Rethinking clinical placements: A response to changing healthcare demands
DOI:
https://doi.org/10.11157/fohpe-vol26iss1id782Keywords:
education, teaching, students, multidisciplinary, clinical placementsAbstract
Clinical placements allow students the opportunity to apply theoretical knowledge and become workforce ready. Demand for clinical placements from education providers already exceeds supply. As healthcare workforce shortages continue, the need for increasing numbers of graduates will generate additional strain, and policymakers targeting health workforce shortages must be cognisant of their impact on the education and health sectors. At the same time, clinical placements must be fit for purpose and meet the learning needs of students. The diverse array of placement models has been compounded by rapid developments during the COVID-19 pandemic. Challenges and considerations include labour intensity, need for capacity building, importance of engagement at institutional and local supervisor levels, cost (including that to students), planetary impact, availability and equity. The future of high-quality clinical placements needs to be secured and built on a sustainable framework to support future clinical placement capacity.
References
Ali, A., & Kumar, S. (2023). Mediating effect of challenges on demographics and coping strategies of Indian healthcare workers during COVID-19. International Journal of Environmental Research and Public Health, 20(5), Article 4474. https://doi.org/10.3390/ijerph20054474
Ash, J. K., Walters, L. K., Prideaux, D. J., & Wilson, I. G. (2012). The context of clinical teaching and learning in Australia. The Medical Journal of Australia, 196(7), Article 475. https://doi.org/10.5694/mja10.11488
Australian Medical Council (AMC). (2023). Standards and assessment for primary programs. https://www.amc.org.au/wp-content/uploads/2023/08/AMC-Medical_School_Standards-FINAL.pdf
Australian Nursing and Midwifery Accreditation Council (ANMAC). (2017). Enrolled nurse accreditation standards 2017. https://anmac.org.au/sites/default/files/2024-06/ANMAC_EN_Standards_web.pdf
Australian Physiotherapy Council. (2024). Guidelines for accreditation. https://cdn.physiocouncil.com.au/assets/volumes/downloads/GUIDELINES-FOR-ACCREDITATION-V4-20052024.pdf
Barrett, J., Trumble, S. C., & McColl, G. (2017). Novice students navigating the clinical environment in an early medical clerkship. Medical Education, 51(10), 1014–1024. https://doi.org/10.1111/medu.13357
Bentley, S. A., Black, A., Khawaja, N., Fylan, F., Griffiths, A. M., & Wood, J. M. (2021). The mental health and wellbeing survey of Australian optometrists. Ophthalmic & Physiological Optics, 41(4), 798–807. https://doi.org/10.1111/opo.12823
Beveridge, J., & Pentland, D. (2020). A mapping review of models of practice education in allied health and social care professions. British Journal of Occupational Therapy, 83(8), 488–513. https://doi.org/10.1177/0308022620904325
Bogossian, F. E., Cant, R. P., Ballard, E. L., Cooper, S. J., Levett-Jones, T. L., McKenna, L. G., Ng, L. C., & Seaton, P. C. (2019). Locating "gold standard" evidence for simulation as a substitute for clinical practice in prelicensure health professional education: A systematic review. Journal of Clinical Nursing, 28(21–22), 3759–3775. https://doi.org/10.1111/jocn.14965
Boud, D., & Soler, R. (2016). Sustainable assessment revisited. Assessment & Evaluation in Higher Education, 41(3), 400–413. https://doi.org/10.1080/02602938.2015.1018133
Bowles, K-. A., Haines, T., Molloy, E., Maloney, S., Kent, F., Sevenhuysen, S., & Tai, J. (2015). The costs and benefits of providing undergraduate student clinical placements. https://www.saxinstitute.org.au/wp-content/uploads/The-costs-and-benefits-of-providing-undergraduate-student-clinical-place....pdf
Byrne, K., Craswell, A., Merollini, K., & Bogossian, F. (2023). Clinical competence, work readiness and cost-effectiveness of undergraduate nursing student clinical placement models: A scoping review protocol. OCF Home, 1. https://doi.org/10.17605/OSF.IO/87N9M
Cheng, A., Kessler, D., Mackinnon, R., Chang, T. P., Nadkami, V. M., Hunt, E. A., Duval-Arnould, J., Lin, Y., Cook, D. A., Pusic, M., Hui, J., Moher, D., Egger, M., & Auerbach, M. (2016). Reporting guidelines for health care simulation research: Extensions to the CONSORT and STROBE statements. BMJ Simulation and Technology Enhanced Learning, 2(3), 51–60. https://doi.org/10.1136/bmjstel-2016-000124
