Employers of allied health professionals welcome applicants from flexible training routes, say Rupert Kerrell and colleagues
The start of the new millennium was an exciting time for universities educating allied health professionals. The NHS Plan identified a need to widen access to these professions, offer students greater choice in the educational routes they might follow, make better use of prior learning and train professionals.
The challenge was to find new and innovative methods of education and to meet these targets.
Working in close collaboration with practitioners, managers, and contracting and professional bodies, King's College London and London South Bank University developed innovative pre-registration programmes for physiotherapy, occupational therapy, and diagnostic and therapeutic radiography. Four-year part-time courses were developed, mainly for assistants working in the NHS in all four professions (in-service programmes), and a two-year accelerated, master's level programme was developed for physiotherapy students with a prior degree. The first cohorts were admitted in 2002-03.
While there are now more programmes like this and the need for increased numbers has reduced, key questions still need answering:
Do these courses meet the needs of practice-based educators and the students?
Are the students employable in an ever-changing NHS?
Have the programmes widened access to the allied professions?
A three-year project to address these issues has just ended. It involved around 300 students from the programmes, 40 academic staff and 100 practice-based educators who supervised the students.
Of the practice-based educators in the project, 95 per cent indicated that they would be happy to employ these students - on the same conditions as any other applicant. In the competitive job market of the NHS, these allied health professions students are likely to have value added skills, be they wider experience of the NHS, increased maturity and commitment or more developed learning skills, making them desirable to employers.
The programmes provided the flexibility students look for. Those on the part-time programmes said the format allowed them to work, earn and study, juggle their family commitments and spread their learning over a longer period. Those on the accelerated programmes also noted cost benefits due to the reduced time commitment and were attracted by the possibility of a master's qualification.
Importantly, these courses appear to attract a wider variety of students. When comparing the gender breakdown on the programmes with the latest NHS workforce figures (2005), there were more men training on four out of five programmes, with diagnostic radiography the only exception. Similarly, all four part-time programmes attracted higher proportions of ethnic minority groups.
One issue that cropped up during the evaluation was that home-based practice placements may be a problem. Some of the radiography students completed placements in a department where they worked. They noted difficulties with staff not knowing whether they were working as assistants or on placements and placements being shortened due to staff sickness, with students having to revert back to their assistant role to provide cover. Also, students felt uncomfortable challenging their supervisor if they were unhappy with the feedback they received, as they were mindful that they had to return to work as assistants in the same department.
What is normal?
Both sets of students expressed concerns that they were seen as "different", and that three-year degree students were considered "normal". The in-service students thought they were not given priority relative to other students on placements, as it was suggested that they could make time up at a later date, and the accelerated students thought supervisors were often challenged as they were completing an MSc.
In terms of learning styles, the in-service students sometimes needed more time for things to be explained, but countered this by their enthusiasm, willingness to learn and commitment. Educators believed the accelerated students were highly motivated, able to initiate self-directed study well and used evidence effectively to justify their reasoning (though sometimes without thinking of the practicalities within the NHS).
Interestingly, when mapped against each other, both types of students were strongest in similar areas - communication, professionalism, team working - and weakest in managing a caseload.
Take-home messages about the programmes are:
students from the programmes are competent to practise;
practitioners would be content to employ the students;
the programmes do meet the needs of differing groups of students;
practitioners may need to adapt their supervisory approaches as the learning styles of these students often differ;
practitioners who are supervising their own in-service staff in the student role should treat these students as students and not revert to the normal work roles.
The results of this evaluation suggest that these programmes create a skilled workforce.
However, further work needs to be done to explore whether graduates from these programmes commit to roles in the London area (where they are educated) or progress more effectively through the career framework than those from traditional programmes. This would provide additional and useful information to inform all stakeholders as they plan the development of a sustainable, adaptable and skilled workforce for the future NHS.
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