Maggie Parks, Lead Nurse Practice Education & Non-medical Prescribing – East London NHS Foundation Trust
Meeting the demand for placement expansion/capacity.
This paper will explore an alternative to traditional clinical placement that supports placement expansion and helps students progress through their programme during Covid restrictions
The Government mandate to increase the number of registered nurses by 2024/5 has resulted in an increased demand for clinical placements that cannot be sustained by the traditional model, further impacted by the Covid pandemic (Salmon 2021). The demand for clinical placements is also affecting Allied Health Professionals, and may be an issue for other undergraduate programmes where learning needs to happen in the ‘real world’. Alternative ways of helping undergraduate nurses to meet the requirements of their programme is needed.
ELFT, in partnership with City University of London and supported by HEE, piloted a virtual clinical placement in mental health undergraduate nursing.
A simulated/virtual platform needs to offer an equivalent authentic learning experience to that of practice, meet professional regulatory and programme requirements, be adequately resourced and accessible (Chernikova et al 2020, NHS Employers 2020). Virtual placements and PEEP methods have been developed and trialled in nursing and Occupational Therapy e.g. Virgin Care (2020), University of East Anglia (2020).
Our choice of a virtual model was influenced by contextual and operational factors – the large number of students to be accommodated, the time scale to achieve this, Covid restrictions and impacts on service delivery and staff shielding/sickness.
The context of virtual placements is important – what people remember is how the content is really implemented (Masie 2006). The virtual placement at ELFT gave students an opportunity to interact with clinicians who they might not ordinarily meet in routine placement and to explore how theory/legislation/policy/care are applied in the ‘real world’. A virtual platform enabled this to happen at scale, uninterrupted by events in the clinical setting.
Students in their 2nd year BSc mental health programme attended on-line workshops, based on case events and delivered by practising clinicians, for the first 4 weeks of a 10 week placement. Weekly reflective sessions were held with City University lecturer. In the subsequent 6 weeks students further demonstrated application of learning to practice to their supervisor and assessor.
Topics covered (mapped to Practice Assessment Document and informed by previous student and manager feedback): physical health (increased morbidity & mortality factors, medication adverse effects vital signs & NEWS2, Covid, delirium, sepsis, asthma, COPD, DVT & pulmonary embolus, obesity hypoventilation syndrome, TB, pneumonia, stroke, angina & MI, myocarditis, endocarditis, heart failure, diabetes, constipation/intestinal obstruction), Learning disability, Rapid Tranquilisation & Seclusion, Mental Health Act, Mental Capacity Act, Trauma Informed Care, care planning, discharge Planning, Serious Untoward Incidents, Child & Adolescent Nursing, Healthcare Regulations CQC & CQUIN, Leadership, Supporting & Coaching Learners – preparation for Supervisor role, Mental Health & Sexuality, NMC Code)
A total of 40 students attended the virtual pilot, releasing 40 x 4 week placements (6,000 hours)
Formal evaluation is underway. Preliminary feedback from students is very positive
invaluable experiences and in some cases more powerful than actual physical placements
“These sessions have been fantastic”
“I don’t think I would have got this level of understanding in practice”
“As well as improving my clinical knowledge, it was fantastic to understand the law and the code in a practical sense. The CQC and how Trusts are measured by commissioners was an eye-opener”
Slides from the session
Recording of the session:
Chernikova O, Heitzmann N, Stadler M, Holzberger D, Seidel T, Fischer F (2020) Simulation-Based Learning in Higher Education: A Meta-Analysis Sage Publishing https://journals.sagepub.com/doi/full/10.3102/0034654320933544
Masie E (2006) The blended learning imperative In Bonk CJ & Graham CR 2006 The Handbook of Blended Learning; global perspectives, local designs pp22-26 San Francisco: John Wiley & Sons Inc
NHS Employers (2020) Expanding Placement Capacity https://www.nhsemployers.org/your-workforce/plan/workforce-supply/education-and-training/expanding-placement-capacity
Salmon G (2021) Unblocking the placements logjam through e-placements in healthcare https://wonkhe.com/blogs/unblocking-the-placements-logjam-through-e-placements-in-healthcare/
University of East Anglia (2020) virtual practice placement for Occupational Therapy 2nd Year BSc students https://www.hee.nhs.uk/our-work/allied-health-professions/occupational-therapy-virtual-practice-placement
Virgin Care (2020) online student nurse assessment placements https://virgincare.co.uk/news/we-have-set-up-the-uks-first-online-student-nurse-assessment-placements-so-covid-19-shielders-can-become-the-nurses-of-the-future/