Clinic Handbook 13-14 final version

4 a – Safety procedures at your placement form b – Cardiff Metropolitan health and safety sessions content 5 Missed / altered clinic sessions form 6 Dealing with placement problems form

CLINICAL

PLACEMENT HANDBOOK 2013/2014

B.Sc (Hons) SPEECH & LANGUAGE THERAPY

CARDIFF SCHOOL OF HEALTH SCIENCES

Clinical Placement Handbook Contents

1 INTRODUCTION 4

1.1 CARDIFF METROPOLITAN CLINICAL STAFF 5

1.2 OVERALL SUMMARY OF ALL CLINICAL MODULES 6

1.3 CARDIFF MET PLACEMENT DATES 2013/2014 9

1.4 OVERALL PROGRAMME AIMS AND LEARNING OUTCOMES 10

2 PRE-CLINICAL REQUIREMENTS FOR ALL STUDENTS 11

2.1 OCCUPATIONAL HEALTH 11

2.2 DBS/POLICE CHECKS AND ISA REGISTRATION 11

2.3 HEALTH AND SAFETY (Appendices 4a and b) 12

2.4 DISABLED STUDENTS 12

2.5 STUDENT LEARNING AGREEMENT (APPENDIX 25) 13

3 GENERAL INFORMATION FOR ALL STUDENTS 14

3.1 CONFIDENTIALITY 14

3.2 CONSENT (Appendices 14, 15, 16, 17 and 18) 15

3.3 PRACTICAL PLACEMENT ISSUES 15

3.4 ADMINISTRATION ISSUES 16

3.5 PROBLEMS ON PLACEMENT 17

4 TECHNIQUES TO SUPPORT LEARNING 18

4.1 SETTING OBJECTIVES/GOALS 18

4.2 BEING REFLECTIVE 20

4.3 FEEDBACK, DISCUSSION AND EVALUATION 21

4.5 SESSION PLANS (Appendix 19) 22

5 ASSESMENTS 23

5.1 PLACEMENT REPORTS (Appendix 9, 10) 23

5.2 YEAR TWO 24

5.3 YEAR THREE 26

Recordings are only to be watched on Cardiff Met premises Recordings must not be copied Recordings must only be watched by the student and the tutor 30

5.4 YEAR FOUR 32

6 INTERNATIONAL PLACEMENT EXCHANGE 37

6.1 APPLICATION CRITERIA 37

7 FAQ’S 38

7.1 ORGANISATION OF THE PLACEMENTS 38

7.2 PRACTICAL ARRANGEMENTS FOR PLACEMENT 39

7.3 WORKING WITH OTHERS ON PLACEMENT 40

7.4 SUPPORT AVAILABLE 41

7.5 OTHER ISSUES 42

4 a – Safety procedures at your placement form

b – Cardiff Metropolitan health and safety sessions content

5 Missed / altered clinic sessions form

6 Dealing with placement problems form

7 a - Ongoing clinical practice hours form,

b - Summary of clinical practice hours form

8 Student’s evaluation of weekly placements form

9 Year 2 Placement report form and marking guidelines

10 Year 3 & 4 Placement report form and marking guidelines

11 Report form Yr 3 Dysphagia (Paeds)

12 Dysphagia Checklist (Adults)

13 a – Student NHS bursary travel form

b – Travel disregard form

14 Example consent letter to parent/carer for treatment by student

15 Client treatment and video consent form – written

16 Client video consent form – pictorial

17 Student consent form

18 Return of video to a placement educator form

19 Session plans

20 Reflective tutorial forms (student submission)

20 a - Reflective tutorial feedback and grading form

21 Format for Case report

22 Block Portfolio

23 Module outlines

24 Clinical education references

25 Student Learning Agreement

26 Placement Checklist

27 Video Tutorial/Visit checklist

28 Record keeping checklist

29 Report writing checklist

30 KSF Framework for all years

1 INTRODUCTION

This placement handbook is designed for placement educators and students and covers issuesrelated to all the Clinical Practice Modules The term ‘placement educator’ or PE refers to aqualified, practising and registered Speech and Language Therapist who is responsible forsupervising the student during the placement

Please also refer to the ‘RCSLT National Standards for Practice-based Learning’ (2006) available onthe RCSLT website This outlines the shared responsibilities of the placement educator/provider,student and Higher Education Institution, and includes self-audit tools for all parties involved inplacements

This handbook has been informed by discussions with Placement Educators and students and wewelcome any feedback on it We hope that the contents will cover all issues related to students ontheir placements throughout the course The handbook cannot anticipate every question, and ifyou have any queries not covered here or if any problems arise, please contact Sarah Patten,Clinical Director or Bev Reed, Placement Administrator or any other members of the CardiffMetropolitan Speech and Language Therapy team

Clinical Director Placement Administrator

Direct line: 029 2041 7280 Direct line: 029 2041 7234

E-mail: spatten@cardiffmet.ac.uk E-mail: breed@cardiffmet.ac.uk

1.1 CARDIFF METROPOLITAN CLINICAL STAFF

PROGRAMME TUTORS

‘Programme tutor’ denotes a qualified, registered practising Speech and Language Therapist who is

a member of the teaching team at the Centre for Speech and Language Therapy Studies, Cardiff Met Other members of the Cardiff Metropolitan staff and visiting lecturers in specialist topics also teach on the programme The following members of staff are involved in the clinical education of the Speech and Language Therapy programme

