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AHP students in public health settings - case studies
These case studies have been developed from people involved in public health placements, to help illustrate how the placements have been organised and what activities have been completed as part of them, alongside the combined benefits.
Back to Supporting the Development of Placements for Allied Health Professional Students in Public Health Settings
A placement provider perspective
- Case study 1 - Borderland Voices
- Case study 2 - The Chartered Society of Physiotherapy
- Case study 3 - University Hospital Dorset NHS Foundation Trust
- Case study 4 - Local libraries (engaging with partners)
- Case study 5 - independent Arts and Health Consultant
A student perspective
- Case study 6 - Centrepoint
- Case study 7 - Public Health England
- Case study 8 - creating resources to support other students
An Education Institution perspective
A placement provider perspective
Case study 1 - Borderland Voices
Background information
I run an independent organisation (just me and volunteers) aiming to offer a safe space for people with mental health difficulties to express themselves through creative activities.
Where did the placement take place?
Borderland Voices, art for health and mental wellbeing micro-charity.
How was the placement organised?
I was contacted by a creative expressive arts student from the local university in 2019. The student wanted to undertake her final placement working with adults in a mental health setting.
How long was the placement for?
The student attended Borderland Voices for around 3 months for one day per week to undertake the hours required.
What did the student do during the placement?
Learning Areas: 1, 2, 6, 7
The student met with the participants at the first session to identify what they wished to do during each session. Although the participants preferred creative art sessions to drama-based activities, the student-produced a scheme of work for both creative writing and art sessions that incorporated elements of her drama training (Learning Areas 1, 2 and 6).
In the art sessions, the student worked with the participants to create box theatres with props and backdrops. Over time, I noticed how she became more confident and at ease with the group. The group members were mainly older adults and I noticed an increasing rapport between the much younger student and the older participants (Learning Areas 1, 2 and 7).
What about support on placement?
I worked as the sole mentor in the organisation for the student which meant that I had to devote a lot of time to provide the placement and ongoing supervision. I don’t think I was aware at the outset quite how much time would be involved, but I do feel it was mutually beneficial in the end.
What barriers did you face offering the placement?
There were several practical barriers to overcome. The student had to be able to drive and own a car as she could not have otherwise reached the placement (public transport connections are poor). The placement occurred over the winter months and several sessions had to be cancelled due to adverse weather.
I had to be very flexible in terms of the timing of the sessions and when I was available to comply with the university’s hours requirements.
What were the benefits of this placement?
I feel that we both gained from the placement. The student became more confident with the group and learned how best to respond to the group’s needs. She worked extremely hard before each session to produce a scheme of work and assemble the materials.
She worked proactively during the sessions and had to have several backup plans when circumstances required it. The group openly demonstrated their gratitude towards the student and came to really look forward to her sessions.
I was able to spend time with the student following each session to discuss what went well and to reflect on her practice. She was able to demonstrate an increasing awareness of how her practice was evolving during her time with us and would change following the placement.
I was pleased to be engaged in the placement opportunity and also feel that the organisation’s profile was raised in the town because of the publicity gained when the box theatres the group produced were put on temporary display in the town library. Additionally, I learned from the process and would be more confident in offering another student placement.
Case study 2 - The Chartered Society of Physiotherapy
Background information
I am a professional adviser working for the Chartered Society of Physiotherapy. I am a registered physiotherapist and have recently been part of a team supporting students on a remote project-based placement at the CSP.
Where did the placement take place?
The Chartered Society of Physiotherapy - the professional body for physiotherapists.
How was the placement organised?
Practice-based learning is a core part of physiotherapy pre-registration degrees, with a requirement of 1000 hours spent in this environment prior to qualification. At the start of the Covid-19 pandemic and subsequent lockdowns, many placements were cancelled as the workforce transitioned to virtual working and redeployment, navigating the landscape themselves and often unable to see how a student would fit into their new and ever-changing practice. Several Higher Education Institutions (HEIs) reported a huge backlog of student placements. The workforce and education team at the CSP have long been supporting universities and placement organisations to think differently about placement settings and methods of delivery. We asked ourselves if we could do the same by creating a non-patient facing placement at the CSP.
We considered what learning opportunities there would be for both students and the organisation. We considered different placement structure options, questioning what would work within our team whilst ensuring quality supervision and support. We considered how many students we could take, the benefits of peer learning on project work and how we could share our experiences with members. We also worked hard to create a quality learning environment for the students and ensure they felt part of our team. Recognising the opportunity that this placement offered to work with students from different regions and demographics, it was decided that we would take 4 students from 4 different universities on placement with us with representatives from England, Wales and Scotland. Going forwards, we aim for student placements to become a regular feature at the CSP.
