CSP placements: what they taught us

Reflecting on our recent experience of hosting physiotherapy students on virtual practice placements

CSP Placements
CSP Placements and what they taught us

In September, the CSP hosted four students on a four-week practice placement. Professional adviser Tamsin Baird, who led on the project, shares her reflections and learning from the experience.

In September we had the pleasure of welcoming four students onto a four-week practice placement with us at the CSP. While we had previously hosted placements, we’d never before taken four students at a time, delivered placements remotely or integrated peer learning and remote supervision into their design. 

As we urge our members to think differently about student placements, it seemed only right that we challenge ourselves to do the same. 

The other ‘new’ here was me. My past experience in creating quality learning environments was predominantly in patient-facing settings and, having only joined the CSP in March, I’m a relatively new member of the workforce and education team.

Now the placement has finished it’s time to reflect on our learning. 

This is my personal reflection on our student placement experience.   

1 Allow yourself to learn (and to make mistakes as you go) 

Irrespective of who we are or where we practice physiotherapy, we are all currently dealing with huge fast-paced change: change in service delivery, change in how we interact with patients, change in practice as well as enormous changes in our personal lives.

Just as physiotherapy practice is changing, so too must student placements to enable our future workforce to both graduate on time and be equipped with the breadth of skills needed. In the words of educational philosopher: ‘If we teach today’s students as we taught yesterday’s, we rob them of tomorrow’ – John Dewey 

Adapting to change is never easy. The very nature of it leads to uncertain results and elements of risk taking. As someone who likes to be in control, to be prepared and have tried and tested methods of working, this has been a huge personal learning curve. My willingness to ‘adapt as we go’ developed throughout the placement and I became more comfortable living with the uncertainty of its outcomes. Rather than striving for perfection during complexity, I quickly learnt that it was far more productive to focus on what we could control and co-learn with the student, organisation and university. During creative change we will make mistakes and this is okay. This is how we learn, how we grow and how we develop. 

Let’s not forget that this situation is also new to students. Their world has been turned upside down. They are getting used to different methods of curriculum delivery, many living away from home and unable to visit due to restrictions, unable to see classmates face-to-face and having considerable (but very normal) concerns and anxieties. They are hearing about the changes in physiotherapy practice, some without having been in a practice environment since March themselves. The profession that they are pursuing is rapidly changing and they know that they need to be adaptable to these changes and show resilience. I believe that the students who came on placement with us were very courageous to do so. They took a leap, not knowing what to expect in an unfamiliar area of practice. Their attitude was so impressive throughout and

I plan to adopt their brave attitude to my learning. 

2 Create a sense of belonging within a team 

The evidence base here is well established: creating a sense of belonging during placements has been found to boost confidence, motivation and the ability to learn among health care students. Maslow identified ‘sense of belonging’ as part of his hierarchy of needs. He described this need as part of the progression towards achieving full potential. When present, it has been found to have a positive effect on learning but a detrimental effect if missing. 

So what does this involve on a placement and how did I observe it in practice? It includes welcoming students into the team and making sure they feel included, supported, challenged and - importantly - valued. Don’t underestimate the power of creating such a sense of belonging. When designing practice placement content, we often spend a large chunk of time filling it with different learning opportunities and the above can be an afterthought. It is mutually beneficial to do both. 

Our placement involved students working in pairs on two projects as well as learning as a group of four to engage with staff across the different directorates. One project sought to create a resource highlighting what students believed made a great placement. Chloe and Abdul chose to create a video interviewing students about their views. A common theme came up – students aspired to be valued and supported by their team.  

As practice educator to two of our students, this point speaks to me on a personal level. Practice educators have a key role, they inspire, guide and support students on placement. This can be challenging but also extremely rewarding, helping to create quality learning cultures within organisations and developing their personal sense of belonging too.  

3 Empower the learner – don’t give them all the answers 

Just as we seek to empower patients and communities to take ownership of their health and change behaviours, we must ensure that we empower students to do the same with their learning. 

Each placement project was designed to allow freedom for the students to come up with a possible solution themselves. This sounds like a simple and straightforward statement. In reality it was the focus of several discussions as to whether this was the right path to take. Are we pleased that we went with this approach?

Absolutely. The students’ engagement, creativity and learning blossomed as a result and what they created totally blew us away. They generated solutions, sought advice when needed and took ownership. This resulted in a huge sense of achievement and deeper learning.

We did meet some challenges along the way. Two projects were more familiar to the students from the outset. These centred around placements and assessment – areas in which they had previous experience and knowledge. The other projects were less familiar and more guidance and knowledge acquisition was required ahead of being able to generate solutions. 

4 Embrace the differences between us all 

No one person is the same. Although I may be stating the obvious here, this point really did hit home more so on this placement than any other I have been involved in. 

Our four students came from four different universities, from three different countries in the UK and from very different demographical areas. They brought different professional and personal experiences to the group and had different values, beliefs and motivators to succeed.     