Ria Bayliss, BSc (Hons) Speech and Language Therapy, Cert MRCSLT, Registered with HCPC

Lecturer in Speech and Language Pathology, Adults with Learning Difficulties, Alternative

Augmentative Communication, dysphagia, Information Technology,

Tel: 029 20205749

E-mail: rbayliss@cardiffmet.ac.uk

Francesca Cooper, MSc (Interprofessional studies), BSc (Hons) Speech Therapy, Advanced

Diploma in Voice Studies, FETC, Cert MRCSLT, Registered with HCPC

Senior Lecturer in Speech & Language Pathology, Voice Disorders, Counselling, Clinical

Communication Studies, Induction Coordinator

Tel: 029 20201546

E-mail: fcooper@cardiffmet.ac.uk

Dr Calum Delaney, MA, BA (Speech & Hearing Therapy), Dip Tertiary Ed., National Cert Noise

Control, Cert MRCSLT, MSAAI, Registered with HCPC

Senior Lecturer in Speech & Language Pathology, Clinical Communication Studies, Fluency

Disorders, Audiology, Medical/biological Sciences, Programme Director

Tel: 029 20416881

E-mail: cdelaney@cardiffmet.ac.uk

Sarah Pattten, BSc (Hons) Speech and Language Pathology and Therapeutics, PGCE, BSL (Level

2), Cert MRCSLT, Registered with HCPC, HEA

Senior Lecturer in Speech and Language Pathology, Hearing Impairment, Professional Studies, CleftPalate, Psychometrics, Director of Clinical Education

Tel: 029 20417280

E-mail: spatten@cardiffmet.ac.uk

Hannah Plumpton, BSc (Hons) Speech and Language Therapy, PGCE, Cert MRCSLT, Registered

with HCPC, HEA, Teaching Fellow (for innovative teaching)

Senior Lecturer in Speech & Language Pathology, Developmental Disorders including SLI and Autism, clinical phonology and education

Tel: 029 20417287

E-mail: hplumpton@cardiffmet.ac.uk

Kate Tucker, BSc (Hons) Speech and Language Therapy, Cert MRCSLT, Registered with HCPC

Lecturer in Speech and Language Pathology, Adult acquired disorders, adult neurology, dysphagiaTel: 029 20416879

E-mail: ktucker@cardiffmet.ac.uk

ADMINISTRATIVE STAFF

Placement Administrator SLT Administrator

Bev Reed Sandra Barry

Placement Office School Administration Office

D1.16 D1.10

Tel: 029 20417234 Tel: 029 20416889

E-mail: breed@cardiffmet.ac.uk E-mail: sbarry@cardiffmet.ac.uk

1.2 OVERALL SUMMARY OF ALL CLINICAL MODULES

During their clinical training, Cardiff Metropolitan students have nine clinical placements asoutlined below

da ys

Hrs Placement

b a s e d

Universit

y b a s e d

Nursery Visits Term 1 –

4halfdays

Adult / Paediatric initial

practice onceweeklyplacement

Term 1

-8days

2 Adult / Paediatric initial

practice onceweeklyplacement

Term 2

-8day

Paediatric (I) treatment

once weeklyplacement

Term 1

-8fulldays

5 Combined Adult/Paediatric

Dysphagiaplacement

Term 2

-8fulldays

-140210

Term 1 or 2

-8fullday

Term 1

-8fullday

s

9 Adult treatment (II) once

weeklyplacement

Term 2

-8fulldays

56

*

h o u r s

139

h o u r s

1.3 CARDIFF MET PLACEMENT DATES 2013/2014

Wednesday

(observation with active participation) Any client group

Students normally have a paediatric placement in one term and an adult in the other Each student has

a placement of 8 days (but if a half day is available it will be 12 days)

Start (week beginning) Finish (week beginning)

YEAR 3 TREATMENT Paediatric and Dysphagia Monday

In term 2 students will have a combined paediatric and adult dysphagia placement This will comprise of

4 days in-house clinical workshops prior to 4 days of combined placement experience, culminating in final in-house learning outcome based workshop day/s Organisation of the dysphagia placement will not involve NHS coordinators, it will be arranged separately by Cardiff Met

Start (week beginning) Finish (week beginning)

2 Dysphagia Placement 20th January - 17th March

SUMMER BLOCK PLACEMENT

Mixed paediatric and adult placement, students are offered variable combinations of adult and

paediatric experience

3 End of Term 3 2nd June 2014 – 11th July 2014 20 - 30 (4-6 weeks)Due to problems sourcing placements the dates of the block cannot be guaranteed as above, students need to be prepared to be flexible during the summer holidays, accept the paediatric/adult combination offered and be ready to source accommodation if required

YEAR 4 TREATMENT Adult and Paediatric Tuesday, Thursday or Friday (Term 1) plus

Monday Term2

Each student has a placement of 8 full days (or 12 half days or 10 ¾ days) in both terms 1 and 2 one will be paediatric and the other adult The students will be offered a third placement in either term 1 or term 2, this third placement will either be adult or paediatric depending upon availability Any client group will be considered