How long was the placement for?
The placement was four weeks long with 35 hours in practice per week and was conducted virtually. Two students have written a webpage on virtual placements that can be found here.
What did the students do during the placement?
Learning Areas: 1, 2, 5, 6
The students all worked on projects that were happening at the CSP. This case study will focus on one project, detailing their input into the development of the Common Placement Assessment Form (CPAF). The students analysed the proposed learning objectives within the form and made sure that they were clearly understood by students. They liaised with the wider student community and created a downloadable guide resource to support the use of CPAF in practice from a student perspective. They also got a chance to fully understand the learning outcomes within CPAF, applying HCPC and CSP standards and building their knowledge and evidence base about the professional and regulatory aspects of practice-based learning (Learning Areas 1, 2, 5 and 6).
The students worked on two projects during their placement. In total, 3 days of the week were allocated to project time – using a combination of group discussion with their educator, independent study and peer learning.
In addition, the students spent time together meeting different people within the CSP. This included the leadership team, communications team and professional advisers amongst others. This enabled a better understanding of the organisation as a whole and enable an opportunity to ask questions and find out more. On Friday afternoons, the team facilitated a session with all students to reflect on what they had learnt in this non-patient facing setting and explore how that related to employability skills they could take forward. (Learning Areas 1, 2 and 5).
What does the student learn whilst on placement?
The students learnt about work completed at the CSP and the roles of physiotherapists working in the organisation, they learnt about the about each other and the differences in health care between their regions. They learnt a huge amount about the transferable skills between a non-patient facing and a patient facing setting. As a group, they identified a key development being communication, changing their method to meet the needs of the audience. They gathered and analysed information and compared this process to a subjective and objective assessment – understanding the skill in capturing information that is meaningful to what you set out to achieve. They learnt about themselves and the importance of independent learning as well as leadership as they delegated tasks, chaired meetings and worked as a collective. The projects raised the students’ awareness about public health, especially as a learning outcome within CPAF centred on this topic. This led the students to openly discuss the need for a physiotherapist to understand the whole person who they are assessing and treating. To think past their diagnosis to the many components of their health from an individual, community and population perspective. Professionalism was something they all took away from this placement and that it goes beyond how you present in front of a patient. One of the students wrote an article on making the most of your placement that can be found here.
What about support on placement?
Prior to the placement, students asked us what they could read or do in preparation. We sent information about the CSP, professional standards and placement details including timetables. For future student placements, we plan to also send out details of the projects.
During the placement, the students worked with their educator, worked together demonstrating peer learning, as well as individually. There was allocated time for their educator to be with them during the project (3.5 hours each week) either as a block of dispersed through the week. I would spend the first half day of the week with them to plan what they would do, discuss what they have done and reflect on their learning, complete a Gannt chart, and plan for the other sessions. We also put in place a ‘catch up’ every day for half an hour to see how things were going. On Friday mornings, I spent an hour with each student separately to go through their specific objectives. Students also spent time with other people who provided feedback, these fed into the midway and final evaluations. It would be great if students who are on non-clinical placements could come together virtually to support each other.
What barriers did you face offering the placement?
The unknown! I had not supported non-clinical placements before and it challenged my biases on what could be achieved. It did take time to plan but once you have a plan and a timetable, it could be used going forward as a template.
What were the benefits of this placement?
There were many. From an organisational perspective, our work benefited from the students input. They provided a unique perspective and helped shape our work to make it even more applicable to the target audience. There was a great team spirit with all of those involved in the placement experience. The students had fresh ideas and different skills and experiences that we all learned from. From a student perspective, we gave structure but also some independence with the projects to enable them to generate ideas. What they produced surpassed our expectations and also developed independent learning skills. Having students from different placements also benefited the placement as it enabled them to learn a lot from each other. A blog about what we learnt can be found here.
Case study 3 - University Hospital Dorset NHS Foundation Trust
Background information
I am the interim head of therapies for an NHS Trust. I have supported physiotherapy students and an occupational therapy student on a public health focused placement, although it could be delivered with all Allied Health Professions as there are many transferrable skills.
Where did the placement take place?
University Hospital Dorset NHS Foundation Trust.
How was the placement organised?
I believe that if you are going to encourage others to support students, then you have to lead by example. By offering the split clinical and public health placement, it supports the clinical teams that may have part-time staff members to have students in their workforce.
I contacted the lecturers at the local university and offered this split placement as it would allow us to accommodate more students. I explained that they could complete a public health-focused project with me, and this is what prompted them to ask if I could also facilitate an occupational therapy student.
