“Blended Placement: A Balancing Act”
DOI:
https://doi.org/10.18552/ijpblhsc.v12i2.953Keywords:
blended placement, health and social care professions, practice education, practice educators experiencesAbstract
The COVID-19 pandemic exacerbated healthcare practice education placement shortages. In Ireland, four occupational therapy programmes developed the blended onsite/offsite practice education placement model to increase placement capacity. Offsite learning included projects, supervision and telehealth, while clinical contact was prioritised when onsite. The aim of this study was to investigate the experiences of practice educators (PEs) who had supervised students using this model. The study used a qualitative interpretive methodology. PEs with experience of supervising a blended placement took part in semi-structured interviews. Reflexive thematic analysis was used to explore themes in the data. PEs felt the model benefitted students’ self-directed learning and independence. The study found that PEs valued the time apart from the student to be able to manage their own workload. Some were concerned about reduced clinical contact and operational challenges. Overall PEs were positive about the model’s use beyond COVID-19. Participants in this study value ongoing use of the blended onsite/offsite placement model. The flexibility of the model for the practice educator is key to its sustainability. Information gathered in this study facilitated the development of a Blended Onsite/Offsite Model (BOOM) Planning Tool, applicable to other health and social care professions. There is a need to promote this model as part of a wider strategy to address placement capacity challenges.
References
Ashby, S. E., Adler, J., & Herbert, L. (2016). An exploratory international study into occupational therapy students' perceptions of professional identity. Australian Occupational Therapy Journal, 63(4), 233-243. https://doi.org/10.1111/1440-1630.12271
Baillie, L. (2019). Exchanging focus groups for individual interviews when collecting qualitative data. Nurse Researcher, 27(2), 15-20. https://doi.org/10.7748/nr.2019.e1633
Barrett, A., Kajamaa, A., & Johnston, J. (2020). How to … be reflexive when conducting qualitative research. The Clinical Teacher, 17(1), 9-12. https://doi.org/10.1111/tct.13133
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
Bhagwat, M., Hewetson, R., Jones, L., Hill, A., Nunn, J., Tosh, R., & Cahill, L. (2018). Comparison of paired and single clinical placement models: A time‐use analysis. International Journal of Language & Communication Disorders, 53(3), 468-479. https://doi.org/10.1111/1460-6984.12360
Bonello, M. (2001). Perceptions of fieldwork education in Malta: challenges and opportunities. Occupational Therapy International, 8(1), 17-33. https://doi.org/10.1002/oti.129
Bourne, E., Short, K., McAllister, L., & Nagarajan, S. (2019). The quantitative impact of placements on allied health time use and productivity in healthcare facilities: a systematic review with meta-analysis. Focus on Health Professional Education: A Multi-Professional Journal, 20(2), 8-40. https://doi.org/10.11157/fohpe.v20i2.315
Braun, V., & Clarke, V. (2013). Successful qualitative research: a practical guide for beginners. SAGE.
Braun, V., & Clarke, V. (2019). Reflecting on reflexive thematic analysis. Qualitative Research in Sport, Exercise and Health, 11(4), 589-597. https://doi.org/10.1080/2159676X.2019.1628806
Braun, V., & Clarke, V. (2021). One size fits all? What counts as quality practice in (reflexive) thematic analysis? Qualitative Research in Psychology, 18(3), 328-352. https://doi.org/https://doi.org/10.1080/14780887.2020.1769238
Brown, T., McKinstry, C. E., & Gustafsson, L. (2016). The need for evidence and new models of practice education to meet the 1000 hour requirement. Australian Occupational Therapy Journal, 63(5), 352-356. https://doi.org/10.1111/1440-1630.12239
Cassidy, E., Norris, M., & Williams, A. (2020). What does it take to graduate? A qualitative exploration of the perceptions of successful physiotherapy graduates from one university in the UK. Physiotherapy Theory and Practice, 36(2), 316-332. https://doi.org/10.1080/09593985.2018.1485799
Clarke, C., Martin, M., Sadlo, G., & de-Visser, R. (2014). The development of an authentic professional identity on role-emerging placements. British Journal of Occupational Therapy, 77(5), 222-229. https://doi.org/10.4276/030802214X13990455043368
Cohen, L., Manion, L., & Morrison, K. (2017). Research Methods in Education. Taylor & Francis Group. http://ebookcentral.proquest.com/lib/univlime-ebooks/detail.action?docID=5103697
Coleman, J., Knott, K., & Jung, B. (2021). Impact of physical therapy and occupational therapy student placements on supervisor productivity: a scoping review. Canadian Medical Education Journal, 12(4), 98-110. https://doi.org/10.36834/cmej.69298
Connelly, L. M. (2016). Trustworthiness in Qualitative Research. Medsurg Nursing, 25(6), 435-436.
