International Journal of Healthcare Simulation

Introduction:

Securing first year placements has been an ongoing challenge. Current research [1] highlights that there are multiple barriers to offering placements such as time and student capability which may explain the challenges securing these placements.

A new placement model was designed with the following aims: reduce the time per student in clinical practice, offset this with simulation, reduce the assessment burden for clinical educators, whilst providing a valuable learning experience which can be classified as placement hours.

Methods:

The total duration of placement required was 3.8 weeks. Historically, this had all been in one clinical setting, with a Level 4 assessment form.

For this iteration, all students attended an introductory week at university. The cohort was then divided into three rotating groups, with one third being on an observational experience, and two thirds at the university per week (see Table 1 for example student timetable).

Table 1-A80.

Monday	Tuesday	Wednesday	Thursday	Friday
• Overview of placement• Introduction to professionalism• Understanding the different healthcare roles• Understanding the NHS and social care system in England	• Infection control• Safeguarding adults• Safeguarding children• Understanding dementia, mental health and learning disabilities	• Moving and handling of people• Basic life support	Introduction to healthcare environment:• Orientation to a ward environment• Use of a call bell/emergency bell• Identifying common ward objects• Familiarisation with resus trolley	Care Certificate workbook and e-learning
Clinical Observation Week
Monday	Tuesday	Wednesday	Thursday	Friday
• Escape room task focused on person-centred care• Community visits simulation activities: stairs assessment, physical observations, observing ADLs, environmental assessment• Breaking bad news – role play	• Cultural conversations – Discussions relating to EDIB in healthcare• Analyse fitness & balance class• Simulated fitness to practice hearing with adapted HCPC cases	• Design and deliver a group exercise class to peers & peer feedback• Activities related to resilience, mental health and wellbeing and completing as peer sessions	• Subjective and objective assessment on a simulated patient (MSK, Neuro, CVR• Personal care• Recordkeeping & SOAP notes• Handover simulation (nurses to physios)	Care Certificate workbook and e-learning
Monday	Tuesday	Wednesday	Thursday	Friday
• MDT discharge planning meeting simulation• Use of mytherappy website• Researching common conditions and medications and teaching each other	• Challenging communication scenarios:• Disorientated patient• Frustrated patient• Low mood patientApplied safeguarding scenarios:• Suspected child neglect• Suspected domestic violence• Suspected self-harm• Suspected financial abuse	• MECC training and considering application to role• Importance of hydration, nutrition and movement• Sustainability in healthcare	Disability awareness:• Hearing impairment simulation• Visual impairment simulation• Reduced dexterity simulation• Reduced mobility simulation• Wheelchair user simulation• Supported feeding• Supported drinking• Supported dressing• Supported oral care	END OF PLACEMENT

The observational experiences were in a variety of settings and were assessed with a feedback form which included total number of hours and feedback on professionalism.

For the simulated weeks there was feedback on professionalism and a record of hours. In addition, the students had to complete the Care Certificate workbooks [2].

Feedback from students about their placement experience was collated through evaluation forms (as per module requirements).

Results:

All students were able to attend a clinical observation period and participate in the simulated activities. The time in a clinical environment per student was reduced by 74%, yet the total number of placement hours for the student remained the same. In addition, the marking burden for the clinician educator was reduced from approximately two hours to five minutes (96% decrease). Students’ perceptions on the simulated activities were mixed – with an average score of 3.3 out of 5.

Discussion:

There was a significant decrease in the demand for clinical educators through this placement model and it enabled all students to complete a placement in the allocated time. However, the review of the Care Certificate workbooks is lengthy (240 pages) and a major challenge of this placement.

The evaluation response rate from students was very low (less than 10%) and therefore may not be representative. From the feedback, that higher fidelity and more immersive simulations were rated higher.

Further evaluation is recommended to identify simulations of higher value to students, staff and educators and long-term evaluation on preparedness of practice would be advantageous.

Ethics statement:

Authors confirm that all relevant ethical standards for research conduct and dissemination have been met. The submitting author confirms that relevant ethical approval was granted, if applicable.

References

1. Smith B, Robson K, Robinson C, Patton N. Factors influencing provision of clinical placements for health students: A scoping review. Focus on Health Professional Education: A Multi-Professional Journal. 2023;24(2): 63–103.

2. Skills for Care. Care Certificate Workbook. Available from: https://www.skillsforcare.org.uk/Developing-your-workforce/Care-Certificate/Care-Certificate-workbook.aspx. [Accessed 30 April 2024].