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At the start of a placement - Orienting students

 

It is important to create a positive and welcoming learning environment. One of the first steps is to provide an organised orientation program and to clearly explain your expectations and what you require of students. This should include spending time clarifying learning needs, setting up learning experiences and allocating adequate time to direct the student’s learning and assessment (Rodger et al., 2011).  Suggestions for developing orientation manual content (McAllister & Lincoln, 2004, p.35):

  • Brainstorm with your colleagues
  • Look at other student orientation materials from a different profession within your workplace
  • Look at orientation materials for new staff within your workplace
  • Look at student orientation manuals from other workplaces
  • Get feedback from past or current students about the existing orientation materials
  • List resources, readings, guidelines, protocols, forms, handouts, equipment and assessments used often

Some examples of orientation manuals are:

Mount Isa Centre for Rural and Remote Health Student Orientation Manual 

National Rural Health Student Network:  Rural Placements Guide

 

Placement details

It is important that student supervisors liaise with the student ahead of placement start to confirm:

  • The dates of your placement
  • Travel to the placement, and any rules/guidelines around driving to and from placement.  Consider also maps, routes, unsealed roads, and suitability of the vehicle
  • First day details - time, location
  • Accommodation
  • Workload requirements (for example:  if you are full time/part time, travel time to outreach services, impact of travel and outreach on access to face to face supervision)
  • Resources and equipment that the student will be provided with, and the resources and equipment they will need to pack with them
  • University placement documentation (e.g., assessment, clinical hours documentation)
  • Access to technology while on placement
  • Visit our Orientation manual for rural and remote settings from more considerations in this practice context

Activities to be completed at commencement of placement:

  • Provide students with appropriate documents and paperwork including orientation kit and various checklists and agreements
  • Conduct orientation program – this could be done interprofessionally to allow students to meet other professionals within the workplace and other students on placements at the same time
  • Show the student around and introduce them to relevant people
  • Ensure the student has a correct identification card and understands any uniform requirements
  • Collect any documentation required from student
  • Discuss goals and opportunities for placement (particularly important when using a learning contract)
  • outline the daily/weekly routines
  • discuss:
    • learning styles
    • preferences for feedback

 

Professional boundaries and ethical practice

In health care, we deal with vulnerable clients, and our professional boundaries may be tested. Professional boundaries are those rules and limits that prevent the lines between carer and client from becoming blurred, ensuring a safe working environment for the client and staff.

Professional boundaries are guided by legal, ethical, organisational and professional codes of conduct or frameworks.  While concepts of ethical practice and codes of conduct will be introduced by universities prior to placement, it is important that professional boundaries are included as part of the orientation to placement to ensure students have a clear understanding of what is expected of them.

You may wish to refer students to their relevant association webpages to access and review guidelines and standards relating to ethical and professional conduct as part of a self-guided orientation activity.

Useful topics to discuss may include:

Ethical issue Orientation considerations
Confidentiality

Within Australia, confidentiality is governed by Information Privacy Acts and Hospital and Health Boards Acts.

 
Health professionals are legally obliged to protect consumer health information.  With growing technological changes such as social media, use of electronic tablets and phones from work to/from home, it is becoming more difficult to maintain one’s privacy. Students, therefore, need to be mindful of their communications both in and out of the workplace. You may like to refer your student to your organisation’s policy relating to privacy and confidentiality, and the use of social media and technology as part of their orientation, as well as the relevant State or Territory Hospital and Health Board Act.

Boundary transgressions and work relationships

This can include romantic or familial relationship with clients or student supervisors. These boundary transgressions are considered a breach of professional boundaries.  Other considerations, such as picking up someone’s shopping for them or taking them to the bank on the way home from the hospital during a home visit, may not be so easy to define.  Introducing this topic and related expectations for student behaviour will ensure that students understand how to navigate or seek assistance to manage possible areas of concern.

Informed Consent

Consumers have the right to choose health care based on the best information available to them at that point in time. This is termed informed consent.   Informed consent, including its components and how to gain and document consent, should be discussed with the student. Relevant resources include the informed consent policies and procedures in your organisation and those found on the Australian Commission on Safety and Quality in Healthcare website.

Competence

Competence or capacity refers to the client’s ability to make decisions regarding their health care, living arrangements or financial situation.  Capacity can be assessed by a multidisciplinary team including the treating medical practitioner, occupational therapist, psychologist and psychiatrist.  If a client is deemed competent to make their own health care decisions, their ability to make sound decisions needs to be respected by you, regardless of what your belief of what the 'ideal' treatment recommendations might be.  A collaborative approach to care ensures mutually set goals and outcomes while working within professional boundaries.  It is important that the student understands their role in the multidisciplinary team, and how to interpret team assessment and decisions relating to capacity.

Vocational Aspects

Clinicians are provided with a multitude of therapy tools and resources to facilitate client care.  The sources of these resources and tools may be biased.  Wherever possible, health care professionals need to reduce bias associated with recommending particular medications, equipment options or organisations based on their own commercial or personal gain. There should be a focus on evidence based, client centred care.  Explaining resource selection and use within your team, as well as guidelines relating to the use of resources by students on placement should also be included in their orientation.

 

As the placement progresses:

Remember, planning cannot account for all circumstances. Be flexible. Should unexpected situations occur, review your plan and make adjustments accordingly.


Communication

  • Communication continues to be the essential component. Maintain effective communication with all involved parties – student/s, other staff members and University placement coordinator.
  • Do not be afraid to ask for help or guidance from peers or the University placement coordinator.
  • Ensure the University placement co-ordinator receives appropriate updates regarding the students’ performance.

 Feedback

  • Continue to provide the student/s with feedback  – informal, formal (not assessed) and formally assessed.
  • You have planned and read the university manual and are aware of the paperwork required and when you are required to submit to the university.

 Facilitation of Learning

  • Continue to Facilitating Learning for your student, maintain an effective learning environment and supporting the student as required.

 Managing Difficult Situations

  • Should a challenging situation occur, access our Managing Difficult Situations section for a framework to manage the situation and develop strategies (which have been agreed with the student) to implement.

 Emotional Wellbeing

 


References:

  • McAllister, L. and Lincoln, M. (2004) Clinical Education in Speech Language Pathology. Whurr: London.
  • Rodger, S., Fitzgerald, C., Davila, W., Millar, F. and Allison, H. (2011), What makes a quality occupational therapy practice placement? Students’ and practice educators’ perspectives. Australian Occupational Therapy Journal, 58, 195–202. DOI: https://doi.org/10.1111/j.1440-1630.2010.00903.x
  • 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.
  • Ausmed (2019) Understanding Professional Boundaries.  Accessed May 2021 from:  Understanding Professional Boundaries | Ausmed
  • Mable Technologies Pty Ltd 2015, ‘Whoa! Please mind my boundaries.’, Mable blog, 28 August, viewed 29 August 2019, https://blog.mable.com.au/blog/care-workers/whoa-please-mind-my-boundaries/.
  • Relationships Australia n.d., Maintaining Personal and Professional Boundaries, Relationships Australia Victoria, viewed 29 August 2019, https://www.relationshipsvictoria.com.au/resources/tip-sheets/maintaining-personal-and-professional-boundaries/.

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