A Collaborative Learning in Practice style approach to increasing student nurse capacity

Dorset County Hospital NHS Foundation Trust

Background:

The NHS Long Term Plan (2019) explained the need to increase the number of learners in placements across the NHS. To meet these aims, employers need to scale up the ability to offer high-quality learning environments that support workforce development. With regards to the NMC Standards for Student Supervision and Assessment (2018) it has become apparent that we need to change the unsustainable practice of 1:1 mentoring of students and increase placement capacity. In October 2019, Dorset County Hospital NHS Foundation Trust implemented a Collaborative Learning in Practice (CLiP) style model on Purbeck, an orthopaedic trauma ward in response to this. This has been developed as part of a quality improvement project with Trust Board support.

Originating in Amsterdam, CLiP is a model of learning using coaching principles to support students in practice and focuses on the student being an active participant in their learning during their practice placement. This was adopted and piloted in East Anglia prior to being adapted and rolled out in hospital trusts across the country; anecdotally it has proven to be popular with students and placement areas.

Overall project objectives include:

1. To meet the goals of the NHS Long Term Plan (2019) by increasing our placement capacity for learners.

2. To offer a high quality placement experience.

3. To measure the impact of CLiP on the patient experience through a formal audit.

Methodology:

Dorset County Hospital appointed two CLiP Facilitators to ensure practice placement areas had ongoing, hands on support in implementing an enhanced placement experience.

Preparation for the commencement of the student-led zone, the area we are designating to the students, involved ongoing engagement with Purbeck Ward. The ward was initially chosen due to the positive attitude of the Ward Sister and her team. The added benefit was the consistently excellent student feedback, which gave a baseline standard to enable comparison of feedback from the project.

• Increased capacity for students by 100% by utilising a coaching model. 
• An allocated student-led zone is run by 3 students on a shift each day supervised by one RN who has had updated training on NMC (2018) Standards for Supervision and Assessment.
• Ideally the students are of varying experience and are able to support and complement each other’s learning.
• Students were encouraged to complete daily learning logs to present to their Practice Assessor at the time of their assessment.
• To develop student leadership skills with the most senior learner coordinating the student-led zone.
• The CLiP Facilitator overseeing this ward made multiple daily visits to ensure ongoing support for all involved with the project.
• Ongoing evaluation will take place. Students, Practice Supervisors and Assessors and patients will be given the opportunity to provide feedback on their experiences.

Learning and future work:

As a formal project our aim is to collect measurement and benefit data including patient, staff and student feedback, safety data and monitoring the actual increase in capacity of learners.

A formal audit of patient questionnaires has been undertaken with support of the Patient Advice and Liaison Service in order to measure the impact of the project on the experience of our patients. The initial patient feedback has shown 100% of patients questioned felt that staff had more time to provide personal care in the student-led zone compared to previous hospital stays and 100% of patients felt that the standard of care they received met their expectations. The ‘Friends and Family Test’ is also being utilised as a method of capturing feedback regarding any student nurses they have engaged with.

In January 2020, our CLiP style practice placement model will be rolled out across two further wards, with a view to increasing to a total of six by September 2020. The pace of the roll out will ensure that our Practice Assessors and Supervisors are well supported in practice, enabling a project that will be sustainable and embedded into Dorset County Hospital culture.  In addition, we are aiming to introduce other learners into the project, including Trainee Nursing Associates and newly recruited Overseas Nurses therefore reflecting the evolving needs of the service.