An Introduction to Practice Education

Table of Contents

1. Overview
2. Using this resource
3. Part One - An introduction to practice education
   1. The role of practice education
   2. The relationship between the academic programme and practice education
   3. Approaches to teaching and learning
   4. Expectations of Professional Practice
   5. Reflection
4. PART TWO - Planning and Preparation for Professional Practice Education
   1. The role of professional practice education
   2. Examining the work environment - resources for learning
   3. Reflection
   4. Possible resources to use with a student with the same learning preference
   5. Possible student anxieties before embarking on a new placement
   6. Suggested information required by practice educators
5. PART THREE - Supervising and Assessing a Student in Professional Practice
   1. Defining the learning experience
   2. Student supervision and feedback
   3. Principles of Assessment
   4. Reflective practice
   5. Coping with the student with difficulties
   6. Reflection
6. Suggested responses and additional notes
   1. Aims and objectives
   2. Video Scenarios - Supervison assessment
   3. Supervision
   4. References

The role of practice education

Practice education is the term used to describe

That special part of a professional educational programme in which students gain 'hands-on' experience of working with clients under the supervision of a qualified practitioner. (Alsop & Ryan, 1996, p.4)

Waters (2001) states that the purpose of placement is three fold:

1. to allow the acquisition of professional knowledge, skills and attitudes.
2. to allow the theorising of practice and the practicing of theory.
3. to allow professional identity formation and enculturisation (the process by which students are inducted and adopt their professional culture)

The term practice education is now generally preferred to those in use previously, such as professional fieldwork experience and clinical practice, with the practitioner known as the student's practice educator. The acceptance of the terms by the Professional Bodies acknowledges the variety of working environments in which therapists now find themselves, outside of the traditional hospital and clinic settings and, in particular, in community-based and inter-professional services. The choice of words also emphasises the educational nature of the process.

Leaving aside for the moment the position of service users themselves, the main parties involved in practice education - students, practitioners acting as practice educators, service managers, professional bodies, Strategic Health Authorities and the university.

Practice education is a compulsory element of an undergraduate course for health care practitioners. In most programmes, it constitutes between one third to a half of the duration of the course.

The use of practice placements allows the university to make the student aware of the differing needs of various groups of individuals, and of the wide range of settings providing services for them. A planned and integrated approach also ensures that practice education can provide practical experience for students at the appropriate time, and reinforce and consolidate aspects of the academic course.

Practice educators are a vital source of information for the university in relation to student progress. However, the university itself must ensure that it communicates effectively with practice educators and provides sufficient support and guidance for them to carry out their role. This process involves a high level of collaboration between the university and the placement sites to ensure that the quality of practice education meets the needs of all stakeholders.

The costs and benefits of practice education (PE) for the university might be summarised as:

Benefit of PE to the university

• Information on student progress
• Balanced, high quality, practical experience for students
• Provision of an essential part of the course

Cost of PE to the university

• Practical support for practice educators
• Provision of information on students and curriculum
• Education and support for practice educators

Research evidence suggests that practice education allows students to practise problem-solving skills, to observe and question the application of practice, and to 'gain insight into the reality of work and the pressures of the work environment' (Alsop and Ryan, 1996, p.7). In addition, placements in a range of settings enable students to gain a comprehensive view of service delivery and help to inform career choice.

Alsop and Ryan (1996, p.8) comment on the opportunity provided by practice education for students to develop 'attitudes and interpersonal skills essential for professional practice'. They identify the benefits as

• A sensitivity to, and an understanding of, the needs of individuals
• The ability to relate and communicate in a professional manner
• The ability to suspend personal judgements and values
• An approach which empowers patients to make informed decisions

Finally, practice education allows students to identify themselves with, and become socialised into the health professions, and can make them aware of the relevance of Continuing Professional Development (CPD) for practice educators.

