To receive a warning, the student must understand the parameters in which they practice and how behaviours and actions are perceived. The majority of these are governed by the HCPC Standards of Proficiency for Physiotherapists, HCPC Guidance on Conduct and ethics for students, and CSP Code of members professional values and behaviours, but students may need guidance on how to apply these in your work area.
Action Plans are a positive act to support student learning and are an integral part of the Process for Raising Concerns Appendix 8, page 38 of the Placement Handbook.The CSP Common Placement Assessment Form (CPAF) provides space to record student performance warnings. Appendix 1. Record of warnings given, Page 32.
If you follow the skills described in the Giving Feedback section creating an action plan can be a positive experience and viewed as a supportive measure to aid success rather than a performance review.
It is important to create the action plan together. Although you are aware of the deficits in performance the student needs to take ownership of the situation and recognise in themselves areas for improvement, suggest methods of how to achieve this, how successful achievement can be measured and a timeframe in which this needs to be achieved.
We recommend SMARTER goals as this helps students to remain focused, aware of their environment and motivated.
S Specific
M Measurable
A Achievable
R Relevant
T Timed
E Environment-Exciting
R Resources-Reward
To assist you here are 2 Action Plan Templates:
A simple example of an action plan may be via the minor event route:
Minor event - Stage 1
A student is late one day. You acknowledge they were late
and ask the circumstances about this. The student explains they were late due
to dropping their child at childcare. You explain the implications of being
late e.g. missing MDT or first patient appointment, that this has an effect on
their professionalism and ask that in future they attend on time.
Record this in their CPAF document page 32. Appendix 1. Record of warnings given.
Minor event - Stage 2
The student is late the following day due to the same
circumstances. You again explain the implications, ask if there are
alternatives that would be explored given that this may repeat if not addressed,
explain this influences their professionalism and ask that in future they
attend on time, but the next occurrence will lead to an action plan and
notification of failing. Placement Handbook, Page 38. Appendix 8. Process for
raising concerns.
Record this in their CPAF document page 32. Appendix 1. Record of warnings given.
Minor event - Stage 3
The student is late a third time for the same reason. You
inform the student that this is now a notification of failure situation, inform
the students personal tutor, University/Trust Practice Education Facilitator
and arrange a tripartite action plan meeting at the earliest convenience.
An action plan may be:
| Goal |
The student will be on placement and ready to work at the start time of 09:00 for the next week of placement |
| Responsible |
Student
|
| Method |
The student will: Look for an alternative childcare provider. In the meantime, they shall ask if another person can support them.
|
|
Measured by |
Student attendance record
|
| Timescale
|
1 week |
| Actions should the goal not be achieved |
If the student is late on one more occasion, then they will fail the placement relating to CSP CPAF Professional Behaviours and Responsibilities item 7 “Is punctual and has good time keeping” |
Record this in their CPAF document page 32. Appendix 1. Record of warnings given.
If you need any support to create an action plan, please don’t hesitate to contact AndrewLloyd, Practice Education Facilitator
The CSP InformationPaper, Record Keeping Guidance Page 10, Countersigning notes and delegation states:
Registered health professionals are accountable for the care of their patients; they remain professionally accountable for the appropriateness of any delegated duties and acts or omissions of care undertaken by students or support workers who they are supervising. They also remain professionally accountable for the quality of record keeping entries undertaken by students and support workers, in respect of delegated duties relating to their patients.
There is no explicit direction from the HCPC regarding when or if the physiotherapist who has delegated tasks to a support worker or undergraduate student should countersign their respective entries to the health record.
The HCPC standards of conduct, performance and ethics state:
For many physiotherapists, the decision to delegate tasks will be governed by a combination of national and local policy on the delivery of care across a patient pathway utilising skill mix. Physiotherapists will also be governed by local employer policy on delegation and supervision of students and support workers.
For further information please see our document on developing a diverse placement.
Occasionally we may feel that we need to speak with a student about something and don’t know how to approach it.
This is usually because it evokes an emotional response in ourselves, and we question how we should begin the conversation.
Students need your guidance to understand how they are being perceived in the workplace. There are probably others that have noticed but they too find it difficult to approach the student.
These conversations follow the same principles as Giving Feedback, please read the Giving Feedback section.
Please refer to our induction document.
If students understand what educators expect of them then they can safely practice within the parameters explained to them.
If on day 1 students are told that mobile phone use is not acceptable outside of staff only areas and they are found using their mobile phone in a clinical area, the parameters have been set, this is unprofessional behaviour.