CORU. (2016). Criteria and Standards of Proficiency. https://coru.ie/health-and-social-care-professionals/education/criteria-and-standards-of-proficiency/
CORU. (2021). Education Information for Education Providers. Impact of COVID-19 on Practice Placement. https://coru.ie/files-education/information-for-education-providers-impact-of-covid-19-on-practice-placements.pdf
Creswell, J. W., & Creswell, J. D. (2018). Research Design: Qualitative, Quantitative, and Mixed Methods Approaches (Fifth ed.). SAGE Publications, Inc.
Cruess, R. L., Cruess, S. R., & Steinert, Y. (2016). Amending Miller’s Pyramid to Include Professional Identity Formation. Academic Medicine, 91(2), 180-185. https://doi.org/10.1097/ACM.0000000000000913
Dancza, K., Volkert, A., & Tempest, S. (2022). Supervision for Occupational Therapy: Practical Guidance for Supervisors and Supervisees. Taylor & Francis.
Dancza, K., Warren, A., Copley, J., Rodger, S., Moran, M., McKay, E., & Taylor, A. (2013). Learning experiences on role‐emerging placements: An exploration from the students' perspective. Australian Occupational Therapy Journal, 60(6), 427-435. https://doi.org/https://doi.org/10.1111/1440-1630.12079
Dornan, T., Boshuizen, H., King, N., & Scherpbier, A. (2007). Experience-based learning: a model linking the processes and outcomes of medical students' workplace learning. Medical Education, 41(1), 84-91. https://doi.org/10.1111/j.1365-2929.2006.02652.x
Fairbrother, M., Nicole, M., Blackford, J., Nagarajan, S. V., & McAllister, L. (2016). A New Model of Clinical Education to Increase Student Placement Availability: The Capacity Development Facilitator Model. Asia-Pacific Journal of Cooperative Education, 17(1), 45-59.
Flood, B., Haslam, L., & Hocking, C. (2010). Implementing a Collaborative Model of Student Supervision in New Zealand: Enhancing Therapist and Student Experiences. New Zealand Journal of Occupational Therapy, 57(1), 22-26.
Fortune, T., Farnworth, L., & McKinstry, C. (2006). Project-focussed fieldwork: Core business or fieldwork fillers? Australian Occupational Therapy Journal, 53(3), 233-236. https://doi.org/10.1111/j.1440-1630.2006.00562.x
Fronek, P., Briggs, L., Rondon-Jackson, R., Hay, K., Maidment, J., & Medina-Martinez, K. (2021). Responding to COVID-19 in social work field education in Australia, New Zealand and the United States. International Social Work, 66(1), 130-143. https://doi.org/10.1177/00208728211048934
Golafshani, N. (2003). Understanding Reliability and Validity in Qualitative Research. The Qualitative Report, 8(4), 597-607. https://doi.org/10.46743/2160-3715/2003.1870
Golos, A., & Tekuzener, E. (2019). Perceptions, expectations and satisfaction levels of occupational therapy students prior to and after practice placement and comparison of practice placement models. BMC Medical Education, 19(1), 324-324. https://doi.org/10.1186/s12909-019-1762-0
Grafton-Clarke, C., Uraiby, H., Gordon, M., Clarke, N., Rees, E., Park, S., Pammi, M., Alston, S., Khamees, D., & Peterson, W. (2022). Pivot to online learning for adapting or continuing workplace-based clinical learning in medical education following the COVID-19 pandemic: A BEME systematic review: BEME Guide No. 70. Medical Teacher, 44(3), 227-243. https://doi.org/10.1080/0142159X.2021.1992372
Graham, C. R., Woodfield, W., & Harrison, J. B. (2013). A framework for institutional adoption and implementation of blended learning in higher education. The Internet and Higher Education, 18, 4-14. https://doi.org/10.1016/j.iheduc.2012.09.003
