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JCPSLP Volume 19, Number 2 2017 97
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.