Mulholland, J., Mallik, M., Moran, P., Scammell, J. and Turnock, C., 2005. Occasional Paper No 6: Making practice-based learning work. An overview of the nature of the preparation of practice educators in five health care disciplines. London: HEA.
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Official URL: http://www.health.heacademy.ac.uk/publications/occ...
EXECUTIVE SUMMARY Practice education is a core element of all educational programmes that prepare health care professionals for academic award and registration to practice. Ensuring quality and effectiveness involves partnership working between Higher Education Institutions (HEI’s) and health care providers, social care communities, voluntary and independent sectors offering client care throughout the United Kingdom and Republic of Ireland. Clearly practitioners who support, supervise and assess learners for entry to their respective professions need to be well prepared and supported in their roles as practice educators. However it would appear that the nature of this support and preparation varies across disciplines and that good practice is not easily shared. With this in mind, the Making Practice Based Learning Work (MPBLW) project aims to make practitioners more effective at supporting and supervising students in the workplace across a range of health care disciplines namely Dietetics, Nursing, Occupational Therapy, Physiotherapy and Radiology. The Department of Employment and Learning (Northern Ireland) and the Higher Education Funding Council for England has funded this collaborative project involving staff from Ulster, Northumbria and Bournemouth Universities. The outcomes for each phase of the project are: Phase One: • Identify and document good practice on how practitioners are prepared for their educational role. Phase Two: • Develop and evaluate learning materials for use by practitioners across five health care disciplines. • Make learning materials available in a number of efficient media, e.g. paper, electronic, CD-ROM and web-based. • Develop a programme applicable to interprofessional and uniprofessional contexts. • Widen access for a multicultural workforce. Phase Three • Embed best educational practice through the establishment of an academic-practitioner network. • Disseminate a range of materials and processes across the wider academic and health and social care communities. This executive summary presents an overview of Phase One of the MPBLW project completed between January 2003 and June 2004. A more detailed report follows in the remainder of this occasional paper and the full report can be accessed at the project website. (www.practicebasedlearning.org) SUMMARY OF THE LITERATURE REVIEW In keeping with the aims of completing a ‘developmental project’ rather than systematic research, the literature review is primarily an appraisal of current issues rather than a systematic review of the literature. A key conclusion of this review is that empirical evidence on issues surrounding practice education, yields results that arise predominantly from small, local, uni-site and uni-professional data gathered from stakeholders such as students, practice educators and HEI lecturers. In addition there is no evidence of a common preparation route for practice educators from the participant professions. Moving from the broader context to key issues, the literature review focused on four main areas: • The nature and effectiveness of practice education • The role and development of the practice educator • Interprofessional learning and practice education • Intercultural issues in practice education To summarise the first section, conceptual and research literature highlights the variables that affect the quality of practice learning. These include: • The placement context e.g., patient dependency, nature of the illness, staffing levels, skill mix and personalities. • Competency and capability of clinical teams e.g. staff are up-to-date and comfortable in the area/speciality of care. • Communication skills of the Practice Educator (PE) and the interpersonal relationship between the learner and the PE. • Length of time available for the learner e.g. increasing numbers of learners in placement areas and increasing service demands on the PE. • Clarity of the purpose and intent of practice learning within the curriculum for learners, PE’s and academic staff Literature related to the preparation for and the role of Practice educators reveals evidence of confusion regarding the role and inconsistency in the level, content and length of preparation courses. Key roles frequently include providing support for learners that will promote confidence, facilitating quality reflection on experiences and in assessing learner competence. In examining preparation for the role, the literature refers mainly to policy and standards documents issued by the registering body. Moving on more specific issues, although policy documents advocate the benefits of interprofessional education, the review concluded that evidence for the effectiveness of interprofessional learning is largely anecdotal. It has been found that learners demonstrate signs of identifying with their professional group and also a strong willingness to engage in interprofessional learning. The literature demonstrates that a major hurdle in implementing practice placement interprofessional learning is the formidable practical and organisational obstacles to finding and accessing exemplary collaborative practice placements. Finally the processes of economic & social globalisation and the increased mobility of labour in health care have resulted in an ethnically and culturally more diverse workforce. This has implications for practice education. Although there is evidence in the literature of work in preparing health care staff to meet the needs of culturally diverse clients, there is very little evidence of projects examining the processes of meeting the needs of practice educators and their students in multicultural workforces. In order to effectively meet the needs of the whole workforce, intercultural competence as a concept and a behaviour or skilled performance needs to be considered when preparing PE’s to facilitate effective practice learning within a multicultural workforce. CASE STUDY METHOD Case study methodology (Yin 1994) underpinned the choice of data collection methods used to map the current nature of practice education in each of the project disciplines. The remit of the project precluded a formal research study and so the intent of phase 1 was to complete a ‘scoping’ exercise using the case study method. From this insights and good practice could be shared across disciplines. Similarities and differences in practice education processes and roles could also be determined in preparation for phase two of the project. Data collection methods included a survey questionnaire, focus groups and finally analysis of secondary documentary data (see appendices 1 and 2). Heads of Departments of all the participating disciplines within HEI’s were targeted, with a request to pass the questionnaire to the most relevant person in the HEI to complete. A total of 193 questionnaires were distributed. The response rate