Factors influencing provision of clinical placements for health students: A scoping review
DOI:
https://doi.org/10.11157/fohpe.v24i2.562Keywords:
clinical education, placement provision, studentsAbstract
Introduction: Clinical placements for students completing health degrees are vital for meeting work-integrated learning requirements and enabling students to develop a broad range of professional capabilities in authentic settings. Understanding the factors that influence the provision of clinical placements for health students from the perspectives of those providing the placements is essential, not only to sustain existing resources but also to expand opportunities to meet growing placement demand.
Methods: A scoping review of articles with a focus on health student clinical placements within the international context, published between 2000–2020, was facilitated using seven databases, including Google Scholar and other sources.
Results: A total of 2,283 records were identified. After removal of duplicates, 1,159 records were screened based on the title and abstract. Full-text review was conducted on 93 articles, and 48 of these publications were included in the final scoping review. Data from these articles were charted and four major themes emerged to illuminate factors that influence the provision of clinical placements for health students: institutional, personal, university engagement and student capability.
Conclusion: Multiple factors influence the provision of clinical placements for health students from the perspectives of those who provide the placements. Understanding these factors is important to sustain existing resources and inform planning to increase placement provision sustainably into the future. From this scoping review, a clear gap in the literature is the perspectives and experiences of two distinct groups: health service managers and health clinicians
References
Abey, S., Susan, L., Callaghan, L., Shaw, S., & Cotton, D. (2015). Identifying factors which enhance capacity to engage in clinical education among podiatry practitioners: An action research project. Journal of Foot & Ankle Research, 8, Article 66. https://doi.org/10.1186/s13047-015-0123-4
Annear, M. J., Lea, E., Lo, A., Tierney, L., & Robinson, A. (2016). Encountering aged care: A mixed methods investigation of medical students' clinical placement experiences. BMC Geriatrics, 16(37), Article 38. https://doi.org/10.1186/s12877-016-0211-8
Ard, N., Rogers, K., & Vinten, S. (2008). Summary of the survey on clinical education in nursing. Nursing Education Perspectives, 29(4), 238–245.
Arksey, H., & O'Malley, L. (2005). Scoping studies: Towards a methodological framework. International Journal of Social Research Methodology, 8(1), 19–32. https://doi.org/10.1080/1364557032000119616
Baldry Currens, J. (2003). The 2:1 clinical placement model: Review. Physiotherapy, 89(9), 540–554. https://doi.org/10.1016/S0031-9406(05)60180-0
Baldry Currens, J. A., & Bithell, C. P. (2000). Clinical education: Listening to different perspectives. Physiotherapy, 86(12), 645–653. https://doi.org/10.1016/S0031-9406(05)61302-8
Barnett, T. E.Walker, L., Jacob, E., Missen, K., Cross, M. D., & Shahwan-Akl, L. (2012). Expanding the clinical placement capacity of rural hospitals in Australia: Displacing Peta to place Paul? Nurse Education Today, 32(5), 485–489. https://doi.org/10.1016/j.nedt.2011.08.013
Barton, H., Bell, K., & Bowles, W. (2005). Help or hindrance? Outcomes of social work student placements. Australian Social Work, 58(3), 301–312. https://doi.org/10.1111/j.1447-0748.2005.00222.x
Blitz, J., Bezuidenhout, J., Conradie, H., de Villiers, M., & van Schalkwyk, S. (2014). "I felt colonised": Emerging clinical teachers on a new rural teaching platform. Rural & Remote Health, 14(2), Article 2511. https://doi.org/10.22605/RRH2511
Blose, S., Chemane, N. C. T., Chetty, V., Govender, P., & Maddocks, S. (2019). Physiotherapists' perception of a community-based primary healthcare clinical education approach to undergraduate learning. African Journal of Health Professions Education, 11(1), 16–21. https://doi.org/10.7196/AJHPE.2019.v11i1.1046
Bowles, K.-A., Haines, T., Molloy, E., Kent, F., Sevenhuysen, S., & Tai, J. (2014). The costs and benefits of providing undergraduate student clinical placements for a health service organisation: A rapid review. HETI. https://www.saxinstitute.org.au/wp-content/uploads/The-costs-and-benefits-of-providing-undergraduate-student-clinical-place....pdf
Braun, V., & Clarke, V. (2006). Using thematic analysis in psychology. Qualitative Research in Psychology, 3(2), 77–101. https://doi.org/10.1191/1478088706qp063oa
Bwanga, O., & Chanda, E. (2019). Experiences of nurses in the clinical supervision of nursing students: Findings from a systematic review and their application to radiography. EAS Journal of Nursing and Midwifery, 1(4), 126–137. https://easpublisher.com/media/features_articles/EASJNM_14_126-137_c_ruZCrfd.pdf
Byrskog, U., Akther, H. A., Khatoon, Z., Bogren, M., & Erlandsson, K. (2019). Social, economic and professional barriers influencing midwives' realities in Bangladesh: A qualitative study of midwifery educators preparing midwifery students for clinical reality. Evidence Based Midwifery, 17(1), 19–26.
