1. Returning-to-Practice Using a Preceptorship and Kawa Model
Jennifer Woods, Senior occupational therapist:
Helen Bowker, Lead occupational therapist:
Belinda Bradley, Return-to-practise occupational therapist:
Jeni

2. Aims of the Session
To evaluate the effectiveness of using a preceptorship in supporting return-to-practice occupational therapists.
To explore how the Kawa Model can be used to identify barriers to a successful placement; and how to over come them.
Jeni

3. Context
Fees introduced for Occupational Therapy degree courses for 2017/2018.
Drop in student applications .
Development of apprenticeships.
Change in demand for clinical placements.
Some university courses available to support return to practice professionals; but not rolled out nationally.
Helen

4. Health and Care Professionals Council Requirements.
0 – 2 years out of practice – no requirements
2 – 5 years out of practice – 30 days of updating
5 years or more out of practice – 60 days of updating
Combination of supervised practice, private study and formal study.
*Private study to make up a maximum of half of the period of updating
*Period of updating can take up to 12 months.
(HCPC 2017)

5. Occupational Therapy Team at The Christie
Lead OT - Band 7
Band 5
1.0 WTE
Band WTE
Band 3
WTE 0.6
TYA Band 6
Band 6
0.8 WTE
Inpatient focused.
Newly formed team.
No direct experience of supporting return to work therapists.
Had previous experience of supporting students and preceptorships.
Helen
June 2016

6. Pre-placement. Pre-placement meeting.
Clinical placement would be 1 day a week over a 6 month period with an additional 6 days to be scheduled into this period (30 days).
Honorary contract arranged.
Undertook induction, which included occupational health screen.

7. Differences Between Return-to-Practice and Student Clinical Placements
OCCUPATIONAL THERAPY STUDENT
Identify own placement (s).
Identified via universities and in accordance with the student’s learning needs.
Limited support network.
Supported by the university and peers.
Return-to- practise process may have to fit around other work / personal commitments.
Submersed in learning and education.
Financial commitment.
Access to student grants.
Learning is guided by the individual.
Clear development goals set out by the university.

8. “You don’t know, what you don’t know.”
Anon
Jeni

9. Using a preceptorship framework
Typically associated with newly qualified health and social care professionals.
Usually has a defined period of 6 months.
Trust policy to use a preceptorship framework with all newly qualified staff and return to practice health professionals.
Undertook training on becoming a preceptor.

10. Definition of a Preceptorship
A period of structured transition for the newly registered practitioner during which he or she will be supported by a preceptor, to develop their confidence as an autonomous professional, refine skills, values and behaviours and to continue on their journey of life-long learning.
Department of Health (2010)
‘Preceptorship should be seen as a model of enhancement, which
acknowledges new graduates/
registrants as safe, competent but novice practitioner as part of their career development / continuing professional development…
Council of Deans (2009) cited in DH (2010)
Jeni

11. Benefits & Barriers to Using Preceptorship Model
Opportunity to set learning development goals.
Perceived as a tool for newly qualified staff (DH 2010)
Provides an opportunity for reflection and reflexivity (Styles 2016)
Requires engagement from both parties
Develops confidence (DH 2010, Mason & Davies 2013, Feltham 2014)
Time (McSharry & Lathlean 2017)
Enables preceptee to direct and be accountable for their learning (DH 2010)
Encourages communication
Enhances clinical reasoning and problem solving skills (McSharry & Lathlean 2017)
Jeni

12. Challenges Arising From the Placement.
Resistance to undertaking the preceptorship process and working towards Knowledge and Skills Framework (KSF) (DH 2004).
Poor engagement in reflective practice.
Different opinions of goals of the placement.
Lack of support for the learner and mentor from professional bodies
Disclosure of a self-diagnosed disability.
Difference of learning styles.

