Quality Education for a Healthier Scotland

Contact Details Margaret Conlon Lecturer and Teaching Fellow Edinburgh Napier University Pat Bradley Programme Leader/Teaching Fellow Stirling University

Quality Education for a Healthier Scotland New Approaches to Practice Placement Provision Hub and Spoke Models and their impact on Practice Learning and Mentoring

Quality Education for a Healthier Scotland What is a Hub and Spoke Placement? The history The concept The purpose

Quality Education for a Healthier Scotland The Hub The core of learning from which is pivotal to all other learning experiences The glue that directs and holds the spokes

Quality Education for a Healthier Scotland The Spokes Led by: Student learning Patient journey Informs: Deep learning Integrated & active learning Offers: Continuity Creates: Capacity

Quality Education for a Healthier Scotland Robert Gordon University MODEL – Whole curriculum approach. Two contrasting HUB settings returning each year. Same mentor in each HUB for whole course. STUDENTS: First, second and third year undergraduates HUB: A single practice learning placement that students return within a year or across a number of years. The primary learning environment SPOKEs: reflect service users’ journey & experiences through a range of services and determined by Hubs. Emerge from the HUB, determined by HUB mentors, students and service users

Quality Education for a Healthier Scotland Hub and Spoke: Whole Programme Approach Stage 1 CPN, Older Adult Services stage 2 CPN, Older Adult Services stage 3 CPN, Older Adult Services stage 1 Adult Acute Admission stage 2 Adult Acute Admission stage 3 Adult Acute Admission

Quality Education for a Healthier Scotland Edinburgh Napier University MODEL: specific clinical pathway: CAMHS STUDENTS: Ten third year mental health undergraduate nursing students HUB: two contrasting ten week placements. Different mentor in each. SPOKEs: voluntary; educational; primary care; and social care settings. Ten exemplar SPOKEs prepared in advance & additional SPOKEs found, negotiated and regulated by student. Between 1 and 10 days in length

Quality Education for a Healthier Scotland Hub One: Community CAMHs Spoke One: Parent Support Group Spoke Two: School Base Hub Two: In patient Unit: Young People Spoke One: Early Psychosis Service Spoke Two: Supported Accommodation Hub and Spoke: A Service Centred Model

Quality Education for a Healthier Scotland Stirling University MODEL: One HUB setting and same mentor for first year. STUDENT: Forty six first year undergraduate: Adult, Mental Health & Learning Disability HUB: Defined by geographical location. SPOKEs: complimentary, contrasting learning experiences relating to the HUB service

Quality Education for a Healthier Scotland Hub and Spoke: Pathways Approach Gynaecology Ward HospiceRadiology Theatre and Recovery Room Out Patient Treatment Infection Control Oncology Ward Specialist Support Nurses

Quality Education for a Healthier Scotland Method of Spokes Definition and Organisation Case Study One: Hierarchy of LearningCase Study Two: Organisation and facilitation Case Study Three: Length of experience and service user journey 1 st level: Spoke relates to and ‘follows’ individual client journey and is likely to be located in third sector; education or social care setting Internal SPOKE Model – Responsibility for planning & arranging SPOKEs & reporting on student progress accepted and managed by HUB mentor. Insight SPOKEs – short visits (½ - 3 days) to services or organisations service user is accessing for a particular reason, e.g. a health improvement clinic 2 nd level: Spoke relates more generally to client population and is likely to be located in third sector; education or social care setting Facilitated SPOKE Model – Responsibility for planning & arranging SPOKEs and reporting on student progress was led by PEFs for the HUB in liaison with HUB and SPOKE mentors and the student. Regular Attachments – ongoing experiences to services accessed by service users, ½ day or full day per week for duration of a Hub e.g. psychotherapy department or an annual return. e.g. to an island community the ward based Hub receives service users for care and treatment. 3 rd level: Spoke directly relates to hub: so, hub=spoke and spoke=hub and is located in primary or secondary care health setting Fixed SPOKE Model – Responsibility for planning & arranging SPOKEs was accepted & discharged by the University campus placement coordinator. Block Spoke Experiences - up to 4 weeks, e.g. Spokes where significant travel is required or there is a reciprocal Hub exchange in place for the duration of the course, e.g. eating disorders in-patient unit & acute admission ward.

Quality Education for a Healthier Scotland Impact on learning 1.Contrasting but complementary hubs enable practice learning aligned to patient journey 2.Reconfiguration of mentor relationship and placement extended and deepened student learning 3.Students sense of belongingness within pathways promoted a deeper learning experience 4.Hub and Spoke model promotes opportunity for interagency and multi professional learning 5.Hub and Spoke model provides learning opportunities beyond secondary and acute care environments

Quality Education for a Healthier Scotland Benefits Learning is aligned to ideals of contemporary nursing Review and reorganisation of placement learning produces opportunities Mentors/mentoring process Enhanced Student experience has a positive effect on retention Placement capacity is enhanced

Quality Education for a Healthier Scotland Challenges Planning & implementing change with current climate Shifting culture towards being innovative and future focused Establishing the model that fits the job Mentor/student Preparation and support specific to pathway Review of documentation in a way that supports individual student learning

Quality Education for a Healthier Scotland Key Messages

Quality Education for a Healthier Scotland Key Messages Aim for creating GOLDSTANDARD learning experiences (not by resources) - It is timely to re-focus the nature & ‘look’ of practice learning Look widely! Think beyond secondary care across fields of practice and within care specialities and population groups. Disseminate and evaluate Long lead in times are require for successful implementation Nurture your mentors and PEF’s! Aim for consensus among all and collective enthusiasm: changes in practice learning model needs championed & supported Disseminate widely!