Let's talk different models of learning
The 1:1 model is always popular, and why wouldn’t it be? Physiotherapy actually has a rich history of implementing different models of learning. Especially those that offer students the opportunity to learn with and from each other. When we shy away from these models, we lose much of the rich learning that comes from being on a placement with a peer.
Evidence suggests that these placements also bring opportunities to lead, see another’s perspective, and are no less onerous for the educator than a 1:1 model to deliver. Here are two great examples to inspire us about models that were once the norm.
Adele Anderson an advanced specialist physiotherapist in elderly rehabilitation and frailty at North Cumbria Integrated Care NHS Trust has been using a 4:1 coaching model for the last 18 months on the elderly rehabilitation wards at the Cumberland Infirmary in Carlisle.
The team supporting the four students consists of a part-time and full-time band 3, two band 5s, a band 6 and Adele as clinical lead.
The students work together to provide peer supported learning, developing leadership, decision making, and enhanced problem solving within the acute setting.
The students cover two ward areas, rotating every two weeks, and working in different pairs. This model gives them two weeks of continuity of care while also challenging them to think on their feet and transfer their skills across different areas.
Two days of each week, students come together to work as a group. The lead on that ward for the week leads the group. During that time the students assess and treat new patients, problem solve and learn from each other’s experiences. Those earlier on in their degree learn from the more experienced, while those with more experience lead, support and coach their peers.
Students also have a service development group project to work on, over a half-day each week. The project is handed on to the next student group, with each group ‘picking up the baton, for the project until completion.
Students have timetabled group supervision weekly which they lead on – determining the topics for discussion, case studies, patient reflections etc. They also receive individual supervision with a member of qualified staff in the team.
The evaluation is being jointly evaluated with partner university the University of Cumbria, Adele notes that ‘the outcomes have thus far been very beneficial, working to create a future workforce with relevant skills needed in today’s NHS’.
She notes ‘teaching can be facilitated in many ways, and that you can’t underestimate the importance of peer supported learning and psychological safety on placement in the clinical setting’.
Student perspective 2:1
Alicia Wilson from University of Essex talks about her quality improvement project placement looking at the effectiveness of the patient activation measure (PAM) in informing patient care plans for the Anglian Community Enterprise Community (ACE) rehab team.
She and her peer collected, analysed and made recommendations to the service about how this outcome measure could be implemented in line with the service’s KPIs and QIIs.
The pair were given objectives to be achieved each week. They met virtually daily to help plan the day or to update each other on progress, whilst working from home. They also had shared meetings with their educator to update them on progress, plan, and ‘course correct’ if necessary.
Alicia’s noted that talking regularly to other members, especially her peer helped her increase her understand of their roles as well as her own.
On working remotely she recommended scheduling meetings or catching up with team members during breaks to help to keep focused and feel part of a team.
Her final recommendation? Be open-minded. This placement helped develop lots of transferable skills.
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