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• References

  Please Note: References remain valid until superseded by later research. The resources referenced here are regularly reviewed and are considered current and relevant to the topics presented.

  Indigenous Allied Health Australia (2013, updated and re-endorsed 2019). Position Paper: Culturally Responsive Health Care.

Communicating with First Peoples

• Communicating with Aboriginal and Torres Strait Islander peoples

  Communicating with Aboriginal and Torres Strait Islander peoples

   Students need to develop appropriate and competent communication skills for working with Aboriginal and Torres Strait Islander peoples. They need to

  • be aware of differences in verbal and non-verbal communication
  • appreciate the variations in linguistic and cultural aspects of interactions
  • recognise miscommunication
  • understand the serious consequences of communication breakdown

  These skills and understanding will require time and experience to develop. However, a number of valuable resources can support students as they develop their communicative competence:

  • Indigenous Allied Health Australia (IAHA) 
  • Queensland Health Aboriginal and Torres Strait Islander Health Division 
  • Edith Cowan University - Creating cultural empathy and challenging attitudes through Indigenous narratives
  • Cooperative Research Centre for Aboriginal Health - Sharing the True Stories:  improving communication in Indigenous health care
  • The Value of Deep Listening - The Aboriginal Gift to the Nation - Emeritus Professor Judy Atkinson. TedX

   

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• Written communication resources

  Written Communication

  Students also need to develop effective written communication that is appropriately adapted for Aboriginal and Torres Strait Islander peoples. Allowing students to spend some time reading reports and letters you have written is important. It might also be useful to provide them with some simple guidelines.

  For example, the University of Queensland Interprofesssional Occupational Therapy and Speech Pathology Clinic at the Murri School in Brisbane provides students with Documentation Guidelines :

  Documentation Guidelines
  

  Writing professional documentation for different audiences is a clinical skill. All health professionals need to learn to effectively communicate with their clients and colleagues. We write reports in positive language and use simple words and phrases in conversational language so it is much less formal than other reports you may write. However, documentation still needs to be professional, specific and measurable.

  Positive language: Where possible, use “needs support with” or “is still learning how to…” rather than “has difficulty with”. This is especially true for the whole class skill development program. In the targeted therapy sessions for children with known difficulties, you may need to use the language of “difficulty with”.

  Simple informal language: use the following substitutions:

  Traditional word we might use	Words that are less formal
  Required	Need
  Prompt	Reminder
  Assistance/support	Help
  Task	Activity
  Developing skills with.....	Learning to .......
  Complete	Finish
  Performance improves when .....	Does his best when .......
  Participate/Contribute to ....	Join in with.......

  Specific and Measurable: Avoid using “poor”, “fine” or “good” as these are subjective terms which we can’t measure. Instead, describe the child’s performance - what they could or could not do. When writing the final report, make sure you use examples to illustrate the “cut and paste” statements where relevant. These examples need to be child-specific and drawn from your progress notes or other observations so it is important that you record this information throughout the program. If you make a statement that a client is ‘sometimes able to ....’ or ‘not able to ......’, then you need to note what the client does in these instances.

  All client related assessments, progress notes and reports are legal documents.

• Communication in specific practice contexts

  Additional Communication Resources

  Aboriginal and Torres Strait Islander children’s language development and use

  Education Queensland’s Aboriginal and Torres Strait Islander Language Statement provides the basis to assist Queensland educators and school communities to support the languages and cultures of their Aboriginal and Torres Strait Islander students within the school context.

  'My Language Matters' is a useful audiovisual resource that aims to provide  understanding that many Indigenous students are ‘invisible’ language learners and outlines the processes required to ensure that every Indigenous student is provided the support they need to access the curriculum.

   

The structure and nature of placements - FN

• Shared Supervision/Multiple Mentoring Placement Models in Aboriginal and Torres Strait Islander settings:

  • You might find it helpful to share the clinical education responsibilities with another student supervisor (from the same or another profession) within your own or with another workplace/agency.
  • Shared supervision:
    • Often suits the 'team approach' used in Aboriginal and Torres Strait Islander health contexts.
    • Can broaden the range of experiences and expose the student to a range of supervisory styles. Partnering with another service provider can address concerns about student case load and mix within clinical hours.
    • Allows students to experience a range of approaches to practice and styles of communication and interaction with Aboriginal and Torres Strait Islander peoples.
    • Allows clinical supervisors to structure their workload to optimise clinical supervision with their student, and progress other workload requirements when the student is with another supervisor (e.g., if you have ‘outreach’ trips and the student cannot go with you, or if you have a certain client where a student’s presence might jeopardise the relationship).
    • Can limit the impact of the additional time you will need to spend with the student (e.g., if you know the student is with you for two days each week, it might be easier to block out time on those days to focus on your clinical educator role). 
    • A shared supervision/multiple mentoring model of placement has been used at the Institute for Urban Indigenous Health. A team of students might spend a day of each week with a different clinical educator which allows them to experience:
    • a range of approaches to practice and styles of communication and interaction with Aboriginal and Torres Strait Islander peoples.
    • a range of supervision styles and expectations.

   

  In the following three videos, two experienced clinical educators from different workplaces describe their experiences of sharing students with each other. In one setting the students are involved in a project placement in an Aboriginal and Torres Strait Islander health program, while in the other it is a more traditional clinical setting. The students are also involved in a community engagement placement run in an Aboriginal and Torres Strait Islander kindergarten and the two clinical educators share the supervision in this setting. The educators offer some suggestion about what makes these placements successful.

   

   

   

  More information on Shared Supervision/Multiple Mentoring can be found in Placement Models and Approaches to Supervision

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• Collaborative Learning Placement Models in Aboriginal and Torres Strait Islander practice settings:

  • You might find that having more than one student on placement at the same time is particularly useful in Aboriginal and Torres Strait Islander Health settings. Students might find it beneficial working together to help each other develop the necessary skills. They might also value having another student’s support to talk through their experiences and developing understanding. This might alleviate the student’s need to spend as much time working these things through with their clinical supervisor.
  • More information on a Collaborative learning model can be found in Placement Models and Approaches to Supervision

   

• Project Placement Model in Aboriginal and Torres Strait Islander practice settings:

  Project placements are commonly used within an Aboriginal and Torres Strait Islander practice settings:

  • Projects can be developed to address needs specific to your workplace - for example, setting up education or prevention programs, creating resources, promoting or evaluating an aspect of service.
  • The projects can be developed collaboratively by the students (working independently or in pairs/groups) and the workplace during the clinical education placement.
  • Project work can be used as one component of a placement - for example, students can undertake projects while the clinical educator is on outreach and would prefer not to, or is unable to, take the student with the them, or alternatively as part of an inter-agency shared supervision model.
  • Project placements have been used successfully at the Institute for Urban Indigenous Health to develop, trial, and evaluate programs. In this video Dr Alison Nelson describes some of the project placements they have offered.

   

   

  Queensland Health's 'Deadly Ears Program' also offer project placements to students. Jodie Booth, a Senior Occupational Therapist and experienced clinical educator explains how the placements work in this video.

   

  More information on a Project based placement model can be found in Placement Models and Approaches to Supervision

   

• Interprofessional Education in Aboriginal and Torres Strait Islander Practice Settings:

  • Working in Aborignal and Torres Strait Islander health services usually requires a multidisciplinary approach. This can extend to offering interprofessional education where students from a range of disciplines work together. There can also be educators from different disciplines providing feedback and supervision to the students. This service model can effectively facilitate ‘holistic’ and client-centred practice and demonstrate to students flexible, collaborative, culturally-appropriate and contextualised services.
  • Speech pathology and occupational therapy students from The University of Queensland experience inter-professional learning on placement at the Murri School, an urban Aboriginal and Torres Strait Islander School in Brisbane. The students experience ‘a service delivery model built on mutual learning, collaboration and understanding and respect of cultural difference. [...] A clinical educator from each profession [is] integral to a well-coordinated approach and has enabled opportunities to share supervision and to model inter-professional clinical skills’ (Davidson, Hill & Nelson, 2013, p.70).

   More information can be found in the Interprofessional Education Practice Context section

   

• Role Emerging Placements in Aboriginal and Torres Strait Islander Practice Settings:

  • With external or off-site discipline-specific supervision, a role emerging placement can demonstrate a need and demand for ongoing services working with Aboriginal and Torres Strait Islander peoples.
  • More information on role emerging placement models can be found in Placement Models and Approaches to Supervision

• Student-led Clinics in Aboriginal and Torres Strait Islander Practice Settings:

  • Student-led Clinics can increase opportunities for student placements as well as increasing the services offered to clients.
  • A student-led clinic at the Institute for Urban Indigenous Health was the starting point for the ‘Work It Out’ program. ‘Work It Out’ is an inter-professional education and exercise program for Aboriginal and Torres Strait Islander clients diagnosed or at risk of a chronic disease. It is an example of the establishment of a new service through a student placement.  The health service staff had identified that there was a need for rehabilitation services and the program was developed in partnership with a private gym. Once the service was established and positively evaluated the program expanded and is now run by a team of dedicated allied health staff. Students from medicine, nursing, occupational therapy, exercise physiology, pharmacy and psychology deliver educational content and assist in exercise supervision, monitoring clients’ health status and making recommendations within their scope of practice and level of experience. (Nelson, Shannon & Carson, 2013, p.31).

   

   

• References: Structure and nature of placement

  References:

  Please Note: References remain valid until superseded by later research. The resources referenced here are regularly reviewed and are considered current and relevant to the topics presented.

   

  Davidson, B., Hill, A., and Nelson, A. (2013). Responding to the World Report on Disability in Australia: Lessons from collaboration in an urban Aboriginal and Torres Strait Islander school. International Journal of Speech-Language Pathology, 15(1), 69-74.  https://doi.org/10.3109/17549507.2012.732116

  Nelson, A., Shannon, C., & Carson, A. (2013). Developing health student placements in partnerships with urban Aboriginal and Torres Strait Islander community controlled health services. Leaders in Indigenous Medical Education Network, LIME Good Practice Case Studies, 2, 29-34.

Student placements in mental health

• Student Placements in Mental Health Care settings

  "Mental health is a state of well-being in which an individual realizes ...their own abilities, can cope with the normal stresses of life, can work productively and is able to make a contribution to his or her community". (World Health Organisation, 2018)

  Each year, one in five Australians are diagnosed with a mental illness that affects their mental health and wellbeing.  The terms mental illness or mental health condition cover a spectrum of disorders that can vary in severity and duration and have a relationship to an individual’s physical wellbeing. As a result, mental health care settings and treatments vary.

  Students may work with a person who has been diagnosed with a mental health condition:

  • Directly, in a specific mental health practice setting:
    • Public and private mental health hospitals
    • Mental health wards within general hospitals
    • Mental health residential care facilities
    • Mental health rehabilitation facilities
    • Community mental health care services (which can include outpatient services, crisis or mobile assessment and treatment units, day programs and outreach services)
  • Indirectly, in any health care setting, where the client may present for treatment for a coexisting health condition (for example, diabetes).

  Depending on the setting, students may have opportunity to gain experience working with a diverse group of people:

  • Children and youth
  • Mothers and children
  • Single parent families
  • People with a lived experience of substance misuse or addiction
  • Aboriginal and Torres Strait Islander Peoples
  • People who are culturally and linguistically diverse
  • Carers and families
  • Older persons
  • People with chronic disease, injury and/or trauma.

  Given that mental health conditions do not discriminate and affects a broad spectrum of Australians at any given time, supervisors and students should also consider the likelihood that they will be working alongside a person with a mental health condition as part of their multidisciplinary team.

• Benefits of student clinical placements - for the consumer

  "Consumers are people who identify as having a living or lived experience of mental illness, irrespective of whether they have a formal diagnosis, have accessed services and/or received treatment. This includes people who describe themselves as a ‘peer’, ‘survivor’ and ‘expert’ by experience" (National Mental Health Commission, nd, Australian Government).

  • Consumers, families and carers may use their lived experience to inform student perceptions and assist to shape the future mental health workforce.
  • Students may bring a fresh perspective to the consumers or allow opportunity for more intensive interventions.
  • Students bring a greater diversity of perspectives to the treating team.

• Benefits of student clinical placements - for the student

  • Promotes understanding of holistic practice and the importance of valuing lived experience.
  • Challenges perceptions and may reduce the stigma and assumptions about mental health conditions and recovery processes
  • Increases understanding of their own mental health and wellbeing.
  • Increases understanding of mental health interventions and treatment planning
  • Increases understanding of ‘designing for diversity’ in mental health to ensure that vulnerable or diverse populations (for example: all cultural and linguistic groups, including Aboriginal and Torres Strait Islander Peoples, culturally and linguistically diverse communities, refugees and asylum seekers, women and gender-diverse people) have the same level of access to the same services.
  • Enables students to understand the relationship between physical and mental health and the interface with health care services.
  • Enables development of transferable skills for all areas of clinical practice, including communication and development of therapeutic relationships, and counselling micro-skills.

   

  In this video, Jamie Williams describes her experience of participating in a Mental Health student placement.  Then, listen to Wendy Szatkowski discussing the opportunities that can be gained by participating in a mental health student placement in the second video.

  
  

   

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• References - student placements in mental health

  Please Note: References remain valid until superseded by later research. The resources referenced here are regularly reviewed and are considered current and relevant to the topics presented.              