Casares, G. S., Bradley, K. P., Jaffe, L. E., & Lee, G. P. (2003). Impact of the changing health care environment on fieldwork education: Perceptions of occupational therapy educators. Journal of Allied Health, 32(4), 246–251.
Colquhoun, H. L., Levac, D., O'Brien, K. K., Straus, S., Tricco, A. C., Perrier, L., Kastner, M., & Moher, D. (2014). Scoping reviews: Time for clarity in definition, methods, and reporting. Journal of Clinical Epidemiology, 67(12), 1291–1294. https://doi.org/10.1016/j.jclinepi.2014.03.013
Crampton, P. E. S., McLachlan, J. C., & Illing, J. C. (2013). A systematic literature review of undergraduate clinical placements in underserved areas. Medical Education, 47(10), 969–978. https://doi.org/10.1111/medu.12215
Dahlstrom, J., Dorai-Raj, A., McGill, D., Owen, C., Tymms, K., & Watson, D. A. R. (2005). What motivates senior clinicians to teach medical students? BMC Medical Education, 5(1), Article 27. https://doi.org/10.1186/1472-6920-5-27
Davies, R., Hanna, E., & Cott, C. (2011). “They put you on your toes”: Physical therapists' perceived benefits from and barriers to supervising students in the clinical setting. Physiotherapy Canada, 63(2), 224–233. https://doi.org/10.3138/ptc.2010-07
De Witt, P., Rothberg, A., & Bruce, J. (2015). Clinical education of occupational therapy students: Reluctant clinical educators. South African Journal of Occupational Therapy, 45(3), 28–33. https://doi.org/10.17159/2310-3833/2015/v45n3/a6
Dybowski, C., & Harendza, S. (2014). “Teaching is like nightshifts …”: A focus group study on the teaching motivations of clinicians. Teaching & Learning in Medicine, 26(4), 393–400. https://doi.org/10.1080/10401334.2014.910467
Edwards, H., Smith, S., Courtney, M., Finlayson, K., & Chapman, H. (2004). The impact of clinical placement location on nursing students’ competence and preparedness for practice. Nurse Education Today, 24(4), 248–255. https://doi.org/10.1016/j.nedt.2004.01.003
Fairbrother, M., Nicole, M., Blackford, J., Nagarajan, S. V., & McAllister, L. (2016). A new model of clinical education to increase student placement availability: The capacity development facilitator model. Asia-Pacific Journal of Cooperative Education, 17(1), 45–59. https://www.ijwil.org/files/APJCE_17_1_45_59.pdf
Ferguson, A., Haantjens, A., & Milosavljevic, M. (2014). Evolution of the clinical educator role to increase student placement capacity: From traditional to innovative. Nutrition & Dietetics, 71(1), 51–56. https://doi.org/10.1111/1747-0080.12041
Foo, J., Rivers, G., Ilic, D., Evans, D. J. R., Walsh, K., Haines, T., Paynter, S., Morgan, P., Lincke, K., Lambrou, H., Nethercote, A., & Maloney, S. (2017). The economic cost of failure in clinical education: A multi-perspective analysis. Medical Education, 51(7), 740–754. https://doi.org/10.1111/medu.13266
Gibson, S., Dart, J., Bone, C., & Palermo, C. (2015). Dietetic student preparedness and performance on clinical placements: Perspectives of clinical educators. Journal of Allied Health, 44(2), 101–107.
Gillieatt, S., Martin, R., Marchant, T., Fielding, A., & Duncanson, K. (2014). Evaluation of an inter-professional training program for student clinical supervision in Australia. Human Resources for Health, 12(1), Article 60. https://doi.org/10.1186/1478-4491-12-60
Gillies, R. A., Jester, D. M., & Hobbs, J. (2005). Evaluating perceptions of community-based physicians from a high-retention clerkship. Family Medicine, 37(9), 639–643.