Hanson, D. J. (2011). The Perspectives of Fieldwork Educators Regarding Level II Fieldwork Students. Occupational Therapy in Health Care, 25(2-3), 164-177. https://doi.org/10.3109/07380577.2011.561420
Houghton, C., Casey, D., Shaw, D., & Murphy, K. (2013). Rigour in qualitative case-study research. Nurse Researcher, 20(4). https://doi.org/10.7748/nr2013.03.20.4.12.e326
Jessup, B., Hoang, H., Podubinski, T., Obamiro, K., Bourke, L., Hellwege, B., Jatrana, S., Heaney, S., Farthing, A., & Sheepway, L. (2022). ‘I can't go, I can't afford it’: Financial concern amongst health students undertaking rural and remote placements during COVID‐19. The Australian Journal of Rural Health, 30(2), 238-251. https://doi.org/10.1111/ajr.12855
Kallio, H., Pietilä, A. M., Johnson, M., & Kangasniemi, M. (2016). Systematic methodological review: developing a framework for a qualitative semi‐structured interview guide. Journal of Advanced Nursing, 72(12), 2954-2965. https://doi.org/10.1111/jan.13031
Kirke, P., Layton, N., & Sim, J. (2007). Informing fieldwork design: Key elements to quality in fieldwork education for undergraduate occupational therapy students. Australian Occupational Therapy Journal, 54(s1), S13-S22. https://doi.org/10.1111/j.1440-1630.2007.00696.x
Lawton, V., Vaughan, R., Jones, T. M., & Pacey, V. (2021). Rising to the Challenge of COVID-19: Pivoting to Online and Project-Based Physiotherapy Student Placements in Contemporary Professional Settings. International Journal of Practice-based Learning in Health and Social Care, 9(2), 21-38. https://doi.org/10.18552/ijpblhsc.v9i2.747
Lewin, L. O., Singh, M., Bateman, B. L., & Glover, P. B. (2009). Improving education in primary care: development of an online curriculum using the blended learning model. BMC Medical Education, 9, Article 33. https://doi.org/10.1186/1472-6920-9-33
Liu, Q., Peng, W., Zhang, F., Hu, R., Li, Y., & Yan, W. (2016). The Effectiveness of Blended Learning in Health Professions: Systematic Review and Meta-Analysis. Journal of Medical Internet Research, 18(1), e2. https://doi.org/10.2196/jmir.4807
Luhanga, F. L., Billay, D., Grundy, Q., Myrick, F., & Yonge, O. (2010). The One-to-One Relationship: Is it Really Key to an Effective Preceptorship Experience? A Review of the Literature. International Journal of Nursing Education Scholarship, 7(1). https://doi.org/10.2202/1548-923x.2012
Malterud, K., Siersma, V. D., & Guassora, A. D. (2015). Sample Size in Qualitative Interview Studies: Guided by Information Power. Qualitative Health Research, 26(13), 1753-1760. https://doi.org/10.1177/1049732315617444
Marchant, J. (2021). Understanding the Allied Health Professions Student Experience of Practice Placements during the First Wave of the Coronavirus Pandemic. International Journal of Practice-based Learning in Health and Social Care, 9(2), 39-48. https://doi.org/10.18552/ijpblhsc.v9i2.741
McBride, L.-J., Fitzgerald, C., Morrison, L., & Hulcombe, J. (2015). Pre-entry student clinical placement demand: Can it be met? Australian Health Review, 39(5), 577-581. https://doi.org/10.1071/AH14156
McGrath, C., Palmgren, P. J., & Liljedahl, M. (2019). Twelve tips for conducting qualitative research interviews. Medical Teacher, 41(9), 1002-1006. https://doi.org/10.1080/0142159X.2018.1497149
Miller, T. W., Miller, J. M., Burton, D., Sprang, R., & Adams, J. (2003). Telehealth: A Model for Clinical Supervision in Allied Health. The Internet Journal of Allied Health Sciences and Practice, 1(2), Article 6. https://doi.org/10.46743/1540-580X/2003.1016