  World Health Organisation (2018) Mental Health:  Strengthening our response. https://www.who.int/news-room/fact-sheets/detail/mental-health-strengthening-our-response

  National Mental Health Commission (nd) Consumer and carer engagement: a practical guide.  Australian Government.  Accessed March 2021 from:  https://www.mentalhealthcommission.gov.au/getmedia/afef7eba-866f-4775-a386-57645bfb3453/NMHC-Consumer-and-Carer-engagement-a-practical-guide

  Australian Bureau of Statistics (2018) Mental Health.  https://www.abs.gov.au/statistics/health/health-conditions-and-risks/mental-health/latest-release

  Australian Institute of Health and Welfare 2017. Mental health services—in brief 2017. Cat. no. HSE 192. Canberra: AIHW

  Australian Government (2021) Mental Health Services In Australia – Australian Instititute of Health and Welfare. https://www.aihw.gov.au/reports-data/health-welfare-services/mental-health-services/overview

  Productivity Commission 2020, Mental Health, Report no. 95, Canberra

  Foster, K., Withers, E. Blanco, T., Lupson, C., Steele, M., Giandinoto, J. A. & Furness, T. (2019) Undergraduate nursing students' stigma and recovery attitudes during mental health clinical placement: A pre/post-test survey study. International Journal of Mental Health Nursing. 28(5):1065-1077. https://doi.org/10.1111/inm.12634.Epub 2019 Jul 23. PMID: 31338978.

  Happell, B., Gaskin, C. J., Byrne, L., Welch, A., & Gellion, S. (2015) Clinical placements in mental health: a literature review. Issues Mental Health Nursing. 36(1):44-51. doi: 10.3109/01612840.2014.915899. Epub 2014 Nov 14. PMID: 25397660.

  Mental Health Coordinating Council (2013). Scoping Report: Mental Health Workforce Professional Entry Practice Placements in the NSW Community Managed Mental Health Sector – a NSW Pilot Study. MHCC, Sydney.

  Pepin, G., (2013). Working in Mental Health. In Stagnitti, K., Schoo, A., & Welch, D. (Eds). Clinical and Fieldwork Placement in the Health Professions (2nd ed.)(pp.95-127). South Melbourne: Oxford University Press.

  Bagatell, N., Lawrence, J., Schwartz, M., & Vuernick, W. (2013) Occupational Therapy Student Experiences and Transformations During Fieldwork in Mental Health Settings, Occupational Therapy in Mental Health, 29(2), 181-196. https://doi.org/10.1080/0164212X.2013.789292

  Occupational Therapy Practice Education Collaborative-Queensland (2017) 'Why supervise a student'. https://otpecq.group.uq.edu.au/education-placements/why-supervise-student.

  Victoria Health (2021) Diversity. https://www2.health.vic.gov.au/mental-health/rights-and-advocacy/diversity

   

Student prep for MH placements

• Generic placement resources

  Mental Health Coordinating Council’s Practice Placements in the Community Managed Mental Health Sector project’s Placement Guide (Appendix 12)

  Mental Health Professional Online Development (MHPOD) This webisite provides an introduction to effective working within the multidisciplinary mental health team, which may assist supervisors to introduce the benefits and considerations of teamwork in mental health practice.

• Knowledge and understanding resources

  Core Principles

  You might consider locating some of your local resources to support student learning and understanding of the frequently used therapies, interventions or management approaches that are utilised in your mental health practice setting.  This might include:

  • The recovery approach:

  Queensland Centre for Mental Health Learning “Real lives, Real People, Real Journey’s:  Sharing responsibility for recovery

  • Trauma informed care: 

  Trauma informed care for alcohol and other drug practice

  Trauma informed care - Implementation resource centre

  Blue Knot Health professional resources on trauma informed care

  Orygen:  Trauma resources

  Supervisors should create a space where students are provided with an opportunity to develop specific skills.  This may occur through the exploration of evidence-based materials, or use of practical resources and reflection (for example role playing or discussion of case studies).

  Mental Health Professional Development Online

  The mental health professional online development (MHPOD) website contains a comprehensive set of evidence-based, open access, eLearning modules for the mental health to broaden student understanding of skill requirements in the mental health field.  These can be used as an introduction to the placement, during orientation or throughout the placement as learning tools for student supervision sessions.

  Mental Health Act

  When working with clients in the mental health setting, students are working with potentially vulnerable persons who may or may not be able to make their own decisions about healthcare, finances or daily activities.  It is important that students are aware of the legislation that governs health professionals practicing under these conditions.  Mental Health Human Rights Acts are examples of legislative documents that explore human rights and reflect contemporary practice, international, national and state policy directions and broad community expectations.

  • Mental Health Acts for Australian States and Territories
  • Australian Human Rights Commission

  Mental Health First Aid

  Mental health first aid is the assistance provided to a person developing a mental health problem or in a mental health crisis until appropriate professional treatment is received or until the crisis resolves (Mental Health First Aid Australia, 2019).

  The plan looks like this (image): 

  

  Retrieved from:  https://mhfa.com.au/about/our-activities/what-we-do-mental-health-first-aid

  Mental Health First Aid TM (MHFA) Australia, is an Australian not-for-profit health promotion charity focused on training and research.  They provide a series of training courses and practice guidelines to support skill development in mental first aid for different population groups, mental health conditions and settings.

  Language guides in mental health care settings

  The use of language in mental health settings is important to reduce stigma and discrimination.  The following are examples of language guides that could be provided to students prior to their placement to draw their attention to the use of inclusive language:

  • Everymind Language and Stigma
  • NSW Health:  What is appropriate language when speaking with someone living with a mental health condition?
  • Mental Health Coordinating Council Recovery oriented language guide
  • The Power of Words:  Having alcohol and other drug conversations:  A practical guide

  Ethics in mental health care settings

  The MHPOD module ‘Professional Ethics’ provides an overview of the core ethical responsibilities and behaviours of mental health professionals, as part of Australia’s National Mental Health Strategy.

   

• Specific pre-placement training resources (relevant to the practice setting)

  You might also consider locating resources that provide an understanding of the context of the mental health care setting in which the student will be undertaking their placement.

  Working with people who have a lived experience of substance misuse or addiction

  • Insight are specialist providers of no cost alcohol and other drug training, education, clinical resources and practice advice.  These resources may be of use to student supervisors for student placements.
  • Dovetail Student Placement Toolkit:  This toolkit has been developed to support student placements and is relevant for all students or workers who wish to enhance their alcohol and other drug (AOD) knowledge.
  • Insight Myths and Misconceptions (00:17:44) is a video that explores the lived experience, stigma and discrimination associated with mental health diagnoses.  (Please note, Insight have indicated that this video resource has been designed as an educational resource and is not aimed at general distribution to the public) 

  Working with children/child safety in a mental health setting

  In some mental health settings, children can be involved and are a particularly vulnerable group of consumers.  Students need to be familiar with identifying potential for harm to children and the reporting requirements if the situation arises.  Resources to support student learning include:

  • Queensland Health has an open access, educational resource: Child abuse and neglect education module, Responsibility, recognising and reporting: A resource for the interdisciplinary team, which aims to develop capabilities associated with child abuse and neglect, such as the ability to recognise abuse and reporting requirements  
  • The Department of Communities has produced a resource on how to complete a child safety assessment.
  • Children of Parents with a Mental Illness (COPMI) is a website that contains comprehensive resources for support and working with parents who have mental health problems
  • Emerging minds provides a series of free eLearing modules that explore child mental health, trauma in childhood, domestic violence and engaging with parents and children in a mental health context.  Foundational modules, which may be appropriate for students undertaking a placement in a mental health context, include 
    • Understanding child mental health
    • Impact of trauma on the child
    • Engaging Parents – an introduction
    • Engaging with Children:  A foundation
    • Family and domestic violence and child-aware practice
  • MHPOD eLearning module: “Child and Adolescent Mental Health Services (CAMHS) and youth MH: conditions and assessments”

  Working with Aboriginal and Torres Strait Islander Peoples in a mental health setting

  When working with a person of Aboriginal or Torres Strait Islander background, there are specific cultural requirements to consider. Resources to support students’ learning include:

  • Beyondblue:  Introductory interview recorded with a Social Worker, Josephine Battaglini, who works with an Aboriginal and Torres Strait Islander community in the Northern Territory. She discusses her recommendations for working with people who have depression and anxiety.
  • Beyond blue:  Beyondblue has a list of tip sheets and guidelines specific to Aboriginal and Torres Strait Islander Peoples, addressing a range of mental health conditions such as depression, panic, drinking problems, eating disorders, suicidal thoughts and behaviours, non-suicidal self-harm, psychosis, traumatic events, problem substance use and problem drinking use
  • Australian and Torres Strait Islander Peoples’ Mental Health is a website devoted to the mental health of Australia’s First Peoples. It contains a range of resources such as guidelines, key issues, and online learning modules. 
  • MHPOD eLearning module: Mental health care for First Peoples
  • QCMHL eLearning module: Cultural capability for mental health
  • Emerging Minds: Working with Aboriginal and Torres Strait Islander Families and Children Toolkit

  Working with Culturally and Linguistically Diverse People in a mental health setting

  Resources that provide an introduction to mental health practice in various cultural groups include:

  • Queensland Transcultural Mental Health Centre - eModule: Cultural Considerations in Mental Health Assessment
  • QCMHL eLearning : Couse QC52 Cultural capability for mental health
  • MHPOD eLearning module: “Cultural awareness” and “Culturally sensitive practice”

  Working with older people in a mental health setting

  MHPOD eLearning contains two introductory modules relating to care of older people with mental ill health:

  • Mental health for Older Persons:  Conditions and assessments
  • Mental health for Older Persons:  Interventions (approaches to mental care for older people)

  Other resources for working with older people in a mental health setting:

  • Black Dog institute fact sheets:  Depression in Older People
  • RANZCP Position statement: Psychiatry services for older people
  • Health Direct - Older people and mental health
  • Australian Human Rights Commission:  Elder Abuse
  • ClinEdAus – Dementia subpage
  • Gold Coast Health – Mental Health (YouTube channel)

  Risk assessment and safety planning

  Students and health professionals need to be able to identify potential risks and respond to these in an appropriate manner. In the mental health setting, students may need to complete a risk assessment. Resources, which focus on risk assessment and safety planning, include:

  • MHPOD eLearning module: Risk and protective factors - This module aims to assist you to identify the range of factors that place an individual at risk of, or protect against, mental illness (risk and protective factors).  It also describes the stress vulnerability model and simulates the use of stress vulnerability model in practice
  • MHPOD eLearning module:  Risk assessment and management - This module is identifies the range of principles and tools available to support practitioners in the assessment and management of risk
  • QCMHL eLearning module:  Course QC48 Mental state examination (fee for access)
  • QCMHL eLearning module: Course QC54 Foundations of risk assessment and management (fee for access)

  Suicide prevention and risk

  Resources available on risk assessment and prevention include:

  • MHPOD eLearning module:  Strategies for Working with People at Risk of Suicide
  • Mental Health First Aid:  Suicidal thoughts and behaviour
  • Conversations matter:  Someone thinking about suicide
  • Royal Australian and New Zealand College of Psychiatrists:  Health Services - Supporting team members after the suicide of a patient
  • The following resources have also been developed by the Royal Australian and New Zealand College of Psychiatrists to support student supervisors in psychiatry, but can also be applied to allied health supervisors and settings:
    • For those in Psychiatry Training - Coping with a patient suicide
    • Psychiatry Supervisors -   Supporting those in psychiatry training after the suicide of a patient

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• References - student preparation for mental health placements

  Please Note: References remain valid until superseded by later research. The resources referenced here are regularly reviewed and are considered current and relevant to the topics presented.

  National Association of Social Workers Association of Social Work Boards. (2013). Best Practice Standards in Social Work Supervision. Washington DC.

  Pargiter, R., & Coverdale, J. (2007). The Ethical Dimension. In S. Bloch. & B. Singh (Eds.), Foundations of Clinical Psychiatry (2nd ed.) (pp.32-42). Melbourne: Melbourne University Press.

  Queensland Government. (2016). About the Mental Health Act. https://www.health.qld.gov.au/clinical-practice/guidelines-procedures/clinical-staff/mental-health/act

  Queensland Health (2021). Occupational Therapy Clinical Education Program Mental Health resource index 2021

  Kitchener B., & Jorm, A. (2002). Mental health first aid training for the public: evaluation of effects on knowledge, attitudes and helping behaviour. BMC Psychiatry, 2(10.https://doi.org/10.1186/1471-244X-2-10

  Mental Health First Aid International (2025). Mental Health First Aid. https://www.mhfa.com.au

  Core Competencies and Measurement Criteria for Beginning Clinicians in Specialist Mental Health Services for Older People (SMHSOP). https://www.health.nsw.gov.au/mentalhealth/resources/Documents/core-competencies-smhsop.pdf

Questioning techniques

• Questioning techniques to advance learning on clinical placements

  Questioning techniques to advance learning on clinical placements

  When possible, rather than ‘telling students what to do’ when confronted by a clinical problem, a supervisor should attempt to help the student solve the problem by asking them specific questions. This helps develop clinical reasoning skills and professional competence and confidence. In the video below, Wendy, a clinical education liaison manager from the School of Health and Rehabilitation Sciences at the University of Queensland, explores how questionning techniques evolve over a student placement:

   

• Advanced Questioning

  Advanced Questioning

  Advanced questioning refers to the skill of asking questions, requiring the student to think and respond in increasingly more challenging (deeper) ways.

  1. Bloom’s Taxonomy (1956, cited in Health Education & Training Institute, 2011, p 33) provides practical examples of the progressive sequencing of cognitive demands. 

   

  Highest Level of Thinking	Creating  e.g. What would happen if ….?
  	Evaluating e.g. Is there a better solution to....?
  	Analysing e.g. How was this similar to .…?
  	Applying e.g. How are you going to do this in practice?
  	Understanding e.g. What do you think?
  	Remembering e.g. What happened after?

  A comprehensive table of questions to develop each category of thinking can be found in Appendix A of the Learning Guide (Health Education & Training Institute, 2011, p 73).