Hall, M., Manns, P., & Beaupre, L. (2015). To supervise or not to supervise a physical therapist student: A national survey of Canadian physical therapists. Journal of Physical Therapy Education, 29(3), 58–67. https://doi.org/10.1097/00001416-201529030-00008
Hall, M., McFarlane, L.-A., & Mulholland, S. (2012). Positive clinical placements: Perspectives of students and clinical educators in rehabilitation medicine. International Journal of Therapy & Rehabilitation, 19(10), 549–556. https://doi.org/10.12968/ijtr.2012.19.10.549
Henderson, M., Upham, S., King, D., Dick, M.-L., & van Driel, M. (2018). Medical students, early general practice placements and positive supervisor experiences. Education for Primary Care, 29(2), 71–78. https://doi.org/10.1080/14739879.2017.1409084
Hills, C., Quigley, D., Bennett, A. E., Haughey, F., & McMahon, S. (2019). Core indicators of quality in practice education placements in allied health and social care professions: A scoping review protocol. JBI Database of Systematic Reviews and Implementation Reports, 17(6), 1060–1070. https://doi.org/10.11124/jbisrir-2017-004031
Hudson, J. N., Weston, K. M., & Farmer, E. A. (2012). Medical students on long-term regional and rural placements: What is the financial cost to supervisors? Rural & Remote Health, 12(2), 1–9. https://doi.org/10.22605/rrh1951
Hughes, R. (2002). University-initiated strategies to increase supervisory capacity and benefits associated with dietetic student supervision: Perceptions of dietetic placement sites. Nutrition & Dietetics, 59(3), 191–194.
Ingwersen, K., Lyons, N., & Hitch, D. (2017). Perceptions of fieldwork in occupational therapy. Clinical Teacher, 14(1), 55–59. https://doi.org/10.1111/tct.12518
Jokelainen, M., Jamookeeah, D., Tossavainen, K., & Turunen, H. (2011). Building organizational capacity for effective mentorship of pre-registration nursing students during placement learning: Finnish and British mentors' conceptions. International Journal of Nursing Practice, 17(5), 509–517. https://doi.org/10.1111/j.1440-172X.2011.01964.x
Latessa, R., Beaty, N., Landis, S., Colvin, G., & Janes, C. (2007). The satisfaction, motivation, and future of community preceptors: The North Carolina experience. Academic Medicine, 82(7), 698–703. https://doi.org/10.1097/ACM.0b013e318067483c
Levett-Jones, T., Fahy, K., Parsons, K., & Mitchell, A. (2006). Enhancing nursing students' clinical placement experiences: A quality improvement project. Contemporary Nurse: A Journal for the Australian Nursing Profession, 23(1), 58–71. https://doi.org/10.5172/conu.2006.23.1.58
Maloney, P., Stagnitti, K., & Schoo, A. (2013). Barriers and enablers to clinical fieldwork education in rural public and private allied health practice. Higher Education Research & Development, 32(3), 420–435. https://doi.org/10.1080/07294360.2012.682255
McAllister, L. (2005). Issues and innovations in clinical education. Advances in Speech Language Pathology, 7(3), 138–148. https://doi.org/10.1080/14417040500181239
McBride, L.-J., Fitzgerald, C., Morrison, L., & Hulcombe, J. (2015). Pre-entry student clinical placement demand: Can it be met? Australian Health Review, 39(5), 577–581. https://doi.org/10.1071/AH14156
Morris, C. (2001). Student supervision: Risky business. International Journal of Language & Communication Disorders, 36(S1), 156–161. https://doi.org/10.3109/13682820109177876
Norman, R. I., & Dogra, N. (2014). A survey of the practice and experience of clinical educators in UK secondary care. BMC Medical Education, 14(1), Article 229. https://doi.org/10.1186/1472-6920-14-229
O'Brien, A., Giles, M., Dempsey, S., Lynne, S., McGregor, M. E., Kable, A., Parmenter, G., & Parker, V. (2014). Evaluating the preceptor role for pre-registration nursing and midwifery student clinical education. Nurse Education Today, 34(1), 19–24. https://doi.org/10.1016/j.nedt.2013.03.015
O'Brien, A., McNeil, K., & Dawson, A. (2019). The student experience of clinical supervision across health disciplines: Perspectives and remedies to enhance clinical placement. Nurse Education in Practice, 34, 48–55. https://doi.org/10.1016/j.nepr.2018.11.006
O'Brien, C. W., Anderson, R., Ayzenberg, B., Chute, P., Farnsworth, T., McLaughlin, R., Romig, B., Samonian, Y., Sample, J., Tynsky, T., Wallace, B., Weinstein, M., & O'Sullivan Maillet, J. (2017). Employers' viewpoint on clinical education. Journal of Allied Health, 46(3), 131–137.