Colquhoun, C., Hafeez, M. R., Heath, K., & Hays, R. (2009). Aligning clinical resources to curriculum needs: The utility of a group of teaching hospitals. Medical Teacher, 31(12), 1081–1085. https://doi.org/10.3109/01421590903199692
Cook, D. A., Hatala, R., Brydges, R., Zendejas, B., Szostek, J. H., Wang, A. T., Erwin, P. J., & Hamstra, S. J. (2011). Technology-enhanced simulation for health professions education: A systematic review and meta-analysis. JAMA, 306(9), 978–988. https://doi.org/10.1001/jama.2011.1234
Craig, P. L., Phillips, C., & Hall, S. (2016). Building social capital with interprofessional student teams in rural settings: A service‐learning model. Australian Journal of Rural Health, 24(4), 271–277. https://doi.org/10.1111/ajr.12268
Darnton, R., Amey, S., & Brimicombe, J. (2022). The nature and prevalence of threats to medical student placement capacity in primary care: A survey of East of England GP practices. BJGP Open, 6(4). https://doi.org/10.3399/BJGPO.2022.0127
Dental Council (2021). Accreditation standards for dental practitioner programs. https://adc.org.au/files/accreditation/standards/ADC_DCNZ_Accreditation_Standards.pdf
Department of Education (Australia). (2019). Discussion paper: Redistribution pool of medical places. https://www.education.gov.au/higher-education-publications/resources/discussion-paper-redistribution-pool-medical-places-including-assessment-framework
Department of Education (Australia). (2023). 20,000 additional Commonwealth supported places. https://www.education.gov.au/higher-education-funding/commonwealth-grant-scheme-cgs/20000-additional-commonwealth-supported-places
Ellaway, R. H., Graves, L., & Cummings, B. A. (2016). Dimensions of integration, continuity and longitudinality in clinical clerkships. Medical Education, 50(9), 912–921. https://doi.org/10.1111/medu.13038
Exercise & Sport Science Australia (ESSA). (2023). Course accreditation requirements: Version 1.1. https://www.essa.org.au/Common/Uploaded%20files/Tools%20and%20templates/Course%20Accreditation%20Requirements_211221_FINAL.pdf
Forbes, R., Dinsdale, A., Copley, J., Booth, J., Cain, D., Crabb, M., Dunwoodie, R., Hunter, L., Sher, A., & Hill, A. (2022). The benefits and barriers of hosting students within allied health private practice settings: The perspective of private practice and clinical education coordinators. Australian Journal of Clinical Education, 11(1), 69–89. https://doi.org/10.53300/001c.34708
Foster, W., Sweet, L., & Graham, K. (2021). Midwifery students experience of continuity of care: A mixed methods study. Midwifery, 98, Article 102966. https://doi.org/10.1016/j.midw.2021.102966
Goldsworthy, S., Goodhand, K., Baron, S., Button, D., Hunter, S., McNeill, L., Budden, F., McIntosh, A., Kay, C., & Fasken, L. (2022). Co-debriefing virtual simulations: An international perspective. Clinical Simulation in Nursing, 63, 1–4. https://doi.org/10.1016/j.ecns.2021.10.007
Griffiths, M., Creedy, D., Carter, A., & Donnellan- Fernandez, R. (2022). Systematic review of interventions to enhance preceptor roles in undergraduate health student clinical learning. Nurse Education in Practice, 62, Article 103349. https://doi.org/10.1016/j.nepr.2022.103349
Hafferty, F. W. (1998). Beyond curriculum reform: Confronting medicine's hidden curriculum. Academic Medicine, 73(4), 403–407. https://doi.org/10.1097/00001888-199804000-00013
Hick, J. L., & Biddinger, P. D. (2020). Novel coronavirus and old lessons: Preparing the health system for the pandemic. The New England Journal of Medicine, 382(20), Article e55. https://doi.org/10.1056/NEJMp2005118
Hong, S. M., Olson-Kellogg, B. J., North, S. E., Davis, J. L., & Staker, J. L. (2020). Telehealth physical therapy as an innovative clinical education model with positive patient impact: A case report in the context of the COVID-19 pandemic. Journal of Physical Therapy Education, 34(4), 275–281. https://doi.org/10.1097/JTE.0000000000000163
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 and Remote Health, 12(2), Article 1951. https://doi.org/10.22605/RRH1951
Isba, R., Boor, K. (2011). Creating a learning environment. In T. Dornan, K. Mann, A. Scherpbier, & J. Spencer (Eds.), Medical education theory and practice (pp. 99–114). Churchill Livingstone Elsevier.
Jaye, C., & Egan, T. (2006). Communities of clinical practice: Implications for health professional education. Focus on Health Professional Education: A Multi-disciplinary Journal, 8(2), 1–10. https://doi.org/10.1177/1363459308097363
Jepson, P., & Hays, R. B. (2011). The utility of primary care in accessing clinical resources required for an undergraduate medical curriculum: A pilot study. Education for Primary Care, 22, 54–56.