  2. Probing questions are used to help learners think through their responses more thoroughly. Examples include:

  • Can you be more specific?
  •  In what ways is that relevant?

  3. Metacognition i.e. encouraging the student to “think about how/why they think” incorporates self-regulation and self-monitoring:

  • What makes you think that?
  • Why did you make that decision?  What were the influences?

  The Superguide refers to other guided questions that encourage independent thinking and problem solving, such as:

  1. What approach are you taking in this situation and why?
  2. Can you explain the steps of the task/treatment/intervention and why they are completed in this way?
  3. What outcomes do you want and how can they be achieved?
  4. What is your action plan if this approach does not work?
  5. What values, attitudes, knowledge and/or skills are being challenged in this situation?
  6. How would you approach the situation next time?

   

• Coaching questions to facilitate clinical decision-making and clinical reasoning with students

  To facilitate clinical decision-making and clinical reasoning skills, student supervisors should consider the questions that they ask themselves.  These questions have value as a teaching and scaffolding tool as they can provide concrete examples of the thinking steps that underpin clinical reasoning.  This can assist students to make the 'jump' from data gathering to making clinical decisions on diagnosis and treatment.

  'Delaney, Golding and Bialocerkowski (2013) in 'Teaching for thinking in clinical education: Making explicit the thinking involved in allied health clinical reasoning' developed a series of questions that can be used by student supervisors to enable students to think and reason like expert health professionals.  Students can also use these questions as a self-reflection activity to increase clinical reasoning skills.

  Clinical role - Questions students can address to determine their clinical role Why am I here? What is the purpose of my role for this person? What can I provide? What are the limitations of my role? What is the purpose of the referral? What do doctors think the prognosis will be? After my intervention, will there still be ongoing issues for the patient? • Who do I need to refer to? Knowledge: Questions students can address to isolate relevant clinical knowledge What is the profile of the patient? What do I need to know for this patient? What information do I need before I start? How does this relate to what I already know? What is the priority? What things about this patient problem will impact on my assessment? Teaching for thinking in clinical education What information should I gather through my subjective and objective examination? What are the problems that need to be assessed? What has been done prior? What has been effective? Do I have enough social information? What have other members of the health team found? What tools do I have available to me? Which assessment or diagnostic tool is going to provide me with the best information? What anatomic structures are involved? What are the connections between the presenting problem, history and patterns? Patient perspective: Questions students can address to integrate the patient narrative and context with their clinical knowledge Who is the patient? What are their concerns, medical conditions, social situations, culture and home environment? Why did the patient present at the hospital? Are there any other issues with vision/hearing/strength/balance/ co-ordination/cognition/pain that impact the patient’s safety/ability to manage at home? What level of function did they have? Where are they now? Where do they want or need to get to? Is the patient/carer aware of my intervention? What would be the best outcome from the patient’s perspective? What actions do I need to take to achieve this outcome? Do I feel I have a full picture of the patient’s lifestyle? What level of questioning can this patient tolerate?

  ---

  References:

  • Delany, C., Golding, C., & Bialocerkowski, A. (2013). Teaching for thinking in clinical education: Making explicit the thinking involved in allied health clinical reasoning. Focus on Health Professional Education, 14(2), 44–56. https://search.informit.org/doi/10.3316/ielapa.344079003268797Christiansen, C., & Baum, C. (1997). Enabling function and well-being (2nd ed.).  Thorofare: Slack

Providing feedback

• Preparing for a feedback session

  Preparing for a feedback session

  Before you provide feedback, it is important to consider your expectations and share these with the student.  Preparing for a feedback session should involve:

  

   You may find it useful to consider the evidence on feedback models and methods to assist you in preparing and planning your feedback session.

• Giving quality feedback

  Giving quality feedback

  Quality feedback needs to be:

  • Focused on patient centred care
  • Timely and in an appropriate setting
  • Objective, specific, constructive, and balanced.

  This next video explores these elements in more detail:

  A feedback session that incorporates the components identified in the video above, should be a dialogue between two people, i.e., you (the supervisor) and the student:

  • Encourage two-way discussion through use of active listening and elements of advanced questioning. 
  • Remember to be aware of you and your student’s body language and moderate how fast you’re talk during the session. 
  • Use pauses to allow the student to consider the feedback and seek clarification if they require.
  • Provide students with an opportunity to comment on the  feedback and to provide explanations for their performance. It is important to remember that students may not be used to receiving feedback or their previous experience of feedback may have been poor. Be prepared for an emotional response from the student, and encourage them to take a break if required.
  • Monitor for understanding.  Allow time and provide opportunity for the student to react, reflect and respond. This might be by including statements or questions like: “Let’s decide together on the action plan required to address the feedback".  

  Asking the student for feedback on the supervision provided can also be good role modelling. This can assist to promote a work culture where ‘feedback’ is the norm.  It also aids in the development of the student-supervisor relationships, and it may identify ways in which you can improve your supervisory skills.  It can also reduce a perceived power imbalance if you, the supervisor, reveals your own vulnerabilities and acknowledging that your learning is ongoing.

  In the figure below, Weallans and colleagues (2021) explore the sequential process of providing feedback:

   

   

• Barriers to effective feedback

  Barriers to effective feedback

  There are many barriers to providing effective feedback, including: 

  • Lack of supervisor confidence in the delivery of feedback and fear of upsetting the student can affect the student supervisor relationship and be a barrier to the delivery of effective feedback
  • Language and cultural differences that affect the way feedback is given and received can also be a barrier to effective feedback if not managed appropriately.
  • Not having sufficient time to provide constructive feedback
  • Feedback that is considered a criticism rather than being constructive

  In this video, Dr Hayden Richards discusses how to seek constructive feedback (05:55)

• Video Scenarios: Ineffective and Effective Feedback

  Video Scenarios:  Ineffective and Effective Feedback

  These four scenarios explore the impact of communication skills on feedback to a student on placement. 

  In scenario 1 the student supervisor provides the student with his view of the session. The feedback is clear and specific but not constructive. The student supervisor does not acknowledge what the student has done well. He does not use positive body language and fails to interpret the student's body language while giving feedback.	In scenario 2 the student supervisor's message is not clear and the student is left wondering about the key take home messages including how to improve their performance.
  In scenario 3 the student supervisor is positive about the student's performance, but time poor.	In the final scenario, the student supervisor has well-developed and effective communication skills. The feedback process facilitated a discussion where the student is engaged and reflects on her performance.

   

• Useful resources

  Useful resources

  Fact sheets and guides

  • GUIDE - University of Adelaide - Active Listening Learning Guide - Active listening is a skill that greatly enhances the efficacy of feedback, reflective practice and facilitation of clinical reasoning. It demands alertness on the part of the listener (Trevithick, 2000 as cited in Health Education & Training Institute, 2012), aiming to understand the intended message as well as the content. 
  • FACT SHEET - Framing Feedback
  • FACT SHEET - Briefing and Debriefing - Briefing and debriefing can be simple interactions between the supervisor and student and can have long lasting effects on how the student placement unfolds. The purpose of briefing is to optimise student learning by addressing student expectations and feelings about new and unfamiliar
  • VIDEO - This video ‘Briefing and debriefing’ (02:12), presents tips for briefing and debriefing in a mental health care setting .

  ELearning professional development

  • Supporting Health students in the workforce Tasmanian Clinical Supervision Learning Package for Health Professionals has been developed to help guide and support clinical education and supervisor training activities in Tasmania. The 4^th module in the series of open access eLearning modules is on ‘Constructive feedback’
  • PEP Module 6:  Feedback and evaluation:  This interactive learning module provides supervisors and students with practical tips and strategies to ensure feedback and evaluation are a positive and rewarding experience.
  • University of Sydney - Effective feedback learning module

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• References - Providing feedback

  References:

  Please Note: References remain valid until superseded by later research. The resources referenced here are regularly reviewed and are considered current and relevant to the topics presented.

  • ACT Government, (nd) ACTPS Performance Framework:  The Art of Feedback:  Giving, seeking and receiving feedback.  Accessed November 2020 from https://www.cmtedd.act.gov.au/__data/assets/pdf_file/0003/463728/art_feedback.pdf
  • Duffy, K., (03.04.2013). "Providing constructive feedback to students during mentoring". Nursing standard (0029-6570), 27 (31), p. 50.
  • Hardavella, G., Aamli-Gaagnat, A., Saad, N., Rousalova, I., & Sreter, K. B. (2017). How to give and receive 
feedback effectively. Breathe (Sheffield, England), 13(4), 327–333. https://doi.org/10.1183/20734735.009917
  • Health Education and Training Institute (2023). Clinical supervision: The superguide: a handbook for supervising allied health professionals https://www.heti.nsw.gov.au/education-and-training/our-focus-areas/allied-health/clinical-supervision
  •  Health Education and Training Institute (2023). Clinical supervision: The Learning Guide a handbook for allied health professionals facilitating learning in the workplace. https://www.heti.nsw.gov.au/education-and-training/our-focus-areas/allied-health/clinical-supervision.  
  • Health Workforce Australia (2013). Enabling Clinical Supervision Skills. Griffith University, Gold Coast.
  • Johnson CE, Keating JL, Molloy EK. Psychological safety in feedback: What does it look like and how can educators work with learners to foster it?. Med Educ. 2020;54:559-570. https://doi.org/10.1111/medu.14154
  • Weallans J, Roberts C, Hamilton S, Parker S. Guidance for providing effective feedback in clinical supervision in postgraduate medical education: a systematic review. Postgrad Med J. 2021 Feb 9:postgradmedj-2020-139566. doi: 10.1136/postgradmedj-2020-139566. Epub ahead of print. PMID: 33563716.

   

Practical ways to start difficult conversations

• When you notice a difficult conversation might be required

  If you have concerns about a student's performance or behaviour, then you should contact the university placement coordinator to discuss your concerns, understand your role and expectations (for example documentation that may be required), and clarify the additional assistance that can be negotiated for both you and the student.

• How you can prepare for the conversation

  How you can prepare for the conversation

  Reflect on the current situation and the conversation ahead. Ask yourself these questions, and determine what actions you might need to take before speaking with the student:

  • Does the placement provide a culture of quality (quality relationships, quality learning and best practice)?
  • Am I providing effective supervision?  You may like to consider some of the supervisor evaluation and reflection tools to answer this question.
  • Have you made any assumptions about the student and/or their performance?
  • Is the placement providing the student with learning opportunities in a supportive environment?
  • Is there effective communication and collaboration between students, the university and placement site?
  • Are there adequate resources and facilities to conduct placement activities?

• Before the conversation

  Before the conversation

  It is important that you spend some time planning the conversation.  You might find it useful to ask yourself the following questions:

  • Why do you want to have this conversation?  What is the purpose?  Is this purpose supportive for the student? 
  • What do you want to achieve?  What is an ideal outcome?  Is this ideal realistic or suitable for the student/setting/supervision?
  • Is your mindset positive?  Will there be positive outcomes from the conversation even though it is difficult?
  • Is the student aware that there is a problem?  How will they perceive it?
  • Do you think that third party support from the university will help you clarify the issue and be objective?

  Seek advice from your university coordinator to identify and complete any documentation required for the conversation.  Ensure that you have all documents that are relevant (for example, competency or assessment forms)
   
  Choose a time and place where you will both feel comfortable and will not be rushed or interrupted. Allow time for the student to prepare for the conversation if required.  The university coordinator may be able to provide the student with tools or templates to help them prepare. 

  Consider the room layout and positioning – sitting next to someone is less confronting than sitting opposite someone.

  Plan what you are going to say by writing down the key points you need to cover.  Think about what information you want to get from the student and write questions that will help you gather that information.  You may find it useful to review the following resources prior to the conversation:

  •  Effective Relationships
  •  Questioning Techniques
  •  Providing feedback

• The actual conversation

  The actual conversation

  Remember that you don’t actually need to talk that much during a difficult conversation. If you use neutral and supportive questions that are task related, you can focus on listening, observing and gathering as much information from the student as possible.  The student will also feel that they are being heard, and in turn will be more likely to then hear you.

  Here are some practical tips for starting your conversation:

  • Begin the conversation by explaining the purpose of the meeting and the problem you are discussing and seeking to resolve.
  • Start your sentences with ‘I’. This helps reinforce that it is your perspective and that it is ok if people have different perspectives.  First describe the behaviour or the problem, then explain the feelings or thoughts it leads to, and the outcomes that result.  For example:
    • ‘When I observe you….I feel like you might need to spend more time on….as it impacts on the outcomes with the client in this way…. ‘ 
  • Some other ‘I’ questions you might find useful in initiating conversation include:
    • I would like to discuss…with you as I think it will help us work together more effectively
    • I’d like to talk about how that client interacted with you, but I’d like to get your point of view first…
    • I think that we may have different expectations about how your workload should be managed, and I’d really like to get your thoughts on this…
    • I’d like to see if we’re on the same page with respect to ….  I want to hear your thoughts, and I’d like to share mine as well.
  • Once you have employed active listening techniques to gather the student’s perspective, you may need to use probing questions to assist the student think through their response more thoroughly, while also ensuring that you understand their perspective and thoughts.  Some examples might include:
    • Can you be more specific?
    • What makes you think that?
    • How do you see it?
    • How might other people see this?
    • In what ways is that relevant?
    • What is going on in this problem or situation?
    • Do you think we both have the entire picture?
    • Is this situation like something that you have experienced in the past?
    • What do you think are the best ways to manage this situation?
  • Once you have started the conversation and have gathered the information you require from the student, it is important that you then explain to the student what you have understood from them, and provide the student with an opportunity to correct you if they feel that their views have been misrepresented:
    • I want to make sure I understand you….
  • You may then need to share your perspectives in relation to their views.  Give specific examples and refer to client sessions, documentation, and other interactions. For example:
    • From what you have told me, I can see why you have that view.  I want to let you know how I see it, and then we can see where we go from there…
  • If you notice that the student is getting upset or frustrated, acknowledge this using ‘I’ statements, for example:
    • I can see that this has been frustrating for you’
  • It’s important to then collaboratively identify solutions or plan the future direction.  Suggest how to move forward and resolve the situation, rather than making demands, and be sure to ask the student to make suggestions that contribute to a positive outcome.  Use phrases like:
    • ‘I’d prefer’
    • ‘I think’
    • ‘I wonder whether’
  • You then need to finalise the conversation.  Write down the action points, dates and next steps and seek agreement with the student and university coordinator (if present). For example
    •  'How do you feel about that?'
    • 'How does that sound to you?'
  • Close the conversation by thanking the student for their input.  For example:
    • 'I want to thank you for being open to this and for taking this feedback on board'.

