What if leadership wasn’t something our occupational therapists learned later in their careers, but something they lived from the beginning? Caroline Stackhouse, Wendy Hall, Lauren Hryniewiecka, Amanda Allen and Sarah Howard look at how one trust has been reimagining student placements.
What if leadership wasn’t something occupational therapists learned later, but something they lived from the beginning? At Cambridgeshire and Peterborough NHS Foundation Trust, we’ve been piloting a new placement model that places leadership at the core of student learning.
Designed in collaboration with allied health professions (AHP) practice education leads and university partners, this model challenges the traditional clinical placement by immersing students in leadership behaviours, system-level thinking and project-based learning, alongside clinical exposure.
Why leadership, why now?
Occupational therapists are increasingly called upon to lead service transformation, champion inclusive and person-centred care, and contribute to system-wide improvement. Yet leadership is still too often viewed as something to be developed later in their career, rather than something that can be nurtured from the start.
We asked: what if we changed that? This placement model was designed to give occupational therapy students the confidence and capability to strengthen their leadership pillar from day one. Whether it was initiating a quality improvement project, contributing to governance discussions, or advocating for service users, students were supported to step into leadership roles early and meaningfully.
At the same time, we recognised the growing challenge of securing high-quality placements for the future occupational therapy workforce.
Competing demands on clinical teams and evolving service models have made traditional placements harder to sustain. Our approach offered an alternative long-arm model that paired students with experienced occupational therapists and senior AHP leaders, providing a rich, structured experience that prioritised leadership, reflection and real-world skills.
The placement model
Two cohorts of MSc students from Anglia Ruskin University, an equal mixture of both occupational therapy and physiotherapy students, participated in placements that blended leadership development with clinical relevance.
All students were in their final placement year and had previously completed at least one clinical placement, ensuring they were already familiar with key concepts such as quality, patient safety and patient experience.
This placement encouraged a shift in perspective, moving beyond hands-on clinical delivery to consider broader aspects of healthcare leadership and service improvement.
The placement model included two days a week embedded in clinical teams, where students led projects rooted in everyday practice. These included producing a video to promote the role of occupational therapists across mental health, physical health and learning disabilities, and mapping services against rehabilitation standards to identify improvements for community-based care.
The remaining three days were spent with a range of AHPs in non-patient-facing roles, focusing on leadership behaviours, patient safety and professional identity.
Highlights included speaking at a careers expo for 15-year-olds, to promote occupational therapy, participating in a reflective workshop on leadership behaviours, and engaging in ‘20-minute conversations’ with AHPs across diverse roles.
Cohort one (July 2024) experienced a five-week hybrid model, with 80% of learning delivered virtually. Students collaborated on a project to create films for Allied Health Professions Day, attended senior AHP meetings, and received structured supervision.
While the virtual format offered flexibility and breadth, students noted a need for stronger links to clinical practice. Leadership education was provided throughout the placement, including reflective practice and observing leadership behaviours in practice.
For cohort two (early 2025), the placement model was altered in response to feedback. The placement was extended to six weeks and included two days a week in a clinical base, where students led service improvement projects aligned with community rehabilitation standards.
The remaining time focused on leadership education, reflective practice and exposure to non-clinical AHP roles, such as Freedom to Speak Up and Equity, Diversity and Inclusion leads.
More focus was aligned to leadership behaviours, the communication skills of the learners and how the skills they were learning could be used across clinical practice.
Creating the conditions for OTs to grow
Occupational therapy students thrived when leadership learning was grounded in real-world practice.
They applied the core occupational therapy skills of communication, reflection and collaboration to lead change. They explored how their leadership pillar worked alongside the other pillars of practice and how it could strengthen the clinical pillar that they were mostly focused upon.
They explored how leadership complements and strengthens the clinical pillar of practice and how their behaviours could shape outcomes for individuals and services alike.
A key moment in their development was attending a multi-professional trust preceptorship study day on leadership, which showcased the link between early career development and preceptorship. This experience helped students understand that once qualified, they would be expected and supported to engage in service improvement and project work from the outset of their careers.
Key enablers included:
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Weekly supervision with an OT in a senior AHP leadership position.
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Reflective practice linked to Health and Care Professions Council standards, ending with a personal learning journey presentation.
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Project-based learning and a final presentation of the outcome.
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Exposure to system-level roles beyond traditional clinical settings.