If they have not been informed of this and found using their mobile phone in a clinical area, can we consider this unprofessional behaviour? Should we have set our expectations on day 1?
When different moments like this are repeated, the students may start to feel anxious in practice and educators may feel frustrated at needing to constantly explain.
The solution is to inform the student of your expectations on day 1.
An example may be:
Just for a moment think back to starting a new job. Did you feel a little anxious and excited?
What was the best first day that you have ever had, and what was the worst?
The difference was probably how prepared each area was for your arrival. The information you received before you arrived, how prepared you felt and the warm welcome you received when you met your new team. A positive experience gives us a sense of feeling valued, belonging and motivates us to do well.
Every time a student goes on placement, they have another first day.
When students are allocated placements on ARC they look at your Profile Of Learning Opportunities (POLO) on ARC-PeP. This is the first impression that they have of you and where they find your contact details.
If your POLO is incomplete, not up to date and has the wrong contact details the student can feel anxious as they try to make contact.
Northumbria University Physiotherapy students have a standardised introduction that they send to new placements. It contains their name, pronouns, a photograph, their contact details, a SWOC analysis, their learning preferences, if they require learning support, their previous placements, and their course content.
If the student requires any reasonable adjustments they should disclose this pre-placement, see the Placement Handbook,Page 19, Reasonable adjustments to placement and Appendix 9, page 39.
When the student contacts the placement area, they should be allocated a named educator. When you as their educator responds to the student it is preferable to address them by their name as it feels more personal, send them a welcome pack including any pre reading, mandatory training, details for a badge and IT access, and details of when, where and who they should meet on their first day.
On the students first day following a warm welcome it is suggested that:
If this process is followed then students will feel welcomed, reassured, motivated and confident from the beginning.
Please see other sections on a draft induction, learning styles and expectations.
Below
is a selection of the frequently asked questions.
The students first priority is to attend placements and time off should never be expected. It is entirely at the discretion of the educator about whether it is appropriate and can be accommodated
Yes. If it is expected of you or you have identified a valid learning experience students can work alternative working patterns provided they have adequate supervision and any reasonable adjustments have been made.
A student must attend over 70% of the placement hours to enable them to pass.
Andrew Lloyd is the dedicated Physiotherapy, Practice Education Facilitator, at Northumbria University. He can support you in anything that you need.
Each student has a personal tutor, if you feel your student needs support advise them to contact their personal tutor or you can, their details should be on page 1 of the CPAF document. Alternatively contact Andrew Lloyd, Practice Education Facilitator. The university also provides substantial student support. A student can access this through their Student Portal or Ask4Help.
Yes. Students do not get leave for bank holidays. If one occurs during placement where that area is normally closed then there are 3 options:
1. Plan the students experience to incorporate the lost time into the placement
2. Arrange for the student to undertake a period of experience in another area within the portfolio of learning.
3. Ask the student to undertake some pre identified work with will be assessed as part of the measure of the agreed practice outcomes (make them accountable for the time).
The moment you feel that your student is not practising at a level that they should be please contact the students personal tutor, Andrew Lloyd, Practice Education Facilitator and your organisations Practice Placement Facilitator, if you have one.
We can support you and the student to create an action plan and a support mechanism to overcome most issues.
The feedback that you have given, supervision records, evidence of practice, reflections and the CPAF document can help to inform the student of their practice and develop an effective action plan.
For further information please see our guide to Giving Feedback.
The organisation or practice hosting students on placement need to ensure that their indemnity insurance includes students.
If you are in any doubt please contact your insurer to check that students are covered in your indemnity insurance.
If you think back to school, college, or university I am sure you can remember the teachers that made learning easy and inspired you but also those who’s lessons seamed to last forever.
No two individuals are the same but if we discover our match, together we can achieve greatness.
Most of us have a vague awareness of our learning style but we should spend a little time to get to know ourselves and the common learning styles please see: mint-hr.com/mumford.html).
As a practice educator it is common for us to teach in either the style in which we were taught or that which suits our own learning.
But if we can align our teaching style to that of the students learning style, we can motivate them, maximise their potential, improve the students experience and enjoy being part of their development.
It helps if the student knows their learning style and can tell you rather than having to work it out for yourself. Have them complete a learning style questionnaire to give you a guide.
Imagine if you are a Kinesthetic Learner and like to learn by being hands on but your student is a Reflective Learner and needs time to think about what you have shown them before they practice. You may be frustrated that the learner waits before being hands on. How could you adapt to align with the student?