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• References - Practical ways to start difficult conversations

  References:

  Please Note: References remain valid until superseded by later research. The resources referenced here are regularly reviewed and are considered current and relevant to the topics presented.

  • Siggins Miller Consultants (2012). Promoting quality in clinical placements: Literature review and national stakeholder consultation. Adelaide: Health
  • Occupational Therapy Practice Education Collaborative-Queensland (OTPEC-Q) (2018). Working through challenges on placement Retrieved from: https://otpecq.group.uq.edu.au/education-placements/working-through-challenges-placement/when-concerns-exist-0
  • Occupational Therapy Practice Education Collaborative-Queensland (OTPEC-Q) (2018). When the student is struggling Retrieved from:  https://otpecq.group.uq.edu.au/education-placements/working-through-challenges-placement/struggling-student
  • Harvard Business review (2017) How to have difficult conversations when you don’t like conflict.  Retrieved November 2021 from:  https://hbr.org/2017/05/how-to-have-difficult-conversations-when-you-dont-like-conflict
  • Ringer, J (nd) We Have to Talk: A Step-By-Step Checklist for Difficult Conversations.  Retrieved November 2021 from: https://www.judyringer.com/resources/articles/we-have-to-talk-a-stepbystep-checklist-for-difficult-conversations.php
  • Williams, B., King, C., & Edlington, T. (2016). Overcoming difficult conversations in clinical supervision. Journal of healthcare leadership, 8, 31–40. https://doi.org/10.2147/JHL.S96592
  • Australian Government – Fairwork Ombudsmen (nd) Manager’s guide to difficult conversations in the workplace.  Retrieved November 2021 from:  https://www.fairwork.gov.au/sites/default/files/migration/712/managers-guide-to-difficult-conversations-in-the-workplace.pdf

Managing difficult situations - supervisor tools

• A framework for managing difficult situations on clinical placements

  Many organisations and learning institutions have their own frameworks in place to assist clinical educators in taking action to identify and manage students in difficulty.  The following strategies and considerations are suggested by The Queensland Occupational Therapy Fieldwork Collaborative (2007) when addressing concerns that are impacting on a student’s ability to perform on placement:

  Identify the problem

  • Raise the concerns you have early and provide the student with specific examples of the behaviour you have observed.  This includes providing timely feedback throughout the placement.

  Explore the background to the problem

  • ­Provide opportunity for the student to reflect on the feedback provided and discuss the background and contributing factors to any difficulties.  Use of active listening and open questions are useful skills to demonstrate in discussion with the student.

  Be Supportive

  • ­Provide the opportunity for the student to explore solutions to the issues raised before problem solving for the student.
  • Consider the student’s preferred learning style and any fears or anxiety they may have.
  • Direct the student to formal counselling support through their university if the need is identified and the student expresses readiness for this support.  Contact the specific university placement coordinator for guidance.

  Develop a strategy

  • ­Once the issue has been isolated, brainstorm solutions with the student.
  • Strategies and outcome measures should be established so the student has clear expectations and opportunity to gain competency in the desired skill.

  Maintain confidentiality

  • ­Universities require that confidentiality relating to academic and clinical performance, university grades and personal issues raised during supervision is protected while on placment.

  Document the process

  • ­Include all important observations, discussions and decisions in minutes of the supervision sessions ensuring the supervisee and clinical educator have a copy of the documents including agreed strategies and timeframes.

  Seek support

  • ­Clinical educators can seek the support of other clinicians or the supervisor at their workplace regarding their concerns, being mindful of confidentiality.
  • Throughout the process of working with a student in difficulty, it is vital to remain in contact with the placement coordinator at the university. The clinical educator may feel the issues can be remediated during the course of the placement, however, communication with the university can assist the placement coordinator in planning subsequent placements and ensure the student has demonstrated their ability to implement the skills they have been taught (Nemeth, E and McAllister, L. 2013).

  Review and evaluate outcomes

  • ­Ensure that dates for review and final evaluation are agreed on with the student and that feedback regarding the specific issue is provided in a timely manner.  Strategies may require review and modification depending on the student’s progress.

   If the student continues to underperform and not implement the agreed strategies, the clinical educator may need to fail the student.  Failing a student is difficult for the student and the clinical educator and the response from the student may vary depending on their readiness to learn from the experience.  Nemeth and McAllister (2013) describe readiness to learn as a student’s “readiness to use the experience of failure in fieldwork placement as a catalyst to alter perceptions of themselves and their worldview… The experience of failure … can become a transformative learning experience” (p 117).  Students who are not ready to learn from the experience and accept the failure can become angry, depressed or remain in denial and blame their clinical educator (Queensland Occupational Therapy Fieldwork Collaborative, 2007; Nemeth & McAllister, 2013). Intervention from the university placement coordinator is required to ensure supports and strategies are put in place to provide the student with their options, and support the clinical educator.

  Troubleshooting

  Preventing observed difficulties becoming a crisis is key to the management of a challenging clinical education experience. The Griffith University Physiotherapy Clinical Education Resource Manual (2013) lists some advice gathered from students on ways for clinical educators to troubleshoot difficulties with students including:

  • Be friendly.
  • Be approachable.
  • Let students know from day one that you want questions to be asked.
  • Let students know they are there to learn, not be examined.
  • Find out what the student wants from the placement.
  • Make sure the student knows that it does not matter if they answer a question incorrectly.
  • Do not be intimidating.
  • Give positive feedback as well as constructive criticism.
  • Find out the way the student likes to learn – if they need observation first or if they like to get in and try first.
  • When possible, give tutorials.

  (Griffith University, 2013, p 68).

  Barriers to supervision by the clinical educator are outlined by the Health Education and Training Institute (2012) and include being absent, ridged, intolerant or irritable, telling instead of coaching and exhibiting a ‘blaming’ attitude. These behaviours can lead to student avoidance, anxiety, poor performance and impact on patient care and safety.

  Clinical education frameworks recommend that an agreement or preventative plan is made between educator and student at the commencement of placement on how conflict will be resolved if it arises (Cunningham Centre, 2011).  Including the opportunity to discuss conflict on the agenda for supervision sessions keeps communication open (Western Australian Country Health Service, 2009).

  Siggins Miller (2012) outlines a list of enablers to successful placement. A clinical educator can ask themselves the following questions before and during a placement to enable a successful experience for both the student and themselves:  

  • Does the placement provide a culture of quality (quality relationships, learning and best practice)?
  • Am I providing effective supervision?
  • Is the placement providing the student with learning opportunities that include direct patient care in a supportive environment?
  • Is there effective communication and collaboration between students, the academic institution and placement site?
  • Are there adequate resources and facilities to conduct placement activities?

  Asking these questions prior to the commencement of the student placement can assist the clinical educator in identifying areas for their own professional development in clinical education.  In addition, Siggins Miller (2012) identifies that occupational stress and workplace incivility and aggression are shown to have a significant impact on the quality of a student placement and can lead to underperforming due to stress and anxiety.  A clinical educator can assist in preparing the student for workplace factors in the initial stages of the placement, monitor the impact on the student and provide opportunity to debrief.

  Summary statement

  Managing a student in difficulty is one of the most challenging situations a clinical educator can encounter.  The types of difficulties encountered by the student can be as a result of multifaceted internal or external factors.  A level of empathy and commitment from the clinical educator and university to work with the student is required to achieve the goals of placement.  Successful negotiation through the difficulty requires early identification, open communication, skilled reflective practice and development of a clear plan of action with regular reviews between the student and clinical educator.

  We also advise the Clinical Educator to refer to the Maintaining Emotional Wellbeing section of this website when Managing a Difficult Situation.

• Video scenario for managing difficult situations on student placements

   

   

   

  Back to top

• Resources for managing difficult situations

  Queensland Health have produced a fact sheet for Occupational Therapists working with students who are having difficulties

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• References - Managing difficult situations - tools for supervisors

  References:

  Please Note: References remain valid until superseded by later research. The resources referenced here are regularly reviewed and are considered current and relevant to the topics presented.

  • Occupational Therapy Practice Education Collaborative-Queensland (OTPEC-Q) (2018). The clinical educator’s resource kit Retrieved from:  https://otpecq.group.uq.edu.au/resources-publications/clinical-educators-resource-kit.
  • Nemeth, E., & McAllister, L. (2013). Learning from failure. In Stagnitti, K., Schoo, A., & Welch, D., Clinical and fieldwork placement in the health professions (2nd Ed) (pp. 115 – 127). Melbourne, Australia: Oxford University Press.
  • Griffith University (2013). Physiotherapy clinical education resource manual. School of Rehabilitation Sciences. Gold Coast, Australia: GU.Australian Learning and Teaching Council (2010). A guide to supervision in social work field education (revised edition). Retrieved from: http://socialworksupervision.csu.edu.au/.
  • Health Education and Training Institute (2012). The learning guide: A handbook for allied health professionals facilitating learning in the workplace. Sydney: HETI. Retrieved from: http://www.heti.nsw.gov.au/Global/HETI-Resources/allied-health/allied-health-learning-guide.pdf
  • Siggins Miller Consultants (2012). Promoting quality in clinical placements: Literature review and national stakeholder consultation. Adelaide: Health
  • Health Workforce Australia (2013). Enabling Clinical Supervision Skills. Griffith University, Gold Coast Australia.
  • Western Australian Country Health Service (2009). Foundations to supervision. Perth: Combined Universities Centre for Rural Health and Western Australian Department of Health:  http://www.wacountry.health.wa.gov.au/fileadmin/sections/allied_health/WACHS_G_AH_FoundationsToSupervision.pdf

   

Supporting students' cultural & linguistic divers

• What is a culturally and linguistically diverse university student?

  Within the tertiary education setting, there are two main groups of culturally and linguistically diverse students:

  1. Domestic students: these students may have been born overseas, have a parent born overseas, or speak a variety of languages.
  2. Students from overseas who are completing their tertiary education in Australia.

• Factors to consider when supporting culturally and linguistically diverse students

  In addition to meeting the placement requirements, evidence suggests that student supervisors need to be aware of additional factors when supporting culturally and linguistically diverse students on placement. Supervisors need to:

  • Acknowledge that students will be adapting to new cultures, settings, systems, customs, and languages in the placement setting.
  • Also acknowledge that students will bring diversity in new cultures, settings, systems, customs and languages that might drive creativity and innovation in the placement setting.
  • Identify ways to teach and support students to adopt a problem-based learning approach.
  • Acknowledge that this student group will be adapting to the nuances and expectations of communication (for example, where students need to communicate and negotiate their workplans directly with their supervisors when, in their own culture this communication approach would not be considered appropriate).
  • Identify ways to teach and support student demonstration of language proficiency and awareness of spoken, written and colloquial language.

  This can lead to some culturally and linguistically diverse students:

  • Taking a longer time to adjust into their placement site.
  • Requiring time to understand how their cultural values impact on the way their learning occurs and how this can apply when adjusting to the placement setting.
  • Experiencing difficulties with communications such as:
    • writing
    • negotiating
    • expressing their workplan or ideas with their supervisors
    • following instructions
    • seeking clarification on the expectations of the supervisor and the placement organisation.

  When these issues arise, it is important to remember that every student is an individual and understanding your student is essential. If your student is experiencing difficulty during placement, utilise the ‘Tools For Educators’ as a framework to identify the problem and develop strategies to address it.

  You may also like to use the following strategies/ideas developed by the University of Tasmania with your student to assist them working through any challenges they encounter:

  • Reassure the student that it is normal to feel apprehensive in unfamiliar circumstances – you can provide an example where you have felt this way.
  • Foster respect and improved understanding by encouraging the conversation about the student’s cultural diversity. This can put people at ease and facilitate interpersonal interactions.  If people express a wish to hear more about your story, be prepared to tell only those parts of it that you are comfortable talking about.
  • Suggest the student seek assistance from the University – there will often be student advisors who can support the student through their placement experience

• How can you support culturally and linguistically diverse students?