Mulholland, S., Derdall, M., & Roy, B. (2006). The Student's Perspective on What Makes an Exceptional Practice Placement Educator. British Journal of Occupational Therapy, 69(12), 567-571. https://doi.org/10.1177/030802260606901206
National HSCP Office. (2021). Report on Health and Social Care Professions Practice Education During and Post-COVID-19 Challenges, Barriers, Solutions and Opportunities. https://www.beai.ie/sites/beai/files/publications/%283%29%20HSCP%20Report%20on%20HSCP%20Practice%20Education%20During%20and%20Post-COVID-19.pdf
Nisbet, G., Lincoln, M., & Dunn, S. (2013). Informal interprofessional learning: an untapped opportunity for learning and change within the workplace. Journal of Interprofessional Care, 27(6), 469-475. https://doi.org/10.3109/13561820.2013.805735
NUIGalway. (2020). Practice Education at NUI Galway. University of Galway. https://www.nuigalway.ie/medicine-nursing-and-health-sciences/healthsciences/disciplines/occupational-therapy/practiceeducation/
O'Connor, A., Cahill, M. and McKay, E.A. (2012). Revisiting 1:1 and 2:1 clinical placement models: Student and clinical educator perspectives. Australian Occupational Therapy Journal, 59(4), 276-283. https://doi.org/10.1111/j.1440-1630.2012.01025.x
O'Connor, M., Lunney, A., Potocnik, J., Kearney, D., & Grehan, J. (2023). Supporting radiography clinical placements in Ireland during the COVID-19 pandemic: The practice educators perspective. Radiography, 29(2), 379-384. https://doi.org/10.1016/j.radi.2023.01.018
O'Leary, N., & Cantillon, P. (2020). Why shouldn't we do that on placement if we're doing it in the real world? Differences between undergraduate and graduate identities in speech and language therapy. Advances in Health Sciences Education: Theory and Practice, 25(4), 781-797. https://doi.org/10.1007/s10459-020-09955-0
Peart, A., Wells, N., Yu, M. L., & Brown, T. (2022). ‘It became quite a complex dynamic’: The experiences of occupational therapy practice educators' move to digital platforms during the COVID‐19 pandemic. Australian Occupational Therapy Journal, 69(1), 38-49. https://doi.org/10.1111/1440-1630.12767
Robinson, L., Brown, T., Fossey, E., Yu, M.-L., Barclay, L., Chu, E., Peart, A., & Callaway, L. (2020). 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://doi.org/10.1007/978-981-13-6106-7_138-1
Rodger, S., Thomas, Y., Greber, C., Broadbridge, J., Edwards, A., Newton, J., & Lyons, M. (2014). Attributes of excellence in practice educators: The perspectives of Australian occupational therapy students. Australian Occupational Therapy Journal, 61(3), 159-167. https://doi.org/10.1111/1440-1630.12096
Rowe, M., Frantz, J., & Bozalek, V. (2012). The role of blended learning in the clinical education of healthcare students: A systematic review. Medical Teacher, 34(4), e216-e221. https://doi.org/10.3109/0142159X.2012.642831
Sagasser, M. H., Kramer, A. W. M., van Weel, C., & van der Vleuten, C. P. M. (2015). GP supervisors' experience in supporting self-regulated learning: a balancing act. Advances in Health Sciences Education: Theory and Practice, 20(3), 727-744. https://doi.org/10.1007/s10459-014-9561-1
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
Samuk Carignani, Ş., & Burchi, S. (2022). Preparing for online interviews during Covid-19: the intricacies of technology and online human interaction. SN Social Sciences, 2, Article 210. https://doi.org/10.1007/s43545-022-00498-2
Sim, J., Saunders, B., Waterfield, J., & Kingstone, T. (2018). Can sample size in qualitative research be determined a priori? International Journal of Social Research Methodology, 21(5), 619-634. https://doi.org/10.1080/13645579.2018.1454643