Kamper, S., Dario, A. B., Waibel, M., O'Connor, D., & Bourne, E. (2021). Co-designing innovative practice-based education for speech pathology students. International Journal of Practice-Based Learning in Health and Social Care, 9(2), 74–77. https://doi.org/10.18552/ijpblhsc.v9i2.746
Kay, J., Ferns, S., Russell, L., Smith, J., & Winchester-Seeto, T. (2019). The emerging future: Innovative models of work-integrated learning. International Journal of Work-Integrated Learning, 20(4), 401–413.
Lyle, D., & Perkins, D. (2010). Health Workforce Australia: For all? Australian Journal of Rural Health, 18(5), 179–180. https://doi.org/10.1111/j.1440-1584.2010.01158.x
Lyons, R., Loftus, L., Rodden, M., Ward Lynch, S., Gaffney, S., & McAndrew, B. (2021). Establishment of an innovative telehealth speech and language therapy placement as a rapid response to COVID-19: Sharing the learning. International Journal of Practice-Based Learning in Health and Social Care, 9(2), 11–20. https://doi.org/10.18552/ijpblhsc.v9i2.738
Martin, P., Hulme, A., Fallon, T., Kumar, S., McGrail, M., Argus, G., Gurney, T., & Kondalsamy-Chennakesavan, S. (2023). Impact of the COVID-19 pandemic on student supervision and education in health care settings: A state-wide survey of health care workers. The Australian Journal of Rural Health, 31(3), 484–492. https://doi.org/10.1111/ajr.12969
Martin, M., Morris, J., Moore, A., Sadlo, G., & Crouch, V. (2004). Evaluating practice education models in occupational therapy: Comparing 1:1, 2:1 and 3:1 placements. British Journal of Occupational Therapy, 67(5), 192–200. https://doi.org/10.1177/030802260406700502
Medical Deans Australia and New Zealand (MDANZ). (2018, July 3). Increasing our understanding of medical students’ contribution to hospital services [Press release]. https://www.medicaldeans.org.au/md/2018/08/2018-July_-Increasing-our-understanding-of-medical-students-contribution-to-hospital-services.pdf
Moran, M., Miles, S., & Martin, P. (2024). Australian rural service learning student placements: A national survey. BMC Medical Education, 24(1), Article 216. https://doi.org/10.1186/s12909-024-05172-0
Optometry Council of Australia and New Zealand (OCANZ). (2023). Accreditation standards and evidence guide for entry-level optometry programs. https://www.ocanz.org/assets/b05848c01d/OCANZ-Accreditation-Standards-and-Evidence-Guide_updated-2023.pdf
National Skills Commission, Australian Government (NSC). (2022). Projecting employment to 2026. https://www.jobsandskills.gov.au/sites/default/files/2022-03/NSC22-0041_Employ%20Projections_glossy_FA_ACC.pdf
Nisbet, G., Thompson, T., McAllister, S., Brady, B., Christie, L., Jennings, M., Kenny, B., & Penman, M. (2023). From burden to benefit: A multi-site study of the impact of allied health work-based learning placements on patient care quality. Advances in Health Sciences Education: Theory and Practice, 28, 759–791. https://doi.org/10.1007/s10459-022-10185-9
Nyoni, C. N., Dyk, L. H. V., & Botma, Y. (2021). Clinical placement models for undergraduate health professions students: A scoping review. BMC Medical Education, 21(1), Article 598. https://doi.org/10.1186/s12909-021-03023-w
Pharmacy Council. (2024). Accreditation for Aotearoa New Zealand pharmacy programmes. https://pharmacycouncil.org.nz/wp-content/uploads/2023/05/Aotearoa-New-Zealand-Accreditations-Standards-for-Pharmacy-Programmes.pdf
Prideaux, D., Worley, P., & Bligh, J. (2007). Symbiosis: A new model for clinical education. The Clinical Teacher, 4(4), 209–212. https://doi.org/10.1111/j.1743-498X.2007.00188.x
Roberts, C., Daly, M., Held, F., & Lyle, D. (2017). Social learning in a longitudinal integrated clinical placement. Advances in Health Sciences Education, 22(4), 1011–1029. https://doi.org/10.1007/s10459-016-9740-3
Robinson, L., Brown, T., Fossey, E., Yu, M. L., Barclay, L., Chu, E., Peart, A., & Callaway, L. (2021). Practice education in lockdown: Lessons learned during the COVID-19 global pandemic. In D. Nestel, G. Reedy, L. McKenna, & S. Gough (Eds.), Clinical education for the health professions: Theory and practice (pp. 1–20). Springer Singapore. https://link.springer.com/referenceworkentry/10.1007/978-981-13-6106-7_138-1
Rodger, S., Webb, G., Devitt, L., Gilbert, J., 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. https://www.jstor.org/stable/48721557
