Part Two: AHP Pre-preceptorship; the evidence base for change

Why is AHP Pre-preceptorship important?

Bridging the gap between education and work, whilst optimising the confidence of AHP learners, are key components to attracting and retaining a highly engaged AHP workforce (AHP Strategy for England: 2022-2027 AHPs Deliver, 2022). 

The NHS Long Term Workforce Plan (2023) highlights the importance of a comprehensive programme of support for the workforce, and preceptorship is one element of this. Providing pre-preceptorship prior to employment, through collaboration and engagement with learners, HEIs and employers, enables a smooth transition into the workforce.  

Research indicates that NQP’s experience ‘reality shock’ (Hsiao et al 2021), describing the experience of entering the workforce as ‘being pushed off a cliff’ (Harvey-Lloyd 2019) and ‘feeling out of my depth’ (Kennedy et al 2015). Pre-preceptorship can help build confidence, enhance preparedness for work, and optimise readiness for preceptorship. 

 A consistent approach to AHP Pre-preceptorship support, and a clear understanding of the key components of effective early career support, are essential to the retention of the future AHP workforce. Well-constructed and delivered pre-preceptorship support can build the confidence of individual professionals as they prepare to transition into the AHP workforce.  

Step to Work eLearning was launched in 2022 as a first step to address transitional concerns, prepare a learner for employment and introduce the concept of preceptorship. Further scoping and research were commissioned by NHS England in 2023 to explore the pre-preceptorship experiences of AHPs and additional opportunities were identified for learners, HEI, and employers during the pre-preceptorship phase. 

Development of AHP Pre-preceptorship recommendations 

The development of AHP Pre-preceptorship recommendations utilised commissioned research and widespread stakeholder engagement including the following groups:  

• Regulatory and professional bodies 

• Pre-registration AHP students and apprentices 

• AHP preceptees and preceptors 

• Members of SSHINE (Sharing Student Healthcare Initiative for Neurodiversity and Equity) 

• Practice Educators and AHP Leads 

• HEIs within the Midlands delivering AHP programmes 

The findings included a consistent lack of understanding of the terms pre-preceptorship and preceptorship, as well as a perceived lack of support from education providers during transition into employment.  

Several reoccurring themes were identified as being imperative to support effective transitioning to employment. 

Themes on transitioning into employment 

Feeling of belonging and confidence

• Learners want to feel part of a team and that they belong within an organisation. 

• Learners can experience imposter syndrome during the transition into employment.  

• Some learners find that local dialect and use of language can be a challenge, especially where English is not their first language.  

Preparedness for practice

• A number of learners feel that the gap between reality in the workplace and learning within the education environment can cause them to feel unprepared.  

Career progression

• Learners want to understand how they can progress and develop in their chosen place of work.  

• Clearly defined training and support programmes are seen as an incentive when applying for roles.  

Employment pathways

• Some learners feel unprepared for NHS job application and interview processes.  

• Learners consider workplace environment and culture when applying for employment. 

Financial concerns

• Learners are often concerned regarding work-related costs such as relocation costs, commuting, paying for parking, and professional body and regulator fees.  

Caring responsibilities

• Learners with caring responsibilities are often concerned about balancing shift working patterns alongside their caring responsibilities, which may prevent them applying for certain roles within organisations.  

Discrimination

• A proportion of learners are concerned about discrimination in the form of micro aggressions and language used, by both staff and service users. Learners feel unprepared to challenge such discrimination.  

• Learners can be concerned and reluctant to disclose physical and mental health issues in the workplace due to judgement and/or perception of being incapable of fulfilling a AHP role.