Students on placements are all different. While some are confident in group discussions, others are not. Some find video calls tiring. Some may have childcare responsibilities that they need to work around. Some may prefer holding back and speaking last. Some may struggle with paperwork. Some may have had experiences of discrimination on previous placements. The list could go on.  

The diversity on this placement helped shape its success, which could never have happened without remote working. 

It also clearly demonstrates that we cannot presume knowledge or have a ‘one size fits all’ approach for all to practice education. We must be aware that all learners are unique and receive and process new information differently throughout the placement duration.     

5 Pause for thoughts  

The importance of reflective practice is well recognised as a key concept to enable an individual to learn from their experiences and actions. Put simply, it involves taking time to pause and review what has been learned by asking questions. What went well? What could have gone better? What would I do differently next time? 

38% of the respondents did not take students pre-Covid

We put time aside for student reflection each week and provided opportunity to discuss learning as a group (should they feel comfortable in doing so). Being a profession of lifelong learners, reflection and being open to change is key. As a non-patient-facing placement, this was considered even more important. To discuss the transferable skills and plan how this learning may be applied in other settings. 

6 Evaluate as you go 

The collection and analysis of data to evaluate student placements is necessary to pave the way to improvement. Consider what you are aiming to evaluate and capture data as you go. As well as student feedback this may include feedback from the wider team. Ensure this information is integrated into ongoing development. 

It is clear from our evaluation that the students gained a huge amount from our placement as well as suggesting ways to further improve. What is also clear is the amount that I and others have learnt throughout our time with Ani, Sam, Chloe and Abdul. 

To all the practice educators out there: thank you. Creating learning during these challenging times while maintaining busy caseloads is pretty amazing and you are doing a fantastic job. 

To all students: keep being brave and open to new emerging placement models. You are truly living through history and these experiences will set you up with skills to work in the ever changing landscape of physiotherapy for years to come.

To members not currently taking students on placement: I urge you to consider what learning you could offer. 

To build a placement that works for your team in your setting. As you can see it is such a worthwhile and rewarding process.

Placements – everyone can offer them

CSP assistant director practice and development Gill Rawlinson:

‘We‘ve heard lots about placement pressures recently but I make no apology for mentioning it again. Clinical education is vital for students to learn and assimilate knowledge in the workplace, to make sense of what they are learning in university and ultimately learn how to be a physiotherapist. Our clinical educators are our most valuable asset and could include any one of us. Wherever you work and whether you’re a clinician (at any level), leader, researcher, academic, private practitioner, innovator, entrepreneur, digital expert, support worker or CSP staff member, we must all play our part in student education. A recent CSP survey showed that 38 per cent of respondents did not take students pre-Covid. Imagine what could be possible if we realised some of that capacity and potential.

Remember not all placements need to be in patient-facing settings, most will be of course, but a more diverse range of placements gives students opportunities to see physiotherapy through a different lens. Welcoming students to work with you in a different setting may ignite a love and understanding of research, discover digital innovators, develop the next policy makers or shape the chief executives of the future, as well, of course as developing the skilled clinicians we need. So when we discussed taking students here at the CSP the team were clear:  we need to model what is possible and give it a go. And it’s safe to say they delivered! The team lived the CSP values of courage, learning, integrity and inclusivity in spades, and for that I thank them.’

The students’ reflections

The placement turned my weaknesses into strengths, helped me be more creative and innovative, boosted my confidence levels and improved my communication, leadership and teamwork skills to superior level

Ani Stoker: The placement was a unique opportunity to enhance my communication skills and see physiotherapy from a different perspective.

Following my placement at the CSP I went straight into a clinical placement. Communication strategies are definitely something that I have used going forward; ensuring that information and the language I am using to convey a message is very specific to my target group, particularly when speaking to different members of the MDT. Developing leadership skills has also been very useful, giving me the confidence to lead discussions, actively organise meetings and take more control during patient interactions.  

Sam Wynne: My virtual placement with the CSP was a brilliant opportunity and really opened my eyes to the benefits of a non-clinical placement. 

Thanks to my CSP placement, an improvement I have seen within myself is my leadership skills. This has given me confidence in my current placement to delegate tasks appropriately, take a more prominent role in the MDT and to also build strong links with different stakeholders of the MDT. 

Abdul Wahab Bseiso: Although I was sceptical of what to expect, the four weeks turned out to be a life changing and unforgettable experience.

The skills and benefits I achieved on the placement were unique, too many to list and cannot compare to any previous placement. Most importantly the placement turned my weaknesses in to strengths, helped me be more creative and innovative, boosted my confidence levels and improved my communication, leadership, and teamwork skills to a superior level. The experience is definitely something that students should consider especially knowing that these skills are what employers yearn for. 

I am grateful that these will be ingrained in me and continuously applied in my future placements, career, education and even in my daily life.

Chloe Munro: I think there are a lot of students who are nervous about online or project-based placements. With the current circumstances, it’s crucial to take every opportunity you can get. 

I would definitely now say that I’m better prepared for the working world. 

I’m so grateful that I was given that opportunity and it’s shown me an aspect of physiotherapy that I would never have gained through a clinical placement.

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