I am passionate about physical activity and public health and offering this placement was a good way of raising awareness of this. I thought about what I would like to do if I had the time and how students could be a part of that. I could not achieve the project outcomes without their input.
How long was the placement for?
The placements lasted between 6 and 8 weeks. This was a split placement where the students spent 3 days a week on their clinical placement and 2 days a week with me on the public health-focused project. This split can be flexible though as I do have another student who is due to complete 4 days with me and 1-day of clinical practice. This was beneficial as the students were able to use what they did on the project in their clinical areas. They can empower the people they are working with based on the knowledge they are gaining.
What did the students do during the placement?
Learning Areas: 1, 2, 3, 5, 7
The students worked on a project which explored the physical activity guidelines. Based in the clinical placement area where they were working, they asked staff and patients if they knew what the guidelines were if they used them and what they thought needed to change. They wrote a report on their findings and they were then able to populate a promotion board to help get the message out to staff and patients. I have presented the results of their projects to our ReSTORE network and facilitated teaching sessions with the students on placement (Learning Areas 1, 2, 3 and 7).
The students review what other students have done and built on this to develop their project, and develop quality improvement skills such as completing driver diagrams (Learning Area 5).
In terms of assessment, the placement is no different to a clinical placement as the skills can be achieved through the projects.
What about support on placement?
Prior to the placement, it would be helpful if students completed learning (E-learning For Health have some great modules) around making every contact count (MECC), public health champions, leadership (the Edward Jenner leadership course is good), and awareness of public health guidance relevant to the project they want to do. I send out resource links to the students before they come on placement about these topics and highlight initiatives such as Better Health and One You.
We work with the Collaborative Learning in Practice (CLIP) model so will often have several students to an educator. They have support from their educator on their clinical placement and then I support them on their 2 days’ project work. I am not with them all the time but there to support when they need it. Support is tailored for each student as they can be at different knowledge and skill levels. If you have more than one student on placement with you, they can support each other.
What barriers did you face?
Some students find it challenging to face the demands of a mixed placement. I try not to focus on the end outcome of the project as they are still learning and achieving skills as they progress. This helps to reduce their stress.
When we began running the placements, staff could see that the students were busy doing their projects but did not know anything about it. We had to get better at prompting the students to discuss their projects in the clinical areas and with educators, which resulted in students presenting their projects and improving engagement.
What did the students learn from this placement?
There are so many transferable skills. Communication, organisation, interacting with different people, public health messaging, MECC conversation skills, and motivational interviewing to name a few.
Students set their own learning objectives for the placement, for example, investigating the knowledge of the team of physical activity guidance, understand the diagnosis and treatment of patients and how physical activity guidance can be applied.
It gives them a broader understanding of population health and public health. If we can engage students in these agendas, they will take them into their workplace. Some AHPs seem to focus more on the wider determinants of health than others, but it is relevant to all of us.
What were the benefits to the organisation?
The organisation has to be a part of the prevention agenda and these project-based placements help as few people have the time to do this. Having an army of students to do it alongside you is great and you are no longer the lone voice. They go a long way in supporting your agenda.
They present their projects to the team who then become more interested in the agenda and it starts to get the public health message out more to staff and patients.
Case study 4 - Local libraries (engaging with partners)
Background information
I am an Osteopath and had an independent practice that operated from a rented space within a library for almost four years. I have been working alongside libraries and new AHP graduates within Westminster to deliver a range of opportunities to speak to members of the public about their health. Although I have not worked with students, the ideas discussed below could be an opportunity for a public health focused placement for allied health professionals. For further information see COGUK website and body back up website and I would be happy to speak to people about my experience contact@coguk.info. I am also a member of the Institute of Health Promotion and Education (IHPE) which student AHPs can join.
Where did the projects take place?
I have engaged new graduates in events and projects such as #mywestminsterday and “Walking for better health” for Fun Palaces and for OpenAge, but this case study focuses on the work we have done with local libraries and their communities.
How were these projects developed and organised?
I wanted to find a space for my practice within the local community that aided collaboration, having worked in settings such as GP surgeries, gyms and corporate headquarters in the past. I asked the local library if they had a room I could rent as, after doing research, I found there were very few healthcare professionals operating out of this setting in the UK.
I have an appetite for sharing health promotion and education and started to get involved in community events, working alongside newly graduated allied health professionals. I met with the library’s public health representative and they connected me with people in the council which helped me to get involved in events. The more I got involved, the more people invited me to connect in other novel ways. I would have to liaise with the library managers and networks in order to organise and run the projects.
How long could a project last for?
Projects could be run over any length of time as long as there was time for planning and delivery. I have delivered projects with new graduates over a variety of lengths of time.