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Multi-professional learning alongside physiotherapy peers and the wider multidisciplinary team.
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Supportive clinical occupational therapy teams guiding the project work.
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Group and project specific supervision to provide multiple avenues for feedback.
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Peer learning and shared reflection.
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Multiprofessional preceptorship study day on leadership.
Students reported a noticeable boost in their confidence across key areas including leadership, time management, interprofessional collaboration and professional behaviours. They demonstrated clear growth across all four pillars of practice and were able to articulate strong, reflective evidence to support their placement assessments.
What stood out most was their personal development. Each occupational therapy student left the placement with greater confidence, maturity and a clearer sense of how their leadership skills would support them in applying for their first roles.
Growth through experience beyond the classroom
At the outset, not all students were enthusiastic about the leadership placement. Some expressed disappointment at not being assigned to a traditional hands-on clinical setting.
One student admitted they initially felt like they’d been handed the ‘last prize’. The idea of a virtualheavy, project-based placement felt unfamiliar and uncertain, but that perception quickly changed.
We were trusted to lead a real project. That trust made all the difference. I left the placement feeling like I could make a difference.”
As the placement progressed, students began to see the value in what they were experiencing. They were given real responsibility, trusted to lead a project and supported by a team that encouraged deep reflection and growth.
They learned how to make mistakes in a safe environment and how to truly reflect to understand not just what happened, but how they would approach things differently next time. A strong scaffolding of support was in place, enabling them to take risks, test ideas and grow in confidence as emerging professionals.
By the end of the placement students had not only met their learning outcomes, but they had also redefined what leadership meant to them. It was no longer an abstract concept, but a lived experience that shaped their confidence, communication, and professional identity.
One person commented: ‘I didn’t expect to enjoy it, but I ended up learning more about leadership and myself than I ever thought I would.’ While another said: ‘We were trusted to lead a real project. That trust made all the difference. I left the placement feeling like I could make a difference.’
Students consistently highlighted how the placement helped them connect leadership learning to clinical practice. One said: ‘I feel this was a fantastic experience that linked the leadership learning to clinical practice.’
While another reflected: ‘It’s rare to have this type of learning experience. Much of what I learned was in reflection on how I could have handled situations better.’
Outcomes and reflections
The occupational therapy students not only met their learning objectives, but they helped shape the placement experience for everyone involved. Their confidence in areas such as time management, communication and leading a project grew significantly over the course of the placement. But what stood out most was the depth of their personal and professional development.
Having an OT in a senior leadership role as their supervisor gave students a strong foundation to reflect meaningfully on their experiences. They moved beyond surface-level reflections to explore how their behaviours influenced outcomes, how they responded to challenge and how they could grow as future professionals. This reflective depth became a defining feature of the placement.
We also encouraged students to develop a clear sense of their own strengths and how these could be applied within a team setting, particularly when working alongside peers with different skill sets.
This allowed them to experience leadership as a fluid and shared responsibility, adapting to the needs of the group and the task at hand.
Their presence also had a noticeable impact on their physiotherapy peers. The OT students brought a holistic, person-centred lens to the group’s work which encouraged inclusive thinking and grounded the project in real-world relevance. Their approach to reflection and systems thinking helped elevate the learning for the whole cohort.
We’ve since seen some of these students return to our organisation, while others are preparing to apply for their first roles as occupational therapists. They leave the placement not only with enhanced skills, but with a strong sense of identity, curiosity and readiness to make an impact.
Leadership as a core OT competency
By embedding leadership development into student placements, we’re not just preparing future occupational therapists to deliver excellent clinical care. We are preparing them to shape services, influence policy and advocate for inclusive, effective systems.
This matters because it shows what’s possible when we trust occupational therapy students with responsibility, support them to reflect deeply, and give them space to lead. They don’t just meet their learning outcomes, they grow into confident, courageous, curious professionals who understand the bigger picture and are ready to contribute from day one.
Leadership isn’t an add-on to occupational therapy, it’s embedded in how we think, how we work and how we advocate. These placements prove that when we nurture it early, we strengthen not just individual students, but the future of the profession.
Words CAROLINE STACKHOUSE, Deputy Chief AHP; WENDY HALL, Head of AHPs; LAUREN HRYNIEWIECKA, Practice Development Lead; AMANDA ALLEN and SARAH HOWARD, AHP Practice Education Leads, Cambridgeshire and Peterborough NHS Foundation Trust