Öhman, A., Hägg, K., & Dahlgren, L. (2005). A stimulating, practice-based job facing increased stress: Clinical supervisors’ perceptions of professional role, physiotherapy education and the status of the profession. Advances in Physiotherapy, 7(3), 114–122. https://doi.org/10.1080/14038190510010359
Papastavrou, E., Lambrinou, E., Tsangari, H., Saarikoski, M., & Leino-Kilpi, H. (2010). Student nurses experience of learning in the clinical environment. Nurse Education in Practice, 10(3), 176–182. https://doi.org/10.1016/j.nepr.2009.07.003
Rodger, S., Webb, G., Devitt, L., Gilbert, J. P., Wrightson, P., & McMeeken, J. (2008). Clinical education and practice placements in the allied health professions: An international perspective. Journal of Allied Health, 37(1), 53–62.
Scott, I., & Sazegar, P. (2006). Why community physicians teach students (or not): Barriers and opportunities for preceptor recruitment. Medical Teacher, 28(6), 563–565. https://doi.org/10.1080/01421590600627375
Sevenhuysen, S. L., & Haines, T. (2011). The slave of duty: Why clinical educators across the continuum of care provide clinical education in physiotherapy. Hong Kong Physiotherapy Journal, 29(2), 64–70. https://doi.org/10.1016/j.hkpj.2011.06.002
Shannon, S. J., Walker-Jeffreys, M., Newbury, J., Cayetano, T., Brown, K., & Petkov, J. (2006). Rural clinician opinion on being a preceptor. Rural & Remote Health, 6(1), Article 490. https://doi.org/10.22605/RRH490
Starr, S., Ferguson, W. J., Haley, H.-L., & Quirk, M. (2003). Community preceptorsʼ views of their identities as teachers. Academic Medicine, 78(8), 820–825. https://doi.org/10.1097/00001888-200308000-00017
Stone, S., Ellers, B., Holmes, D., Orgren, R., & Qualters, D. (2002). Identifying oneself as a teacher: The perceptions of preceptors. Medical Education, 36(2), 180–185. https://doi.org/10.1046/j.1365-2923.2002.01064.x
Strohschein, J., Hagler, P., & May, L. (2002). Assessing the need for change in clinical education practices. Physical Therapy, 82(2), 160–172. https://doi.org/10.1093/ptj/82.2.160
Sturman, N., Régo, P., & Dick, M.-L. (2011). Rewards, costs and challenges: The general practitioner's experience of teaching medical students. Medical Education, 45(7), 722–730. https://doi.org/10.1111/j.1365-2923.2011.03930.x
Taylor, C., Angel, L., Nyanga, L., & Dickson, C. (2017). The process and challenges of obtaining and sustaining clinical placements for nursing and allied health students. Journal of Clinical Nursing, 26(19–20), 3099–3110. https://doi.org/10.1111/jocn.13658
Thomasz, T., & Young, D. (2016). Speech pathology and occupational therapy students participating in placements where their supervisor works in a dual role. Australian Journal of Rural Health, 24(1), 36–40. https://doi.org/10.1111/ajr.12238
Waterhouse, T., McLagan, S., & Murr, A. (2011). From practitioner to practice educator: What supports and what hinders the development of confidence in teaching and assessing student social workers? Practice: Social Work in Action, 23(2), 95–110. https://doi.org/10.1080/09503153.2011.555532
Widyandana, D., Majoor, G. D., & Scherpbier, A. J. J. A. (2011). Comparison of three clinical environments for pre-clinical clinical skills training. Medical Teacher, 33(11), 928–932. https://doi.org/10.3109/0142159X.2011.558141
World Health Organization (WHO). (2011). Transformative scale up of health professional education: An effort to increase the numbers of health professionals and to strengthen their impact on population health. https://apps.who.int/iris/handle/10665/70573
Zuchowski, I. (2014). Planting the seeds for someone else's discussion: Experiences of task supervisors supporting social work placements. Journal of Practice Teaching & Learning, 13(3), 5–23.
Downloads
Published
How to Cite
Issue
Section
License
Copyright (c) 2023 Focus on Health Professional Education: A Multi-Professional Journal
This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.
On acceptance for publication in FoHPE the copyright of the manuscript is signed over to ANZAHPE, the publisher of FoHPE.
