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Practice Placements: work-based learning for professional development

Gifford Batstone

Practice Placements

Findings of review undertaken for NHSU Some theoretical aspects Implications for supervisor development

Key Issues

Increased numbers Range of programmes Funding Regulation QAA Placement supervision IPE agenda

Linking learning outcomes to placements Learner expectations Clinical governance Transferability Confusion of roles

Review Findings
Modes of learning




Modes of assessment

Support via contracts & QA

IT access Audit of placements Library Common learning Learning outcomes Practice mentor skills

Workforce needs Flexibility IPE Learner experience

Educational and clinical governance

Mentor development

R&R policies Regulatory needs Career pathways Wider range of placements Learner preparation Transferability New roles

Some theoretical aspects

Evolution of professional education Erauts model Vicarious learning Zones of proximity Novice to expert Bordages diagnostic expertise

Evolution of professional education

Apprenticeship Scholastic Craft-knowledge Reflective practitioner What next? judgement?, intuition?, capability?

Erauts model

Propositional Process Personal

Vicarious learning Zones of proximity

Novice to Expert

Novice Advanced Beginner Competent Proficient Expert


Reduced Dispersed Elaborated Compiled


Implications for development of supervisors

Anticipated learning outcomes Means of assessment Level of development of learners Unpacking own expertise Recognising zones of proximity

What is the hallmark of competence?

Practice assessment Clinical skills assessment Problem-solving assessment Knowledge assessment 1960

Professional or clinical Authenticity


A simple model of competence

Professional authenticity

Does Shows how Knows how Knows

Miller GE. The assessment of clinical skills/competence/performance. Academic Medicine (Supplement) 1990; 65: S63-S7.

A simple model of competence

Performance assessment in vivo: Undercover SPs, Video, Logs.. Performance assessment in vitro: OSCE, SP-based test.. (Clinical) Context based tests: MCQ, essay type, oral.. Factual tests: MCQ, essay type, oral..


Shows how Shows how Knows how Knows how Knows Knows

Whats missing?
Basic method: Learning process evaluation

Does Shows how Knows how Knows

Meta skills