As an educator it is your role to challenge the student.
There is credibility in using all learning styles in our development even if they don’t naturally align with our style.
We may be a Humanist Learner and like options and choices but sometimes we need to learn as a Behaviourist and be rewarded by completing the correct procedure i.e., suctioning.
It is ok to be a Reflectionist Learner and need to think about what you have seen demonstrated but sometimes you just need to be a Kinesthetic/Activist Learner and be hands on.
If you don’t feel that you are making a connection with your student then speak with them. How are they enjoying the placement? How do they feel about the teaching style you are using? Can we make any changes?
Our Physiotherapy students at Northumbria receive mandatory training in:
There may be an occasion when your student is absent and makes no communication with you. In these instances, we advise.
Negative behaviour is unacceptable in the workplace and must be addressed in a timely manner.
It is important that students receive feedback, learn, and understand professionalism in the workplace from you as their role model.
In most instances simple feedback will correct behaviour in the workplace as students learn to fit in to the environment. The severity of unprofessional behaviour witnessed will determine the route on the Placement Handbook,Page 38, Appendix 8. Process for raising concerns and potential failure ofplacement.
However, when considering negative behaviour, it is necessary to recognise that each previous placement will have its own characteristics, humour and educator’s personal values and beliefs that may influence the student on this placement.
It is important that we set out our expectations on the first day of placement, so the student is aware of what is expected from them. If we know and understand the parameters, then we perform accordingly. An example may be the use of mobile phones on placement. Some educators suggest a strict ban on their use, others see them as a useful tool to research. However, most agree taking a personal call or texting in front of a patient is unprofessional.
Also, the student is lead by our example. If the student sees others using a mobile phone, making jokes or being late they may consider this acceptable behaviour.
Sometimes inappropriate behaviour is an indication that the student is in difficulty. The disappearing student, the quiet student, or the angry student. Offer them a safe, supportive environment when giving feedback. There may be factors impacting on their learning that they have not so far disclosed.
Please see the sections on Expectations, Giving feedback, Action Plans and The Failing Student.
For further information please see our document on New Placement Models.
A reasonable adjustment under the Equality Act 2010 is considered an adjustment to practice or the environment to enable a student to work comfortably and effectively. Solutions may vary depending on the individuals needs but these may include:
Adjustments do have to be “reasonable” and some adjustments may be achievable in one environment but not in another so it is important to conduct an assessment based on individual needs and the workplace.
Although reasonable adjustments often allude to long term conditions they can be utilised for short term injuries or to accommodate factors that may impact on learning, Common Practice Assessment Form (CPAF), Page 8.
Placement Handbook, Page 19. Reasonable Adjustments to placement
All students undergo occupational health assessment before commencement on the physiotherapy programme. Where this assessment identifies health needs, recommendations and reasonable adjustments for placement will be discussed with the personal tutor. For any student where a new health need arises during the programme, a re-referral to occupational health can be initiated by the student or by the personal tutor. On some occasions, this is in response to a University Disabled Student Support Recommendations (DSSR) report which outlines the requirement for referral to occupational health.
In advance of each placement, and as part of pre-placement tutorials, health needs and/or learning needs and associated reasonable adjustments will be reviewed and documented with re-referral to occupational health if required. All students will be offered support to communicate reasonable adjustments to the practice area although in non-complex situations, some students may advocate for themselves to negotiate reasonable adjustments to placement to support with health or learning needs.
In more complex situations the student and personal tutor (and with support from the PPF where relevant) will have a tri-partite meeting with the educator to discuss reasonable adjustments to placement learning. If adjustments cannot be accommodated, an alternative placement will be sought.
An outline of the process for assessing and communicating reasonable adjustments to placement is provided in the Placement Handbook, Page 39. Appendix 9
Any absence from placement must be recorded on the CSP Common Placement Assessment Form (CPAF). Page 30, Record of Placement Hours.
Practice placements are an integral part of the BSc and MSc (pre-registration) physiotherapy programmes. All physiotherapy students must complete and pass 1000 hours of assessed practice learning to enable programme completion and registration with the Health and Care Professions Council (HCPC), (HCPC, 2017).
Students are informed that engaging with placements is a priority and that:
Please ensure that your contact details and sickness reporting procedures are correct on your Profile Of Learning Opportunities (POLO) on ARC-PEP
During your induction and initial interview when students arrive on placement, please be explicit as to your procedure for reporting sickness.