  In the video below, Anne, a clinical educator in speech pathology at the University of Queensland outlines some factors and strategies to consider when supporting a student from a culturally and/or linguistically diverse background:

   

  Create positive learning environments:

  • Provide a structured and supportive orientation for entry into a new placement setting. Additional time may be required to provide this orientation.
  • Be familiar with the requirements for assessment. Spend time working with the student to be explicit about what they will demonstrate, how, when and why, and how these will link with the assessment.
  • Allow for a flexible approach to placement and consider reasonable adjustment to placement structure if the student requires additional time to adjust to the cultural diversity at their placement setting (not because of the student’s inability to practice).
  • Plan to provide additional time to allow students to connect theory with practice in a placement setting that may be culturally unfamiliar.
  • Use modelling (where relevant) to provide students with an example of how the client interaction could occur. 
  • Provide materials in advance so the student has adequate time to process the language and prepare for the placement experience.
  • Be aware of different learning preferences.
  • Initiate conversation to acknowledge:
    • their experiences
    • their reality e.g., communication approaches
    • the value of their experiences to the university community
    • the existence of, shows interest in, demonstrates knowledge of, and expresses appreciation for the student’s ethnicity and culture.
  • Assist students to achieve their potential including skill development, cultural adjustment, English language proficiency, computer literacy, information literacy etc.
  • Assist students to understand the importance of self-reflection in terms of their performance, development and professional expectations.
  • Set clear expectations.
  • Offer support when experiencing cultural insensitivity or when facing feelings of isolation and uncertainty, and in dealing with racism.
  • Withhold judgment and set your assumptions aside.
  • Acknowledge that cultural generalisations exist, but they do not apply to every individual or every situation

  Use inclusive teaching and language approaches:

  These resources define and provide strategies for inclusive teaching approaches:

  • Deakin University - Inclusive education toolkit: Culturally and Linguistically Diverse students
  • University of Queensland – Inclusive Practice
  • University of Queensland – Inclusive Language
  • Inside Higher Ed – 5 principles as pathways to inclusive teaching

  Use a variety of communication strategies:

  • Be complete, explicit and pay attention to the other person’s response.
  • Be alert for different meanings.
  • Avoid metaphors, colloquialisms and jargon. Define any jargon that you must use.
  • Attempt to be clear while avoiding the over-simplification of terms as it may seem insulting.
  • Always provide a why. Cultural patterns or rules may seem arbitrary if unexplained. If a student is uncomfortable with a decision or situation, explaining why is important, particularly if the issue is non-negotiable.
  • Use a variety of communication strategies such as writing, listening, speaking slower, asking students to repeat an instruction, using visual aids, giving simple instructions, and prompting students to ask questions. This variety is important when providing an introduction to the placement setting, and placement tasks, but equally important when providing performance feedback to the student.  You may like to refer to the 'Providing feedback' page of this website to consider this in more detail.

  Be culturally responsive:

  A culturally responsive supervisor who can discuss and provide guidance on multicultural issues is greatly valued by students on placement and evokes greater student satisfaction with the supervision provided. This includes supervisor awareness of their own biases and values, and reflection on how these biases and values may impact on their assessment, teaching and judgement of students.

  The following resources link to eLearning opportunities, information and tools to support your professional development in becoming a culturally-responsive student supervisor:

  • ClinEdAus - Developing Cultural Awareness
  • SBS Cultural Atlas

  ---

   

• References - supporting culturally and linguistically diverse university students

  References:

  Please Note: References remain valid until superseded by later research. The resources referenced here are regularly reviewed and are considered current and relevant to the topics presented.

  • Australian Institute of Health and Welfare 2018. Australia’s health 2018. Australia’s health series no. 16. AUS 221. Canberra: AIHW
  • Kristina Mikkonen, Satu Elo, Heli-Maria Kuivila, Anna-Maria Tuomikoski, Maria Kääriäinen, (2016) Culturally and linguistically diverse healthcare students’ experiences of learning in a clinical environment: A systematic review of qualitative studies, International Journal of Nursing Studies,Volume 54, Pages 173-187,https://doi.org/10.1016/j.ijnurstu.2015.06.004.
  • UNSW Sydney (20196) Equity Groups: Culturally and Linguistically Diverse (Culturally and linguistically diverse) students.  Accessed October 2021 from: https://www.gie.unsw.edu.au/research/equity-groups-culturally-and-linguistically-diverse-culturally and linguistically diverse-students
  • Brennan, E., Horne-Thompson, A., & Clark, I. (2013). Strategies to support the success of culturally and linguistically diverse health students during clinical placements : a systematic review. Focus on Health Professional Education, 15(2), 78–93. https://search-informit-org.libraryproxy.griffith.edu.au/doi/10.3316/aeipt.201591
  • Siggins Miller Consultants (2012). Promoting quality in clinical placements: Literature review and national stakeholder consultation. Adelaide: Health Workforce Australia. Retrieved from:  https://www.adea.com.au/wp-content/uploads/2013/08/Promoting-quality-in-clinical-placements-report-20130408.pdf
  • University of Tasmania Student Centre (2012). Cross Cultural Awareness and Communication. Retrieved from:  https://www.utas.edu.au/students/shw/cross-cultural
  • Attrill, Stacie & Lincoln, Michelle & McAllister, Sue. (2019). International students in professional placements: supervision strategies for positive learning experiences. 10.1111/1460-6984.12516#.XejH6zgeRA0.twitter.
  • Liikanen, E. (2019). Culturally and linguistically diverse healthcare students’ experiences of the clinical learning environment and mentoring: A qualitative study. Nurse Education in Practice, 41 doi:http://dx.doi.org/10.1016/j.nepr.2019.102637
  • Lee, DC.A., Newton, F., Yu, ML. et al. Supervisors’ experiences in supervising higher education students from culturally and linguistically diverse backgrounds during work-integrated learning of health and non-health courses. High Educ 81, 665–683 (2021). https://doi-org.libraryproxy.griffith.edu.au/10.1007/s10734-020-00567-6
  • O'Reilly, Sharleen & Milner, Julia. (2015). Supporting culturally and linguistically diverse students during clinical placement: strategies from both sides of the table. BMC Medical Education. 15. 175. 10.1186/s12909-015-0458-3.

Supporting disability or medical conditions

• Disclosure

  Students are not required to disclose their disability or medical condition/s to the University or placement site unless it poses a risk to the student’s health or safety or to that of others. Some students successfully manage their disabilities or health conditions with external support, and do not disclose their condition or disability to the University, supervisor or service setting. Other students will opt to disclose their circumstance to university disability support services who can then collaborate with placement facilitators, supervisors and services settings when planning placements.

  “Where a student has not disclosed a disability, teaching and other staff are not responsible for providing education related adjustments (Australian Disability Clearinghouse on Education and Training, 2013).”

  It is the student supervisor’s responsibility to be aware that all disclosures made to them by their student are confidential unless the student gives you direct permission to discuss with another named party (eg. the University representative). The only exception is to ensure Mandatory Reporting obligations are met.

• Inherent requirements

  Inherent requirements or fitness to practice requirements are developed for each university program. Inherent requirements are the core activities, tasks or skills that need to be demonstrated to award the program or course. They do not necessarily specify how a task or skill needs to be accomplished but describe the essential outcomes that need to be demonstrated in order for the task to be carried out in a safe and competent manner.

  They can be used by universities to:

  • Determine eligibility for entry into a particular program of study
  • Assess medical conditions or disabilities
  • Guide reasonable adjustment planning

  They can be used by students to make an informed decision about whether they will be able to meet the requirements for the university program.

  Coursework for a university program and student placements are quite different experiences. It is important to note that a student may be successful in completing their coursework requirements and may not realise that they will not be able to meet the inherent requirements for their chosen program of study until they have commenced on their student placement.

  For some programs of study students may not be able to participate successfully in placements despite the implementation of reasonable adjustments, due to the inherent requirements of the program and the nature of the student’s disability or medical condition.

  Within health professions, inherent requirements might include:

  • Requirements for communication – for example, verbal, non-verbal, written
  • Requirements for cognition – for example, reading, writing, number skills, concentrating, knowledge acquisition,
  • Mental wellness, mental endurance and self-awareness
  • Requirements for sensory skills – for example, visual assessment, observation, listening, tactile ability, smell
  • Requirements for physical tasks - for example, gross and fine motor function

• Reasonable adjustment

  Reasonable adjustment is any modification (physical, intellectual, cultural, religious other) made by the university, supervisor or service setting to assist a student with a medical condition or disability participate or access something on the same basis as someone without the condition or disability. Reasonable adjustments may allow a program’s inherent requirements to be met. However, adjustments will not compromise the integrity of the academic program.

  On placement, reasonable adjustment can be quite complex because each student will have different learning needs, and the placement site might also have it’s own inherent requirements for the health professional role. Some reasonable adjustments might include: placement timing and duration, adjusting hours, type of placement or placement model, aids to support sensory disabilities, decision making tools and templates to support cognition (for example checklists for planning sessions, subheadings to guide report writing, sample case notes).

  The student is often the best resource when determining any barriers that might exist and potential strategies to overcome these barriers. The university placement coordinator will play a vital role in assisting you to develop strategies.

  To support students to navigate the placement experience, it is important the student supervisor:

  • Confirm with the university placement coordinator the university processes for planning and negotiating reasonable adjustments to a placement for a student with a disclosed disability or medical condition. 
  • Prior to the commencement of every student placement, identify support services offered by both the university and the service, so that they are ‘on hand’ should the student wish to seek further support.
  • Establish the organisation’s capacity to accommodate university requests for reasonable adjustment to placement structure (for example, how to manage a part time placement with concurrent student placements and workload demands). Although not a ‘difficult situation’, you may find the steps identified in the ‘Framework for managing difficult situations’ useful when making this determination.
  • Identify if there are specific adjustments that are not reasonable or practicable for your organisation or setting,(for example core contracted working hours, occupational health and safety) and inform the university of these limitations when you make your placement offers.  (The Australian Human Rights Commission provides information relating to reasonable adjustment to support people to complete their duties effectively).
  • Initiate early conversations with the student about their health and wellbeing to normalise and demonstrate the importance of establishing good self-care strategies. This might include a daily routine discussion about how the student is managing their health and wellbeing and the supports that they may need. Share strategies for wellbeing that you and your team have implemented. Alternatively, supervisors can create a ‘safe space’ for sharing of concerns.
  • Identify processes to maintain the safety of the student and the client and provide immediate support for the student. Consider strategies that can be employed before, during and after a triggering event.

  ---

• References: Supporting students with a disability or medical condition

  References:

  Please Note: References remain valid until superseded by later research. The resources referenced here are regularly reviewed and are considered current and relevant to the topics presented.

  • Australian Disability Clearinghouse on Education and Training (2013). Disclosure of Disability. Retrieved from: http://www.adcet.edu.au/Student_Resources/Disclosure_of_Disability.chpx
  • Australian Learning and Teaching Council (2010). A guide to supervision in social work field education. Retrieved from: http://www.socialworksupervision.csu.edu.au/resources/docs/CSU-guide-social-work-field-education.pdf
  • Siggins Miller Consultants (2012). Promoting quality in clinical placements: Literature review and national stakeholder consultation. Adelaide: Health Workforce Australia. Retrieved from: https://www.adea.com.au/wp-content/uploads/2013/08/Promoting-quality-in-clinical-placements-report-20130408.pdf
  • RMIT (nd) Inherent requirements guide. Accessed June 2021 from: https://www.rmit.edu.au/content/dam/rmit/documents/about/policy/program-course/IR%20guidance%20material.pdf
  • University of Technology Sydney (UTS)(nd) Inherent requirements. Accessed June 2021 from: https://www.uts.edu.au/about/faculty-health/clinical-practice/getting-ready/inherent-requirements
  • University of Sydney (nd) Inherent Requirements for Physiotherapy Courses Accessed June 2021 from: https://www.sydney.edu.au/content/dam/students/documents/enrolment/course-requirements/inherent-requirements/physiotherapy-inherent-requirements.pdf
  • University of South Australia (2019) Fitness to Practice in Professional Experience Placements Inherent Requirements. Accessed June 2021 from: https://study.unisa.edu.au/contentassets/c2ed49440edb420f9c53f7548f124e39/fitness-to-practice-in-professional-experience-placements-inherent-requirements_education.pdf
  • University of Queensland (nd) Inherent requirements for education programs. Accessed June 2021 from: https://future-students.uq.edu.au/admissions/inherent-requirements/inherent-requirements-education-programs
  • Sharby, N., & Roush, S. E. (2009). Analytical Decision-making Model for Addressing the Needs of Allied Health Students With Disabilities. Journal of Allied Health, 38(1), 54-62. Available at: http://ingentaconnect.com/contentone/asahp/jah/2009/00000038/00000001/art00009

Virtual supervision

• Advantages and challenges associated with virtual supervision models

  Advantages and challenges of providing virtual supervision are outlined in the table below:

  Table:  Advantages and challenges associated with virtual supervision models

  Advantages

  Challenges

  Uses technology to enhance service delivery Cost and time effective (reduced travel to remote sites, allowing more time for supervision) Opportunity for students to be responsive and flexible

  Potential for less informal learning Communication requires deliberate and careful planning Less opportunity for observing team dynamics, interactions and learning in this way, as supervision is ‘scheduled’ Challenges the traditional view of ‘placement’. Students may feel disappointed or overwhelmed as their perception of placement may be different to their experience of placement Difficulty in assessing students’ performance using practical examinations

   

• Considerations for supervisors planning virtual placements

  In addition to standard preparation and planning for placement activities, supervisors should consider the additional guidance and support that may be required for students who are embarking on virtual placements and/or with virtual supervision.  You may find the following checklist useful when planning a virtual placement:

   

  Checklist for virtual supervision:

  Communication	I have discussed with the student how learning opportunities will be supported and supervised in the virtual placement model.	☐
  	I have discussed with the student how assessment will be supported and implemented in the virtual placement model.	☐
  	I have discussed online communication expectations with the student and provided them with resources to support them learn how to communicate in an online environment.	☐
  	I have scheduled opportunities before and during the placement, for me to get to know the student and to develop a working relationship in the online environment.	☐
  	I have ensured that there are both formal and informal sessions scheduled with the student to promote connection.	☐
  Placement type and progression	I have selected a placement model that fits the health service and virtual placement environment, and university requirements.	☐
  	I have planned the placement to provide the student with the opportunity to progressively immerse themselves in client care, in a structured and developmental manner. For example, starting with setting up online consultations, shadowing virtual health clinics (patient consent required), consulting simple cases (or providing part of the consult) and progressing to a full caseload.	☐
  Informal learning opportunities	I have explored the functionality of the virtual platform to support students while they are working with clients (for example use of messaging/chat function or communicating off screen during supervision sessions).	☐
  	I have scheduled online contact time (i.e., without clients) to ensure professional socialisation for the student with other team members.	☐
  	I have planned local team‐based activities and events so that the students and supervisors can meet in person (facilitated within local restrictions).	☐
  Assessment	I have contacted the university to establish how assessment should be completed in a virtual environment.	☐
  	I have reviewed the assessment criteria/competencies and have considered how they can be demonstrated in a virtual environment.	☐
  	I can join a student-client session as a third party (if the supervisor and student are not co-located).	☐
  Documentation	I have established how client documentation will occur in the virtual healthcare environment and it meets my organisation’s requirements.	☐
  	I have established a process for countersigning health record entries completed by the student (if required).	☐
  Student safety	I have reviewed and I understand my organisation’s and the university’s policies and procedures relating to the use of online supervision and healthcare using videoconferencing platforms and other supporting technology or software.	☐
  	I have provided the student with instructions on how to manage risks in the virtual placement setting. (Consider environmental risks, occupational health and safety, management of emergencies)	☐

• Adjusting in-person placements to virtual health care settings

  Orientation:

  • Visit ‘Preparing for and managing placements’ section of ClinEdAus to consider:
    • Placement model
    • Creating a safe learning environment
    • Pre-placement planning
    • Standard orientation inclusions
  • Consider the additional elements that will be required for student orientation to the virtual placement setting:
    • Training or introduction to the telehealth or other virtual platforms and associated technology
      • technology /digital literacy requirements
      • the back-up plan or troubleshooting problems with technology
      • the emergency plan for acute health or technology problems
      • the processes in place to ensure privacy and confidentiality of client information
    • Setting up the ‘virtual office’
    • Adapting therapeutic skills for the virtual setting
    • Training in virtual assessment / diagnostic / tools

  Placement planning:

  • Liaise with the university about the sequencing of virtual placements (e.g., as a first or subsequent placement) so you understand how the virtual placement model will provide complimentary opportunities for student learning and build skills for contemporary practice.
  • Contact your health professional association to determine if profession-specific frameworks and tools are available to guide placement planning for a virtual health care placement model.

  A note on 'hands on' therapies:

  Some assessments/interventions that are considered ‘hands on’ (e.g., assessment of strength) may not be possible using standard assessments if the client is not in the same location as the student.  Supervisors need to be mindful of the additional support that may be required to assist students to think laterally on how these ‘hands on’ assessments or interventions may be delivered in a virtual health care environment.  This might include:

  • Considering the literature for evidence of ‘hands off’ treatments specific to your profession
  • Providing opportunities for students to practice a technique on each other.  This method of learning on how to perform a technique can then inform the student’s observation or assessment of a client’s performance of this technique in the virtual environment.
  • Focusing on the development of students’ verbal communication skills (in particular their questioning) to ensure they can elicit data from the client in sufficient detail when not in-person. Supervisors may need to ask students to explicitly describe the intervention prior to performing with a client virtually. 
  • Recording client sessions may facilitate the student’s ongoing assessment, interpretation and intervention for the client, when reviewed with the supervisor and feedback is provided in real time (note:  you will need to ensure compliance with your organisation’s policies relating to consent, privacy and confidentiality)
  • Contacting your professional organisation / owner of your professions’ standardised assessment tool to ascertain whether they  have supporting resources to determine how competency assessment relates to a virtual setting when using these tools.

• Virtual supervision resources

  • Ahpra Information paper – good practice approaches to embedding clinical placements, pedagogical innovations and evidence based technological advances in health practitioner education
  • Co-operative education and work integrated learning (Canada) – Tips for onboarding students remotely
  • Co-operative education and work integrated learning (Canada) – Tips for supervising student remotely
  • Australian Collaborative Education Network – guides for online work integrated learning placements and projects
  • Allied Health Professions Australia – Telehealth Guide for Allied Health Professionals
  • Ahpra Telehealth consultations with patient
  • Telehealth measure to improve access to psychological services for patients under the Better Access initiative
  • 3 Rivers Department of Rural Health (Charles Sturt University) student professional development online learning module (open access):  Telehealth - embracing technology in healthcare
  • Digitalhealth.gov.au – Telehealth
  • Digital health CRC – Telehealth hub
  • ClinEdAus – Rural and remote placements:  
    • Student placement models in rural and remote settings
    • Modes of supervision and peer support in rural and remote settings
    • Maintaining student wellbeing on rural and remote placements

  ---

• References: Virtual supervision and virtual placements

  References:

  Please Note: References remain valid until superseded by later research. The resources referenced here are regularly reviewed and are considered current and relevant to the topics presented.

  • Agency for Clinical Innovation. Virtual Care in Practice 2021. Available from: https://aci.health.nsw.gov.au/__data/assets/pdf_file/0004/651208/virtual-care-in-practice.pdf [Accessed 2 November 2022].
  • Australian Health Practitioners Regulation Agency (2023) Information paper: good practice approaches to embedding clinical placements, pedagogical innovations and evidence-based technological advances in health practitioner education . Available from https://www.ahpra.gov.au/News/2024-04-29-Consultation-on-embedding-good-practice-in-clinical-placements.aspx  Accessed August 2024)
  • Bacon, R., Hopkins, S., Georgousopoulou, E., Nahon, I., Hilly, C., Millar, C., ... & Brown, N. (2023). While allied health students prefer face-to-face clinical placement, telehealth can support competency development: results from a mixed-methods study. Frontiers in Medicine, 10, 1151980.
  • Bacon, R., Hopkins, S., Kellett, J., Millar, C., Smillie, L., & Sutherland, R. (2022). The benefits, challenges and impacts of telehealth student clinical placements for accredited health programs during the COVID-19 pandemic. Frontiers in Medicine, 9, 842685.
  • Bridgman K, Erickson S, Furlong L, Bird A. Allied Health Student Engagement in Telehealth Clinical Placements: A Rapid Review. The Internet Journal of Allied Health Sciences and Practice. 2022 Mar 31;20(2), Article 1.
  • Gill, R., Allied Health student supervision for telehealth placements, Flinders University, Editor. 2020, Government of South Australia, SA health
  • Klarowska, B., Telesupervision: How Remote Supervision Can Help, Time2Track, Editor. 2019.
  • McIver, S. and B. Murphy, What just happened? Student perspectives on health promotion placements during COVID-19. Health Promot J Austr, 2021.
  • O'Connor, M., et al., 3D virtual reality simulation in radiography education: The students' experience. Radiography (Lond), 2021. 27(1): p. 208-214.
  • Peart, A., et al., 'It became quite a complex dynamic': The experiences of occupational therapy practice educators' move to digital platforms during the COVID-19 pandemic. Aust Occup Ther J, 2022. 69(1): p. 38-49.
  • Rossettini, G., et al., Digital Entry-Level Education in Physiotherapy: a Commentary to Inform Post-COVID-19 Future Directions. Med Sci Educ, 2021. 31(6): p. 2071-2083.
  • Greenlees, N.T., et al., A novel blended placement model improves dietitian students' work-readiness and wellbeing and has a positive impact on rural communities: a qualitative study. BMC Med Educ, 2021. 21(1): p. 387.
  • Twogood, R., et al., Rapid implementation and improvement of a virtual student placement model in response to the COVID-19 pandemic. BMJ Open Qual, 2020. 9(4).

   

Placement models and approaches to supervision

• Traditional model

  The traditional model consists of one health professional supervising one student, both from the same profession.  The traditional model is also known as: one-to-one placement; apprenticeship model; mentorship; or role-established placement. Direct supervision is used.

  Benefits	Considerations
  Closer supervision of the student Facilitates modelling of skills Easier for student to demonstrate autonomy May be easier to accommodate one student than a group of students Time available for individual student supervision and feedback	Limited opportunity for collaborative or peer learning Often limited to service delivery practicing skills within an existing and well-defined role Student is largely dependent on supervisor to facilitate learning Limits supervisor’s capacity to offer placements

• Collaborative model

  The collaborative model also known as: paired/group supervision; two-to-one; co-operative model; peer collaboration; multiple-student placement.  The collaborative model consists of one health professional supervising more than one student.

  Benefits

  Considerations

  Students experience peer-based learning, including: Practising skills and techniques Questioning techniques Providing feedback   Students develop teamwork skills Students are supported by each other and are less dependent on their supervisor.

  Supervisors require skills to facilitate peer learning and collaboration There may be some incompatibility of personality/learning style between students Matching of student experience and performance may be required. Time available for individual student supervision and feedback Time available to complete multiple student assessments Adequate space, resources, clients and casemix for multiple students

   

  Useful resources:

  • Benefits of the collaborative student placement model
  • Tips for increasing efficiency using the collaborative placement model

  In this video Sarah Jackson, physiotherapist with the Mount Isa Centre for Rural and Remote Health, describes a collaborative and multiple mentoring placement model.

   In this video Helen Bourne and Jayne Moyle describe the Central Queensland University student led clinic.

• Multiple mentoring

  Multiple mentoring also known as: shared supervision; team supervision; shared-responsibility; inter-agency placements, consists of a team of two or more supervisors supervising a single student, or a team of two or more students.

  Benefits

  Considerations

  Greater flexibility as supervisors can have different practice focus or different workplaces Can combine a more traditional placement model with another placement model Students are exposed to a range of experiences and practice approaches, skills and styles Facilitates the development of clinical reasoning skills (as one supervisor can explain why they have a different approach from another supervisor) Can allow part-time staff to be involved in clinical education Can allow first time supervisors to learn from more experienced educators

  Expectations need to be consistent between supervisors including: Placement structure Student learning opportunities Student assessment Communication Methods for communicating between supervisors is required Methods for moderating feedback or assessments are required Consideration of a primary supervisor and secondary supervisor Consistency of students’ progress and learning aims needs to be considered between supervisors

   

  Useful resources:

  Benefits of the multiple mentoring student placement model 

  Tips for greater efficiency using the multiple mentoring placement model 

  In the following videos two experienced clinical educators from different workplaces describe their experiences of sharing students with each other. In one setting the students are involved in a project placement while in the other it is a more traditional clinical setting. The educators offer some suggestions about what makes these placements successful.

   

   
  In this video physiotherapist Megan Saunders describes how multiple mentoring has been implemented in Mobile Rehab, a private practice setting.
  
  

• Role-emerging placements

  Role emerging placements, also known as: non-traditional placements occur where that particular profession does not currently offer a service. The student/s explores the possibilities and establishes the provision of a professional role within that setting in liaison with key stakeholders.

  Benefits

  Considerations

  Provides an opportunity to partner with community organisations Students raise the profile of their profession and the potential for services within the setting Broadens students' understanding of their professional role and assists students to understand the broad diversity of roles within their profession

  Direct supervision is usually provided by a staff member from a different profession Indirect profession-specific supervision may be required from a supervisor working in another service or from the university Paired or groups of students may feel more supported when working together in a role-emerging placement Students are often concerned about the lack of opportunity to develop core clinical skills, or receive profession specific supervision to guide their clinical skills development

   

  Useful resources:

  • Benefits of role-emerging placements 
  • How to set up and manage a role-emerging placement 

  
  In the following three videos Professor Lindy McAllister explains how role-emerging placements work and gives an example of a role-emerging placement in Broken Hill.

   

   

   

  In this video Antoinette Fitzgerald, an Advanced (Clinical Specialist) Occupational Therapist with Queensland Health's Child Development Program, explains how community engagement has been achieved through clinical education placements. A student placement model within a kindergarten for Aboriginal and Torres Strait Islander children has allowed relationships to develop and build the capacity of the kindergarten staff to identify and encourage children who need to access allied health services.

   

  In this video Professor Barbara Dodd describes an innovative clinical education placement structure for a rural community where students have established services that would not otherwise have been available.

   

   

• Project placements

  Project placements, also known as: non-traditional placements; macro-strategy placements; community development projects; public health placements involve student/s completing a specific project for the placement organisation. Frequently projects are focused on quality assurance; health promotion; service development; capacity building; and/or community engagement.

  A project sponsor from within the workplace organisation usually provides and explains the project brief and assists the student/s to identify the parameters and scope of the project.

  Benefits

  Considerations

  Can occur in traditional and non-traditional placement settings Develops students' critical thinking, autonomy, and communication skills. Assists students to understand the broader practice context and the policy, economic, political and other factors that are often significant

  Supervision can be provided by a student supervisor located within the placement organisation or from a university staff member Students can be involved in planning, implementing, and evaluating services or resources Tends to be most effective when students have already developed a range of clinical skills in other placements Direct supervision workload requirements may be dependent on the strengths of the students

   

  Useful resources:

  Benefits of project-focused placements

  How to set up and manage a project-focused placement 

  Jodie Booth, Senior Occupational Therapist with Queensland Health's Deadly Ears program, describes in this video how project placements have been successfully offered within their service.

   

  Project placements are also offered within the Institute for Urban Indigenous Health. Dr Alison Nelson explains how these placements are run in this video.

   

  ---

• Other resources

  The Superguide: a handbook for supervising allied health professionals has an informative section on student supervision. Topics include: functions of supervision, methods of supervision, setting expectations, documenting supervision and evaluation of supervision.  This site provides a number of examples documents to help supervisors.

   

• References: Placement models and approaches to supervision

  References:
  

  Please Note: References remain valid until superseded by later research. The resources referenced here are regularly reviewed and are considered current and relevant to the topics presented.