Smith, B. (2018). Generalizability in qualitative research: misunderstandings, opportunities and recommendations for the sport and exercise sciences. Qualitative Research in Sport, Exercise and Health, 10(1), 137-149. https://doi.org/10.1080/2159676X.2017.1393221
Swanson, H. L., Pierre‐Louis, C., Monjaras‐Gaytan, L. Y., Zinter, K. E., McGarity‐Palmer, R., & Clark Withington, M. H. (2022). Graduate student workload: Pandemic challenges and recommendations for accommodations. Journal of Community Psychology, 50(5), 2225-2242. https://doi.org/10.1002/jcop.22769
Syed, S., & Duncan, A. (2019). Role Emerging Placements: Skills Development, Postgraduate Employment, and Career Pathways. The Open Journal of Occupational Therapy, 7(1). https://doi.org/10.15453/2168-6408.1489
Tai, J., Penman, M., Chou, C., & Teherani, A. (2020). Learning with and from Peers in Clinical Education. In D. Nestel, G. Reedy, L. McKenna, & S. Gough (Eds.), Clinical Education for the Health Professions: Theory and Practice (pp. 1-19). Springer, Singapore. https://doi.org/10.1007/978-981-13-6106-7_90-1
Taylor, C., Angel, L., Nyanga, L., & Dickson, C. (2017). The process and challenges of obtaining and sustaining clinical placements for nursing and allied health students. Journal of Clinical Nursing, 26(19-20), 3099-3110. https://doi.org/10.1111/jocn.13658
Taylor, L. & Salmon, G. (2021). Enhancing Peer Learning through Online Placements for Health and Social Care Professions. International Journal of Practice-based Learning in Health and Social Care, 9(2), 1-10. https://doi.org/10.18552/ijpblhsc.v9i2.723
Teng, C. W. C., Lim, R. B. T., Chow, D. W. S., Narayanasamy, S., Liow, C. H., & Lee, J. J.-M. (2021). Internships before and during COVID-19: experiences and perceptions of undergraduate interns and supervisors. Higher Education, Skills and Work-Based Learning, 12(3), 459-474. https://doi.org/10.1108/HESWBL-05-2021-0104
Twogood, R., Hares, E., Wyatt, M., & Cuff, A. (2020). Rapid implementation and improvement of a virtual student placement model in response to the COVID-19 pandemic. BMJ Open Quality, 9(4), e001107. https://doi.org/10.1136/bmjoq-2020-001107
Vaismoradi, M., Turunen, H., & Bondas, T. (2013). Content analysis and thematic analysis: Implications for conducting a qualitative descriptive study. Nursing & Health Sciences, 15(3), 398-405. https://doi.org/10.1111/nhs.12048
Varland, J., Cardell, E., Koski, J., & McFadden, M. (2017). Factors Influencing Occupational Therapists' Decision to Supervise Fieldwork Students. Occupational Therapy In Health Care, 31(3), 238-254. https://doi.org/10.1080/07380577.2017.1328631
Wagg, A. J., & Morgan, K. (2022). Online Virtual Nursing Placements: A Case Study on Placement Expansion. SAGE Open Nursing, 8, 23779608221117392. https://doi.org/10.1177/23779608221117392
Waldron, R. (2022). Experiencing housing precarity in the private rental sector during the covid-19 pandemic: the case of Ireland. Housing Studies, 38(1), 84-106. https://doi.org/10.1080/02673037.2022.2032613
WFOT. (2020). WFOT Minimum Standards for the Education of Occupational Therapists (revised 2016). https://wfot.org/resources/new-minimum-standards-for-the-education-of-occupational-therapists-2016-e-copy
Zahoransky, M. A., & Lape, J. E. (2020). Telehealth and Home Health Occupational Therapy: Clients' Perceived Satisfaction with and Perception of Occupational Performance. International Journal of Telerehabilitation, 12(2), 105-124. https://doi.org/10.5195/ijt.2020.6327
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