Learning experiences on role-emerging placements: an exploration from the students' perspective

Bridging the Gap between Clinical Service and Academic Education of Hand-Splinting Practice: Perspectives and Experiences of Thai Occupational Therapists

A gap in knowledge about current splinting practice exists between the educational program and clinical service. To bridge this gap, we investigated the perspectives and experiences of Thai occupational therapists regarding contemporary hand splinting practices in clinical use. A mixed-method study was designed. An explanatory sequential mixed methods design was used. In the first quantitative phase, a survey questionnaire was mailed to occupational therapists. The questions were regarding contemporary hand splinting practices in clinical use at seven hospitals in the capital city of Bangkok and outskirt areas. In the second phase, semi-structured interviews were completed to explore expert occupational therapists’ perspectives on practice in the same hospital settings. Transcripts were analyzed using thematic analysis. The results showed that most conditions receiving splints were nerve injuries, orthopedics, and stroke, which represented the service frequency of splint types: functional resting (100%), cock-up (93.3%), and thumb spica splints (80%). Bone and joint deformity prevention ranked first with muscle contracture prevention being ranked second, and the third-ranked was maintaining range of motion. Three themes emerged from the interviews: starting with the patient condition; effective function and value; knowledge and experiential skills. Perspectives and experiences of occupational therapists in splinting practice contribute to education based on the reality of practice. Integrated numerical and textual data of professional skills and knowledge in actual splinting practice can be reflected through splints and orthoses program revisions to meet future learning outcomes.

Identifying the characteristics of occupation-centred practice: A Delphi study

INTRODUCTION

Occupation-centred practice is key to aligning with the contemporary paradigm. Benefits of this approach for clients and the profession are well documented, yet how to identify occupation-centred practice is not yet understood. Therefore, this study aimed to uncover the characteristics of occupation-centred practice and how they can be identified in practice.

METHODS

A three round Delphi survey was conducted to gain consensus on the defining characteristics of occupation-centred practice. Purposive, convenience, and snowball sampling were used to distribute three survey rounds to occupational therapists internationally. Content analysis was used to create characteristics, descriptions, and examples of occupation-centred practice. Percentage agreement between occupational therapists were calculated to determine consensus.

RESULTS

Responses were received from 100 participants in round one, 89 in round two, and 70 in round three. Round one generated 12 characteristics that were refined and finalised into four defining characteristics, one of which had three subcharacteristics. The four characteristics are as follows: guided by theory and philosophy grounded in occupation, language and documentation promotes occupation among stakeholders, understanding and incorporating the person's context, and occupation as core to practice, which includes occupation in goal setting, assessment, and intervention. Descriptions and examples were generated for each characteristic.

CONCLUSION

This study presents valuable information for occupational therapists wanting to practise in an occupation-centred manner. The characteristics, descriptions, and examples provide a foundation upon which occupational therapists can understand and identify occupation-centred practice. Examples provided were highly influenced by factors including practice settings and preferred terminology. Future research will explore the creation of a tool for occupational therapists to evaluate their own practice against the characteristics to demonstrate areas of strength and for development.

Student-Led Clinics in Aotearoa New Zealand: A Scoping Review with Stakeholder Consultation

Background

Student-led clinics have gained increasing attention as a mechanism for students across various health professions to gain authentic interprofessional clinical placement experience during their educational programme.

Purpose

This scoping review is designed to identify and describe experiences relating to student-led clinics in Aotearoa New Zealand.

Methods

The review involved five key steps: 1) identifying the research question; 2) identifying relevant studies; 3) study selection; 4) charting the data; and 5) collating, summarising and reporting the results.

Discussion

Student-led health clinics present invaluable educational opportunities for authentic collaborative practice and capacity to improve population health and well-being, especially in marginalised and disadvantaged communities. Clinic establishment and operation require consideration of a complex set of factors.

Conclusion

Community consultation (including with Indigenous populations) should precede establishment of clinics. There is scope for more reporting and objective evaluation to ensure best practice is being determined, developed, and achieved.

PLUS Framework: guidance for practice educators

BACKGROUND

The practice educator role is complex and becoming more so with changes in placement configurations since the COVID-19 pandemic. The role requires practitioners to manage clinical activities while providing learning opportunities and supervision for students. This can be time-consuming in often stretched clinical settings. This research investigated how experienced practice educators in occupational therapy tailored their approach to supporting student learning to make the most of limited supervision time. The results were developed into the Professional Learning through Useful Support (PLUS) Framework, which revealed how experienced practice educators focused their supervisory approach with students to maximise learning.

