Placements and placement documentation

Multidisciplinary placements: Information for clinical staff

Students' pre-placement guidance

We give the students mandatory pre-placement briefings in which we discuss with them how placements are organised, what we expect them to do, what expectations we have of their conduct and behaviour, and how to contact you.

They can additionally access placement information on their Canvas dashboard.

We inform the students that multidisciplinary placements are primarily observational, rather than specifically about the practice of techniques and procedures. In general, the objectives of these placements are to expose them to a range of learning opportunities, for example:

  • follow the patient journey beyond handover at ED
  • observe and practice history-taking and examination skills under supervision of registered healthcare professionals
  • learn from specialists in their field
  • further develop and refine critical reasoning and clinical decision-making skills according to the most up-to-date practice guidelines.

Please facilitate as many opportunities as possible to practice supervised examination skills with the consent of the patient within their scope of practice at that time in their training.

Students will require signatures to evidence their attendance in placement. We teach them how to approach coaching conversations and write their Learning Logs. For multidisciplinary placements, we expect them to contact you for placement arrangements (e.g. shifts) no less than two weeks ahead if they have not received an email from placement.

Paramedic student practice documentation

The students bring a Practice Learning Log (PLL) with them to record their learning activities. This takes a form that will likely be familiar to you as the Coaching Model (TGROW) used in nursing and other allied health practice documentation.

The students will bring their timesheets for confirmation of attendance and hours in placement. They are required to be given a minimum of 37.5hrs per week and be supernumerary. They are expected to phone the unit if they are going to be absent as soon as possible that morning. If they do not do so, please inform us.

The nature of the multidisciplinary placements mean that there are no competencies that need to be assessed, but students are required to complete at least one PLL. The students do require the support of a Practice Supervisor (a registered healthcare professional) who will support them to develop learning logs for the shift, in common with the student nurses. The students will also require feedback from supervisors for each learning log they complete.

Download a copy of the Level 5 PLL (Word doc)

Conduct and performance

We expect our students to arrive on time, always identify themselves as a Paramedic student and have their ID badge, respect confidentiality at all times and be courteous. They are also expected to apply themselves, be accountable, and remember that they are an ambassador for ARU and the paramedic profession.

You may refer to the Cause for Concern policy if you would like to raise an issue relating to performance. However, we encourage you to use our Lapses in Professionalism (LiP) policy and form when you have concerns regarding conduct.

Students will require signatures confirming their attendance and this will be collected electronically via ePAD. If the student’s conduct falls below this standard, then you may want to consult our Lapses in Professionalism policy.

We normally expect Practice Supervisors for each Unit to have a discussion with the student about the issue and review the LiP form to make a determination about what, if any, tariff may be applied. You can forward this to the Placement Support Facilitators, Helena Fotiou for Cambridge students ([email protected]) and Rena Kydd-Williams for Eseex students ([email protected]).

These forms need to go to the PDT for further action and review the form. They will judge whether the concern requires a tariff and meet with the student to ensure appropriate development actions are taken, including the most appropriate tariff. If you require further advice, the Education Champion can assist you.

If Practice Supervisors do not have the opportunity to tell the student that a LiP form will be raised face to face, they can still complete the LiP form and the PDT will use this and any other information to meet with the students separately and make their own determination about the tariff.

LiP is not a punitive measure; it is for the communication of expected standards, and implementation of appropriate actions to meet the student’s professional development needs.

How Practice Supervisors can support Paramedic students in multidisciplinary placements

  • Organise the student’s shifts on the off-duty rota.
  • Complete and document an induction and orientation on their first day in placement.
  • Have coaching conversations with these students to provide guidance about how they will spend the shift under supervision with yourself or delegated healthcare professionals in your setting.
  • Provide reflective feedback at the end of the shift based on the chosen topic and document this on their Learning Log.
  • Sign their timesheet.
  • Complete our Cause for Concern process for those students you have concerns about.
  • Contact the Practice Support Facilitators if you would like to discuss any placement or student issues.

Covid-related issues in placement

All ARU students complete an internal covid risk assessment process annually and if flagged, they may undergo further review from our OH provider before they attend placement. If their assessment recommends specific restrictions to their practice, e.g. what covid risk level areas they may be exposed to, this will be discussed with the placement area.

They should be facilitated to wear appropriately fitted masks at all times during placement activity and conform to the Trust’s covid policy. They will have been fitted for masks prior to placement, however if they have required hoods they should be able to bring these with them to placement. They have been asked to make enquiries with you directly if they have any concerns about bringing this PPE with them to placement.

Ambulance placements

Students' pre-placement guidance

Students have a pre-placement briefing alongside briefings provided by the Ambulance Trusts so that they understand:

  • How placements are organised
  • What we expect them to do
  • What expectations we have of their conduct and behaviour
  • The completion of their Practice Learning Log (PLL).

