describes the development as well as face and content validation of an instrument for measuring the clinical learning environment of professional healthcare students. A methodological research design was used to develop the instrument and a Delphi technique was used to determine face and content validity. The research was conducted systematically in two phases to construct the instrument, and to establish face and content validity. Phase 1 comprised a general literature overview to identify existing instruments. The retrieved instruments were thematically analysed into the four themes of atmosphere, teamwork, workload and learning opportunities, and then the first version instrument was drafted. In Phase 2, the first version instrument was evaluated for face and content validity. Thirty-six healthcare professional experts responded in the consensus Delphi study, and consensus was reached after three rounds. A consensus Delphi study confirmed the face and content validity of 62 items. The second version of the new instrument was determined. A new holistic clinical learning environment measuring instrument, based on existing instruments, was developed to promote quality student placements.

Lizemari Hugo-van Dyk

Hanlie Jordaan

Some is not everything? Designing an instrument that measures the clinical learning environment holistically

“一些并不代表全部？设计一种全面评估临床学习环境的工具”

The COVID-19 pandemic brought about rapid digital transformation of physiotherapy practice and education. Previous studies have suggested a lack of knowledge, beliefs, and clinical acceptance of telerehabilitation as barriers to implementation and sustainability of telerehabilitation. Providing pre-registration specific teaching and practical experience of telerehabilitation may improve physiotherapy student confidence and competence in delivering telerehabilitation and support clinical acceptance of telerehabilitation in practice. A 2-week Peer Enhanced E-Placement (PEEP) was developed and evaluated to explore its impact on third year physiotherapy student attitudes, and perceived competence and confidence in delivering telerehabilitation. Students completed a Likert scale questionnaire, immediately pre and post the PEEP placement, rating their perceived confidence and competence in four key areas of telerehabilitation: assessment, intervention, communication, and problem solving. In addition, students participated in group discussions to explore the impact of the PEEP on their attitudes towards telerehabilitation. 59 students completed the PEEP, 49 (mean age 25±6.6 years, 41% male) completed both the pre and post placement questionnaire. 55 students participated in group discussions (n=8). Following the PEEP, self-perceived confidence and competence increased in all four key areas assessed. Analysis of the group discussions identified three core themes: Prior experience and assumptions of telerehabilitation, Opportunities and barriers, and Experience of the PEEP. Participation in a 2-week PEEP had a positive impact on physiotherapy student confidence and perceived competence in delivering telerehabilitation. Student attitudes towards telerehabilitation generally improved, with increased acceptance and recognition of its clinical value for physiotherapy practice. Students’ concerns echoed those of clinicians identified in prior research related to the opportunities and barriers facing telerehabilitation. The intensive structure of the PEEP, peer interaction and simulation appeared to positively impact on outcomes related to confidence and acceptance of telerehabilitation. Further research is required to understand and evaluate the effectiveness of pre-registration telerehabilitation training as a means of preparing students for practice and supporting sustainability of telerehabilitation in the post-COVID era.

Christie Robinson

Sarah Buckingham

Jennifer Freeman

Evaluating the impact of a 2-week Peer Enhanced E-Placement (PEEP) on pre-registration physiotherapy students’ attitudes, self-perceived confidence, and competence in delivering telerehabilitation.

评估为期两周的同伴增强电子实习（PEEP）对预注册物理治疗学生态度、自我感知信心及远程康复能力的影响。

Reflective practice (RP) activities are regularly employed as part of clinical education programs for SLP. Studies examining SLP student perception of RP, suggest that in general RP activities are valued and learning occurs (Dunne et al., 2019; Tillard et al., 2018). However, it is not known whether perceptions of RP activities change as clinical placement experience increases. The impact of RP activities on outcomes such as: confidence; communication; job satisfaction; stress; uncertainty; and desire for improvement also has not been examined. Aims: 1. To determine perceptions of reflective capacity and outcomes of engaging in RP in three groups of SLP students (following their second, fourth or sixth clinical placement experience) utilizing a validated and reliable instrument. 2. To examine patterns of perceptions of reflective capacity and outcomes of engaging in RP across SLP students utilizing Hierarchical clustering (Manhattan distance). 70 SLP students completed The Reflective Practice Questionnaire (RPQ) (Priddis &amp; Rogers, 2018; Rogers et al., 2019). The majority of SLP students perceived they had high levels of reflective capacity. In general, as SLP student clinical placement experience increased so did perception of RP abilities and subscales associated with outcomes of engaging in RP. A significant positive effect for three subscales of the RPQ (communication confidence, confidence general and job satisfaction) was found as clinical placement experience increased. Three groupings were identified as a result of Hierarchical clustering. This study provides quantitative data to support the teaching and use of RP activities with students across clinical programs.