METHODS

An Action Research methodology was used across four cycles. Semi-structured interviews and naturally occurring placement documentation were gathered to determine the critical features of practice educator supervision. Template analysis was used to explore the approaches employed by practice educators to support student learning. Key focal points were linked and situated within educational theory to create the PLUS Framework.

FINDINGS

Three key focal points for practice educators were identified: (1) guiding learning, (2) making the theory-to-practice links explicit and (3) supportively challenging students.

DISCUSSION

The PLUS Framework is an educational tool that describes a set of guidance strategies used by skilled practice educators, whilst acknowledging the critical influences of workplace and university contexts. The proposed key features could be useful target areas for busy practice educators to help make the most of limited supervision time. Future research will explore the PLUS Framework in different countries and professions' practice education environments.

Peer supervision experiences of drug sellers in a rural district in East-Central Uganda: a qualitative study

BACKGROUND

Support supervision improves performance outcomes among health workers. However, the national professional guidelines for new licenses and renewal for Class C drug shops in Uganda prescribe self-supervision of licensed private drug sellers. Without support supervision, inappropriate treatment of malaria, pneumonia and diarrhoea among children under 5 years of age continues unabated. This study assessed experiences of drug sellers and peer supervisors at the end of a peer supervision intervention in Luuka District in East Central Uganda.

METHODS

Eight in-depth interviews (IDIs) were held with peer supervisors while five focus group discussions (FGDs) were conducted among registered drug sellers at the end of the peer supervision intervention. The study assessed experiences and challenges of peer supervisors and drug sellers regarding peer supervision. Transcripts were imported into Atlas.ti 7 qualitative data management software where they were analysed using thematic content analysis.

RESULTS

Initially, peer supervisors were disliked and regarded by drug sellers as another extension of drug inspectors. However, with time a good relationship was established between drug sellers and peer supervisors leading to regular, predictable and supportive peer supervision. This increased confidence of drug sellers in using respiratory timers and rapid diagnostic tests in diagnosing pneumonia symptoms and uncomplicated malaria, respectively, among children under 5 years. There was also an improvement in completing the sick child register which was used for self-assessment by drug sellers. The drug shop association was mentioned as a place where peer supervision should be anchored since it was a one-stop centre for sharing experiences and continuous professional development. Drug sellers proposed including community health workers in monthly drug shop association meetings so that they may also gain from the associated benefits. Untimely completion of the sick child registers by drug sellers and inadequate financial resources were the main peer supervision challenges mentioned.

CONCLUSION

Drug sellers benefitted from peer supervision by developing a good relationship with peer supervisors. This relationship guaranteed reliable and predictable supervision ultimately leading to improved treatment practices. There is need to explore the minimum resources needed for peer supervision of drug sellers to further inform practice and policy.

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.

Preparedness for advancing future health: a national qualitative exploration of dietetics graduates' experiences

Effective health workforce preparation is critical to the health of those who stand to benefit from its services. Emerging dietitians can provide important insights on an evolving workforce that is well-placed to advance future global health. This study aimed to explore a national sample of dietetics graduates' experiences of, and challenges faced in, dietetics workforce preparation and preparedness in Australia. An interpretive description methodology guided this study whereby researchers interpreted the meanings that participants attributed to their experiences. Twenty dietitians (graduated within the last 2 years) were purposively sampled from across Australia and detailed insights were obtained through semi-structured interviews. A multi-analyst approach employing thematic and template analysis, enabled five themes to be identified across the data set. These included: (1) being held back; (2) chasing the prize; (3) valuing real learning; (4) easing the transition; and (5) encountering influencers. While graduates appreciated their preparation, they were not empowered or equipped to embrace opportunities in diverse and emerging areas of dietetics practice. Graduates were challenged by the competitive landscape of securing obvious job opportunities and by a lack of support in transitioning into the workforce. Practice exposures and encounters with influential dietitians were highly valued. Research on role-emerging dietetics placements along with enhanced support mechanisms for novice dietitians is urgently required to ensure appropriate alignment between future dietetics preparation and practice. Obtaining insights into health professional graduates' experiences of their education can be used to ensure that emerging health workforces are relevant and responsive to future market needs.

Allied health pre-entry student clinical placement capacity: can it be sustained?

