PLACE-BASED LEARNING: RE-IMAGINING CLINICAL PLACEMENTS IN COMMUNITY SETTINGS

D. O'Connor¹, C. Hamshire¹, K. Jack¹, A. Chambers¹, A. Lea², J. Nicholson¹

Background: Clinical placements form a substantial component of pre-registration Physiotherapy training and education, yet capacity in the United Kingdom, is increasingly limited, due to service redesign and availability of educators.   Developing innovative new placements is therefore essential in order to meet the Health Education England (HEE) ambitious targets to increase the workforce to provide quality patient care in new and innovative ways (HEE, 2019).   
Public Health England (2019) sets out a place-based approach to tackling health inequalities, and such place-based approaches enable students to consider not only medical models of care but also the wider psychosocial influences on behaviour in a specific geographical location. This approach affords opportunities for students to follow people throughout their health and social care journey, enabling a holistic learning experience.

Purpose: The purpose of this study was to increase student clinical placement capacity across Physiotherapy and Nursing in the North West of the United Kingdom.   Utilising an innovative model of team working, centred around people and place, this work provided Physiotherapy students with alternative opportunities for learning in multi-disciplinary student teams within primary care environments.  

Methods: A mixed method design was used, combining quantitative and qualitative data to develop a comprehensive analysis of the issues. Data were collected from the students and educators involved in this study. The use of more than one method enabled a holistic picture of the students’ and staff experiences and factors influencing education to be assembled. Data was subsequently analysed using a thematic approach.

Results: The results of this study indicate that the place-based model provided an innovative way to increase placement capacity. Utilising patient pathways enabled students to support the patient journey and understand different sectors of health and social care.  The students’ indicated feelings of belonging to a community of practice, whilst also gaining a greater understanding of the needs of a specific population of people within one geographical location.  Student experiences were enriched by peer learning, multi-disciplinary supervision and the opportunities provided within different community based learning environments.

Conclusion(s): People and place are at the heart of this model of student education promoting understanding of the complexity of influences on health behaviours and outcomes.   Multi-disciplinary student teams facilitate peer learning, enabling different supervision models away from traditional 1:1 student/educator relationships.  Using the wider team to provide learning opportunities facilitated greater awareness of roles and enhanced the student’s contribution to the patient journey.

Implications: Reimaging Physiotherapy student clinical education is a highly complex and multifactorial process. The place-based model provides a different approach to education, using the multi-disciplinary team and peer learning to shape student-learning experiences.  The student contribution to the neighbourhood team provides workforce development, career progression and secures the future of healthcare in community settings.
This project provides an opportunity to consider how system design can support student education in a novel, innovative and exciting way as well as increase clinical placement capacity to meet workforce demand.

Funding, acknowledgements: This work was funded by Health Education England

Keywords: Place-based education, Clinical placements, Practice learning

Topic: Education: clinical

Did this work require ethics approval? Yes

Institution: Manchester Metropolitan University

Committee: Faculty of Health, Psychology and Social Care

Ethics number: Ethos - 21661