Co-supervision Model of Placement

Discussion

The aim of the study wasto explore clinician’s perspectives as students of their experience of co-supervision practice education placements.  This was done by exploring the challenges and benefits of the co-supervision model as experienced as a student across locations and/or with two therapists.  The emerging themes were generally synonymous with previous research in the area.  The discussion will provide an overview of the key themes identified, and their significance to both advance practice in clinically based education, and to enhance students’ experiences and learning.

Clear Communication

Due to the co-supervision models multitude of diverse communication channels between co-supervisors, the student, the agency, and the university, open and clear communication is key to the models effective working (Coulton and Krimmer 2004).  The findings show thatcommunication is essential in enabling the co-supervision model to work well.  The evidence demonstrates that practicing the co-supervision model of placement improves and encourages students’ communication skills (NHS 2007).Agreeing on clear communication lines between the student and the educator is essential in the success of practice placements (Barr et al. 2006).  The current results show that communication between the student and the Educators, both formally, in supervision, and informally, was crucial in the development of the student’s learning.  The research shows that a vital component of successful communication was an open and unthreatening environment.  This is in-line with Henderson (2006), who suggests that a supportive positive working environment created by the practice educator plays an important role in the transfer of learning to the student in a clinical context. An open environment offers the student an opportunity to make mistakes and learn from these mistakes without the fear of being reprimanded (Richardson et al. 1997).  Communication between the educator and the student is not only essential in carrying out a split model of placement, but it is also crucial in managing the safety of the client group (Clouder and Daly 2002).  Open communication has been shown to nurture learning among students on clinical educational placements (Bates, Bates and Bates, 2007; Richards, Sweet and Billett, 2013 cited in Grace and O Neill 2014).

Preparation

The results demonstrate that the preparation of both the educators and the students play an important role in the 2:1 model of placement.  When educators failed to prepare for the arrival of their student, it resulted in the student’s negative experience on placement.  Whereas, when educators were fully prepared for their students, students reported an overall positive experience on placement by the student.  The results indicate that clinical supervisors must allow themselves sufficient preparation time to put supports in place to ensure the optimum learning of the student (Grace and O Neill 2014).  Preparation for the student on placement means to allow the student the time and resources to gather information on their client group and setting, envision any obstacles they may face, and develop strategies and coping skills to manage these difficulties (Tuenissen and Westerman 2011).  Evidence in the area highlights that organisational and preparation skills learned prior to placement plays an important role in the utilisation of the 2:1 model (Sevenhuysen 2014).  In the absence of adequate preparation, the student is entering a placement with an increased risk of anxiety and stress (Kaneo and Keoske 2010). Poor fieldwork preparation by students results in the negative emotions of anxiety and strain which lead to poorer performance overall on placement (Gelman 2004).

Increased Workload

Students preferred the learning opportunities of the co-supervision model at a later stage of placement.  This is in line with Cahill et al. (2012) who shows that the timing of the clinical education model is an important factor while on placement.  The results stated that the co-supervision model of placement was not suitable for a student’s initial placement, as the student had to manage a variety of factors, which included learning styles, varied populations and locations.  The co-supervision model of placement is more suitable at a later stage of placement, when the student has accumulated the skills to manage a fast pace environment (O Connor et al., 2012).  The findings suggest that working across two sectors on a split placement had both its strengths and weaknesses.  A strength of the co-supervision model across two sectors was that it allowed for the student to maximise their learning experience of different client groups and settings. The advantages of an increased workload provide the student with broader fieldwork experiences (Occupational Therapy Outreach 2004).  However, the results show that a challenge of this was that the student experienced a less a structured placement, which led to a challenging feeling of switching mindsets between client groups and locations.  This is in line with Gaiptman and Forma (1991), who highlight that switching between two practice areas can cause the student frustration and make it difficult for the student to follow through on client care plans.  Further challenges identified that the co-supervision model of placement was not suitable for a short placement as it did not allow the student sufficient time to become familiar with the setting, the client group, and/or the educators.

Influence of Learning Styles

An unexpected theme of the importance of the influence of learning styles on the student and educator relationship and learning, emerged from the research.  The facilitation and identification of the student’s different learning styles and needs allows for a professional relationship and interaction with clinical educators (Murphy et al. 2012; Kelly 2007).  This was also apparent in the current study, which emphasized that differing student and educator learning styles, in some cases, proved beneficial as it made for more dynamic supervision.  In agreement with these results, previous research indicates that for the student and educator to work well together they must negotiate roles and workings styles (Coulton and Krimmer 2005).  However, the results also showed that negotiating different learning styles can also be difficult.  Evidence demonstrates that in other cases students found it difficult to learn if their learning styles were not compatible with that of their clinical instructor (Secomb 2008).  The relationship between student and educator is a critical factor that impacts learning while on placement (Andrew and Roberts 2003).  Thus, the relationship and the negotiation of learning styles of the student and educator is crucial to the success of the placement.

Enhanced Learning

In line with the current research, the results show that experiencing a co-supervision model of placement may improve clinical ability in the workplace (DeClute and Ladyshewsky 1993), as it offers the student a real-life experience of managing fast working environments and different working styles.  In addition to this learning, the student experiences problem solving and treatment styles, which increases their learning opportunities (NHS 2007).  The co-supervision model offers the student potential to enhance learning, and can be used throughout diverse clinical settings (Baldry, Currens and Bithell 2003).  Participants stated that the co-supervision model can add value to placement when having two educators as it can provide the student with double the support and increased confidence.  Practice educators acknowledged that it is of benefit to the student to learn from other Occupational Therapists and team members while on placement (Rodger 2011).  Turner (2001) adds to this acknowledgement by stating that more than one assessors can also be beneficial for the staff and for the student as if offers more attentive and productive educators when they are not overburden and over-worked.

Future Recommendations for implementation of the model

The results of the study show that more formal training of the use of the co-supervision model of placement could benefit both the supervisor and the student.  This result is reflected in other research, which purports that less than half health care professionals are confident in their supervisory skills and would have more confidence in facilitating supervision if more resources were put into formal training (McMahon 2014).  On-going training and support for practice educators is essential for ensuring higher standards of supervision for health care students (Plenty and Gower 2013).

Participants stated that acknowledging the experience of other students who went on placement before them may be helpful as it may provide them with a knowledge base of what to expect before going on placement.  Previous research highlights that preceding students in health care disciplines represent a positive role model for the students in clinical training (Dale et al. 2013).  Hearing other students’ experiences of their clinical practice provide greater understanding for the prospective student going out on placement (Shariff 2005).

Conclusion

The findings from this descriptive qualitative study are generally consistent with previous work in co-supervision models.  The results of the current study informed best practice; this was carried out by focusing on three recommendations from the results.  Best practice of the co-supervision model of placement can include a welcoming environment for the student to work in.  Preparation on the part of the educator and the student is essential in creating a working environment that is free from anxiety.  Communication is a key component is facilitating the co-supervision model of practice placement.  Formal training of educators is important for establishing higher standards of supervision for students.

The result show challenging factors of co-supervision to be the students’ difficulty with adapting to different learning styles, multiple practice educators, settings and client groups.  Whereas, the benefits of a co-supervision placement highlight the preparation for real-life situations, managing fast paced work environments and increased learning opportunities.

Limitations

The findings of this study are limited because the respondents were self-identifiedand not randomly selected. Snowball sampling does not allow for random selection.

Implications for Occupational Therapy Education

This data provides valuable information for the Occupational Therapy profession, notably clinical education placements, regarding needs and resources to adopt collaborative relationships between the student and the educator in fieldwork education.