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

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.

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

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.

Understanding the Allied Health Professions Student Experience of Practice Placements during the First Wave of the Coronavirus Pandemic

In England, a national lockdown came into effect on 23 March 2020 in response to the rapid spread of the Coronavirus. Healthcare services were quickly redesigned or scaled back to meet the significant and rising demands. Many practice placements were discontinued, which resulted in large numbers of Allied Health Professions (AHPs) pre-registration students requiring placements to meet the required practice hours. The challenge for placement providers, who were experiencing increased demand and uncertainty, was to continue providing quality placements. At the local trust, 58 AHP students had a placement between April and July 2020. Some clinical areas offered traditional placements. However due to social distancing rules many placements utilised blended practice; using aspects of both direct face-to-face and remote practice. It is important to understand the student experience in anticipation of future surges of Coronavirus. In total, 36 students responded to a placement survey. Results showed the majority of the students reported positive placement experiences overall. Despite the ever-changing placement landscape and the need for flexibility, it is important to ensure that placements are well planned and that students are well informed about the safety measures in place. It is vital that student’s feel welcomed and valued in order to learn and reach their full potential whilst on placement. The use of a blended placement model provided valuable learning experiences, however consideration needs to be given to ensure that students feel part of the team and have confidence that their learning needs are met.

Rising to the Challenge of COVID-19: Pivoting to Online and Project-Based Physiotherapy Student Placements in Contemporary Professional Settings

Online and project-based student placements in sport and corporate settings were incorporated within the Macquarie University Doctor of Physiotherapy following the restriction of face-to-face delivery during the COVID-19 pandemic. This study explores student and educator perceptions of these placements, and analyses student performance results to provide future recommendations. The mixed-methods design included a student survey, semi-structured educator interviews and quantitative analysis of student assessment performance comparing 2020 to 2018/2019 cohorts. Quantitative survey data were described, with proportional differences between groups analysed. Open-ended survey responses and interview transcripts were thematically analysed, and integration of all results was performed. Themes derived from 24 student surveys highlighted that the learning experiences and skills required for online and project-based placements were varied and valuable. Analysis of 176 students’ performance showed differences between performance and applicability of assessment items in 2020 placements in comparison to previous years, although all students met performance requirements. Analysis of eight educator interviews identified that online and project-based placements changed experiences for all stakeholders and highlighted the need for enhanced educator and student communication and organisation for the placement to be successful. Online and project-based placements were considered a better reflection of contemporary work practices, producing valuable deliverables to the business. Three final integrated themes were identified regarding online and project-based elements of placements: learning experiences of students differed, skills for students and educators differed, and placements were representative of real-world work. A hybrid approach that incorporates both online and onsite placement time and includes a project-based component is recommended for future placements. Project-based and online elements provide genuine and valuable learning opportunities for physiotherapy students in preparation for real-world work.

Enhancing Peer Learning through Online Placements for Health and Social Care Professions

This article reports on the innovative design and the delivery of an online placement for university students, in response to the suspension of face-to-face placements due to COVID-19 restrictions in April 2020. A high quality, evidence-based and pedagogically sound experience was built, delivered and reviewed. The online placement not only met the professional standards and demonstrated equivalence in achieving placement learning outcomes, compared to traditional face to face placements, but also offered emergent benefits. The online placement showed enhanced peer learning and improved professional reasoning development by the students. In view of the interest and need for alternative placements, online placements were explored further, contextualised and built into a model which came to be known as Peer-Enhanced E-Placement (PEEP). Throughout 2020, and into 2021, the ‘logjam’ of increased student numbers and reduced placements, dramatically increased the interest in alternative placement learning and the PEEP model. A PEEP professional development acquisition experience was developed and piloted, to disseminate, scale and contextualize the approach by health and social care teams. Feedback from the pilot acquisition experiences indicated that the participants were able to design and implement PEEPs in their own contexts with their students. The scaling up and roll out of the PEEP acquisition experiences now extends to over fifteen professions. Conclusions include that the PEEP model offers a viable, acceptable and successful online practice-based learning option for health and social care students, achieving equivalence in placement learning outcomes and enhanced peer learning.

Establishment of an Innovative Telehealth Speech and Language Therapy Placement as a Rapid Response to COVID-19: Sharing the Learning

The aim of this evaluation was to explore practice educators’ and speech and language therapy (SLT) students’ experiences of a rapid response telehealth placement in response to the COVID-19 pandemic in order to inform quality improvement. In March 2020, public health restrictions were imposed across Ireland in efforts to ‘flatten the curve’ in response to the COVID-19 pandemic. All placements were cancelled. According to an Irish Association of Speech and Language Therapists survey in April 2020, 47% of SLTs were redeployed to swabbing and contact tracing roles, and many remain redeployed seven months later. This redeployment, along with strict public health measures in clinical sites, significantly reduced the availability of clinical placements. A rapid response was required to enable students to develop clinical competencies. Although telehealth has been used to deliver speech and language therapy in other countries, it had not been used routinely in service provision in Ireland. In this article, we outline how we built on existing partnerships with practice educators, both on- and off-site, to design a much-needed telehealth placement. We explored educators’ and students’ experiences using an online focus group and online survey respectively. The evaluations of practice educators were positive in that despite their initial apprehension, they reported that this placement provided valuable learning opportunities for students while also providing benefits for clients. They also reported some technological and sustainability challenges. The students also evaluated this placement positively with 83.3% of respondents rating the placement as ‘excellent ‘and 16.7% rating it as ‘good’. All stakeholders valued this learning experience.