  • Briffa, C. & Porter, J. (2013) A systematic review of the collaborative clinical education model to inform speech-language pathology practice. International Journal of Speech-Language Pathology, 1-11.
  • Copley, J. & Nelson, A. (2012). Practice educator perspectives of multiple mentoring in diverse clinical settings. British Journal of Occupational Therapy, 75, 456-462.
  • Fieldhouse, J. & Fedden, T. (2009). Exploring the learning process on a role-emerging practice placement: a qualitative study. British Journal of Occupational Therapy, 72, 302-307.
  • Fortune, T. & McKinstry, C. (2012). Project-based fieldwork: Perspectives of graduate entry students and project sponsors. Australian Occupational Therapy Journal, 59, 265-275.
  • Lekkas, P. et al. (2007). No model of clinical education for physiotherapy students is superior to another: a systematic review. Australian Journal of Physiotherapy, 53, 19-28.
  • Nelson, A., Copley, J. & Salama, R. (2010). Occupational therapy students’ perceptions of the multiple mentoring model of clinical supervision.  Focus on health professional education, 11, 1427.
  • O'Connor, A., Cahill, M., and McKay, E. (2012). Revisiting 1:1 and 2:1 clinical placement models: student and clinical educator perspectives. Australian Occupational Therapy Journal, 59(4), 276-83.
  • Overton, A., Clark, M., & Thomas, Y. (2009). A review of non-traditional occupational therapy practice placement education: a focus on role-emerging and project placements. British Journal of Occupational Therapy, 72, 294-301.
  • Queensland Occupational Therapy Fieldwork Collaborative (2007). Clinical Placement Models. within the Clinical Educator's Resource Kit.
  • Rindflesch, A. et al. (2009). Collaborative model of clinical education in physical and occupational therapy at the mayo Clinic. Journal of Allied Health, 38, 132-143.
  • Rodger, S., Thomas, Y., Holley, S., Springfield, E., Edwards, A., Broadbridge, J., Greber, C., McBryde, C., Banks, R., & Hawkins, R. (2009). Increasing the occupational therapy mental health workforce through innovative practice education: a pilot project. Australian Occupational Therapy Journal, 56, 409-417.
  • Sheepway, L., Lincoln, M. & Togher, L. (2011). An international study of clinical education practices in speech-language pathology. International Journal of Speech-Language Pathology, 13(2), 174–185.

Evaluating the placement experience

• Supervisor self-reflection

  It is important for a supervisor to reflect on their placement experience to identify areas where development might further their clinical supervision skills and gain confidence in continued, edge, skills and confidence to support allied health student placements.

  Student supervisor self-reflection might include evaluation of knowledge, skills and confidence in:

  • Preparation and planning of the student placement
  • Facilitation of the learning process
  • Ability to problem solve
  • Communication skills and styles
  • Quality and Safety
  • Meeting organisational demands

  Depending on your setting, you may wish to develop your own guided evaluation and reflection.  Alternatively, you can use existing tools, some examples are provided below:

  • Clinical Learning Education and Research Service (CLEaRS), Northern Territory Government Allied Health Clinical Educator Skills Review
    
  • Curtin University – Strategies for Fieldwork Supervisors
  • Health Education and Training (HETI)- My Training Space – Self assessment tool
  • HETI Superguide
  • Maastricht Questionnaire for supervisors (see below for this tool)
  • SA Health Allied Health Clinical Supervision Framework

• Student feedback tools to aid supervisor self-reflection

  Seeking feedback from learners can be a first step in assisting a student supervisor reflect on their supervisory skills.  Feedback could be sought from the student on:

  • Adequacy of introduction and orientation
  • Learning goals and performance expectations
  • Placement elements, for example case load and volume
  • Adequacy of supervision, for example access to supervisor, type and frequency of informal and formal supervision activities
  • Type and frequency of feedback
  • Ability to work as part of a department or multidisciplinary team
  • Adequacy of the physical environment to support learning
  • The best elements of the placement
  • The best elements of supervision
  • Areas for improvement for placement and/or supervision

  Again, depending on your setting, you may wish to develop an evaluation tool, or access existing examples, some of which are included below:

  • Clinical Placement Quality Survey (CPQS-S) - a psychometrically robust survey designed to evaluate allied health students’ perception of placement
  • Clinical Learning Education and Research Service (CLEaRS), Northern Territory Government Student Feedback Survey
  • Maastricht Questionnaire for students (See below)

   

• Assessment of placement quality

  • Clinical Placement Quality Survey (CPQS-S) - The CPQS-S is a valid and reliable tool for evaluating allied health students’ perception of a quality clinical placement experience, underpinned by current best practice frameworks. The CPQS-S provides all stakeholders with an easily scalable and objective method for evaluating placement quality to engage in quality improvement processes.  Further information is found at: Jones, T., Kirwan, G. W., Howells, S., & Hams, A. (2022). Clinical Placement Quality Survey–Student (CPQS-S): A tool to evaluate allied health placement quality. International Journal of Work-Integrated Learning, 23(4), 579-593.  https://www.ijwil.org/files/IJWIL_23_4_579_593.pdf 
  • A suite of placement quality resources has been developed, supported by the Sydney Integrated Clinical Training Network and the University of Sydney Education Innovation Grant.  These tools gather perceptions of placement from four stakeholder groups:  Students , Clinical (Academic), Clinical (Supervisors) and Placement Site Managers. The student survey has been validated.  Further information is found at: McAllister, L., Nagarajan, S., Scott, L., Smith, L., & Thomson, K. (2018). ‘Developing measures of placement quality in allied health, dentistry, medicine, and pharmacy’. International Journal of Practice-based Learning in Health and Social Care, 6 (2), 31–47.  https://doi.org/10.18552/ijpblhsc.v6i2.493

• Evaluating supervisor performance and resources to support professional development

  In addition to the examples above there are also a series of resources that can aid the professional development of clinical supervisors through content, reflection and online learning.  Some of these include:

  • National Clinical Supervision Competency Resource in Victoria The National Clinical Supervision Competency Resource describes the core competencies of clinical supervision, across all allied health professions, settings and sectors, and provides access to a variety of resources using different mediums, including the Clinical Supervision Skills Review Tool
  • Western Australia Clinical Training Network – provides training and development opportunities for clinical supervisors with identified development needs and hosts the On Track eLearning package which provides insight into evaluating student placements
  • SA Health – Professional Development and Training in Allied Health provides a series of resources relating to allied health student placements and clinical supervision
  • Health Education and Training (HETI) Clinical Supervision Training Space – provides a range of resources designed to improve clinical supervision

• Useful ClinEdAus links

  Core Clinical Education Skills – Characteristics of effective clinical educators

  Once you have reflected on the placement, it is an ideal time to start planning for future placements.  Visit:  Preparing for and Managing Clinical Placements

• Maastricht Clinical Teaching Questionnaire For Clinical Educators

  Clinical Supervisors: SELF ASSESSMENT FORM

  Maastricht Clinical Teaching Questionnaire¹

  This is a TWO sided form.

   

  Name:________________

  Date: _________________

  Years of specialist practice:          ¨ 0-4     ¨ 5- 9     ¨ 10-14    ¨14+

  Primary practice location:

  Previous experience in clinical supervision/teaching development:

  ¨ None              

  ¨ Basic professional development:  workshops/training < 20 hours in total

  ¨ Advanced professional development: workshops/training >= 20 hours in total

  ¨ Qualification (e.g. CERT IV, Masters of Nursing Education, Graduate Certificate of Health Professional Education)

  Please indicate your level of agreement with the following statements:	Fully                                                                                                     Fully Disagree                                                                                              Agree					Unable to comment
  	1	2	3	4	5
  1.    I consistently demonstrate how to perform clinical tasks
  2.    I clearly explain the important element for the execution of a given task
  3.    I create sufficient opportunity for the student to observe me
  4.    I serve as a role model as to the kind of health professional students would like to become
  5.    I observe students multiple times during patient encounters
  6.    I give useful feedback during or immediately after direct observation of the student’s patient encounters
  7.     I help the student understand which aspects they need to improve
  8.     I adjust my teaching activities to the level of experience of students
  9.     I offer sufficient opportunities to students to perform activities independently
  10.  I support students in activities that they find difficult to perform
  11.  I gradually reduce the support given to allow students to perform certain activities more independently
  Please indicate your level of agreement with the following statements:	Fully                                                                                                     Fully Disagree                                                                                              Agree					Unable to comment
  	1	2	3	4	5
  12.  I ask students to provide a rationale for their actions
  13.  I help students become aware of gaps in their knowledge and skills
  14.  I ask students questions aimed at increasing their understanding
  15.  I encourage students to ask me questions to increase their understanding
  16.  I stimulate students to explore their strengths and weaknesses
  17.  I stimulate students to consider how they could improve their strengths and weaknesses
  18.  I encourage students to formulate learning goals
  19.  I encourage students to pursue their learning goals
  20.  I encourage students to learn new things
  21.  I create a safe learning environment
  22.  I take sufficient time to supervise students
  23.  I am genuinely interested in the students
  24.  I show respect to students

   

  Rate yourself on an overall assessment (1 – 10) of your own clinical supervision performance (10=excellent):   

  _______/10

   

  What are your strengths as a clinical supervisor?

   

   

   

   

  What areas would you like to improve on as a clinical supervisor?

   

   

   

  To access full article and copyright permissions for this tool, please access: Stalmeijer R, Dolmans D, Wolfhagen I, et al. 2010. Combined student ratings and self-assessment provide useful feedback for clinical teachers. Advances in Health Sciences Education 15(3) 315-28. doi: 10.1007/s10459-009-9199-6

• Maastricht Clinical Teaching Questionnaire For Students

  Multisource Feedback for Clinical Supervisors: STUDENT FORM

  Maastricht Clinical Teaching Questionnaire¹

   

  This is a TWO sided form. All responses will be collated and returned to the clinical supervisor.

   

  Clinical Supervisor’s Surname: ____________________

  First name: _____________________

  Date: _________________

  Health profession you are studying (e.g. nursing, physiotherapy, medicine etc): _______________

  Your year of study: ________________

  Length of time you have worked with this clinical educator: ____________ (indicate days or weeks or months)

  Please indicate your level of agreement with the following statements:	Fully                                                                                           Fully   Disagree                                                                                    Agree					Unable to comment
  	1	2	3	4	5
  This clinical supervisor:
  1.     consistently demonstrated how different tasks should be performed
  2.    clearly explained the important elements for the execution of a given task
  3.    created sufficient opportunities for me to observe them.
  4.    was a role model as to the kind of health professional I wish to become
  This clinical supervisor:
  5.    observed me multiple times during patient encounters
  6.    provided me with useful feedback during or following direct observation of patient encounters
  7.     helped me understand which aspects I needed to improve
  This clinical supervisor:
  8.     Adjusted teaching activities to my level of experience
  9.     Offered me sufficient opportunities to perform activities independently
  10.  Supported me in activities I find difficult to perform
  11.  Gradually reduced the support given to allow me to perform certain activities more independently

  Please indicate your level of agreement with the following statements:	Fully                                                                                                  Fully     Disagree                                                                                         Agree					Unable to comment
  	1	2	3	4	5
  This clinical supervisor:
  12.    Asked me to provide a rationale for my actions
  13.    Helped me to become aware of gaps in my knowledge and skills
  14.    Asked me questions aimed at increasing my understanding
  15.    Encouraged me to ask questions to increase my understanding
  This clinical supervisor:
  16.    Stimulated me to explore my strengths and weaknesses
  17.    Stimulated me to consider how I might improve my strengths and weaknesses
  This clinical supervisor:
  18.    Encouraged me to formulate learning goals.
  19.    Encouraged me to pursue my learning goals.
  20.    Encouraged me to learn new things.
  This clinical supervisor:
  21.  Created a safe learning environment.
  22.  Took sufficient time to supervise me.
  23.  Was genuinely interested in me as a student.
  24.  Showed me respect.

  Overall, give this clinical supervisor an overall assessment (1 – 10) of their clinical teaching performance (10 =excellent):   

  _______/10

   

  What are the strengths of this clinical supervisor?

   

   

    

   

  Which aspects of the performance of this clinical supervisor can be improved?

   

    

   

  To access full article and copyright permissions for this tool, please access: Stalmeijer R, Dolmans D, Wolfhagen I, et al. 2010. Combined student ratings and self-assessment provide useful feedback for clinical teachers. Advances in Health Sciences Education 15(3) 315-28. doi: 10.1007/s10459-009-9199-6

IPE for supervisors

• Getting started – top tips for supervisors

  Universities tend to have their own IPE curriculum, so when planning for an IPE opportunity, supervisors should:

  • Contact the relevant university for information relating to IPE placements and curriculum requirements.
  • Establish the IPE education students have received prior to commencing their placement.

  A Kick-start guide to Interprofessional Fieldwork: Developing capabilities for future work (Brewer & Flavell, 2018) provides supervisors with tips for planning IPE placements including:

  • Before you begin designing IPE placements
  • Leading IPE programs
  • Designing and implementing IPE placements (including theoretical frameworks, constructive alignment, staff training and student orientation)
  • Evaluating and disseminating IPE placements

• Considering IPE opportunities and activities for your site

  There are many opportunities for interprofessional education in a student placement.  Some examples of interactive learning include:

  Information exchange based	Use a topic or case that is relevant to a range of health professionals (Some examples include models of care, referral pathways, micro-counselling skills, building a therapeutic relationship with a client) to bring students on placement together to undertake activities including a debate, tutorial or workshop/Inservice or structure case study where that allow students from different professions to discuss their roles and scope of practice in the context of the care of a client.
  Observation based	Observation of a patient consult/group therapy sessions to enhance student understanding of interprofessional teamwork Attendance at a team meeting, discharge planning meeting or ward round to provide students with an opportunity to observe team communication Shadowing a health professional (or student health professional) from another profession providing care
  Action based	Joint research or quality improvement project (one that requires input from more than one health profession) Problem-based learning or case-based learning – use of ‘buddies’ from different professions to provide students with insight into another’s roles and responsibilities in the delivery of client care
  Simulation based	Experiential group work in a simulated ward, where students prepare a joint handover report Role play or drama to enact the realities of practice to initiate debate and discussion (including the perspective of the client/patient)

  Source: Freeth, D. S., Hammick, M., Reeves, S., Koppel, I., & Barr, H. (2005). Effective interprofessional education: development, delivery, and evaluation. Wiley-Blackwell.

