Preparedness for Practice
It is vital that in every health and care profession, graduates are as well prepared as possible for their first day of work. For example, there is evidence to suggest that when trainee doctors start their first work placement as a Foundation Year 1 doctor (F1) it has a negative impact on patient safety and can have an impact on the functioning of the broader healthcare team. Similarly, the transition from student to professional nurse has been identified as a period of considerable turbulence, strain and anxiety. 
We have a rich collection of research within PIHR's Future Ready Health and Care System theme related to the education and preparedness to practice of a wide range of health and care professionals. 
Medicine

PIHR researchers have been undertaking a range of studies on the preparedness for practice both medical students and graduates.

Graduate preparedness:

Medical graduates preparedness for anticipated healthcare needs: The aim of this study is to investigate whether graduates are prepared for the future healthcare needs specifically: 1. the changing patient-doctor relationship 2. the doctor in a multi-disciplinary team and 3. complex clinical decision making. This research used a mixed methods design including a rapid review of the literature, inter-professional simulation and qualitative interviews with stakeholders. This study was funded by the GMC.

2020 medical graduates: The work and wellbeing of interim Foundation Year 1 (FiY1) doctors during COVID-19: All new doctors face challenges at the point of transition to practice, but FiY1s faced this in an extraordinary context. This GMC funded study explored the impact of COVID-19 restrictions on medical students training and transition to work on their well-being

Pedagogy and student preparedness:

Student perceptions of teamwork education: Researchers within the Peninsula School of Medicine have been exploring’ perceptions of teamwork education amongst fourth year medical students.

Watson, Dolley, Perwaiz, Saxelby, Bertone, Burr, Collett, Jeffery, Zahra

Anaesthetic training: Professor Tom Gale and Dr Marie Bryce have been awarded funding from the National Institute of Academic Anaesthesia to deliver a two year project exploring the stressors in anaesthetic training and mechanisms to improve trainee wellbeing.

Dentistry

PIHR researchers have recently been making significant strides in the area of dental education research. Commissioned by the General Dental Council (GDC) in preparation of the UK leaving the European Union (EU), research led by PIHR's Professor Tom Gale explored dental education standards across the EU. This found variation between, and within, countries in the provision of dental education standards. In addition, the research found that there have been many proposals for harmonisation between Member States but little evidence of these having been implemented. Variation was also found in how dental education was quality assured – see New report maps international dental training provision.

A number of projects on dental education projects take place within the University’s Peninsula Dental School. A recent example includes a collaboration between the schools’ Dr Aengus Kelly and the School of Society and Culture’s Dr John Matthews, to develop equality and diversity clinical scenarios for dental students with the help of acting students, funded through the Arts Health Collaboration Fund.

Nursing

We secured funding from Higher Education England (HEE) to investigate a new initiative in the South West called CLIP (Collaborative Learning in Practice) which is a coaching and peer-learning model for students’ placement learning that replaces the old mentorship model. The Nursing and Midwifery Council explicitly ended mentorship in 2018 with their new standards, and this coincided with our need to increase placement capacity.

Our research began in acute sector placements and has moved into the community. Adele Kane led this across the region as School of Nursing and Midwifery Associate Head of the School of Nursing & Midwifery (SNAM) for Placements. Graham Williamson, Associate Professor in Adult Nursing in SNAM based in Exeter, was Principal Investigator for the research and lead author on the related publications. Our team, included nursing and midwifery, HEE and trust staff have generated several the publications about future nursing workforce. This engagement with local NHS, GP practices and private sector organisations is essential for impact as they are the future employers of our graduates.

Following a successful conclusion, Kane and Williamson, with a team of SNAM staff, have secured further funding from HEE to evaluate CLIP in GP nursing settings in selected Primary Care Networks in Devon, Cornwall and Somerset.

Preparing the future workforce for practice also means preparing them for the increasing role that digital is playing in healthcare. The Centre for Health Technology’s Dr Toni Page examined the prospects for embedding digital within the nursing curriculum as part of her PhD.  

Allied Health Professionals

The COVID-19 pandemic has seen major shifts in the working practices of all professions and allied health professionals (AHPs) are no exception. In particular it has led to a steep rise in the use of telehealth. With continued pressure upon healthcare workforces and telehealth delivery becoming embedded within services, there is an ongoing need for educators to prepare healthcare students in telehealth protocols prior to practice-based learning. A team from the School of Health Professions has been working with La Trobe University, Melbourne, on an international research project to explore how the required skills, knowledge, and behaviours for traditional face to face practice such as professionalism, etiquette, relationship building, and interpersonal skills and behaviours, apply in a telehealth context for AHPs. The research has included a scoping review of some 92,535 (40 for the final review) covering 32 different AHPs existing in the UK and Australia.

The UoP research team includes: Dr Krithika Anil, Dr Sally Abey, Professor Jennifer Freeman and Christie Robinson 

A more specific modification to a training programme resulting from COVID-19 is the OT Hybrid PEEP model which has supported Occupational Therapy (OT) students by utilising peer group learning and linking students with community organisations in emerging areas of practice virtually via ZOOM. Researchers from the Schools of Health Professions and Nursing and Midwifery have been undertaking an evaluation of the model. This has involved exploring the views of the students, long arm occupational therapy supervisors and onsite supervisors of this innovative placement model used during COVID.

The research team includes: Jen Rolfe, Dr Alison Warren, Sarah Reynolds, Dr Toni Page, Emily Thubron and Shaen Milward

A team from Peninsula Dental School led by Professor Catherine Coelho is currently undertaking a HEE South-West Simulation Network funded project to develop a Mixed Reality training package for students training to be allied healthcare professionals. This package will help AHPs to identify common dental issues, thus optimising patient care and appropriate referral pathways.

Pedagogy

PIHR researchers are also engaged in pedagogic research more generally. CAMERA's Division of Education and Scholarship (DES) brings together core teaching staff from the Peninsula Medical and Dental Schools undertaking scholarship and research related to teaching and learning. 

Much of Professor Lucy Spowart's work has focused on the professionalisation and enhancement of teaching in higher education, as well as the continuing professional development of the healthcare workforce. Her recent work has included a study of the impact of Principal Fellowships on individuals and their institutions for Advance HE.

The Collaboration for the Advancement of Medical Education Research and Assessment (CAMERa) researchers aim to improve the development and sustainability of the healthcare workforce by focusing on three research themes, namely workforce development, continuum of education, and professional regulation.

CAMERa's research programme, carried out by a multi-professional group and employing a mix of qualitative and quantitative methods, impacts directly on national and international literature, educational theory, practice and policy.

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