Objective Meeting the demand for clinical placements in an environment of increasing university cohort growth and changes in health service delivery models is challenging. This paper describes the outcomes of a quality review activity designed to gain key stakeholder perspectives on the enablers and barriers to sustaining effort to placement provision and reports on: (1) measures used to determine the effect of a jurisdiction-wide initiative in clinical education for five allied health professions; (2) outcomes of data related to key factors affecting placement supply and demand; and (3) qualitative perspectives from management, workforce and university stakeholders on placement sustainability. Methods This study reviewed clinical placement, staff full-time equivalent numbers, university program and student cohort data for five allied health professions from 2013 to 2016. In addition, qualitative response data from key stakeholder surveys was analysed thematically. Results In the study period, the rate of growth in placement offers did not match that of university program student numbers and full-time equivalent staff numbers. All stakeholders agreed that sustaining placement provision is enabled by collaboration, continuation of management support for dedicated clinical education staff, a focus on clinical education capacity building activities, outcome data reporting and statewide profession-specific governance, including leadership positions. Collaborations and networks across health and education sectors were reported to enhance efficiency, minimise duplication, streamline communication and support information and resource sharing within and across professions and stakeholders, ultimately sustaining placement provision. Identified barriers to sustainability centred on resourcing and the continued increasing demand for placements. Conclusion Sustaining pre-entry student placements requires stakeholder flexibility and responsiveness and is underpinned by collaboration, information and resource sharing. Dedicated clinical education positions were highly valued and seen as a key contributor to placement sustainability. What is known about the topic? The increasing demand for student placements and strategies used to enhance placement capacity are well known. To date, there have been limited studies investigating cross-sectoral trends and health service enablers and barriers to sustaining responses to placement demand. What does this paper add? This paper describes outcomes of a clinical placement capacity building initiative within public health services, developed from a unique opportunity to provide funding through an industrial agreement. It presents key allied health staff and university partner perspectives on enablers to sustaining placement supply in an environment of increasing placement demand. What are the implications for practitioners? This paper demonstrates that key enablers for the sustainability of placement provision are collaboration between university and health sectors, continuation of management support for dedicated clinical education staff, outcome data reporting and statewide profession-specific governance and leadership. It supports current practices of profession-specific and interprofessional clinical education resource and strategy development and the sharing of expertise for sustained placement provision.

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

INTRODUCTION

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.

METHODS

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.

RESULTS

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'.

CONCLUSION

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.

"Perceptions, expectations and satisfaction levels of occupational therapy students prior to and after practice placement and comparison of practice placement models"

BACKGROUND

Practice placements in occupational therapy are fundamental components in developing a student's professional identity. Various models of placements are available to expose and expand students' participation in various community-based services. The purpose of this study was to compare occupational therapy students' perceptions and expectations prior to placements with their perceptions and satisfaction levels upon completion of placements, and to compare clinical placement models (role-established and role-emerging).

METHODS

The study included 155 undergraduate occupational therapy students, who completed questionnaires prior to and upon completion of their placements. The questionnaire included items that were divided into categories of placement setting and supervision, personal skills, professional skills, and community. Paired t-tests and two-way repeated measures analyses of variance (ANOVA) were used in order to examine the change in scores over time, and a-parametric tests were used in order to compare the two models.

RESULTS

For all students a significant decrease in scores was found from pre- to post-placement regarding setting and supervision (t[df] = 3.96[154], p < .001), and a significant increase in scores was found from pre- to post-placement regarding personal and professional skills (t[df] = 7.82[154], p < .001; t[df] = 14.24[154], p < .001, respectively). Comparison between placement models indicated nonsignificant differences regarding personal and professional skills. However, role-established post-scores were significantly higher than role-emerging scores regarding setting and supervision, but significantly lower regarding the contribution of services to the community.

CONCLUSIONS

Practice placements promote a student's personal and professional skills. Students were less satisfied with the setting and supervision in comparison to their pre-placement expectations. Both models may contribute to students' professional development. Role-established model had an advantage in students' satisfaction with settings and supervision, while role-emerging models had an advantage in students' perceptions regarding contribution to the community. Role-emerging model may contribute to developing and expanding areas of practice in the community.

Dietetics students' experiences of dietetics workforce preparation and preparedness: a systematic review and qualitative synthesis

BACKGROUND

Dietetics students are a widely researched group. As emerging dietitians, they can provide valuable insights to inform how dietetics education programmes may be enhanced to meet contemporary healthcare needs. This review aimed to systematically synthesise dietetics students' experiences of dietetics workforce preparation.

