M. Wijbenga1,2, P. Teunissen2, S. Ramaekers1, E. Driessen2, R. Duvivier2
1Amsterdam University of Applied Sciences, European School of Physiotherapy, Amsterdam, Netherlands, 2Maastricht University, School of Health Professions Education, Maastricht, Netherlands
Background: The transition from preclinical to clinical training challenges healthcare students both on a personal as well as on a professional level. To facilitate this transition it is crucial that these students are given time to realign with their social learning context, in order to create learning opportunities. Evidence clearly shows that students must actively participate in practice to enhance workplace learning. Educational programmes include international placements based on the assumption that this can be met, whilst it remains unclear how local healthcare practices may facilitate or hinder initiation of workplace learning.
Purpose: The aim of this study was to explore individual learning experiences during the initiation of clinical placement within an international healthcare setting, focused on students’ engagement in practice.
Methods: Twelve Year 1 students at the European School of Physiotherapy signed informed consent and recorded audio diaries during the first month of placement. Individual audio entries were transcribed verbatim, before being independently coded by two researchers. We applied a step-wise template analysis approach using qualitative data analysis software (Atlas.ti v8.3.1). Team discussions focused on resolving potential conflicts in coding and interpretation, following an iterative process of data analysis until more conceptual interpretation of results was achieved.
Results: Healthcare students’ participation in local practices during the initiation of international placements required orientation and adjustment to:
1) standard of care;
2) differences in education and supervision; and
3) personal learning strategies and goals.
Whilst students needed to adapt to the local standard of care, differences in education and supervision were continuously negotiated with healthcare professionals and peers. Unravelling these differences in professional practice stimulated students’ learning, as did the additional learning opportunities that were created by different approaches to care encountered in the workplace.
1) standard of care;
2) differences in education and supervision; and
3) personal learning strategies and goals.
Whilst students needed to adapt to the local standard of care, differences in education and supervision were continuously negotiated with healthcare professionals and peers. Unravelling these differences in professional practice stimulated students’ learning, as did the additional learning opportunities that were created by different approaches to care encountered in the workplace.
Conclusion(s): Student’ participation during initiation of clinical international placements involves continuous orientation and adjustment to organisation and content of care. Active participation in patient-related tasks and team activities can reveal differences in professional practice, to which the students need to respond. Local practices are often adopted, although this also depends on the dialogue between student and local healthcare professionals. This dialogue should allow for discussion and critical reflection on different professional approaches, which helps align mutual expectations and create individual learning goals. It would be interesting to see what elements of international professional practice students disagree with, and how this may influence their clinical learning experience if/when they choose to discuss this with their supervisors.
Implications: International clinical placements offer students the possibility to broaden their understanding of professional practice and standard of care. Critical reflection and discussion of healthcare practices, whether evidence-based or best practice, supports the overall clinical learning experience. Educational programmes therefore should train healthcare students and their clinical supervisors in building ongoing dialogue during clinical placements. Supervision should aim to reveal and inform on differences in professional practice, including discussion about educational approaches. By means of professional dialogue students will learn to combine the best of both worlds, helping them turn into flexible future healthcare professionals.
Funding, acknowledgements: The authors declare that no funding was received.
Keywords: Clinical placements, Healthcare students, Participation
Topic: Education: clinical
Did this work require ethics approval? Yes
Institution: The Netherlands Association for Medical Education (NVMO)
Committee: NVMO-ERB (Ethics Review Board)
Ethics number: no. 00995
All authors, affiliations and abstracts have been published as submitted.
