We explore the shared responsibility between university and placement provider to support students' wellbeing
Charlotte Carter-Lang is the practice education lead and a physiotherapy lecturer at the University of Leicester. She works alongside Sarah Luckraft, physiotherapy practice learning lead at University Hospitals of Leicester NHS Trust to provide placements to students on the BSc (Hons) programme.
Here they explain how they work together to support students wellbeing while on placement.
Pandemic aside, we’re all aware how rapidly the world is changing, and how complex healthcare is. Over the past five years, we hear more and more from clinicians, managers and leaders that to ‘survive’, or rather ‘to thrive’, one needs resilience.
Resilience isn’t a code word for ‘toughing up’; it’s about understanding the need to take care of yourself and your own wellbeing in order to navigate that change. Students can’t be expected to build resilience alone. Supportive structures need to be in place to help them grow.
We offer all students mental health support from the start of their course, through to when they graduate, regardless of whether they’ve disclosed a condition.
In the first year, we run a mandatory six-week mental health programme and every student has a personal tutor who remains the same person throughout the student’s time at the university. The personal tutor gets to know their students well, which helps them to identify any changes in behaviour or attitude and quickly have conversations to prevent things escalating.
All members of the teaching staff can provide support, but we also have a dedicated additional needs tutor in the physiotherapy department to provide further support, with a large demand for the service relating to mental health.
As a team, we have strong links with the university’s mental health team. As lecturers, we can refer students to the counselling service. The university has online mental health resources and students can even access services such as pet therapy.
Students that start placement with us have a wellbeing talk, during their placement induction. This is given by the physiotherapy practice learning lead. They outline the support available from the practice learning team, wellbeing resources and strategies to look after their health and wellbeing whilst on placement. We also signpost them to services within the trust that are available to both staff and students, including how to access them.
We work closely with the practice educators throughout placements to support any students that may need it. Before the placement starts, if we suspect a student might be struggling with their mental health, we encourage the student to make the practice educator/practice learning lead aware.
Each student has a visiting tutor who will be the student’s main university contact although personal tutors and the additional needs tutor are still on hand. We know that the team are also available to offer additional support to both students and practice educators throughout.
Depending on what the problem is, and whether it continues or progresses, the student, visiting tutor, and practice educator / practice learning lead will discuss how the support is structured. If concerns continue, the additional needs tutor can also make contact or visit the student.
If we think outside agencies are needed, we can refer the student for counselling, encourage them to make a GP appointment, or if there’s a safeguarding issue, we can refer directly and raise this concern with the university.
What happens if this isn’t enough?
We try to help students to develop their skills so they are ready for difficult and challenging situations but recognise this may not always be enough. We support students to remain on placement where possible and safe to do so and only look to remove them when necessary. We’ll help students develop coping strategies and mechanisms such as reflective practice or talking to someone they trust.
We might encourage a struggling student to defer until they felt well enough to continue. Mostly though, we find that the placement helps to keep students focused when they are having temporary or longer-term mental health issues.
What support is there after the placement?
The course is designed so students have time to reflect and talk after a placement. This is an important aspect of learning, and is especially true if something hasn’t gone well.
In between each placement, students have a reflective module where we talk in groups about emotional resilience, encourage health promotion and look at techniques such as cognitive behavioural therapy strategies. Our nursing lead also runs a seminar about PTSD, which can help address traumatic events.
We set ground rules for group discussions so students feel they can speak up. We always get some students who prefer to speak privately about their concerns, so they can go to their personal tutors or speak to the seminar lead too.
How important is a joint approach?
Placements wouldn’t be successful if the relationship we had with Sarah and her team wasn’t well developed. We’ve worked closely for several years,and we’ve spoken a lot about the different support we can offer students and staff and models of supervision available to us.
Educator training days set out the expectations of both parties and we look specifically at how practice educators can support students who are struggling while on placement. The pandemic has really highlighted the importance of having good support structures in place in both settings to ensure our students and educators are well supported and can access it as needed.
Some of our lecturers still work in the Trusts and practices where the students go out on placement, this way they know what’s happening in practice. Knowing people face to face, and knowing how to get hold of the team also makes a big difference.
Is this a growing issue?
In the last couple of years, and particularly with the pandemic, there has been a big increase in the number of students talking more openly about mental health.
Wellbeing is spoken about at school and university more than ever before and the stigma is decreasing. Students are therefore aware of how to spot warning signs. We are also made aware about student’s mental health concerns sooner, and know a lot more than ever before.
From September, our placement marking and educator comments will all be on online via the student’s iPad so we’ll be able to see live data from their educator’s weekly feedback. One of the positives to this is that we can identify quickly any drops in a student’s performance that might mean we need to visit the student or speak to them sooner to see if they are ok. We won’t need to wait to be contacted by the student or educator and potentially delay any support.
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