Placement dates

Start (week beginning) Finish (week beginning)

1.4 OVERALL PROGRAMME AIMS AND LEARNING OUTCOMES

The overall aim of the Cardiff Metropolitan undergraduate degree in Speech & Language Therapy is

to develop competent and confident Newly Qualified Practitioners In order to do so the student isexpected to engage in a lifelong learning process and develop transferable skills through a widerange of placements Students will develop a critical understanding of communication,communication breakdown and swallowing disorders, together with the application of thisknowledge and the development of clinical and evaluation skills necessary for professional practice(see appendix 23) The assessments and programme aims have been developed in accordancewith the KSF and newly qualified practitioners competencies framework (appendix 30)

The aims of the programme are:

• to provide a sound theoretical and conceptual base in speech and language pathologyand therapeutics, the supporting disciplines of speech and language therapy, researchculture and methods, and the context of the professional practice of speech andlanguage therapy

• to develop principles, concepts, skills and applications required for the practice ofspeech and language therapy, including the identification and assessment of abilities,needs and requirements, the formulation of plans and strategies to meet these needsand requirements, the approaches techniques and procedures to give effect to theseplans, and the evaluation of the outcome and consequences of the intervention ormanagement

• to develop an appreciation of the professional requirements for the practice of speechand language therapy, including professional autonomy, accountability and conduct,professional relationships, and personal and professional skills

On successful completion of the four-year programme, the student graduates with a BSc (Hons)degree in Speech & Language Therapy The programme team will then advise the Health and CareProfessions Council (HCPC) of a student’s eligibility to be registered to practise, and advise RCSLT

of their eligibility to be registered as Certified Members of RCSLT

2 PRE-CLINICAL REQUIREMENTS FOR ALL STUDENTS

There are several statutory requirements with which the students have to comply prior to theirplacements to ensure that they are adhering to RCSLT, LHB, Trust and Government policies andlegislation These are detailed here

2.1 OCCUPATIONAL HEALTH

In agreement with all of the Welsh NHS LHB’s/Trusts our students are now required to complete andsubmit an occupational health questionnaire prior to attending the course This questionnaire issent to prospective students within their admissions packs following an offer of a place on thecourse They will then be required to attend an occupational health appointment to ensure theyfully comply with all of the inoculations required by the LHB’s/Trusts and to screen for additionalpotential health difficulties Students who are not cleared by the screening process will be offeredthe inoculations/support they require prior to attending the course The list of inoculations isextensive if you require further detail please contact the placement administrator, it does howeverinclude the following essential areas:

Rubella (German measles)

Poliomyelitis

Tetanus and Diphtheria

Hepatitis B (a programme of vaccinations)

The students are then required to submit an annual declaration throughout the duration of thecourse, which states there have been no changes in their medical history (including mental healthissues) during the past 12 months This must be signed and returned to the PlacementAdministrator before the student goes out on placement Should they have a change incircumstance to declare they will be re-referred to the occupational health department where theywill be re-screened If at any point during the course there are additional concerns identified byPlacement Educators or university staff an additional referral will be requested All students must

be declared ‘fit to practice’ before they can attend subsequent placements and as such arerequired to attend all appointments offered in relation to this matter

2.2 DBS/POLICE CHECKS AND ISA REGISTRATION

All students are required to be ISA registered and they will need to obtain an enhanced leveldisclosure from the Disclosure and Barring Service as part of the admission process Certain types

of criminal cautions or convictions could result in a student being refused a place on the course orsubsequently be unable to complete their clinical training and therefore unable to obtain a clinical

degree The student is required to keep their disclosure certificate safe AND ensure that they take

their DBS number on placement with them in case questioned No one has the legal right to accessyour DBS form except Cardiff Metropolitan University as your ‘employer’ Should any otherestablishment request sight of your form you are instructed to politely decline the request and askthem to contact the placement administrator or director of clinical education for confirmation ofyour status

At the beginning of Years 2, 3 and 4 the student is required to sign a declaration that there are nochanges to their DBS status This must be signed and returned to the Placement Administratorbefore the student goes out on placement

It is the student's responsibility to inform their individual tutor immediately of any changes to their

disclosure status while they are enrolled on the programme, that is, if they are cautioned or

convicted of a crime during their 4 year training

Failure to inform of any change in disclosure status will be viewed as a very serious omission on thestudents’ part

2.3 HEALTH AND SAFETY (Appendices 4a and b)

To ensure that the student is aware of LHB/Trust-specific health and safety procedures, he/she is

required to complete the Safety procedures at your placement form (appendix 4a), or an

equivalent as provided by the LHB/Trust, on the first day of the placement This should be keptsafely by the student and may be audited by Cardiff Metropolitan Students are required to informCardiff Met of any changes to their placement attendance by phone/email and completion of themissed/altered clinic session form (appendix 5)