METHODS

MEDLINE, CINAHL, Embase, PsycINFO, ERIC, Informit and ProQuest Dissertations and Theses Global were searched to identify research published until June 2017. Studies investigating dietetics students' experiences of dietetics workforce preparation, and employing qualitative data collection and analysis methods were included. Data analysis was guided by thematic synthesis, where themes were constructed through an iterative and inductive process. Study quality was appraised using the RATS Qualitative Research Review Guidelines.

RESULTS

From the 3301 records identified, five studies met the inclusion criteria and the views of 120 dietetics students from two countries over a 9-year period were synthesised. The overarching theme of 'navigating through the ups and downs' was underpinned by four main themes: enduring hurdles; reconciling expectations; transforming self; and making and breaking connections. Quality appraisal results rated selection bias as being inadequate/inappropriate across all studies.

CONCLUSIONS

Dietetics students undertake a transformational journey through dietetics education. They are inspired by seeing what is possible through meaningful encounters with practitioners in diverse settings. However, they are challenged by competitive environments and perceived ideals that are embedded in the profession. Strategies that focus on exposing dietetics students to inspirational practitioners, increasing and celebrating diversity in academic/placement settings, and incentivising collaboration across dietetics education, could act as catalysts to enhance the experience of future dietetics students and the nutrition-related health of those they will serve.

Challenges in preparing the dietetics workforce of the future: An exploration of dietetics educators' experiences

AIM

Dietetics educators represent a small but influential workforce group that has experienced significant change in recent years. The workforce development challenges faced by this group have been largely unexplored. The present study aimed to explore the experiences of, and challenges faced by, academic dietetics educators in preparing dietitians for the workforce.

METHODS

The approach taken in the present study was informed by qualitative description. Fifteen dietetics educators employed by 13 universities across Australia were purposively sampled. In-depth, semi-structured interviews conducted via telephone (n = 12) or face-to-face (n = 3) were digitally recorded then transcribed verbatim. Data were managed with NVivo and inductively analysed using open coding. Codes were condensed into themes through an iterative process involving multiple researchers.

RESULTS

The overarching theme of 'aiming for a moving target' was underpinned by the themes of: (i) striving for betterment; (ii) bridging dissonance and (iii) distressing impossibilities. Interviewees described how they were driven to enhance the preparation of dietitians but acknowledged disparity between what graduates are being prepared for and what they need to be prepared for. Heightened expectations of others, professional constraints and a lack of collegiality among the profession were among the challenges that manifested in a sense of frustration, concern and isolation.

CONCLUSIONS

Dietetics educators are motivated to shape and enhance the future profession. However, they face numerous challenges in their efforts to prepare graduates who are well-equipped for increasingly diverse dietetics practice. Strong leadership, academic collaboration and greater engagement of the broader workforce are required for the benefit of the entire profession.

Development of a template to facilitate reflection among student pharmacists

BACKGROUND

Reflective practice activities utilizing appropriate tools enhance learning during and after experiential placements. Reflective tools described in the literature, used to support students on traditional placements of a duration of at least two weeks, sit at the unstructured end of a continuum (completely unstructured to just minimal structure). Additionally, non-traditional settings in role-emerging placements are of value as an alternative for experiential education. There were no reflective tools in the literature to provide a means of supporting pharmacy students as novice reflectors in non-traditional settings.

OBJECTIVES

To develop one fit-for-purpose tool that students could utilize across their experiences, regardless of type or duration of experiential placement.

METHODS

A multi-phased approach was adopted, including a mix of methodologies: interviews, focus groups, informal feedback from stakeholders, and grading reflective accounts utilizing Mezirow's categories of reflection. A range of stakeholders were involved at each stage to ensure the reflective tool was fit-for-purpose. These included students, placement preceptors, and academic staff acting as graders of student reflective accounts.

RESULTS

A total of 24 students participated in focus groups, 13 supervisors/preceptors engaged in interviews and informal feedback, and 853 student reflective accounts were graded, over 3 years. The final tool that has been developed and evaluated in this research supported students to develop to critical reflectors (6% - Phase 2 increased to 62.9% - Phase 3).

CONCLUSIONS

This novel and innovative approach supports novice reflectors, encourages reflection on action and enhances professional development. It is a structured yet flexible tool, for which there was a gap in the published literature. It can be utilized in varied placements in pharmacy curricula internationally.