Kate Cook

Cheryl Messick

Megan McAuliffe

Examining SLP student perceptions of reflective practice. How do students compare on the reflective practice questionnaire?

考察言语语言病理学学生对反思实践的看法。学生在反思实践问卷上的表现如何比较？

While evidence of the impact of simulation in nursing education is growing, COVID-19 pandemic may carry further evaluation beyond the existing perception. To explore Jordanian nursing students' perspectives toward utilizing high-fidelity simulation learning as alternative clinical bedside training during COVID-19 pandemic. A qualitative thematic analysis approach was employed through direct focus group discussions. Transcripts were thematically analyzed using Marshall and Rossman's (1999) process. Thirty-five nursing students joined seven focus group discussions. Two major themes emerged from data analysis as follow: "Restored factual training environment", and "Proficiency devoid from self-confidence". Students articulated the implication of using HFS on their knowledge, practical skills, communication, and team working. However, a criticism on HFS inability to promote self-confidence was addressed. Despite the effectiveness of HFS in nursing education, it was viewed as incompetent for building sufficient confidence required for direct interaction with contagious patients in real settings.

Ghada Abu Shosha

Mahmoud Al-Kalaldeh

Perspectives of Nursing Students toward High-Fidelity Simulation Learning During COVID-19 Pandemic

COVID-19疫情期间护理学生对高保真模拟学习的看法

Nursing students are exposed to a variety of stressors during their clinical training. The impact of stress must be considered as an important factor that may have negative impact on clinical performance and patient care. The purpose of this study was to identify the relationship between self-esteem and stress and coping mechanisms among nursing students during clinical practice. A descriptive-correlational study was used in the study; a self-reported questionnaire was used to collect the data. A convenience sample of 300 baccalaureate-nursing students from Palestinian universities and had clinical training in governmental and/or private hospitals participated in the study. The most common type of stressors perceived was stress from taking care of patients (Mean= 9.8), followed by stress from instructors and nursing staff (Mean= 8). Problem solving was the most prevalent coping strategy used by the participants (Mean= 14.2), followed by staying optimistic (Mean= 9). The results showed that avoidance, and transference have significant positive correlations with all stressors (p &lt; 0.05), while self-esteem has significant negative correlation with all stressors. The findings of this study revealed that nursing students experienced mild to moderate stress, and the most prevalent form of stresses experienced was stress from taking care of patients, followed by stress from instructors and nursing staff. Students commonly used problem solving followed by staying optimistic to cope with their stress, and they found these methods to be effective.

Mutaz Dreidi

Duaa Abed

Haya Salameh

Inas Abu Sbeih

Saja Asmar

Sewar Salameh

Imad Asmar

Khalid Yaseen

Omar Al-Mahmoud

The Effect of Self-esteem on Stress and Coping Mechanisms among Nursing Students during Clinical Training in Palestinian Universities

巴勒斯坦大学护理学生在临床培训期间自尊对压力和应对机制的影响

涉及主题	心理学医学医学教育政治学法学经济社会学经济增长计算机科学教育学护理部哲学医疗保健生物人类学物理社会科学业务数学认识论地理工程类社会心理学物理疗法
出版信息	出版商: Coventry University，出版周期: ，期刊类型: journal，开源期刊: 否
基本数据	创刊年份: 2019，原创研究文献占比: 0.00%，自引率:N.A.， Gold OA占比: 0.00%

International Journal of Practice-Based Learning in Health and Social Care

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