What did the graduates do during the projects?
Learning Areas: 1, 2, 6, 7
We ran musculoskeletal help desks where we had a sign up and were in our white coats (which made a difference) and people just came over to talk. It showed how many people were suffering with MSK problems across all ages but receiving no help. We helped run half term events for children, which involved arts and crafts and books selected by the library around a topic, and we incorporated a related ‘health and understanding the body’ element. We were able to turn some of the events into PowerPoint packages integrating items to print off and information on how to run the event. These events were well attended and had adults and children sharing the learning together. We have also supported the library when running events on public health topics like body image and mental health and wellbeing that emanated from Public Health England campaigns (Learning Areas 1, 2 and 7).
Students from a range of professions could meet, consider their skill sets, form an idea on what they wanted to deliver (event, workshop, help desk), and design and deliver this together with the library. They would have to consider the set up and resources needed as well as the promotional side which is key to getting the public involved (Learning Areas 1, 2, 6 and 7).
What could students learn from doing a project like this?
The graduates were able to see how health conditions affect people’s lives and see the knock-on effect on people’s mental health, work, and relationships. This helped them to see the relevance of treating the whole person. They developed confidence in their abilities to use their skills and knowledge in a real yet non-clinical environment. Communication skills are important and the graduates developed skills in adapting information to suit their audience. They developed skills in leadership, presentation, handling question and answer sessions, creating communication materials, and working in an interprofessional way. They also improved their professionalism and professional identity by exploring boundaries in a different setting. The graduates learnt about making engagement with people useful and meaningful yet less pressured than a formal clinical encounter. All of these skills could be developed whilst working with students on projects such as these.
What about support for students?
Before the placement, students would be able to view health and wellbeing videos which may help to consider different project ideas. I would meet with the students as I did the new graduates and discuss our limitations and legal remits and making sure they know when to sign post people for further action without giving a diagnosis. I would advise getting the library’s public health representative to give a talk on the background of the population’s demographics and local needs and goals.
The students would support each other if they were in a small group by sharing experiences and knowledge. I held a debrief session with the new graduates who made notes on each person they had spoken to, and reviewed the event as a whole.
What barriers did the you face?
Managing hierarchies within organisations can be challenging, as is getting permission to run events. People are busy and it is sometimes difficult to find someone with the capacity to do something different. There is a lot of co-ordination needed for an event, including marketing so people know it is happening.
What would be the benefits of this placement?
The libraries enjoy footfall, usage and trust. They are there as a supportive community hub and these events help that agenda. People were popping into the events and then taking out library cards and the staff enjoyed being involved.
Case study 5 - independent Arts and Health Consultant
Background information
I am an independent Arts and Health Consultant and registered Art Therapist. I have supported placements previously in clinical settings.
Where would the placement take place?
In my independent practice where I am commissioned by the NHS, the education sector and by businesses to design and deliver projects with a public health focus. The Arts Drop website provides an insight into work I have done to support vulnerable children and young people during the Covid-19 pandemic.
Who could you offer a placement to?
I think I could support art, music or drama therapists as I am familiar with working in a creative way with other therapists. I could potentially offer placements to other health professionals due to working with all professions in the hospital. It would be useful if the student had completed other placements before so they have knowledge of how an art therapist works in various settings.
How could the placement be organised?
I would either contact the university I have worked with before whilst supervising clinical placements or I would look for placement websites that I might be able to engage with to make an offer. I would need to see how this was received and would need the interested parties to be proactive and support the set-up of the placement as I would have limited time to do this.
How long would the placement last for?
I would say a placement would need to be three months as a minimum although six months would be ideal. This would be on a part-time basis to fit with projects.
What would the student do and learn on placement?
Learning Areas: 1, 2, 4, 6
I would see the NHS-based projects as an anchor but would encourage the student to spend time with me in other areas to see the work across the sectors. They would work alongside other professionals to explore what influences people’s lives, experiencing a multi-agency way of working and what art therapy can bring to that. They would explore why the project has been commissioned and how the contract is different to delivering art therapy. The student would explore the boundaries of this and be clear of their role whilst developing their professional identity. An example of a strategy I developed for an NHS trust can be found through this link. I would be keen to send them into schools and understand the lives of children from deprived areas. This would help with understanding the multiple factors affecting health and how they connect. They could explore other initiatives in education settings and why the family approach is important.
I would want the student to think in a different way and understand the importance of a public health mindset. Art therapy is often focused primarily on the individual and sometimes less on the wider societal systems in which they live. The shift in exploring the wider determinants of health is an additional way of viewing the whole person. This placement would also help them to see theory in a real-world situation.
What about support on placement?