14. “Learning requires trust”
Anon
Helen

15. “Using a model on yourself can be scary and challenging as it is uncomfortable doing a self-analysis…. But the kawa model was a creative way of putting the thoughts in my head onto paper and being able to work through the placement and my learning development goal”
Belinda
Helen

16. Kawa Model – Return-to-Practise Occupational Therapist
Previous placement experience
Preceptorship
Dyslexia
Resilient
Church
Finances
Family
2 children
Health
Helen
IT Skills
Husband
Resourceful
Determined
Aware of learning style

17. Kawa Model – Return-to-Practice Mentor
Work / Life Balance
Change in team dynamics
Committed
2 children
Husband
Transitioning to Band 6 post
Role conflict
NHS
Jeni
HCPC
Enthusiastic
Clinical skills
Clinical supervisor

18. Kawa Model – Rivers Flowing Together
Start of placement
Review of placement
End of placement

19. “Those who arrive at the end of the journey are not those who began”
T S Elliot
Jeni

20. Reflections on the Return-to-Practice Process
The role of the mentor.
Should clinical placement be a stronger element to the return-to-practice process.
Skills fade quicker than we realise. (GMC 2014)
Return to practise is not just about updating clinical skills, but also about preparing for a return to work.
Using a preceptorship framework provides a structured approach to guide learning.
There needs to be clear competencies such as the KSF to work towards.
Jeni – points 2, 4, 6 / Helen 1, 3, 5

21. Top Tips for Return-to-Practise Occupational Therapists
Organise things from the beginning.
Be clear on the process.
You must be motivated to undertake this. Is this what you really want?
Consider the costs of undertaking this process and how long it will take you.
Take opportunities to learn new skills.
Be honest and communicate.
Link in with different resources and networks.
Update your IT skills.
Embrace change.
Engage in reflective practise from the beginning.
Helen

22. Top Tips for Return-to-Practise Mentors
Consider the impact that the placement will have on your service and other members of staff. Be sure that you can commit to the process.
Have several meetings prior to committing to the placement.
Be clear of what is expected of one another.
Consider what skills you have to be a mentor and what additional training or support you may need.
Set time frames and be clear of the plan before you start.
Use a preceptorship framework.
Be flexible on your approach. Goals can change.
Use professional bodies for guidance and support.
Have the confidence to address challenges and barriers.
Reflect on the process.
Jeni

23. Summary
We have a duty to support return-to-work practitioners to retain the occupational therapy national workforce.
It will become more challenging in the current climate for return to practice occupational therapists to find placements.
Better networking and support needs to be available across the UK to support mentors / return-to-practice occupational therapists.
Preceptorship model provides structure to support transition.
Using an holistic model such as the Kawa enables us to evaulate the barriers to a successful clinical placement and can be applied to student placements as well.
Jeni 1,3,5 / Helen 2,4

24. Questions

25. References
Council of Deans (2009) Report from preceptorship workshops retreat. Bristol
Department of Health (2010) Preceptorship Framework for Newly Registered Nurses, Midwives and Allied Health Professionals. London: DH
Department of Health (2004) The NHS Knowledge and Skills Framework (NHS KSF) and the Development Review Process. London: Department of Health
Health Care Professionals Council (2017) Returning to practice. Information about our requirements for professionals returning to practice. London: HCPC
Feltham C (2014) The value of preceptorship for newly qualified midwives. British Journal of Midwifery 22(6):
General Medical Council (2014) Skills Fade: A review of the evidence that clinical and professional skills fade during time out of practice, and how skills fade may be measured or remediated. Manchester: GMC: Available from: [accessed 1/06/2017]
Kawa

26. References
Lim, H and Iwama, M (2006) Emerging models- An Asian perspective : The Kawa (River) Model in Duncan, E.A.S (ed)2006 Foundations for Practice Therapy. 4th Edition. London: Elsevier Limited. Pg 126
Mason J & Davies S (2013) An evaluation of a midwifery programme of preceptorship, which was implemented in 2004 in one NHS Trust in north west England. Evidence Based Midwifery Available from: [accessed 1/6/2017]
McSharry, E and Lathlean, J (2017) Clinical teaching and learning within a preceptorship model in an acute care hospital in Ireland; a qualitive study. Nurse Education Today. 51; 73-80
Styles G, R, (2016) Developing professional identity in occupational therapy: A phenomenological study of newly qualified staff and their experiences in the preceptorship period. Accessed: [accessed 1/6/2017]