This information is also made available as recorded presentations for the students on their Placement Information site at ARU.

Students will require signatures to evidence their attendance on each shift. We teach them about how to write their Learning Logs and have coaching conversations with their PEd.

Student documentation – The Practice Learning Log

Students need to achieve competence to meet the HCPC Standards of Proficiency for Paramedics and the HCPC Standards of Conduct, Performance and Ethics. There are seven domains that the student is assessed against:

  • Communication
  • Consultation, history taking and physical examination
  • Development of differential diagnosis
  • Development of an appropriate clinical management plan
  • Medicines management
  • Safe referral
  • Extrication and onward transportation to hospital (when required) including manual handing

These domains are designed to reflect the knowledge and skills utilised in a typical patient encounter.

You can find full guidance, a skills list, and assessment matrices on pages 51-59 of the Level 5 PLL (Word doc).

Competence against these skills is summatively assessed in practice by PEds at the end of each placement. Students should aim to complete one Learning Log for each of the ‘domain’ areas.

The students need to achieve a minimum of seven Learning Logs throughout all placements. These should be self-directed by the student and completed by them. They will document their discussions with you about their practice in all seven domains, and then at the end of each Learning Log the PEd will need to give a summary of their feedback. This approach to practice learning is based on a coaching model.

The principles of coaching

Coaching concerns the facilitation of learning through the development of a professional relationship based on rapport and trust. This can support the development of interpersonal and communication skills, professional behaviours and critical thinking.

A PEd who is encouraging, sets boundaries and actively builds respect and trust can create a sense of safety, so that the PEd may be able to hold more challenging conversations that arise during the student’s supervision and teaching. A relationship like this also encourages students to discuss their learning requirements and believe that these will be heard and addressed.

The environment for learning matters and the mentoring relationship is embedded in everyday interactions in the whole environment the student is exposed to, whether this is at the station or on the road, and in formal or informal settings. The PEd role-models behaviours these students will adopt in their own clinical practice and development.

The coaching principles also inform some key mentor skills:

  • High quality listening skills: this means attentive listening that responds to cues the PEd recognises from the student, and the use of clarification to ensure a shared understanding when giving instructions or constructive feedback. It also helps to ensure the PEd’s expectations match with those of the student, and may facilitate the sharing of different opinions and perceptions to be discussed and explored more openly.
  • Skilful questioning: the use of open questions (the ‘what’s, when’s, how’s and why’s’) and helps the students develop critical reasoning necessary for their evolving clinical judgement.
  • Chunking and checking: breaking explanations down into digestible pieces (particularly when this is long or complex) and asking students to repeat it or explain it in their own words to ensure they have understood what has been said.

The TGROW model

This is the coaching model used to help structure a student-led coaching conversation in order to formulate a learning goal which is recorded in the Learning Log.

The student needs to choose a topic that relates to one of the seven domains. This conversation is then structured to reflect the TGROW model:

  • Topic
  • Reality
  • Options
  • Way forward

The student will choose a topic arising from one of the competency domains (Topic). They then need to consider what experience they have of this in the past (Reality) and if there will be opportunities to meet their goal and how they may approach it (Options). The topic is agreed in partnership and is a much less prescriptive approach to learning that can be more tailored to the particular needs of the individual student.

The PEd will need to complete a mid-point and end-point review of placement in which they give the student verbal and written feedback on how they are progressing for each domain. We recommend that the student agrees a date with their PEd to hold these reviews well ahead of time.

The completion of both reviews ensures that PEd and student share a good, mutual understanding of continuing learning needs. The mid-point review should be sufficient for the PEd to have formed an opinion as to their progress in all domains, and more importantly, provide clarity about priorities for their clinical learning needs for the remainder of their placement.

If the student is having consistent difficulties in their progress in a domain or their approach to learning and conduct, please consider whether a Cause for Concern form (Word doc) would be an appropriate way to address their needs and ensure improvement. Unlike the Cause for Concern process, a DAP will not draw in additional resources from the University or Trust to support the student in your work together to progress their development. Please refer to the student paramedic support page for further details on the Cause for concern process.

Conduct and performance

We expect our students to arrive on time, always identify themselves as a Paramedic student, respect confidentiality at all times and be courteous. They are also expected to apply themselves, be accountable, and remember that they are an ambassador for ARU, the Trust and the paramedic profession as a whole. They are expected to demonstrate professionalism in line with the HCPC ‘Guidance on conduct and ethics for students’.

Covid-related issues in placement

All ARU students complete an internal covid risk assessment process and if flagged, they may undergo further OH review before being cleared for placement. EEAST also have a covid Assessment process prior to placement. They should be facilitated to wear appropriately PPE at all times during placement activity that conforms to the Trust’s covid policy.