Apprehension and interest

Purpose

Role-emerging placements have been used internationally within occupational therapy education but are relatively new to Ireland. At times, there has been a debate in the profession regarding the use of this placement model. This paper aims to generate views from both occupational therapists and occupational therapy students on the use of role-emerging placements in the Republic of Ireland.

Design/methodology/approach

Electronic surveys were administered to occupational therapy students and occupational therapists in Ireland. Quantitative data were analysed using the SPSS Statistics software package and the content of the open question responses were analysed into themes.

Findings

Occupational therapists (n = 60) and occupational therapy students (n = 45) indicated that there were inconsistent views surrounding role-emerging placements. It is deemed as an effective method for student learning, but apprehension exists around inclusion within occupational therapy programmes in the Republic of Ireland. Preference was indicated towards inclusion of role-emerging placements on a part-time basis within formal occupational therapy education.

Originality/value

Both respondent groups viewed that role-emerging placements can positively influence new areas of occupational therapy practice and concern over the use of the placement model requires further exploration and debate. This study is from an Irish context, although there are similarities with other countries’ use of the placement model. There is a need for research through an in-depth exploration of the learning experience of undertaking role-emerging placements from the students’ perspective and identification of supports required to promote an optimal learning experience.

Benefits and challenges of role-emerging placements of student occupational therapists in HIV service organisations

Background and aims:

Recognising the importance of occupational therapy for people with Human Immunodeficiency Virus (HIV) has led to the possibility of promoting and integrating services in HIV service organisations through role-emerging placements for student occupational therapists. The objective of this study was to investigate the benefits and challenges of role-emerging placements of student occupational therapists in HIV service organisations.

Methods:

This study employed qualitative methods to understand the perspectives of student occupational therapists, HIV service organisation staff, an occupational therapy preceptor, and people with HIV following 8-week role-emerging placements of student occupational therapists in HIV service organisations. Transcribed interviews were analysed using content analysis to identify themes.

Findings:

Results highlighted the following benefits: 1) Reinforcing professional skills; 2) Developing competency in providing rehabilitation services for people with HIV; 3) Shining a light on the role of occupational therapy; and 4) Empowering HIV service organisations. Challenges included: 1) Starting the groundwork; and 2) Building relationships.

Conclusion:

The placements of student occupational therapists in HIV service organisations can foster the integration of occupational therapy services in these organisations to maintain the optimum community responses. Findings also demonstrated the value that role-emerging placements have in increasing the competencies of the student occupational therapists as future rehabilitation professionals.

Fluctuations in the emotional intelligence of therapy students during clinical placements: Implication for educators, supervisors, and students

This study investigated the changes in emotional intelligence (EI) of occupational therapy, physiotherapy, and speech pathology students (therapy students). Clinical placements have multiple benefits including the development of interprofessional skills, enhancing practice skills and interpersonal skills. Higher EI competencies have been shown to have a positive impact on patient outcomes, teamwork skills, dealing with stress, and patient satisfaction. Data for this study were collected at two time points: before third-year therapy students commenced extended clinical placements (T1 with 261 students) and approximately 7 months later after students had completed one or more clinical placements (T2 with 109 students). EI was measured using the Emotional Quotient Inventory 2.0 (EQ-i^2.0). Only one EI score, assertiveness, demonstrated a significant decline. No EI score showed a significant increase. A third or more of the students showed increases of five points or more in self-actualisation, emotional expression, independence, reality testing and optimism. However, of concern were the five EI scores where therapy students' EI scores decreased by more than five points: assertiveness (where 38% of students declined), problem solving (37%), impulse control (35%), self-actualisation (35%), and stress tolerance (33%). With EI scores declining for some students during clinical placements, there are implications for clinical supervisors and interprofessional facilitators as clinical performance may decline concurrently. There is a range of potential reasons that clinical placements could negatively influence the EI competencies of a therapy student, including poor clinical supervision, conflict between a student, and supervisor and failing a clinical placement. The research suggests that interprofessional facilitators and university educators might consider students undertaking EI tests before clinical placements.