overall was 40.9 % (n=79), Dietetics 46.2% (n=6), Nursing 23.8% (n= 19), Occupational Therapy 67.7 % (n= 21), Physiotherapy 56.8% (n= 21) and Radiography 46.2% (n = 12). Focus groups were conducted at two regional workshops aimed at staff involved in practice education to gather more detailed qualitative data. Four groups of ten participated from the first workshop and two groups of ten at the second. Descriptive statistical analysis of quantitative data was undertaken using SPSS. Qualitative data were analysed using thematic analysis (Polit and Hungler 1995). Secondary source data was obtained for each of the participant professions through accessing professional and statutory body reports. Case study writers used their experience and networks to access relevant HEI and placement-based policies and documents. These secondary sources were used to provide insight into professional expectations and were compared with current practice through triangulation with both questionnaire and focus group data. Limitations of the case study approach included a poor response rate to the nursing questionnaire. This may be compensated to some extent by the dominance of nursing within the literature. Intercultural issues were not fully explored due to limitations in the questionnaire design. This will given specific focus within phase two. OVERVIEW OF FINDINGS In keeping with their determination to provide early and wide dissemination of findings, the project team developed a web-site where the case studies have been published in full (www.practicebasedlearning.org). Abstracts from each case study are reproduced within this occasional paper and will not be repeated here. Cross analysis of the five Case Studies highlighted areas of commonality, differences, areas of good practice and perceived topics for further development across all the professional groups. Commonalities included the following: • All professions have statutory requirements regarding the nature of work-based learning within the curriculum. • All students are prepared for the placement experience. • All professions report to being under-resourced in terms of time, resources and availability of placements. • All professional groups are required to function within the interprofessional learning and working environment. • Interprofessional learning is curriculum based rather than work based. • All practice educators receive a period of development although the content, length and level vary across and within professions and do not necessarily have a statutory agreement. • No formal career pathway for practice educators exists within the professions. • All practice educators are involved in formative assessment but to varying degrees in summative assessment. • Learning needs of practice educators are similar across the professions. Differences include the following: • Management, organisation and location of placements within the curriculum and between disciplines. • Different methods are used to determine placement quality and standards. • Titles, roles and responsibilities given to the practice educator contrast greatly across the professional groups. • Criteria for becoming a practice educator vary across the professional groups. • Recognition, accreditation and standing of the practice educator and method of reward differ within and between professional groups. • Volume of students; student to practice educator ratios; and models of working with students diverge across groups. • Supervision and assessment of work based learning by practice educators. • The nature of the preparation of the practice educator, its length, contents, monitoring or not differs across disciplines. • Support for practice educators is varied and reported to be insufficient in some instances. • Divergence in student funding and reimbursement for work based learning. Several areas of innovative practice emerged which would benefit from wider dissemination and application to other disciplines. Some examples include interprofessional practice educator preparatory programmes, portfolio assessment, regional database of placement availability, e-resources for students and education staff, shared assessment tools across HEI’s, variety of supervision models. A number of shared areas of concern also emerged such as the lack of resources for practice education, poor valuing of the practice educator role, shortage of placements and practice educators given increased student numbers. Some of these issues are beyond the scope of the project to consider. Having analysed the findings, six themes emerged that can be seen to provide a useful platform for future work: • Learning and Teaching in Practice • Support for Learning in Practice • Reflection in Practice • Assessment in Practice • Interprofessional Learning in Practice • Diversity in Practice CONCLUSIONS AND RECOMMENDATIONS FOR PHASE TWO The anticipated outcome of phase one was to ‘identify and document good practice on how practitioners are prepared for their educational role’. The case study method whilst not comprehensive did yield a sufficiently detailed snapshot of the nature of the preparation of practice educators in five health care disciplines. The exception is that the data related to diversity was inadequate and the project team acknowledge that this area requires particular focus in later phases. However through the vehicle of a case study, a developing practice educator network and the project website, the team has attempted to share good practice in practice education widely as well as highlight issues of concern. Phase one also highlighted the types of learning resources valued by practitioners involved in practice education. The outcomes of phase two were anticipated to be to: • Develop and evaluate learning materials for use by practitioners across five health care disciplines. • Make learning materials available in a number of efficient media, e.g. paper, electronic, CD-ROM and web-based. • Develop a programme applicable to interprofessional and uniprofessional contexts. • Widen access for a multicultural workforce. As the third point illustrates, the project team intended to develop a cross-curricular practice educator preparation programme. However the case study indicates that differing professional standards and requirements would make this difficult to achieve and embed. Instead responding to data from the case study, phase 2 (June 2004 – May 2005) has involved developing a freely-accessible web-portal of learning materials for use by practice educators in curriculum design and delivery. Working with representatives from across the disciplines, the six themes from phase one have been used to group learning resources and a search facility will be provided. The utility and effectiveness of the learning resources will be evaluated during phase three of the project.
|Series Name:||Occasional Paper|
|Series Name:||Occasional Paper|
|Subjects:||Technology > Medicine and Health > Nursing and Midwifery|
|Group:||School of Health and Social Care > Centre for Wellbeing and Quality of Life|
|Deposited By:||Dr Janet ME Scammell|
|Deposited On:||20 Sep 2010 14:36|
|Last Modified:||07 Mar 2013 15:36|
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