The student would shadow me and have opportunities for independent work in the projects. I would provide the same support I have done in clinical placements. They could do pre-placement reading around health inequalities and the social determinants of health, as well as the theoretical frameworks associated with a population approach.
What barriers might you face in offering the placement?
This would be additional work as an independent practitioner that I would undertake owing to my motivation to support students in public health settings. I would need support to set up this placement and for the structure to be carefully worked out so it suited my working patterns.
What would be the benefits of this placement?
Promoting the joined-up thinking between individual clinical practice and the wider factors of health. Students would see why organisations invest in services like mine, and the organisations would benefit from having the input from a student and hosting a student may raise their profile and add to my credibility as a practitioner.
A student perspective
Case study 6 - Centrepoint
Background information
I am a student dietitian and I completed a placement between my 2nd and 3rd years of study in my integrated Masters course which was not part of the official placement programme for the course.
Where did the placement take place?
Centrepoint in London which is a youth homelessness charity.
How was the placement organised?
I organised this placement myself after reading an article about the charity in Dietetics Today. The dietitian at the charity contacted me to discuss what a placement would look like. I had to undergo Disclosure and Barring Service checks and complete volunteering forms.
How long was the placement for?
I was with the charity for 3 weeks.
What did you do during the placement?
Learning Areas: 1, 2, 4, 5, 7
I worked with the multi-disciplinary team who worked with young people on areas such as their health and wellbeing, their mental health, substance abuse and healthier relationships (Learning Areas 1 and 2).
I undertook a project as part of an audit. I conducted interviews with site managers to discuss how they used the food stock which resulted in me producing a piece of reflection and recommendations such as potentially recruiting a volunteer to transport donations to one of the sites. I also created a questionnaire to be conducted with the young people to explore the use of the emergency food cupboards. The organisation planned for the next student placement to conduct this questionnaire with the young people (Learning Areas 1, 2 and 4).
I helped to run the social supermarket on a Thursday each week alongside the dietitian. During this, I would support the young person to make food choices based around the Eatwell Guide. The young people would get a basket of shopping for £3 where the food was mostly donated by charities such as Fare Share. I also helped to cook the meals provided to the young people who attended in the evening. This resulted in me being able to work with the young people to empower and encourage them to be more proactive in their eating behaviours. In the last week, I worked alongside a data analysis organisation to explore diet and hunger with the intention of lobbying the government to improve access to universal credit (Learning Areas 1, 2, 5 and 7).
What about support on placement?
I was happy with the level of supervision given to me during the placement from the dietitian and the team. Effective supervisory support was important to the success of the placement.
What barriers did the you face?
This was an additional placement so I had to be motivated to do this outside of the course requirements. Living in London for three weeks could be a financial barrier to some students.
What did you learn from this placement?
My transferable skills such as professional confidence, communication and organisation were all enhanced during this placement. I was pleased to see how my dietetics knowledge could be used in this environment.
I learnt how to better support young people who face many more problems than I was used to seeing within the NHS. I feel it is important to have as wide an experience as possible with many non-NHS organisations and this can only be a positive outcome for AHPs.
I feel, even within this short placement period, that I had made a difference to the organisation and the young people within it. I believe that I gained new skills and experiences through this placement. I have written an article about this placement for the benefit of a wide range of healthcare students at my university wishing to undertake public health placements.
Case study 7 - Public Health England
Background information
I am an occupational therapy student and I completed a role emerging placement as my final practice placement of my Masters pre-registration course. I did this alongside another occupational therapy student from the same university.
Where did the placement take place?
Public Health England as a virtual placement.
How was the placement organised?
The placement opportunity came through Public Health England as the Covid-19 pandemic prompted the need to look at virtual placements as an option. A discussion was held between Public Health England and my university to explore what my and my fellow student’s skill sets were and to identify the needs of a role emerging placement within this organisation. A timetable was then prepared for us to show the projects we would be working on.
How long was the placement for?
The placement lasted for 6 weeks.
What did you do during the placement?
Learning Areas: 1, 2, 3 and 6
In the first two weeks, we were working on a takeover of the AHPs4PH (Allied Health Professions Public Health) Twitter account. This focused on student AHPs and working within public health. This meant that we had to work with a number of bodies including NHS England and Health Education England (Learning Areas 1 and 2).
We then worked on a project exploring how to best support the health and wellbeing of paramedics which was part of a broader piece of work to reduce suicide risk amongst ambulance service staff. We had to jump in at the deep end in order to better understand the situation as it was new to us. We considered a concept which we had learnt at university called WRAP, which aims to support wellbeing, and suggested this in a meeting. This resulted in us drafting the first plan for wellbeing for paramedic students and newly recruited ambulance staff (Learning Area 1, 2, 3 and 6).