In-house Cardiff Met Health and Safety workshops are completed by the student at specified timesduring their training (see table below and appendix 4b) These workshops are compulsory and thestudent is issued with a 'Certificate of attendance’ The in-house Health and Safety programme isupdated annually in response to the needs of placement providers with input from RegisteredHealth and Safety advisers from Cardiff Metropolitan They include discussion of real-life SLTscenarios related to students on placement linked to Risk Assessment procedures

Term 2/3 Year 3 six week summer block

Year 4 Adult & Paediatric weekly placements

As stated previously it is a Health and Safety requirement that Cardiff Metropolitan University isadvised of any changes to the placement e.g venue, day of placement etc Students also have aresponsibility to report any Health and Safety concerns whilst on placement to their placementeducator and Cardiff Metropolitan These must also be recorded on the placement evaluation form(appendix 8)

2.4 DISABLED STUDENTS

1 in 7 of the population has a disability and the Disability Discrimination Act (part IV 2001) requiresthat universities and placement providers should not treat disabled students less favourably, theyshould make reasonable adjustments and anticipate their needs Students may be identified asrequiring additional support via the occupational health process, course tutors, student services,themselves, disability services, etc

In order to adhere to this act any student, who has been identified as having a mental or physicaldisability and is being supported by the Cardiff Metropolitan University Disability Service, is invited

to have a personal meeting with the Clinical Director and the Placement Administrator In thismeeting the information provided by student disability services and the impact of their disabilityare discussed and reasonable adjustments for placements are considered/identified Following themeeting, with the student’s consent, a summary of the meeting is sent to a prospective placementco-ordinator to enable them to plan for the student, outlining to whom the summary informationmay be disclosed (such as placement co-ordinator only, or all Placement Educators involved in theplacement) This information (with the student’s consent) is also shared with Cardiff MetropolitanDisability Service to ensure parity and effective support

We endeavour to supply the Placement Educator/s with this information at the earliest possiblepoint in order that adjustments (where necessary) can be made At this point we rely on the PE togive feedback regarding the suitability of the placement If the suitability of the placement iscompromised, despite adjustments being made, we will endeavour to find a more appropriateplacement for the student This could however result in a placement being undertaken outside ofthe scheduled times.

The process takes some of the pressure off the student having to raise their needs in the firstsession of their placement, and also enables the placement provider to anticipate and plan fornecessary adjustments, thereby ensuring the whole process is transparent However, we stronglyadvise students to remain open, honest and proactive regarding any difficulties that may occurwithin their placement, they should engage in discussions with their PE and/or Cardiff Metropolitanstaff

Students have the right not to disclose their disability, and they may elect not to attend a meeting

to discuss its impact However, if in such a case, the disability subsequently has a negative effect

on their performance the grade awarded must reflect this performance, without adjustments beingconsidered at the time or retrospectively The RCSLT National Standards for ‘Practice-based

Learning’ (RCSLT 3.30) states that “The student has a responsibility for alerting the placement educator and the Higher Education Institution of any factors negatively affecting his/her performance” By discussing their requirements, we are hoping to prepare students for the

workplace, where employees need to state their requirements, in order for employers to meetthem

As with all placements, either the placement educator or disabled student may contact Cardiff Met

at any time should they have any concerns before, during or after the placement CardiffMetropolitan University remains committed to supporting both the Placement Educator and thestudent given these additional circumstances

In all cases where the student and/or PE are required to make reasonable adjustments, theseassume that the student will be able to perform at an acceptable level if allowances are made for

their disability Reasonable adjustment means adjusting the method of the assessment, or how the

student achieves a standard It does not mean adjusting the standard itself PE’s are reminded thatthey are required to be flexible in their approach to these students and if they have any concernsthey should contact Cardiff Metropolitan for advice Students should discuss any potential lack ofadjustments with their PE or the local coordinator in the first instance and then with CardiffMetropolitan

In some cases students may have a condition which they do not regard as a disability, however ifadjustments are required within their placements in order to manage this condition, students will

be required to disclose this through student services We are not in a position to make adjustmentswithout an assessment of need having been made by student services

2.5 STUDENT LEARNING AGREEMENT (APPENDIX 25)

Prior to commencing year 2 of the course all students are required to complete the studentlearning agreement This is discussed with the students during the clinical induction process at thestart of year 2 The clinical handbook identifies Cardiff Metropolitan’s commitment to the student’sclinical education, the completion of the student learning agreement is an indication of thestudent’s commitment to their learning and conduct throughout the course, and particularly withinthe clinical placements In order to complete this agreement they are required to have read andunderstood the clinical handbook

3 GENERAL INFORMATION FOR ALL STUDENTS

This section aims to provide generic placement information and is applicable to all years of thecourse It will cover areas which are applicable during the placement rather than informationrequired in preparation for placement Throughout the course we ask you to keep us informed ofany changes to your personal circumstances that may impact on your placements in any way Wewill endeavour to support students whenever we are able to aid successful attendance andcompletion of placements However, students should note that some circumstances will NOT beconsidered when allocating placements e.g paid employment, holidays, weddings, etc

