JCPSLP Vol 19 No 2 2017

Echo This shortened repeat version of the first three phases gave clinical sites and the facilitator an opportunity to apply the modifications agreed during the evaluation phase to better tailor the framework to the needs of the site, CEs and students. The framework, strategies and approaches for each site were refined through multiple iterations across up to six placement blocks per year. The Echo phase can, but does not always, include all aspects of the previous three phases, depending on the needs of the site, staff and students. Our reflections Involvement with the reiterations, directed towards an improved version of the framework, was rewarding for all stakeholders. We found that the continued close and frequent contact with the sites allowed us to develop a deeper understanding of their needs and thus our support became more efficient, responsive and reflexive. More staff are involved in clinical education and developing their skills in this area. Our continued engagement with students at the CDF sites has allowed us to step in earlier to provide targeted learning support when needed and enabled us to be more attuned and skilled at supporting better student learning outcomes. Embed This phase occurred when the model was established enough within a site to have elements of sustainability, such as maintaining increased numbers of new placements across year(s), with no decrease in placement quality reported in formal university subject evaluation surveys. The foci of this phase were sustainability and efficiency for CEs and support staff, and in achievement of student learning outcomes. Features of this phase included use of highly skilled CEs supporting newer CEs able to develop their supervision skills, and resourcing sites with systems and packages for easy implementation in a range of student placements models. University support and/or the facilitator continued depending on the level of support requested by the site, but this was less intense than in the early phases of the framework. The ongoing support from the university in this embedding phase varied from site to site and was again tailored to the sites’ needs in developing embedded, sustainable higher numbers of high-quality placements. For some sites, the facilitator was no longer required on-site except in special circumstances (such as individual support for students identified at risk of not developing competency) and support could often be provided by phone. Our reflections Our reflections on this phase are intertwined with our perceptions of the overall project outcomes and are addressed in the section below. Overall reflections on the CDF framework Through the CDF framework we aimed to build the capacity of sites to provide sustainable higher volume student placements, and to maintain the quality of the placements, including maintaining or increasing student learning opportunities. Capacity building of placement numbers Using the framework resulted in a 219% overall increase in placement numbers in the target sites between 2012 (56 placements) and 2014 (123 placements). The increase was

Our reflections We feel that a detailed and well-organised establishment phase led to a smoother encouragement phase. The tutorials were developed during the encouragement phase and this allowed the content to be responsive to issues raised by the students and CEs during the placement. The facilitator drew on university resources regarding teaching methods as well as current research on the chosen topic(s), ensuring efficient development of up-to-date resources for use during the initial and subsequent placements. Many students told us they appreciated the supportive environment of the tutorials and we believe students were more forthcoming in tutorials because they were not being assessed by the facilitator. Facilitators also enriched students’ learning experience by adding or extending opportunities – for example utilising simulation wards or coordinating multidisciplinary case-based discussions between SLP students and other professionals. CEs reported that the tutorials provided valuable student-free time for them to complete other important work tasks (administrative and clinical). Some also reported that students’ knowledge and practical skills were enhanced by the tutorials. CEs also received improved support by engaging in regular formal and informal conversations, with the facilitator as well as planned group discussions with all CEs for support and up-skilling in areas identified as learning needs. Evaluate This phase is critical in the review, refinement and sustainability of the CDF framework and the partnerships, and took place at the end of each placement. The duration of this phase varied according to site requirements. Key personnel, including CEs, workplace stakeholders such as department heads, students, and facilitator/s were consulted through a range of strategies including written questionnaires and verbal discussions. Importantly, methods and content for this evaluation were designed according to the outcomes and targets for the site(s), as agreed during the establish phase (see Figure 2): for example, if the service aimed to see more patients then these numbers were compared to previous departmental data. Using evaluation data, the facilitator liaised with the department manager and/ or site champion to highlight priority areas for change and identified key successes to maintain in future placements. This phase was also a time to explore new service opportunities to which students could contribute or supervisory models for future placements. Agreed improvements were jointly identified and plans made for their implementation in the Echo phase. Our reflections This phase allowed us to critically review the strengths and weaknesses of our framework and strategies. Strengths included maintenance of expected clinical caseload throughput, positive student feedback regarding learning opportunities and satisfaction of CEs with the supervision model. Areas for change included changing the role of the facilitator to increase their focus on clinical educator support, refining student tutorials, improvements to the student placement timetables, and extending the service; for example, considering the addition of a slower-stream communication group arose from a debrief evaluation discussion with the CEs within one adult facility. It was rewarding for all involved to make practical changes in response to CE and student comments, as this showed the mutual benefits of using and evaluating the framework.

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JCPSLP Volume 19, Number 2 2017

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