Are there any 'costs'? Practice education means that students:

• Have to be able to adjust to new environments and personnel in a variety of placements areas
• Must be prepared to travel to reach placement sites
• Are subject to assessment during, and at the end of the placement
• Have fewer holidays than many undergraduates, reducing the opportunity for paid employment and/or travel.

Nevertheless, practice education is highly regarded by students.

Practice education is the essential bridge from classroom to service delivery settings. The Department of Health (Nov 2003) identified ten key roles for Allied Health Professionals. One of these states:

To train and develop, teach and mentor, educate and inform Allied Health Professionals, students, patients and carers, including the provision of consultancy support to other roles and services in respect of patient independence and functioning. Department of Health (Nov 2003)

The professional bodies make it clear that it is a moral and professional responsibility for practitioners to provide opportunities for practice education as students work towards professional qualification. This requires you, the practitioner, to take on a different role - that of an educator rather than of a therapist.

As the student relies on practice education in their development towards professional competence, so the process of practice education itself will allow you to develop your capabilities as a practice educator - an important aspect of your own continuing professional development. Engaging in student supervision will encourage you to reflect on, and reappraise your own practice and that of your service setting, and may expose you to new theoretical knowledge and practices.

The benefits are that it will:

• Enable you to gain insight into your own skills as a therapist and your own professional identity
• Give you the opportunity to consolidate and verify your own development
• Develop the acquisition of new skills and knowledge to facilitate learning in the practice environment.

The 'costs' for practitioners will be described in more detail later (see the expectations of professional practice), but it will almost certainly mean that you will need to be more organised as well as being willing to expose your practice to external scrutiny. Service users will still be your priority and you will need to ensure that your workload level allows you to give sufficient time to practice education. Managerial and peer support networks are an essential resource for you during any placement.

Practice education can be viewed by those in charge of delivering services as a means of securing the quantity and quality of professional staff required for the future - a worthwhile investment for their own service setting as well as for the profession as a whole.

Service managers will be called on to give time to support other staff who are supervising students, and will need to consider whether workload levels allow practice education and service delivery to be managed effectively. It may be feasible for staff to take on additional, straightforward cases, which can be dealt with by students, under the appropriate level of supervision.

The benefits are that it will:

• Provide an investment for their own service setting
• Development of all staff
• Positive marketing of the service that may aid future selection and recruitment.

The costs are that it will be:-

• Time consuming for staff
• That productivity may be affected
• That there may be training issues for staff.

In 2000, The Chartered Society of Physiotherapy agreed 5 key principals as a basis for good practice in practice based learning, including that: clinical education is part of the responsibility and role of all clinical practitioners. CSP Council Minutes (2000), C005, Minute 355 (1).

The College of Radiographers Statement for Professional Conduct, statement number 6 says 'additionally, radiographers have a responsibility to engage in developing the body of knowledge, and in teaching and educating fellow colleagues, students and the public about the science and practice of medical imaging and radiotherapy treatment and care.' The College of Radiographers 2002, Statements for Professional Conduct.

The College of Occupational Therapists (OT) Code of Ethics and Professional Conduct (2000) states 5.5, 'OT's have a professional responsibility to participate in the education of OT students, particularly in the area of practice education'. The College of Occupational Therapists (OT) Code of Ethics and Professional Conduct (2000).

The SHA commission the number of students in training. It is in their interest to ensure the quality of the whole learning experience, including practice education.

It should now be clear that practice education can achieve a wide range of positive outcomes for all parties involved, but that effective communication and collaboration between the stakeholders is essential.

A final note, on the place of the service user in professional practice education:

It has already been stated that service delivery remains a priority for practice educators. The Patient's Charter (1995, p.6) givesservice users the right to refuse treatment by medical students, and this can be extended to include all students undertaking professional practice. Ensuring that you have the agreement of service users to the presence and participation of a student is vital - without them, practice education would be a very limited experience indeed! The Good Practice in Consent Implementation Guide by the Department of Health (2001) gives more details.