We inform students that if in doubt:
Physiotherapy students can claim placement expenses through the:
Both are administered by the NHS Business Services Authority (NHSBSA).
If they are eligible, they can get:
NHSLSF guidance booklet 2022-23 (V2) 11.2022.pdf
You can watch a short video with informationabout NHS LSF.
Travel and Dual Accommodation Expenses (TDAE)
Provides reimbursement of excess travel or accommodation costs incurred due to undertaking practical training on a clinical placement.
Completing your TDAE claim - a guide for students and universities (PDF: 429 KB)
You can watch a short video with informationabout TDAE.
For more information on the grants and funds available to students please visit: nhsbsa.nhs.uk/student-services
From the moment you suspect your student is underperforming please contact their personal tutor, Andrew Lloyd, Practice Education Facilitator, and your trust Practice Placement Facilitator if you have one. The earlier you inform us, the earlier we can support you and the student to have a successful placement.
As a quick reference to the process please see the Placement Handbook,Page 38, Appendix 8. Process for raising concerns and potential failure ofplacement.
Having a student that is struggling or failing can be emotional as by our nature HealthCare Professionals are caring and nurturing. The role of Andrew Lloyd,Practice Education Facilitator and your trust Practice Placement Facilitator is to offer advice, guidance, support, and a sympathetic ear to maintain your health and wellbeing.
As suervisors and educators, we are custodians of our profession, it is our responsibility to ensure the quality and capability of the future workforce. Students must demonstrate the competencies and requirements for passing the placement at each level, clearly described within the CPAF document. As students’ progress these requirements increase so if a student is underperforming it places an immense pressure on them and their educator on the next placement.
Students are experiencing diverse placements in Practice Based and Non-Practice Based learning so not standardised in their abilities.
However, if you have asked them if there are any factors impacting on their learning, given them time, highlighted areas for development, training, altered teaching styles, given all the additional support that you are able to, and they are still failing then it is appropriate to allow them the “right to fail” than pass them to the next, harder level of practice with a false sense of achievement.
Educators must assess the student’s performance on placement based on the evidence. It is the student’s responsibility to divulge any factors that may impact on their learning. If they do not do so, you can’t offer any reasonable adjustments and so must assess their performance based on their practice.
By following the notification of failing pathway, you are highlighting that a student is failing, and you are giving them the opportunity to access additional support mechanisms i.e. peer support, academic support and counselling in order to improve and succeed. An action plan is a positive step as it highlights the exact areas for improvement and focuses the student.
Sometimes, because of our caring nature we postpone making the decision of failing but the longer we wait the harder it can be to justify and evidence our decisions.
Below is a guide of factors to consider when you feel your student is underperforming.
1.1 know the limits of their practice and when to seek advice or refer to another professional
1.2 recognise the need to manage their own workload and resources effectively and be able to practise accordingly
To assist students who need to use public transport when travelling to placements the following website can help when planning the journey - traveline.info
The purpose of weekly supervision meetings is to provide the student with regular protected time to support their personal and professional development. It is not a management performance review or a time to share operational information.
It is recommended that a student receives a minimum of 1 hour of formal supervision per week, but this may be increased depending on need.
Clinical supervisions can be delivered in a variety of ways:
The role of the supervisor is to promote reflection, discussion and problem solving in a meaningful way to challenge students and promote growth.
The qualities of a supervisor are, to be knowledgeable and have relevant experience, support continual professional development, be an active listener, reflective in practice, express warmth, respect diversity and be empathetic.
Weekly supervisions may include:
Things to consider when preparing for weekly supervision meetings are:
Although not a performance review, during the supervision it is important to review the students Personal Development Plan, CPAF document, Page 11 to ensure they are on target to achieve their goals.
To guide students some placements, develop placement specific aims and objectives, effectively taking the students goals and reducing them into smaller goals to ensure the student is on track.
Some use an action plan base:
|
Aim/Objective |
How will this be achieved? |
How will this be assessed? |
Timeframe to completion |
|
Be confident and competent in carrying out subjective assessments |
Observation Develop a proforma for subjective assessment |
Observed taking a subjective history |
2 weeks |
|
Be able to carry out an objective assessment on a specific condition |
Observation Teaching Self Learning |
Observe completing an objective assessment |
2 weeks |
Others use a time frame or Gantt chart as a guide:
| Goal | Week 1 | Week 2 | Week 3 | Week 4 |
|
To be able to conduct and write up a full assessment in 30 minutes |
100 minutes | 60 minutes | 45 minutes | 30 minutes |
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