3.1 CONFIDENTIALITY

Students are responsible for the maintenance of confidentiality This applies to their PE, clinicalsetting, other professionals/carers and the clients This relates to all verbal, audio/audio-visual andwritten material across a variety of mediums; academic, clinical and social network sites Failure to

do so is regarded as a professional misconduct issue

In order to maintain confidentiality people and/or places must not be identifiable in any way, underany circumstance As such no reference should be made to the names of people,clinics/schools/hospitals, dates of birth, etc Where an individual needs to be referred to, details

must be coded by the use of a single letter

During the written submission of material to Cardiff Metropolitan e.g for assessment, writtenprotocols are provided to help ensure the student adheres to the confidentiality policy Onoccasions when this protocol is not followed correctly but confidentiality is not breached, e.g theprovision of a first name with no other identifiable information, a student is at risk of a reduction intheir marks If however there is information that allows the identification of a person/place this will

be a breach of confidentiality and will result in 10% being deducted from their grade, e.g 75% willbecome 65% and 45% will become 35% As such students need to be aware that this could result

in a full grade reduction or potentially a fail if the original grade was in the D band More than onebreach of confidentiality by a student during the course will be looked at on an individual basis bythe course team, in order to ratify the nature and extent of any subsequent penalties In relation tothe Year 4 Adult Case Report ANY deviation from the confidentiality protocol will result in anautomatic fail, the assignment awarded 0%

In instances where procedure has not been adhered to as outlined above, but no individual/place isidentifiable (e.g where a client’s first name is used rather than a single letter, but there is no otheridentifiable information) this will be considered a breach of procedure and will result in a loss ofmarks The severity of the reduction in marks will depend upon the significance of the breach ofprocedure

In respect of audio visual material students must adhere to the process outlined in section 5.3, inorder to ensure confidentiality and security of this material

3.2 CONSENT (Appendices 14, 15, 16, 17 and 18)

In all cases consent for the student to be present/involved with a client should be sought by the

placement educator, and recorded in the client's case notes In the case of children this consentshould be obtained from the person with parental responsibility The placement educator will need

to refer to his/her LHB/Trust policy on obtaining consent

In the case of clients who are unable to consent for themselves, guidance should be sought by accessing the Department of Health website at

http://www.dh.gov.uk/PolicyAndGuidance/HealthAndSocialCareTopics/Consent/fs/en

When obtaining consent for student involvement it is advisable to ascertain at this point whetherthe client would be prepared to be videoed as part of the students assessment This avoidsstressful situations arising where the student is refused permission to video a session with a clientafter/during an episode of treatment However, it is accepted that any client has the right towithdraw consent at anytime It is the student’s responsibility to obtain written consent from theclient if they intend to video them Please see the appendices above for relevant forms

The student is required to provide evidence of consent for all parties who may be recorded whethervisual and/or audio recordings This includes any person who can be heard and/or seen within therecording whether intentionally or accidentally

Students need to be aware that they are not authorised to access and/or obtain information fromcase notes/files WITHOUT the consent of the PE

Students will also be asked to give their consent for recorded material to be used in thesubsequent training of other students and Placement Educators

3.3 PRACTICAL PLACEMENT ISSUES

- The Placement Administrator is responsible for all arrangements regarding placements; students must not approach placement educators or their colleagues to arrange a placement independently or to arrange observation sessions Contact the Placement Administrator if you feel you need

more sessions If you are intending to volunteer/undertake paid work with potentialSLT clients you must inform the placement administrator or clinical director prior toagreeing to undertake such work

- It is a Health and Safety requirement that Cardiff Met is made aware of any changes to placements If the placement details change before the start of the

placement e.g location, day of placement, client group etc, it is the responsibility of

the Placement Educator to inform the Placement Administrator of these changes

as soon as possible

If the placement details change during the placement e.g location, day of placement, client

group etc, it is the responsibility of the student to inform the Placement Administrator of these

changes as soon as possible The placement provider will normally provide an alternativeplacement in the case of illness or absence of the placement educator Exceptionally it will benecessary to swap a student who has initially been allocated to a particular placementeducator Both placement educator and student will be advised of this immediately should this

be necessary Students are not allowed to make any changes to their placement without prioragreement with the placement administrator

- The roles and responsibilities of the student are stated in the RCSLT NationalStandards for Practice-based Learning in the sections for the student This also

includes a self-audit checklist which the student is encouraged to complete andupdate in their file along with their clinic log, DBS etc.

- The roles and responsibilities of the PE are stated in the RCSLT National Standardsfor Practice-based Learning in the sections for the PE/placement provider This alsoincludes a self-audit checklist which the placement educator is encouraged tocomplete

- New PEs are requested to telephone the university after the student has been onplacement for three sessions, or earlier if deemed necessary This is an informaldiscussion regarding how the placement is going and to offer support if required Thelocal placement coordinator is also expected to be available to all PEsaccommodating students on placement in their locality

- Students should contact their PE/lead PE at least one week before the start of theirplacement If the student has problems getting hold of their PE, it is expected thatthey will try to call at least 3 times before leaving a message for the PE to call themback They will also be provided the PE’s email address in case contact via phone isproblematic A phone is available for use in the SLT clinic room in Cardiff Met Shouldstudents continue to encounter difficulties contacting their PE they are required toinform the placement administrator

- Whilst on placement students are expected to discuss mutually agreed methods ofcontact with their placement educator Students are reminded to respect theworkloads of their PE’s on days when they are not placed with them and as suchcontact may not be possible outside of placement hours, unless previously agreed

