A rollercoaster ride through multiple models of practice-based education Dr Jane Morris Deputy Head of School (Learning and Teaching) HEA National Teaching Fellow Chair of the National Association of Educators in Practice School of Health Sciences

Aims of the session: To explore a range of models that facilitate practice learning and build capacity To be creative leading to innovation

Learning in Practice: a critical perspective 2018 Values-based learning in practice Quality improvement in and through practice learning Enhancing capacity and productivity in and through practice learning

Why do we need to explore different models of placement? Changes to healthcare education funding Increasing demand for Health Professionals Professional bodies encouraging innovative methods of placement provision in order to grow placement capacity Continued shortages of placements traditional 1:1 models unable to support increased demands for placements. Need to prepare students for working in a changing healthcare environment Cross (2013) including in integrated teams

Alternative models of placement delivery : Collaborative or Peer Assisted Learning models 2:1,3:1 & 4:1 ( Moore et al, 2003) Role - emerging model (Huddleston 2001) also known as Diverse placement model (Clarke,2014) Team models (Bennett,2003) Interprofessional Peer Learning model (Anderson et al, 2016 ; Matchett and Seagrave (2018)

Collaborative or peer assisted placement models One educator working with more than one student in the practice setting Educator generally reduces their own caseload to facilitate and assess two or more students Mirrors educational philosophy of H.E.increasing self-direction and partnership in learning (Ladyshewsky, 2003)

Collaborative /Peer learning 2:1 placement model Working in small groups : What are the main advantages of 2 or more students learning together in your setting? What are the possible challenges? How would you address them? Time to be innovative.

Findings 2:1 model (Moore et al, 2003;O’Connor et al,2012) Advantages Peer support Learning enhanced : Peer discussion, peer practice; peer reflection and evaluation; peer feedback Clinical reasoning improved Educator used as a consultant Foster collaborative skills Challenges Peer learning not always optimised Perceptions of decreased productivity levels unfounded Ensure individual time Identify joint goals/projects to deter competition and promote collaboration

Quote 2:1 Student PT “ It’s nice to be with someone who’s in the same boat” Educator “ It definitely encourages them to be more forthright ,it gives them more confidence than with just me “

O’Connor et al 2012 quote “ If there are 2 students they can bounce things off each other and there is a lot of shared learning so I always felt that it is better with 2 students” ( CE,6 PT 2:1)

What are role emerging placements? Role emerging placements – “occur at sites where there is not an established occupational therapist role” (COT, 2006) and as such no on- site OT supervisor. Students supervised daily by on-site member of staff and supported by external OT supervisor (either a practicing therapist or academic) Examples – homeless service, voluntary agencies, health promotion departments.

Interprofessional Peer Learning Model (Matchett & Seagrave,2018) +ve effects peer and IPL Increased understanding of how collaboration improves patient outcomes Enhanced learning environment and IP practice challenge and support Increased autonomy, resilience and professional behaviour

Leicester model learning cycle (Kolb,1984) Concrete Experience IPE teams complete a service user holistic care analysis Reflective observation IPE student analysis & reflection on different professional perspectives Active experimentation IPE student team debate and discuss possibilities to deepen insight Abstract conceptualisation Seek understanding and future possibilities of care

IPE in practice – becoming a professional “ we were actually working together it worked quite well to get the most out of our patients ..it’s given me more understanding of other people's roles and how other people perceive your work as well, very much so.. I now have a lot more respect for what they did and the goals we need to meet and how to work together – joint working sort of brings it together – makes it more alert” (Morris,2011)

Group work: What innovative ideas are you taking away for increasing: placement capacity peer learning interprofessional learning on placement How will you achieve your goals? How will you measure the success of your ideas?

Any questions?

Further reading: Anderson, S.A. Ford,J & Kinnair,D.J. (2016)Interprofessional Education and Practice Guide No. 6: Developing practice-based interprofessional learning using a short placement model, Journal of Interprofessional Care, 30:4, 433-440, Clarke C (2014b) Role emerging placements: a useful model for occupational therapy? A literature review. International Journal of Practice-based learning in health and social care. DOI: 10.11120/pblh.2014.00020 : http://bit.ly/1f1BRNj Cross, V (2013) “Practice Educators in an Uncertain World: Still Too Much to Ask?” International Journal of Practice Based learning in Health and Social Care, Vol 1, Issue 1 O’Connor, A.Cahill,M.McKay,E.(2012) “Revisiting 1:1 and 2:1 clinical placement models: Student and clinical educator perspectives” Australian Occupational Therapy Journal (2012) 59, 276–283