The final project we worked on was around the Sustainability of Equipment. This was challenging due to the amount of detailed research and preparation needed in order to really understand the topic, for example, the costs of cleaning reusable equipment versus ordering new equipment for each patient (Learning Area 1, 2 and 3).
What about support on placement?
We completed the placement in a pair which allowed us to support each other through the placement. I had a long arm supervisor from university and my onsite supervisor at Public Health England. Effective supervision was vital for the final successful outcome. I appreciated the placement being towards the end of my degree programme as I felt better able to make a positive contribution.
What barriers did the student face?
I feel I gained more from this placement having already completed a module in public health during my course. It may be difficult for students who do not get a lot of public health teaching to complete a public health based placement. However, with a bit of pre-reading to help understand what is meant by public health, a placement in this area can really help someone understand an AHPs role in public health.
I had issues with internet connectivity prior to starting my virtual placement and if these had continued, I would have struggled to engage with the placement.
What did you learn from this placement?
I gained a greater understanding of other AHP roles, in particular, that of paramedics as a result of the second project. I would not have achieved this insight without this placement.
I feel that working with other bodies (NHS England, HEE) has strengthened my understanding of the wider NHS structures which I feel will be of benefit in my future career.
The sustainability of equipment project changed my understanding of the complexity around the re-use of OT equipment. This was not something I had considered before and it was an unanticipated additional benefit of the placement. This project really opened my eyes to the bigger picture of working as an OT and what I have learnt will change my future practice.
The learning outcomes I achieved during the public health placement included; increasing confidence, experience of leadership roles, improved research and critiquing techniques and report writing. The placement made me realise that although I felt I had received holistic training before this point, there were far more holistic opportunities in the wider public health arena and this should be open to all AHPs.
The placement was marked according to our university placement learning domains and all outcomes were met although an element of adaptability was necessary.
I have written a blog about my experience which you can find here.
Case study 8 - creating resources to support other students
Two student AHPs reflected on their placement with Public Health England.
One of our placement objectives was to develop peer to peer messaging that would promote the value of public health placements to AHPs. We initially decided to create a blog post of our experiences but this soon expanded as our ideas grew and we considered the value of having a place where different students could go to share their experiences of different AHP placements. We thought that this would allow students to find out more information about what to expect from a non-traditional placement.
We decided that we wanted to create a website for students as a resource to promote public health placements and placements in non-traditional settings, and as a place where they could access information about public health placements. Through planning discussions for the features of the website, we decided that it would be useful to include an introduction page, information about role emerging placements, information on what AHPs do, and resource files for our solo and collaborative projects (we uploaded our individual blogs to share our experiences of the projects we have been working on).
Prior to starting our placement, we attended an online lecture that allowed us to hear the experience of a student who had undertaken a placement with Public Health England. However, some students may not have the opportunity to listen to another student’s experience of being on a public health placement. This motivated us to design a resource that could address several questions students may have about participating in a public health placement.
We realised that the website may not be able to answer all questions or queries of the students. To address this issue, we decided to include a forum page within the website. The forum would allow students to be able to direct their questions to other students about various topics. This includes public health placements, clinical/non-traditional placements, role emerging placements and AHP discussions. There are also other options in the forum to share resources and have general discussions about being a student. We hoped this would promote ongoing engagement with the website from student AHPs.
The website resource can be found by following this link and we hope that this helps other students in the future – occupationaltherapyplacement.wordpress.com
An Education Institution perspective
Case study 9 - HMP Grampian
Background information
I am an Occupational Therapy Lecturer in a university in Scotland, and I have developed the occupational therapy Masters programme to include a focus on public and population health, including encouraging placements with a focus on this aspect of health.
Where did the placement take place?
We have students going to a variety of placements where they adopt a focus on public health, but this case study will focus on placements in HMP Grampian. If ever a population needs population health and AHPs, it is prisons.
How was the placement organised?
The relationship with the prison has been developed over the years and they have had a focus on public health from the start. I started going into the prison in 2003 with students to get to know the population where we began with a lunch group with the prisoners. The idea was to learn with and from each other whilst discussing health promoting activities. This led into a project called Roots and Shoots where we worked within an occupational perspective of health to explore what was important to the prisoners and their health whilst creating a garden in the concrete area of the prison. The prisoners would have their work routine in the garden and we would then use the produce from the garden to make lunch and discuss issues such as their transition out of prison. This project led to the recruitment of an occupational therapist, very much adopting an occupational perspective and public health/ population approach (not mental health) within the prison, to work with the prisoners’ complex needs. This approach has facilitated ongoing placements between the university and the prison.