- The student must not undertake home visits alone, but may attend with a qualifiedprofessional, e.g speech and language therapist or occupational therapist

- If the Placement Educator is not on the clinic premises at any time during thestudent’s placement, or is not with the student, for example on a home visit, it is thePEs responsibility to deputise to another professional on his/her behalf It is notdeemed good practice for the student to be without regular access to theirdesignated Placement Educator Regular observations are required to inform thefeedback and assessment process and ensure client and student safety

- The PE may feel it is useful to receive feedback from the student's perspective onthe placement, thereby improving the quality of the learning process for the student

concerned, and for subsequent students All students are required to fill out astudent evaluation of weekly placement form (appendix 8) at the halfway feedbacksession and at the end of every placement These forms are available on Blackboard.Student’s final placement grade will be withheld until feedback has been received.These forms will be sent to the coordinators who will distribute them to theappropriate PEs.

- All students who can claim travelling expenses should fill out the relevant form(appendix 13a and b) which can be found on Blackboard All forms need to besubmitted to the placement administrator’s office at the end of each calendarmonth, or on a weekly basis if required

- Students need to keep an ongoing record of clients seen for each placement, theyshould use the ongoing clinical practice hours form (appendix 7a), accessed viaBlackboard They also need to submit a summary of clinical practice hours form(appendix 7b) at the end of each academic year, after the summer block placementfor year 3 and prior to the vivas for year 4

- Each LHB/Trust will have its own guidelines to ensure the accurate andcontemporaneous recording of client information adheres to legal requirements.Students are required to follow specific LHB/Trust guidelines These will over-ride theRecord Keeping and Report Writing best practice checklists devised by the CardiffMet Clinical Placement Action Group in appendices 28 and 29 which are intended asguidelines only

- Throughout the placement, the student should refer to the clinical module aims andoutcomes as outlined in Section 1 of this handbook It is the student’s responsibility

to demonstrate the learning outcomes are being met and record such evidence Anygaps in learning outcomes may be used to inform their placement objectives forsubsequent placements

3.5 PROBLEMS ON PLACEMENT

DEALING WITH PLACEMENT PROBLEMS (Appendix 6)

If any problems arise, for either the student or the PE, it is preferable to try to deal with them as

soon as possible, by discussing the issue openly with the person concerned The form in appendix

6 outlines a process that may help clarify the issue, why it has arisen and what could be done to

Issues identified should be raised immediately and reflected within the half way discussion toenable either the student and/or PE to have the opportunity to redress issues before the placementends The report forms and the evaluation form should facilitate this discussion If the situation hasnot been resolved, the student and/or PE are expected to contact the clinical director or placementadministrator to discuss possible resolutions as soon as possible.

Each NHS LHB/Trust will also have a procedure for dealing with problems and complaints ThePlacement Educator should make the student aware of this (see also appendix 3)

MANAGING WEAK / FAILING STUDENTS

Students in year 2 will be attending placements with no/little prior clinical experience, in years 3and 4 they may have had little experience of particular client groups/clinical settings In thesecircumstances a student not previously identified as having any difficulties may present as weak orfailing In this situation the PE is expected to make their concerns explicit to the student at theearliest opportunity (you are advised not to wait until the half way discussion point) and identifyappropriate learning targets Concerns at this point should be raised with Cardiff Met staff

During any placement, at any point on the course, support is available over the phone/email,however if required a visit from a Cardiff Met tutor can be arranged in order to further support both

PE and student The visit will incorporate observation of the students work and the feedback

offered by the PE A full and open discussion will then take place between all three parties, thecourse of action to be taken will be agreed upon and recorded at this point in time All parties willhave a record of this discussion to ascertain whether or not the student subsequently shows theimprovement required It is expected that the student will have the opportunity to make progress

by completing the placement unless there is evidence of gross misconduct which could adverselyaffect the client

On occasion Cardiff Met may place a student within a LHB/Trust who has previously been identified

as weak or having previously failed a placement If they are a weak student the PE will be offeredspecific guidance regarding the areas the student requires support in and will be contacted byCardiff Met on a regular basis to monitor the situation and offer advice if required If a student haspreviously failed a placement they will require a re-sit placement, in this circumstance theprovision of a placement within a LHB/Trust will only occur following discussion with and theagreement of the PE involved Full support and advice will continue to be offered throughout theduration of the placement if required Should a student continue to be identified as havingdifficulties that may result in a fail of the re-sit placement then there will be a visit from a CardiffMet tutor which will be videoed This enables the student’s performance to be independentlyassessed by the external examiner, and is therefore a quality assurance mechanism whichsafeguards the student and the placement educator (Please also see the above section 'Dealingwith placement problems’ and appendix 6)

If a student fails a placement at the first attempt, he/she will have one opportunity to retrieve it.

