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Sarah Foster

RePAIR Fellow

HEE London

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Biography

Sarah is an experienced paediatric dietitian, who completed a 12-month secondment as an AHP Clinical Education Improvement Fellow, in conjunction with HEE South East, the Florence Nightingale Foundation, and Canterbury Christ Church University. She has recently begun a RePAIR fellowship with HEE London.

Sarah’s 12-month clinical education improvement project sought to answer a key question about practice-based learning for pre-registration students in smaller allied health professions: does profession size make a difference?

The perception among many in smaller allied health professions that there are factors which make it more challenging for them has not previously been explored, and so there was a knowledge gap.

High quality practice-based learning, that prepares students well to join the workforce as confident and competent newly qualified practitioners, ultimately improves patient care.

Sarah’s project explored current practice, and the underpinning evidence base, and sought to investigate challenges in practice-based learning and potential solutions. The project has generated significant transferable learning, especially for the smaller professions.

The experiences and insights of key stakeholders were collected in a series of semi-structured interviews, group discussions and observations. Data collection concentrated on challenges, barriers and enablers in practice-based learning, and examples of good practice were sought. Throughout the project, a realist lens was used in discussion and interpretation of the data with stakeholders, to generate a contingent understanding of 'what works’ in delivering practice education capacity and quality for smaller allied health professions (AHPs).

The project then focussed on dietetics, as a case study of a smaller allied health profession. Key stakeholders were engaged in an experience-based co-design process to explore the findings, agree priorities for action, and co-produce recommendations. The aim of the recommendations is to ensure sustainable, high quality practice-based learning, which enables learners to achieve essential learning outcomes and prepares them well to join the workforce, and to embed continuing evaluation and improvement into systems.

Three key messages from the stakeholders were:
• Quality is key, because we are training health professionals to provide patient care.
• There is increasing pressure on an already pressurised system, with Covid causing an acute exacerbation of a chronic problem.
• Yes, profession size does matter.

There are risks to maintaining and building practice education capacity and quality which have greater significance for smaller professions.
There are also profession-specific issues, which can be overlooked due to the lesser visibility and influence of smaller professional groups.
“Those in smaller professions often feel that they slip under the radar, compared with larger professions, who have louder voices, and make a bigger noise.”

The allied health professions encompass an extremely diverse range of professions, with significant differences in professional practice and training.
A “one size fits all” approach is unlikely to succeed. Any multi-professional approaches must consider the needs of every profession, however small.

Smaller professions, with fewer members, may benefit from collaboration at a higher level, perhaps regional or national, rather than local, especially around profession-specific considerations.

They may also need extra support or funding that is not in proportion to student numbers, because they lack economies of scale.


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