How long was the placement for?
The placement is for 6 weeks; the student’s final placement (of five placements) is an elective where they develop a proposal for an elective placement with the university’s approval. This includes areas of placement where an occupational therapist may not traditionally work. Students can potentially go on placement at HMP Grampian for their third or fourth placement if appropriate, to balance their learning needs and practice experience.
What did the student do during the placement?
Learning Areas: 1, 2, 7
The student undertakes the placement as outlined in the practice placement guidelines with their practice educator. They may have a caseload which is formed by referrals from various processes within the prison. The occupational therapist will unpick what is going on for the men [the prisoners] who often have layers of complex needs. The students may work with prisoners who have addiction issues, learning difficulties, coupled with poor mental health and coping strategies; many layers of issues that make daily life challenging for them as a population. The students may work with the prison officers who have a good understanding of the issues affecting the prisoners. They get to know and understand the experience of the person [the prisoner], listening to their history and story, understanding their behaviours
which often lead to the offending behaviours. In the prison setting, the occupational therapist might make adaptations to the work routine to enable the prisoners to engage positively and to build a routine for them in the prison setting. An example may be redesigning work duties so the person [prisoner] is able to continue participating in this based on their needs. The occupational therapist will also conduct standardised assessments such as the MOHO assessments to explore what factors prevent the person from participating in their daily occupations to keep them well as opposed to a pathogenic conditions approach (Learning Areas 1, 2 and 7).
What does the student learn whilst on placement?
We have specific categories in our assessment documentation to cover a range of settings which also captures a public health perspective. Examples of key skills developed on placement include implementation and evaluation of occupational therapy, communication skills, and the importance of building a therapeutic relationship. Students write their own learning outcomes for the placement. Examples of learning outcomes might be; to develop a critical analysis of the population; to critically evaluate an occupational perspective of health with the population; and to evidence and demonstrate the benefits of occupational therapy for the prisoner population.
If the prison placement does not present the opportunities to work with the prisoners in the way the student would have planned for, due to unforeseen circumstances, [we] explore how the student can demonstrate they have met the learning outcomes of the placement in relation to the population and setting, in conjunction with the practice educator.
The mindset shift occurs for the students in understanding health inequalities and the marginalisation of people’s [prisoners’] health. They see the issues around human rights and justice and the recognition of what we try to manage in medical and acute settings is something we should be trying to prevent upstream. We see a transformation in confidence, becoming more attuned to listening to the person’s [prisoner’s] story and realising the antecedents to risk and offending behaviour. The students broaden their view of the world so that it is not just based on clinical diagnosis.
What about support on placement?
Prior to the placement, the student will have undertaken a public health module where we explore different populations using situated learning, where the students go into different settings and learn with and from those populations. They learn to understand the complexities of what affects populations and their health and link this to occupational therapy theory and practice. Students learn about what is influencing a person’s health, about health inequalities, and about the barriers to engagement. This learning better prepares the students for going into an elective placement and to adopt a public health perspective.
During the placement, students have support from the practice educators (currently there are two occupational therapists in the prison). Occupational therapy works closely with other prison staff and the multi-disciplinary team. Lecturers from the university are there for support and conduct a half-way call to explore with the student and practice educator a half-way report on how the placement is progressing and address any issues which may have
arisen. It is also an opportunity for the student to reflect and discuss the progress of their learning.
What barriers did you face offering the placement?
There are so many unmet needs in the prison with the prisoner population and there is so much work we could do as an occupational therapist. The challenge is having time and commitment to work in the way you want to as an occupational therapist given the nature of the setting and the range of needs of the prisoner population.
What were the benefits of this placement?
The prison recognised the benefit of the occupational therapist working from a population public health approach from the original projects in the prison and the excellent work of the current occupational therapist in post, which resulted in the recruitment of anther occupational therapist for the prison. The prison team acknowledge their way of thinking about the population they work with has been enhanced from working with occupational therapy. The prison staff recognise that the occupational therapist could enable the prisoners who experienced the greatest barriers to accessing programmes in prison by working with prison staff. The HMIP Scotland reports have commented very positively on the work of the occupational therapist in the prison. Prisoners have also provided feedback such as “this is the first time someone has tried to explain how I could do things differently”.
Case study 10 - local county council
Background information
I am an occupational therapy (OT) lecturer and placement co-ordinator for a university in England. I have been involved in organising role emerging placements for many years. Role emerging placements are traditionally environments where there is not an established occupational therapy service.
Where did the placement take place?
We have organised placements in a variety of settings (e.g., retired OT groups, community centres, and farms). This case study will focus on placements with the local county council where students are able to apply a public health focus to their work.