Profile of 1 year of fieldwork experiences for undergraduate occupational therapy students from a large regional Australian university

Objective Fieldwork experience is a significant component of many health professional education programs and affects future practice for graduates. The present study used self-reported student data to produce a profile of undergraduate student placement experiences. Methods Cross-sectional surveys exploring placement location, setting and client types, models of supervision, interventions and financial costs were completed by students following each placement. Data were analysed using descriptive analysis. Results Placements were predominantly conducted outside capital cities (69.8%; n=184), with 25.8% (n=68) in rural settings. Students experienced predominantly public health in-patient settings and community settings, with only 15% experiencing private settings. Conclusions The placement profile of undergraduate occupational therapy students appeared to be consistent with workforce reports on occupational therapy professional practice. What is known about the topic? Fieldwork experienced by health professional students is critical to preparing new graduates for practice. Although the World Federation of Occupational Therapy provides guidance on what is required for occupational therapy fieldwork experience, little is known about what students actually experience during their fieldwork placements. What does this paper add? The present study is the first to document the range of fieldwork experienced by occupational therapy students in one program over 1 year, and provides the basis for comparison with other occupational therapy programs, as well as other disciplines nationally and internationally. What are the implications for practitioners? Occupational therapy students experienced few opportunities in private practice or speciality services, and had mostly one-on-one supervision. To provide a future workforce that is able to address the changing health system, it is vital that students are exposed to a range of fieldwork experiences and supervision styles that replicate the demands of future practice.

The development of a theory-informed workbook as an additional support for students on role-emerging placements

Introduction

During role-emerging placements students require different support as occupational therapy specific supervision is provided periodically and they cannot model their practice on experienced occupational therapists. This paper describes the development and evaluation of a workbook designed to reinforce the integration of theory with practice and provide an additional resource to support students when a supervisor was not present.

Method

A social constructionist perspective and action research methodology were used. Participants were 14 final year occupational therapy students and three off-site occupational therapy supervisors. All participants were involved in role-emerging placements in school settings in England. In-depth, semi-structured interviews across four action research cycles informed the development and evaluation of the workbook.

Findings

While the workbook originally focused on supplementing students’ knowledge of occupational therapy theory, during the action research cycles the focus shifted to consider how educational theory informed workbook design and content. Key features and critical aspects which supported students’ learning were identified.

Conclusion

The workbook was received positively by students and supervisors. Aspects which were particularly valued included the provision of examples and scenarios which contextualised theory within the placement setting. The workbook was proposed to have scope for use in placements beyond school-based practice.

Feedback on students' clinical reasoning skills during fieldwork education

Background/aim

Feedback on clinical reasoning skills during fieldwork education is regarded as vital in occupational therapy students' professional development. The nature of supervisors' feedback however, could be confirmative and/or corrective and corrective feedback could be with or without suggestions on how to improve. The aim of the study was to evaluate the impact of supervisors' feedback on final-year occupational therapy students' clinical reasoning skills through comparing the nature of feedback with the students' subsequent clinical reasoning ability.

Method

A mixed-method approach with a convergent parallel design was used combining the collection and analysis of qualitative and quantitative data. From focus groups and interviews with students, data were collected and analysed qualitatively to determine how the students experienced the feedback they received from their supervisors. By quantitatively comparing the final practical exam grades with the nature of the feedback, their fieldwork End-of-Term grades and average academic performance it became possible to merge the results for comparison and interpretation.

Results

Students' clinical reasoning skills seem to be improved through corrective feedback if accompanied by suggestions on how to improve, irrespective of their average academic performance. Supervisors were inclined to underrate high performing students and overrate lower performing students.

Conclusions

Students who obtained higher grades in the final practical examinations received more corrective feedback with suggestions on how to improve from their supervisors. Confirmative feedback alone may not be sufficient for improving the clinical reasoning skills of students.

Sustaining professional identity in practice following role-emerging placements: Opportunities and challenges for occupational therapists

Introduction

Role-emerging placements are increasingly being used to help prepare occupational therapy graduates for practice in a changing health and social care climate. However, while the literature on such placements is increasing, few longitudinal studies have explored their impact on graduates’ professional practice and identity.

Method

Interpretative phenomenological analysis was used to gain an understanding of the ways in which five occupational therapy graduates felt their role-emerging placement influenced their professional identity and practice once qualified. In-depth interviews were carried out with the graduates once they had been working as occupational therapists for a minimum of 6 months.

Results

In the absence of other occupational therapists, students on placements created professional identities of their own making and generated visions of the type of therapist they wanted to become. Once qualified, however, there were mixed experiences concerning the extent to which this identity could be sustained in practice. Particular difficulty was encountered by those working in National Health Service settings, where graduates questioned whether their practice was congruent with the professional understandings and ways of being they had developed on placement.

Conclusion

Role-emerging placements acted as a catalyst for participants’ personal and professional development. Further research on the long-term influence of role-emerging placements is required.