Balancing quality and capacity: exploring collaborative learning models for effective learning environments and increase capacity for pre-registration practice-based learning placements


The demand for greater capacity for practice-based learning (PrBL) placements to support the training of the future workforce and meet the NHS Long Term Plan. The challenge within practice-based learning is managing the pace of change within educational constructs and learning models, alongside the increasing clinical and operational demands, often with no increase in resource. It is critical to rise to this challenge whilst safeguarding the ability of services to develop their existing workforce, improving quality, provide the optimal patient experience and delivering evidence-based healthcare to achieve the best outcomes. The aims were:

· Design and test models PrBL education for pre-registration students

· Scope how deliver a sustainable increase in placement capacity

· Invest in and develop the knowledge & skills of educators

· Define and express a collaborative, inclusive, creative departmental educational culture with a ‘growth’ mindset

Academic year 2016/17
Placement capacity was15 students.
Academic year 2019/20
Placement capacity was increased to 30 students.


A quality improvement programme board was created from each of the six physiotherapy teams. Concurrent and sequential Plan, Do, Study, Act (PDSA) cycles have been followed alongside the NHS Model for Improvement and utilising NHS Improvement Quality, Service Improvement & Redesign (QSIR) tools. A staff survey and engagement events for all clinical educators explored the needs of staff, gaps in knowledge, and the readiness for change. A model of collaborative learning was designed for pilot testing across all years, cohorting students for each placement block (6 to 8 students). Key elements of pilot model included the development of: a digital placement timetable, group learning sessions, teaching plans and presentations, learning resources and a shared drive, inquiry-based learning tasks, ‘clinical skills passport’, guidance for clinical educators for the marking criteria and support meetings, the development of ‘spoke’ learning opportunities and the creation of ‘placement co-ordinator’ role.


Results: The pilot model was evaluated, refined and retested over 5 placement blocks spanning all placements. Educators and students were involved through focus groups, questionnaire surveys, structured learner feedback and appraisal of educational activity. Feedback has been overwhelmingly positive from educators and learners pertaining to quality of teaching delivery, experience of the environment, access to learning and support, and managing alongside other demands. Placement capacity has increased from 15 students in 2016/17 to 30 in 2019/20. Planning for phase 2 (2020/21) has begun, exploring how to safeguard sustainability, encourage adoption & spread across other physiotherapy services within primary and secondary care, utilise technology-enhanced learning and other methods.

Conclusion(s): Collaborative learning models have the potential for multiple benefits within a large department, enabling effective learning environments, enhancing the quality of education, increasing placement capacity. Viewing the development of educational practice and culture within a department as a journey of quality improvement, supported by an ethos of co-design and co-production, was observed to have positive impact on educator and learner experiences

Cost and savings

There was an increase in productivity within the team for supporting students, and also an increase in capacity of number of students. There has currently been no additional costs, savings have not been formally measured at this point.


The rising demand for PrBL placement capacity to help support the development of the workforce of the future, innovative approaches for enabling effective learning environments and enhancing placement capacity are required. Utilising inclusive quality improvement initiatives which address cultural as well as structural and organisational change could prove a valuable strategy.

Top three learning points

No further information. 

Funding acknowledgements

No funding was received in the undertaking of this work.