Innovation between academics and clinical partners has been crucial to the development of practice maintenance of key skills ( Swift et al ., 2020 ). Stout et al . ( 2021 ) explored this , reviewing the performance of medical students ( n = 16 ) during a 12-week block of four placements , with clinical teams each lasting 3 weeks . The contact time was limited , and students were expected to develop skills using group work within their bubbles . Quantitatively , n = 17 outcome measures were assessed using a Likert scale of 1 ( not confident at all ) to 5 ( extremely confident ), pre ( baseline ) and post ( 12 weeks ). Confidence increased in many practical skills such as performing venepuncture ( 3.13 vs 3.8 ; p = 0.04 ) and performing cannulation ( 2.6 vs 3.07 ; p = 0.01 ). However , many verbal skills such as taking a patient history ( 3.53 vs 3.53 ; p = 1 ) and asking advice from a senior colleague ( 3.73 vs 4.27 ; p = 0.1 ) failed to significantly improve . Should the issues of verbal reasoning and clinical skills be substandard , the option of deferred hours was being considered . Swift et al . ( 2020 ) states the option of continued practice for student nurses was often removed citing a lack of supervisory staff ; however , the deferred hours led to excess pressure on student health professionals ( Taylor et al ., 2017 ). Even with focused placements , SAHP could not allocate all students .
Virtual placement settings grew quickly during 2020 , led by initiatives from the Chartered Society of Physiotherapists ( CSP ), and encouraged placements to be innovative and creative when developing new models ( CSP , 2020 ). Twogood et al . ( 2020 ) altered their placement delivery options , increasing self-directed learning and virtual presentations compared to the previous models , as well as altering the placement after each cycle following student feedback . The virtual model allowed n = 182 students to be assessed in 2020 , an increase of 520 % in 2019 ( n = 35 ) and 404 % in 2018 ( n = 45 ); sadly data have not been published as to the student experience or learning outcomes . However , Wright et al . ( 2018 ) reported that simulation placements increased confidence in ( n = 60 ) in final year Physiotherapy students using Physiotherapy tools for assessments . Students spent 6 days in each speciality improving overall confidence in each area , Cardiopulmonary ( 31.82 vs 56.9 ; p =. 001 ); Neurology ( 31.35 vs 56.35 ; p =. 001 ) and Musculoskeletal ( 31.61 vs 56.78 ; p =. 001 ). Furthermore , mean scores for simulation students were higher than there non simulation counterparts in professional ( 3.18 vs 2.69 ; p = 0.001 ) and clinical skills ( 2.89 vs 2.44 ; p = 0.001 ), demonstrating that skills can still be developed in a virtual world with appropriate guidance . Furthermore , Salter et al ., ( 2020 ) showed there was an increased ability of students and clinicians to handle tele-practice ; there appears to be growing evidence of a positive engagement where patients often appear to opt for this opportunity in future care ( Bryat et al ., 2020 ). Added benefits included a reduction in travel time , allowing clinicians to be more productive and to apply greater focus to student mental health ( Salter et al . 2020 ).
COVID-19 has compounded the growing issue of sustaining high-quality student placements due to expansion of cohorts and the growing number of institutions offering health courses ( Romig et al ., 2017 ; McBride et al ., 2018 ). This difficulty is also prominent in Australia where collaboration and information sharing with specific aligned partnerships is required to meet the growing demand ( McBride 2020 ). The study qualitatively reviewed responses from all staff involved in student placement ; there was a low response from educators ( n = 327 ; 8.3 %), whereas management stakeholders ( n = 31 ; 66 %) and University staff ( n = 39 ; 53 %) had responses which were numerically lower but proportionally higher , which may offer a skewed perspective . Barriers to future placements include reductions in funding allocations and large-scale alterations of services , reducing the capacity of safe placements . Whereas McBride et al . ( 2018 ) suggest there are also enablers such as : demonstrations that the outcomes of placements are meeting demand , good collaboration between institutions and health providers , and valued efforts supporting the workforce . Consequently , for the relationship to be successful , the health care providers need to be adequately compensated for their time , while educators need to see the production of well-qualified students to professionals .
During COVID-19 , the aim of SAHP was to at least maintain good clinical practice and placements for Physiotherapy students . Overall , the literature suggests positive learning environments and clinical contact can happen during a pandemic ( Stout et al ., 2021 ; Twogood et al ., 2020 ) and are encouraged by governing bodies ( CSP , 2020 ). This includes building specific clinical skills across allied health professions ( Wright et al ., 2018 ; Stout et al ., 2021 ). Therefore , solutions highlighted within this pandemic may influence future clinical practice and offer unforeseen solutions to the lack of clinical placements ( Romig et al ., 2017 ; McBride et al ., 2018 ). However , verbal and communication skills may fail to improve ( Stout et al . 2021 ); therefore , to assure balance of skill set , placement type may benefit from variation . If successful , large scale virtual placements can be found . This may prove to be a solution to the decreasing placement opportunities for students ( McBride et al . 2020 ). Yet , there is a lack of student perspective
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