Methods
Results and Discussion
evidence supporting evolution of traditional placements to the virtual realm .
Methods
This focus group study reviewed Year 3 BSc Physiotherapy student experiences within a 5-week virtual placement with Cardiac Rehabilitation ( CR ) at the University Hospital of North Midlands ( UHNM ). Students ( n = 11 ) were randomly assigned to the CR placement via an independent member of the clinical team who is unaffiliated with this study . Initially , as part of a service evaluation , participants were asked 20 questions separated into 4 sections , focusing on the NHS team , clinical skills , collaboration with peers and overall themes . Thirteen of these questions were in the form of a Likert scale , with 5 possible answers , extremely disagree ( 1 ), disagree ( 2 ), neither agree or disagree ( 3 ), agree ( 4 ) and extremely agree ( 5 ). The remaining questions requested expansion of answers in the students ’ own words , allowing greater insight of outcomes .
Students were unable to opt out of the questionnaire once answers were submitted , as all results were collected anonymously . They were made aware that any answers may affect practice of students on future placements within the team . This study attempted to recruit all students ; n = 4 agreed to form the focus group and , due to COVID-19 regulations , the meeting took place on Microsoft Teams while being recorded . The outcomes of the initial questionnaire formed the indicative questions , with the aim to build on the developing themes . Students who partook in the study were offered £ 4 to cover the cost of a meal deal , matching what they would have received for participating in-situ . The money was transferred directly to their accounts . All participants were given information sheets and signed consent forms , offering insight into the risks of participation . Ethical approval was granted by the Keele Institute for Innovation and Teaching Excellence Ethics committee .
Results and Discussion
The service review Likert scale questionnaire revealed certain trends within the participant group ; positive communication between student , educator and clinical team appeared to represent the highest level of satisfaction . It should be noted no area showed overall trends of dissatisfaction , with only one student highlighting working with peers and gaining knowledge from peers as a concern . Working with the clinical educator , CR team and gaining clinical skills , were all highlighted as achieved positive outcomes by the students . The placement was not a planned alteration to become virtual but one that occurred out of necessity to meet student needs . This focus group built on the themes and trends empathised and built on any subthemes that emerge , with the aim of improving student experience and securing of clinical skills that match SAHP and students ’ expectations .
The level of positive communication appears to be the main component of a successful placement ( Barret et al ., 2019 ). This was reported by all students to be a positive , stating they felt the educator leading the project and the CR team could not have improved on this aspect . This was achieved via regular meeting with the students and placement rules set within induction stating expectations of communication . This pertained to e-mail availability at any time , to be responded to within 24 working hours , and virtual contact at least twice per week . However , one member reported that increased contact with other health professionals such as nurses on the ward would have been of benefit , offering further awareness into the patient pathway and allowing for insight into the roles and knowledge of staff leading to patient discharge .
Role-play from staff was enjoyable and relatable as they brought in real stories and experiences from patients , with two students commenting this did not replicate the use of real patients . However , they were happy under the circumstances of the placement that their needs were met . Students stated that they enjoyed the peer working , and were particularly successful using flipped learning , where students address tasks aimed at preparing them for future work , introduction to new technologies and high-level educational content ( Chen et al ., 2014 ). In this case , students worked together to address the progression of a patient through the hospital and into CR care . This was the most interactive the group were throughout placement and may justify why one student verbalised they could not have worked closer with the group . Countering this , one participant emphasised staff role-play , was the part of the placement that allowed them to meet their clinical skill needs .
Assessment can be a difficult process in large groups with collaborative work , with issues arising where students lacking underpinning knowledge begin to free ride , while educators do not possess the appropriate assessment skills ( Murphy et al ., 2020 ). This was counteracted at the start of placement by ensuring that students were given independent work to complete following peer discussions , and that each student assessed on their own input to virtual clinics . Students did not report concerns over assessments marking ; however , all students did state they were not assessed on their ability to progression an exercise session , leading to concerns that the placement did not meet the intended learning objectives and concerns they would lack these skills moving into clinical practice . One student further noted that
32