Clinical learning experiences of healthcare professional students in a student-led clinical learning environment (SLCLE) - A mixed methods evaluation

Aim: To evaluate healthcare professional (HCP) students clinical learning experiences' whilst undertaking placements in a student-led clinical learning environment (SLCLE) and any changes in self-reported ratings of confidence.

Background: The English NHS Long Term Workforce Plan (2023) highlights the need to expand domestic education of HCPs to meet workforce shortages. The demand for quality clinical placements to support the preparation of HCP students remains a challenge globally. A creative solution has been the development of student-led learning clinical environments in healthcare settings. SLCLEs provide high-quality learning experience, increase clinical placement capacity whilst maintaining patient care standards. A multisite NHS Trust adopted this model as evidence suggests HCP students will be better prepared on qualification to adopt registered practitioner professional responsibilities. This model has been integrated across three hospital sites within a large teaching hospital, providing care for a diverse population and designed to accommodate students from a range of HCP disciplines and higher educational institutions.

Design: A mixed methods convergent design.

Methods: An online survey was administered to SLCLE allocated nursing and allied health profession (AHP) undergraduate and graduate-entry first, second and third-year students (n=132). Face to face focus groups/individual interviews were undertaken with a purposive sample of student participants (n=80) to evaluate their experiences of clinical learning in SLCLEs. Survey data were analysed using descriptive statistics and paired t-tests, interviews using framework method.

Results: Undergraduate and graduate-entry students from four UK universities completed the survey (n=132), 103 students (78 %) responded. Most were year 2 students (n=43/42 %), pursuing nursing programmes (n=82/80 %). Most considered the SLCLE met their expectations (n=76/74 %), reported increased confidence post-placement (n=84/82 %), felt supported by staff (n=80/78 %), peers (n=93/90 %) and clinical educators (n=93/90 %). Self-reported confidence scores post-SLCLE were significantly higher than pre-SLCLE. On-line pre-placement information was infrequently accessed yet identified as an omission. Four themes were identified: (i) preconceptions and initial anxiety; (ii) empowerment, growth and a unique learning experience; (iii) collaborative inter-professional learning and support; and (iv) insights and anticipations.

Conclusions: The SLCLE allocation enhanced students' confidence and knowledge. Support from clinical educators, ward staff and doctors was perceived as invaluable for creating a positive learning culture. Peer support and opportunities to lead care delivery contributed to students' professional development. The format and method for providing pre-placement information needs review as do strategies for avoiding delays in completing assessment documentation. Overall, the SLCLE experience offers much potential as a nurturing and effective learning environment for HCP students.