The student may have to wait until a suitable retrieval placement is obtained, which may not bepossible within that current academic year Students should note that the year 3 dysphagiaplacement is unique in its format and as a result if any student were to miss a substantial portion

of either component (in-house or external) regardless of the circumstances they will have toundertake this placement the following year Any student failing this placement will also have towait until the following year to retrieve it If a student fails the year 3 block placement it will not bepossible to re-sit this placement prior to the commencement of year 4, as such the student will berequired to take a year out Re-sit placements are usually arranged with a different LHB/Trust to theone within which the student originally failed

Students in years 3 will not be able to undertake their block placement unless all previousplacements have been passed Students will not be able to progress to the next year of their

studies without having passed all clinical components

In accordance with Cardiff Met regulations any written assignments relating to the clinical moduleswill be allowed two retrieval attempts following a fail Students need to be aware that the reflectivetutorial and viva examination that occur in year 4 are NOT treated as written assignments as theyconstitute part of the clinical skills being assessed in that module As a result students who fail

their first attempt at these two assessments will only have one opportunity to retrieve it A fail of

the subsequent re-sit attempt will prevent a student from being able to complete the Speech andLanguage Therapy degree, they will be offered the alternative Human Communication degree andwill therefore be unable to practice as a speech and language therapist

4 TECHNIQUES TO SUPPORT LEARNING

Whilst on placement both the student and the PE will benefit from transparent recognised

mechanisms for supporting a good learning experience Some of these are explored in the sectionsbelow and are further expanded within the rolling programme of Cardiff Metropolitan’s placement educator training days, which all PE’s will be expected to attend

4.1 SETTING OBJECTIVES/GOALS

An objective/goal is something that a person is expected to DO or ACHIEVE within a stated time.Students are expected to set personal objectives throughout their placements which reflect theiracademic and/or clinical learning needs When engaged with client sessions they are also expected

to set objectives for their clients both within that session and, on the transfer from Year 3 to 4, wewould expect students to identify objectives which the client is expected to meet by the end of theidentified episode of care During Year 2 it is anticipated that students will require significantsupport in setting such objectives, with feedback from PEs helping to formulate personalobjectives/goals and guidance for appropriate client objectives/goals during a session By Year 4 wewould expect students to be able to identify and formulate both independently It is essential thatall objectives/goals are specific and hierarchical i.e they need to be broken down into small,achievable steps.

Personal objectives/goals

Initially students will identify personal objectives/goals via the aims and expectations form they arerequired to complete prior to each placement These will be broad as students will not be able toeffectively anticipate the exact nature of the clinical setting or the clients they are likely toencounter However, students are expected to identify their own individual needs from:

- Module learning outcomes

- Items from the placement assessment/report form

- Feedback from Cardiff Met tutors or previous PEs

- Self awareness of aspects requiring development (e.g from theirPersonal/Professional Development Profile (PDP) form)

As students progress through a placement and receive feedback we would expect their ownpersonal goals to be more specific and individual to their needs As they progress through thecourse we would expect them to identify these needs more independently Thus we may expect thefollowing progression of objectives/goals:

‘By the end of the placement I will have undertaken formal assessments with children’

‘Within this session I will have accurately recorded the child’s expressive output whilst undertaking

a RAPT’

A personal objective/goal should reflect the student’s needs and not the client As a result ‘I will keep the child’s attention throughout the RAPT’ is NOT appropriate, this would need to be either ‘I will evidence use of two (specified) techniques to support the child’s attention throughout the RAPT’ as a personal objective and/or ‘the number of prompts the child will require in order to undertake the RAPT will be recorded’ as an objective/for the client i.e it is ‘how’ the student

maintains a child’s attention which should be a personal goal and the child’s attention itself anarea for monitoring/managing their needs hence a client objective

Students often use a generic, non-specific personal objective/goal which is not acceptable e.g ‘to improve my confidence’, here there is no timescale (i.e by ‘when’ is this to be achieved) or

specification of ‘confidence’ (i.e in ‘what’ aspect do they feel unconfident) and we have nomeasure of outcome (i.e what constitutes ‘more confident’) could this simply reflect morefamiliarity and comfort in that particular clinical setting or with that particular client group An

appropriate objective/goal could be ‘by the end of the session I will have independently sought A’s teacher and offered feedback on his performance during the assessment’ or ‘at the end of the session I will spontaneously offer the PE my observations of the client’.

Client objectives/goals

As previously stated objectives/goals set for the client should reflect what they are expected to do

or achieve by the end of the session or episode of care rather than what the student is trying todevelop as part of their learning These are still required specific and hierarchical for example:

Client objective: ‘A will attend for long enough during the session to complete a

RAPT’

‘the number of prompts required for A to undertake a RAPT will

be recorded’

Personal objective: ‘I will accurately record A’s responses expressive output whilst

undertaking a RAPT during a session’

‘ by the end of the session I will offer my views of A’s expressive

language needs and his management needs in relation to his

attention’

Client objectives should by determined by knowledge of the client and their background and/or ajustified attempt to determine their needs.