How was the placement organised?
Initially the placement was brought to our attention as a graduate’s parent was the principle social worker for the council. She had heard about the role emerging placement and made contact, stating that their locality teams did not have an OT and this was something they wanted to explore. Since this placement, they have appointed a principal OT, who subsequently offered three placements for 2021. Unfortunately, due to the ongoing pandemic only one of the suggested projects was able to go ahead. The students who attended the first placement did excellent work which no doubt facilitated the development of this relationship. One of the students from the initial placement is now working as an
occupational therapist for the council and has been involved with the supervision of the students this year.
To help develop relationships with partners, we share examples of previous placement projects using student posters that are developed as one of the modes of assessment. This illustrates the diversity in projects and areas accessed by the placements.
How long was the placement for?
The placement block for the role emerging placement lasts for 9 weeks; the students spend 4.5 days on placement and half a day in teaching. The placement is the final placement of the course. The course team strongly feel that students need to consolidate their clinical skills and professional identity before going into an environment that is less structured.
What did the student do during the placement?
Learning Areas: 1, 2, 4, 6
The project this year has focused on the gaps in provision for clients on the discharge to assess pathway, residing in transitional beds. Students identified that service users were experiencing delayed discharges, inadequate packages of care and limited provision from appropriate wrap-around services. Their project aims to develop a pathway which encourages collaborative working, therapy-led assessments, and strength-based approaches to meet service user needs and efficiently utilise social service resources (Learning Areas 1, 2 and 6).
Previously, students have scoped the possibility of the role of an OT in the locality team. They identified that the process for referring a client to OT from the locality team was a complicated and time-consuming process, leading to a delay in assessment of an increase in care packages. Both options were financially costly and had the potential to disable the client further. They shadowed the team but did not do any hands-on work. It was imperative not to provide a service that could not be continued immediately after the placement ended. Instead, they observed and investigated the processes and suggested what could be implemented to make a difference. They prepared a business case outlining what occupational therapy could offer, and demonstrated the cost differences and savings that could be made in terms of the reduced care packages compared to employing an occupational therapist (Learning Areas 1, 2 and 4).
What does the student learn whilst on placement?
Assessment consists of the programme placement assessment document (50%) and poster and viva relating to the service development (50%). The involvement in these projects develops creative problem-solving skills, entrepreneurship and communication skills. Identifying cost margins is a skill that they would never have thought that they would have developed at the beginning of the placement! All placements are modules in their own right and have a set of learning outcomes that meet the programme and professional requirements. They included, for example: critically appraising the current influences on health and wellbeing and the relevance of these to an occupational therapy focused service development. This aligns with the public health agenda.
Role emerging placement changes occupational therapy students! When they finish, they are more confident, they can articulate the role of the occupational therapist much more proficiently. They can identify how they can transfer their skills to different settings as they have had to think outside the traditional sphere of practice in different environments.
What about support on placement?
Prior to the placement, we have a presentation day where organisations who are offering a role emerging placement present a pitch to the students about the projects which they could be involved in. We start to prepare the students early in the academic year to think about these placements. We do this preparation in conjunction with the onsite supervisors (staff from the organisations) and the long arm supervisors (occupational therapists) (we explain we need commitment for these events from the organisations when we are setting up the placement).
The students undertake placement in pairs as they are in very different environments and this peer support helps. For the first five weeks, they have a weekly peer support session as a cohort to help problem solve between themselves. Long arm supervisors provide formal supervision once a week for an hour (in pairs or individually).
We arrange for long arm supervision from registered OTs. This tends to be from OTs who cannot facilitate placements in their current work environment but want to continue supporting students, such as OTs in management positions or who work part-time. The commitment from them is 1 hour per student each week. There is also the commitment from the long arm supervisor to meet with the on-site supervisor at the start, middle and end of the placement to complete the assessment documentation.
Providing an on-site supervisor is a non-negotiable commitment that is necessary to establish from the placement. This person meets with the student on a regular basis but they do not need to work alongside them all of the time.
What barriers did you face offering the placement?
The placements are hosted in a wide variety of settings. This can create tensions initially with the organisation staff as they may be unaware of the role of occupational therapy. As students do not have an OT supervisor within the placement, they must develop skills to be able to manage such challenges.
What were the benefits of this placement?
We promote role emerging placement to the organisation as a way for them to carry out a project which they would like to do but lack the time to do it. We offer them two students who can focus on a project that would be evidence-based and rigorous, and which will leave a legacy. We do make it very clear they are not just another pair of hands, although they should be involved in all aspects of the organisation for the first two weeks in order to identify the occupational needs of the client group.