by Dr Nicky Eddison and Lisa Smith
Student placement supervision is an action and process where a person (the supervisor) has been given responsibility for the support, training, learning, and development of a student to help ensure the individual meets the needs of the role1.
There are a variety of placement supervision models available, Including the traditional 1:1 model, which is now seen as rigid and restrictive and provides the student with the perspective of only one clinician. The Dyad model which advocates a 2:1 approach (two students to one clinician) has the added benefit of increased placement capacity and permits peer learning between students, fostering a self-directed learning approach. The split placement models can be utilised by services lacking in staff or which have limited operating hours. In such cases, the student placement is shared with another service, which can be a different profession to widen the students’ experience2.
The Collaborative learning in practice placement (CLiPP) incorporates a variety of learners in one learning area and aims to enhance the student placement experience by allowing for peer-to-peer support from other students in different year groups and across different professions. Â All care whilst on placement is overseen by a practice supervisor/assessor but it is the student who organises and delivers the care. The CLiPP learning model offers a very hands-on approach, giving students the most realistic experience; helping to boost confidence and increase leadership and clinical practice skills1. It also has the potential to increase the number of student placements when compared to the more traditional models.
The CLiPP model has been used successfully for nursing students at Walsall Healthcare Trust (WHT) but had not been trialled with the allied health professions (AHPs).
The CLiPP model for AHPs at Walsall Healthcare Trust
In 2021 I (Lisa Smith) was seconded to a Clinical Placement Expansion Programme (CPEP) role to increase student capacity for WHT for both occupational therapy and physiotherapy students. I worked alongside Amy Jowicz (CLiPP Project Support Officer), and Kate Cornforth (Practice education facilitator) and together we introduced the CLiPP model for our AHP students. Initially, there was some trepidation about the implementation of a new student placement model, with staff feeling unsure how the model would work in their areas. To ensure the placements were planned appropriately and would meet the needs of our students, a pilot was devised. This allowed staff to gain an understanding of how the placements would operate and get involved in the development of the programme.
Figure 1: The staff involved in the pilot of CLiPP at WHT
Three AHP-specific toolkits were developed to assist the students during their placements. Following a successful pilot, the new placement model was launched In November 2022, in collaboration with Wolverhampton University. The first cohort of students was a mix of occupational therapy students, physiotherapy students, and nursing students, all of whom were allocated to the Holly Bank Stroke Rehabilitation Unit.
Figure 2: The staff and students involved in the first AHP CLiPP programme at WHT
Students on CLiPP are encouraged to take the lead in their practice, supporting their learning through identified daily learning outcomes with the aid of learning plans. The placements WHT were designed around ‘huddles’:
Huddle One
- A list of jobs for the day was produced by the nurse, occupational therapist, or physiotherapist and then each student allocated themselves to complete each job to meet their goal.
- Everyone went onto the unit and was hands-on from the start of the morning.
Huddle Two
- All students and practice placement educators came together to reflect on their morning. This was a very positive time as students were eager to share what they had learned and were willing to discuss what they would do next time. All students were able to go through the GROW Model to reflect on their morning.
Huddle Three
- At the end of the day, students came together with practice placement educators and reflected on their afternoon.
Because the CLiPP model utilises the multi-disciplinary team (MDT) rather than a traditional uniprofessional approach, it enables the student to fully understand the whole of the patient’s journey rather than focusing on the treatment related to their speciality. Enabling our AHP students to learn alongside nursing students increased the students’ knowledge of medication and skin integrity. Exposure to the wider MDT provides students with a deeper understanding of different areas and roles in a ward, providing the students with a more realistic view of patient care and patient pathways.
An environment which enables students to work alongside other students across professions helps build confidence, through sharing knowledge, seeking advice and supporting one another when challenges arise1.
Staff feedback: Michelle Awale (Lead Occupational Therapist) and Laura Nock (Lead Physiotherapist)
As the lead therapists involved in implementing CLiPP on the Stroke Rehabilitation Unit at Hollybank House, we attended many planning meetings in the run-up to the launch to provide an excellent first CLiPP experience on the unit. Having previously only been used to one student to one educator placement model it did feel daunting to be having a 2:1 model, especially at a time of significant understaffing. The initial weeks of CLiPP felt very time and energy-consuming for us as educators and students. As the weeks progressed, through negotiation we began to find a structure of CLiPP that worked for our team. By the final week, we had a much-improved process which we plan to take forward to the next CLiPP placement. We do feel that CLiPP will work very well and enhance student experience when the team is well-staffed with qualified therapists, as this would relieve pressure off the educators and enable them to focus on the placement model and the additional students that it entails. We look forward to the next placement, and to be able to see the comparison with the previous placement following the implementation of changes.
Lessons learned
Our first CLiPP programme was a huge success and received excellent feedback from students and staff. However, we are still keen to keep improving. Our students told us they would benefit from a longer induction period.  Both staff and students felt that an introduction and orientation to the unit and swipe cards issued before the start of their placement would be beneficial. In response to this feedback, we are considering introducing a preplacement visit.
Students also reported that they felt like they had been ‘thrown together’ without having the opportunity to get to know the other students. In response, we are planning to introduce an ‘icebreaker’ task to help the students get to know each other.
Going forward
We have planned a second cohort to run CLiPP at Holly Bank Stroke Rehabilitation Unit in April 2023. As a team, we are going to meet and plan a 6-week Practice Placement with the University of Wolverhampton. During the planning stage, we will use our evaluation to alter aspects of the CLiPP model from feedback provided in the first cohort to ensure that we make relevant changes to ensure the student receives a good experience. Furthermore, I (Lisa Smith) will be working with Beth Lowe (Practice Educator Facilitator) at WHT to implement CLiPP across other areas of the hospital and involve a wider scope of AHPs. I will be discussing and promoting our model of CLiPP in the Stroke Rehabilitation at WHT with other NHS Trusts who are also interested in using the CLiPP care and coaching model.
For more information about the CLiPP programme please contact Lisa Smith lisa.smith254@nhs.net
References
- NHS Employers. Clinical placement supervision models. https://www.nhsemployers.org/articles/clinical-placement-supervision-models. Accessed June 22, 2022.
- Eddison N. Leslie R. Craven M and Phoenix O. AHP student clinical supervision: whose role is it anyway? Inst if Heal Soc Care Manag. 2022. https://ihscm.org.uk/2022/08/15/ahp-student-clinical-supervision-whose-role-is-it-anyway-by-dr-nicky-eddison-dr-ros-leslie-matt-craven-and-olivia-phoenix/. Accessed January 16, 2023.