The process

Regardless of whether the student is setting personal or client based objectives/ goals there are asmany frameworks to support the process as there are different learning styles and ways ofworking Although no framework can capture all aspects of clinical work and continual breakdowncan be extreme and artificial they do provide a structure and allow students to evidence theirthoughts There are two frameworks which both students and PEs have previously reported ashelpful They are similar but offer different terminology which will may appeal to different users;they are the SMART(H) framework and the ABCD behavioural framework and are detailed below SMART(H)

S = Specific (to whom/what)

M = Measurable (success can be identified)

A = Agreed (the objective/goal is understood and agreed by all involved)

R = Realistic (it is something which can be achieved)

T= Timed (there is a set timeframe)

H = Holistic (it encompasses a wider parameter than just the session dynamics)

Given the previous example a SMART objective/goal would be evidenced thus:

‘A will attend for long enough during the session to complete a RAPT’

S = Specific; completion of the RAPT by A

M = Measurable; a completed record sheet

A = Agreed; with the client, they know what is expected of them

R = Realistic; this particular client should have the ability to do this within a session

or the clinician should have the skills to ensure they do

T= Timed; by the end of the session

ABCD

A = Audience (who is doing the behaviour)

B = Behaviour (what do you want to do/want the other person to do)

C = Context or Condition (when/environment)

D = Degree (time/date, number of times)

Given the previous example an ABCD objective/goal will be evidenced thus:

‘I (A) will accurately record A’s responses expressive output (B) whilst undertaking a RAPT (C) during a session (D)’

The extent to which objectives/goals are evidenced and met should provide the basis for aconcrete, factual discussion and feedback following a session and at the half way feedback point.They should also inform reflection for both the PE and the student throughout the placement

4.2 BEING REFLECTIVE

Both placement educators and students are required to reflect on the clinical education process aspart of their CPD/PDP profiles Why questions are especially useful e.g “why did you……?” forunderstanding the thinking underpinning an action, thought or behaviour We would advise that aspiral rather than linear or cyclical model is used to support this and develop ongoing action plans.The following stages (Johns 2004) could be employed within this process:

• Description – What happened?

• Feelings – What were you thinking/feeling?

• Evaluation – What was good/bad about it?

• Analysis – What sense can you make of the situation?

• Conclusion – What else could you have done?

• Action Plan – If it arose again, what would you do?

All healthcare practitioners are required to demonstrate evidence of being reflective The student is

experienced on clinical placements to help understand, monitor and develop personal andprofessional practice It is not seen by PEs or tutors, but will also provide material for discussion inuniversity clinical tutorials This can be kept with the student’s personal and professional (PAP)records file.

Examples from the student’s clinical log can be used as evidence for discussions with the PE, toself-monitor development and demonstrate reflective thinking

4.3 FEEDBACK, DISCUSSION AND EVALUATION

The Placement Educator is encouraged to give the student regular weekly feedback to guide thestudent’s development Pendleton’s Rules suggest the following framework is useful when givingfeedback:

1 The learner goes first and performs the activity

2 Questions are then allowed only on points of clarification of fact

3 The learner then says what they thought was done well

4 The teacher then says what they thought was done well

5 The learner then says what was not done so well and could be improved upon

6 The teacher then says what was not done so well and suggests ways for

improvements, with discussion in a helpful and constructive mannerHalf way through the placement, the placement educator and student are required to set sometime aside to discuss the student’s performance This is in addition to ongoing contemporaneousfeedback and the end of term report This mid point evaluation, is based around the placementreport and enables both parties to review the progress made to date, the extent to which thestudent’s objectives set at the start of the placement are being met, and what may be done tofacilitate achieving them by the end of the placement It helps focus on what needs to be achievedand how by the end of the placement and may involve identifying new aspects to focus on It isessential that this half way evaluation is undertaken effectively to ensure the student has theopportunity to try and address issues identified before the placement ends It is expected thatBOTH the student and the PE complete a report form at this point to guide discussion and identifyany discrepancies in perspective (see below) It may be helpful to devise an ‘action plan’ tofacilitate achievement of the placement goals

The student is encouraged to be pro-active and complete a self-assessment of the placementreport form for the half way discussion, and include examples in the report comments box, toprovide supporting evidence for the self-ratings given The PE and student are encouraged to sharetheir respective evaluations and discuss why any differences in perceptions may have occurred.Examples from the student’s clinical log can be used as evidence for discussions, to self-monitordevelopment and demonstrate reflective thinking Students are also asked to complete theplacement evaluation form for discussion with their PE at the half way point (Appendix 8) Thestudent should reflect on the discussion and feedback provided by PE and others to inform theiroverall development as recorded in their Personal Development Plan (PDP)

The halfway feedback process is an ideal opportunity to gather information relating to wideraspects of the placement At this point we would expect both the PE and the student to be able toopenly discuss any concerns or deficits within the learning process We would also expect them to

be able to offer positive feedback relating to aspects of the placement not identified on the reportform Some areas you may wish to explore could include:

• Level of comfort working with the client group

• Enjoyment of placement experience including setting, environment, organisation, etc

• Relationship with PE and/or other professionals

• Logistics e.g travel/accommodation

• Additional external factors e.g family, work/life balance, illness, etc

The aim of this discussion is to ascertain whether there are any discrepancies between the PE’sview of the placement and the student’s and if there are any factors impacting on performance.Should there be any issues which can not be resolved at this point we would expect either party tocontact the local placement coordinator and/or Cardiff Met However we would expect resolution inthe majority of cases based on open and honest discussion between the PE and the student