Salter, C., Oates, R. K., Swanson, C., & Bourke, L. (2020). Working remotely: Innovative allied health placements in response to COVID-19. International Journal of Work-Integrated Learning, 21(5), 587–600. https://www.ijwil.org/files/IJWIL_21_5_587_600.pdf
Smith, L. C., Watson, H., Fair, L., Carter, G., Mackay, P., Lykens, K., Bradstock, J., Arnold, K., & Whalen, M. (2022). Evidence-based practices in developing and maintaining clinical nurse preceptors: An integrative review. Nurse Education Today, 117(6), Article 105468. https://doi.org/10.1016/j.nedt.2022.105468
Snell, R., Fyfe, S., Fyfe, G., Blackwood, D., & Itsiopoulos, C. (2020). Development of professional identity and professional socialisation in allied health students: A scoping review. Focus on Health Professional Education: A Multi-Professional Journal, 21(1), 29–56. https://doi.org/10.11157/fohpe.v21i1.322
Søvold, L. E., Naslund, J. A., Kousoulis, A. A., Saxena, S., Qoronfleh, M. W., Grobler, C., & Münter, L. (2021). Prioritizing the mental health and well-being of healthcare workers: An urgent global public health priority. Frontiers in Public Health, 9, Article 679397. https://doi.org/10.3389/fpubh.2021.679397
Tempest, S., Craig, V., Volkert, A., Volkert, A., Green, C., Howson, C. A., Moran, M., & Papertalk, L. (2022). Making and maintaining connections within the supervisory relationship. In K. Dancza, A. Volkert, & S. Tempest (Eds.), Supervision for occupational therapy: Practical guidance for supervisees and supervisors (pp. 76–77). Routledge. https://doi.org/10.4324/9781003092544
Tiberius, R. G., & Gaiptman, B. (1985). The supervisor–student ratio: 1:1 versus 1:2. Canadian Journal of Occupational Therapy, 52, 179–183. https://doi.org/10.1177/000841748505200403
Trede, F., Macklin, R., & Bridges, D. (2012). Professional identity development: A review of the higher education literature. Studies in Higher Education, 37(3), 365–384. https://doi.org/10.1080/03075079.2010.521237
Twyford, L. (2024, August 20). Allied health professions are in demand but students have been excluded from “placement poverty” solution. ABC News Australia. https://www.abc.net.au/news/2024-08-20/allied-health-students-placement-poverty-graduation/104243024
van Dellen, T., & Cohen-Scali, V. (2015). The transformative potential of workplace learning: Construction of identity in learning spaces. International Review of Education, 61(6), 725–734. https://doi.org/10.1007/s11159-015-9528-3
van Schalkwyk, S., Blitz, J., Couper, I., de Villiers, M., Lourens, G., Muller, J., & van Heerden, B. (2018). Consequences, conditions and caveats: A qualitative exploration of the influence of undergraduate health professions students at distributed clinical training sites. BMC Medical Education, 18(1), Article 311. https://doi.org/10.1186/s12909-018-1412-y
Walters, L. (2014). Rural medical education guide. https://www.globalfamilydoctor.com/groups/WorkingParties/RuralPractice/ruralguidebook.aspx
Whitehead, A. J., Beak, K. M., Russell, T., & Ross, M. H. (2023). Allied health clinical placements with a remote supervision model: Students’ and clinical educators’ perceptions. Distance Education, 44(2), 284–305. https://doi.org/10.1080/01587919.2023.2209024
Winkelmann, J., Webb, E., Williams, G. A., Hernández-Quevedo, C., Maier, C. B., & Panteli, D. (2022). European countries' responses in ensuring sufficient physical infrastructure and workforce capacity during the first COVID-19 wave. Health Policy, 126(5), 362–372. https://doi.org/10.1016/j.healthpol.2021.06.015
World Federation of Occupational Therapists (WFOT). (2016). Minimum standards for the education of occupational therapists. https://wfot.org/resources/new-minimum-standards-for-the-education-of-occupational-therapists-2016-e-copy
World Health Organisation (WHO). (2022). Our duty of care: A global call to action to protect the mental health of health and care workers. https://www.who.int/publications/m/item/wish_report
Worley, R. B., & Dyrud, M. A. (2006). Focus on teaching. Business and Professional Communication Quarterly, 69(2), 184–185. https://doi.org/10.1177/1080569906288069
Zhao, Y., Russell, D. J., Guthridge, S., Ramjan, M., Jones, M. P., Humphreys, J. S., & Wakerman, J. (2019). Cost impact of high staff turnover on primary care in remote Australia. Australian Health Review, 43(6), 689–695. https://doi.org/10.1071/AH17262
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