  In this video, Teresa and Anne from the School of Health and Rehabilitation Sciences, University of Queensland, discuss how learning opportunities can be facilitated during an interprofessional student placement (02:20):

  Useful resources

  • A Kick-start guide to Interprofessional Fieldwork:  Developing capabilities for future work (Brewer & Flavell, 2018)
  • University of Toronto Flexible Learning Activities  

  Reflect

  Consider your own practice and workplace setting. What unique IPE opportunities does your workplace provide? Make a list and discuss these opportunities with your student? Ask your student to link their identified learning goals with the learning opportunities that your workplace can offer.

• Learning outcomes for students

  The table below unpacks some of the learning outcomes associated with interprofessional education.

  Outcome/theme	Sub-themes
  Teamwork	Students gain knowledge and skills in: collaborating with other health professionals to facilitate interprofessional care, recognising common goals, understanding team dynamics and power relationships, recognising barriers to teamwork, and cooperation and accountability.
  Roles/ responsibilities	Students can describe similarities and differences in the roles, responsibilities and expertise of team members and gain knowledge in: different philosophies of care, health systems, and their own professional scope and boundaries.
  Communication	Students appreciate the differences in professionals’ language and learn to communicate with other students and professionals involved with client care.  This can include: active listening to the ideas of other team members, shared decision making, and negotiation and conflict resolution.
  Client centred	Students value and seek out opportunities to work together as a team in the best interests of the client.  This can include: understanding the client’s role and perspective as a partner within the team recognising the client’s needs, and managing client safety concerns.
  Ethics/ attitudes	Students gain knowledge and skills in: respecting and acknowledging the views and ideas of other health professionals, even when they may be different from their own, coping with uncertainty, and ethical issues relating to teamwork.

  Adapted from: Thistlethwaite, J. & Moran, M. (2010). Learning outcomes for interprofessional education (IPE): Literature review and synthesis. Journal of Interprofessional Care, 24 (5), 503–513. https://doi.org/10.3109/13561820.2010.483366

  As you can see, learning outcomes include teamwork, communication, reflection, and understanding ethics, attitudes, and client centred care. The knowledge and skills students achieve from these learning outcomes will guide their transition to a competent health professional.

  The learning outcomes from these IPE opportunities then contribute to profession-specific supervisor evaluation of student performance.

• Interprofessional education placement examples

  Some IPE examples can be viewed in the videos below:

  IPE education example

  The video ‘Interprofessional model’ (00:03:15), illustrates an interprofessional education placement model used by the Institute of Urban Indigenous Health:

  IPE aged care example

  • Brightwater Interprofessional Education (3:31): 

   

  • Brightwater Interprofessional Education – student placement with Brightwater Care Group (2:04): 

  Other resources:

  • Queensland Health - Capricornia Student Led Clinic
  • UQ Health Care student assisted clinics
  • Student assisted clinics to support neurological rehabilitation in remote Queensland
  • Monash collaborative care curriculum framework:
    • Collaborative care curriculum
    • Digital framework curriculum
  • IPE simulation scenarios Edith Cowan University including video clips, proposed learning format and competencies and a facilitator manual for each topic. 

• IPE - learning goals and debrief

  It is important that the supervisor develop and share the learning goals for the IPE experience with the student. An example learning goal might be: ‘student able to identify the roles of three other health professions following the case meeting’.

  Following the IPE experience, the supervisor and student should debrief to discuss:

  • Their rationale for choosing particular interventions
  • What the student in their own role would look for in the same situation
  • Which roles could potentially be shared, and which are profession specific
  • Who else might need to be included in the patient’s care.

  • All discussions need to be focused on the overarching session goals

  Useful resources:

  A Kick-start guide to Interprofessional Fieldwork:  Developing capabilities for future work (Brewer & Flavell, 2018)
   

  ---

  References:

  References remain valid until superseded by later research. The resources referenced here are regularly reviewed and are considered current and relevant to the topics presented.:

  • About the Health Fusion Health Care Team Challenge, (n.d.). Retrieved from http://www.healthfusionteamchallenge.com/
  • Thistlethwaite, J. & Moran, M. (2010). Learning outcomes for interprofessional education (IPE): Literature review and synthesis. Journal of Interprofessional Care, 24 (5), 503–513. https://doi.org/10.3109/13561820.2010.483366
  • Occupational Therapy Clinical Education Program (2019) Factsheet: Supporting student learning through interprofessional opportunities.  Queensland Health
  • Freeth, D. S., Hammick, M., Reeves, S., Koppel, I., & Barr, H. (2005). Effective interprofessional education: development, delivery, and evaluation. Wiley-Blackwell.

   

Benefits of student placements in NDIS

• Benefits for NDIS participants

  Working with a student can offer real benefits to NDIS participants

  Often there is a concern that working with a student will use up your funding and mean a lesser service or outcome. However, it is important to note that any students you work with will be properly supervised and they can often do things for you that your Allied Health professional may not have the time to do. Our research has found that students can help NDIS participants to get more value from their service – giving more time to work through goals and questions, while bringing a new perspective. Students offer a new resource, who can allocate more time, to work through things with you – especially the non-treatment, real-life issues and goals that your Allied Health professional may not have time to address.

  In the video 'Benefits to Participants and students' (04:31),  you will hear from other NDIS participants, students and Allied Health professionals on the benefits they see coming from working with students.

   

  Useful resources

  • Future Allies - Reflective partnering - participant checklist

  Working with a student is an investment in future care

  Beyond the benefits for each individual participant, we need student placements if we are to sustain the number of Allied Health professional available to work with participants across the NDIS. As a participant, you can contribute to improving student placements. Future Allies has found that placements work best when viewed as a partnership between participants, students, providers and educators.

• Benefits for NDIS participants and providers

  Taking on an Allied Health student placement is a real contribution to building the future workforce we need to provide high quality care to our NDIS participants. A student placement is an investment in the sustainability and capability of our future Allied Health workforce. There are also more immediate benefits to NDIS providers with students making it possible to do more for your participants. Students offer an opportunity to increase the time and support provided to your participants and enhance the value you create for those participants. You can hear from NDIS participants, providers, and students on how they see the benefits to providers through student placements in the video 'Benefits to providers' (03:41):

• Benefits for educators

  Benefits of student placements in the NDIS

  Allied Health placements in the NDIS are critical to sustaining a viable and capable workforce for the disability sector. Encouraging and supporting students in NDIS placements is a strategic contribution to the quality of care for participants into the future. NDIS placements also provide more immediate benefits to participants and students. Participants benefit from the additional time that students bring, while students benefit from learning about the NDIS context – which is now influencing so many aspects of Allied Health practice. 

Planning student placements in NDIS

• Practical support for providers

  Many providers are not sure what to expect from their students and/or how to manage a placement to make sure it delivers to the needs of the student, their participants and their organisation.  The following resources can support providers:

  Useful resources

  • Information for student orientation
  • Being an effective supervisor of NDIS student placements
  • Managing a difficult NDIS student placement
  • FLIP BOOKS (PDF):
    • What to expect from students
    • Being an effective supervisor
    • Managing a difficult placement

  Doing Placements Better

  If we are to make Allied Health student placements better meet the needs of all parties involved, we need to re-think how we approach those placements. Future Allies has identified the need to establish mutually-beneficial partnerships between NDIS participants, providers, students and educators as key to making placements better and more sustainable.

  Useful resources

  Partnering to improve placements

  • Reflective partnering - overview and checklists
  • Reflective partnering - participant checklist

  Future supervision models

  Examines new and innovative ways to set-up and deliver placements to address some of the key issues in current models.

  • Future supervision models for NDIS student placements
  • FLIP BOOKS (PDF):
    • Future supervision models

  Enhancing communication

  Provides insights on how we can establish effective communication between all parties in making student placements work.

  • Enhancing communication for NDIS student placements
  • FLIP BOOKS (PDF):
    • Enhancing communication

• Practical supports for educators

  What does it mean to prepare allied health students for the NDIS?

  The Future Allies research found that what NDIS providers and participants really expect of educators is to focus on developing students’ general clinical and professional skills. While, some background knowledge about the NDIS is assumed, largely, providers expect that they will have a key role in teaching students about the NDIS – its practices and ways of working. Educators don’t need to think of NDIS placements as requiring any burdensome additional preparation – like any placement, it’s about ensuring students have a good grounding in practical clinical and professional skills. You can hear from NDIS participants and providers on their expectations of Allied Health students and their educators in preparing for placement in the following video 'Preparing students for placements' (03:46)

  Useful resources:

  • The University’s check-list for NDIS student placements
  • The educator’s check-list
  • SMART goal-setting for student placements
  • SMART goal-recording for student placements
  •  Assessment and reporting in the NDIS
  • FLIP BOOKS (PDF):
    • The Educator’s checklist
    • Goal setting for student placements
    • Goal setting - getting the most out of placements
    •  Holistic assessment and reporting

  Placements for the future

  If we are to make Allied Health student placements better meet the needs of all parties involved, we need to re-think how we approach those placements. Future Allies has identified the need to establish mutually-beneficial partnerships between NDIS participants, providers, students and educators as key to providing high-quality, sustainable placements.

  Useful resources

  • Reflective partnering overview and checklists
  • Future supervision models for NDIS student placements
  • Enhancing communication for NDIS student placements

Supervisor MH references

• References:

  Please Note: References remain valid until superseded by later research. The resources referenced here are regularly reviewed and are considered current and relevant to the topics presented.

  Mental Health Coordinating Council (2013). Practice Placement Guide: Mental Health Workforce Professional Entry Practice Placements in the NSW Community Managed Mental Health Sector – a NSW Pilot Study. MHCC, Sydney. http://mhcc.org.au/media/11009/ppp-placement-guide-final-2013.pdf

  Pisani, A. (2005). Talk to me: Supervisee disclosure in supervision. Smith College Studies in Social Work, 75 (1), 29.

  Pearson, Q. (2004). Getting the Most Out of Clinical Supervision: Strategies for Mental Health. Journal of Mental Health Counselling, 26(4), 361-373.

  Clinical Supervision Guidelines for Mental Health Services (2009), Retrieved from Queensland Health: 

  https://www.health.qld.gov.au/qcmhl/supervision_res

   

  Queensland Centre for Mental Health Learning (2008). Supervision Training 2008 - Supervisor Toolkit. Retrieved from http://www.health.qld.gov.au/qcmhl/Supervision/SuperTool.pdf

Planning Placements in MH references

• References

  Mental Health Coordinating Council (2013). Practice Placement Guide: Mental Health Workforce Professional Entry Practice Placements in the NSW Community Managed Mental Health Sector – a NSW Pilot Study. MHCC, Sydney.  http://mhcc.org.au/media/11009/ppp-placement-guide-final-2013.pdf

  Mental Health Coordinating Council (2013). Scoping Report: Mental Health Workforce Professional Entry Practice Placements in the NSW Community Managed Mental Health Sector – a NSW Pilot Study. MHCC, Sydney. https://www.mhcc.org.au/wp-content/uploads/2018/05/ppp-scoping-report-final-2013.pdf

Student Placements with First Nations Peoples Refs

• References

  Please Note: References remain valid until superseded by later research. The resources referenced here are regularly reviewed and are considered current and relevant to the topics presented.

  Indigenous Allied Health Australia (2019). Position Paper: Culturally Responsive Health Care. https://iaha.com.au/wp-content/uploads/2019/10/Cultural-Safety-Through-Responsive-Health-Practice-Position-Statement.pdf

   

Benefits of placements with First Nations Refs

• References

  Please Note: References remain valid until superseded by later research. The resources referenced here are regularly reviewed and are considered current and relevant to the topics presented. The information in this section was identified in interviews with clinicians working with Aboriginal and Torres Strait Islander peoples in conjunction with the following references:

  Davidson, B., Hill, A., and Nelson, A. (2013) Responding to the World Report on Disability in Australia: Lessons from collaboration in an urban Aboriginal and Torres Strait Islander school. International Journal of Speech-Language Pathology, 15(1), 69-74. https://doi.org/10.3109/17549507.2012.732116
  Mazel, O, and Anderson, I. (2011). Advancing Indigenous health through medical education. Focus on Health Professional Education: A Multi-disciplinary Journal, 13(1), 1-12.
  Nelson, A. (2007). Seeing white: a critical exploration of occupational therapy with Indigenous Australian people. Occupational Therapy International, 14(4), 237–255.  https://doi.org/10.1002/oti.236
  Nelson, A. and Iwama, M. (2010). Cultural Influences and Occupation-centred Practice with Children and Families. In Rodger, S. (Ed.), Occupation-centred practice with children: A practical guide for occupational therapists (pp.75-93). Oxford, UK: Wiley-Blackwell. 
  Nelson, A., Shannon, C., & Carson, A. (2013). Developing health student placements in partnerships with urban Aboriginal and Torres Strait Islander community controlled health services. Leaders in Indigenous Medical Education Network, LIME Good Practice Case Studies, 2, 29-34.
  Thomson, K. (2013)  Students' Stories. Speech Pathology Paediatric Indigenous Network Newsletter - Issue 9, September 2013.
  Whitford, D., Taylor, J., and Thomas, K. (2013). Working in Indigenous health settings. In K. Stagnitti, A. Schoo, & D. Welch (Eds.), Clinical and fieldwork placements in the health professions (2nd ed) (pp. 329-347). Melbourne, Victoria: Oxford University Press.