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Table 1 Summary of data charting

From: Clinical placement models for undergraduate health professions students: a scoping review

Author and year

Country

Profession

Design

Name of placement model

Purpose of the study

Outcomes

Recommendations

McDonnel Smedts and Louw. (2008) [15]

Australia

Medicine

Quantitative

Block

To investigate the association of the placement approach with return to practice in the placement environment

- there was an association between longer periods of placement and the return of graduates to take up internship in the Northern Territory

- research on the elements of longer placements and students who return

- investigation on the characteristics of students that return

Birks et al. (2017) [16]

Australia

Nursing

Qualitative

Block

To compare students’ perceptions on the impact of block placement over distributed placements

- “We’re there to learn”

- block has advantage of consistency over distributed placement

- feeling part of a team

- adequate preparation of clinical environment and the staff who support students undertaking clinical placements

- distributed placements may be of greater value earlier in the programme and block placements in senior years

- ensure appropriate sequencing of placements to align with theoretical and chronological stages of study

- promoting consistency by enabling students to return to a familiar venue

- adequately preparing the clinical environment for students they receive on placement

- establishing a culture that encourages students to feel as though they are members of the team

Kell and Owen (2009) [17]

United Kingdom

Physiotherapy

Case study

Block

To describe the possible influence of the placement learning environment on students’ approaches to learning

- the numbers of educators and assessors involved in the placement education affect the approach students adopt to their learning.

- having more than two students in any one placement may increase their fear of failing the placement

- students achieving the highest placement grades are those who perceive themselves to be strategic learners with a very low fear of failure

- students with the lowest placement marks have the highest fear of failure

- deep learning may be greatest on lone student placements

- surface approaches to learning may be greatest where two students share a placement

- students perceived the greatest ability to monitor their effectiveness on individual placement

- for most students, there was a strong positive relation between predicted and actual placement scores

- students with the greatest difference between their self-rated and actual placement marks were those who perceived themselves as deep learners

- there was no gender interaction

none reported

Blakely et al. (2009 )[18]

United Kingdom

Occupational Therapy

Not reported

Collaborative 2:1 placement model

To describe the students’ experience of the 2:1 placement model

- individual students offer a confidential arena to discuss issues

- peer supervision allowed for students to learn about different learning styles

- combining supervision styles was helpful for students

- model worked well where there was no need for a clinical case load

- an opportunity to enable students to engage in a range of supervision styles

- need for more clinical facilitators

Cohen et al. (2015) [7]

United States

Midwifery

Quantitative

Collaborative clinical learning dyad model (CLDM)

To evaluate the CLDM model through a survey to assess usage, attitudes and perceived programme benefits and challenges

- increased programme capacity

- increased interaction between students

- opportunity for peer-to-peer learning

- scheduling flexibility benefit

- less time doing orientation

- research on the impact of the model on senior students

Kreulen et al. (2008) [19]

United States

Nursing

Quantitative

Collaborative clinical education partnership model

To evaluate the clinical education partnership model

- students were satisfied with the model

- students met course objectives, understood special health care needs, and felt comfortable intervening to help children and families

- staff agreed that students helped in meeting health needs of the community

- commitment of both the school district and college administration is crucial

- leaders from each partnership agency are needed

- positive ongoing interaction

Newton et al. (2012) [20]

Australia

Nursing

Quantitative

Collaborative preceptor partnership model

To investigate the clinical learning environment from the perspective of students participating in a structured partnership model

- students did not rate the clinical learning environment favourably

- student-centeredness was reported from the students the structured model

- continuity of the clinical teacher is integral in facilitating students’ engagement in the learning environment

- research on the tensions between clinical practice environments and student learning is recommended

- follow-up with both levels of practitioner is essential

Newton et al. (2011) [21]

Australia

Nursing

Qualitative

Collaborative clinical partnership model

To describe factors that facilitate or hinder nursing students’ perceptions of their work-readiness upon graduation

- students felt support and were made to feel part of the professional team

- students acknowledged understanding staff and organisation, and not having to ‘re-learn’ information about each setting afforded them greater confidence and the ability to participate meaningfully

- the work environment fostered a sense of belongingness and generated a degree of work-relatedness

- the model is dependent on the commitment of nurses

- recommendations for preceptor training and recognition

- further research on alternative partnership models of clinical learning to ensure that graduates ‘hit the ground running’

- research on how healthcare organisations could foster a culture of learning practice

Bhagwat et al. (2018) [22]

Australia

Speech and language therapy

Mixed methods

Collaborative paired and single clinical placement models

To compare paired and single clinical placement models relative to time use by students and clinical educators

- Clinical educators and student time use was not significantly different when comparing placement models

- the clinical educators paired and single cohorts had similar time use

- high satisfaction with both models

- paired placements can be used with limited implication on service and time

- clinical educators and students need engagement in patient- and non-patient-related activities

Lynam et al. (2015) [23]

Ireland

Dietetics

Qualitative

Collaborative 2:1 placement model

To pilot the 2:1 placement model

- a framework for implementing a 2:1 model was developed

- need for optimal guidelines

- the need to schedule one-on-one time within the 2:1 model to enhance transparency

Nash et al. (2009) [24]

Australia

Nursing

Mixed methods

Collaborative transition model

To describe the preparedness to practice by final-year nursing students exposed to two separate clinical placement models

- there was no significant difference between students exposed to the collaborative model and those who were not regarding their preparedness

- a sense of belonging to a team

- being part of a team

- experiencing the real world of nursing practice

- students in the trial model rated themselves higher in preparedness before and after the intervention

- essential to match students to an appropriate placement model

- students should be aware of the placement options

- further research on student characteristics and matching with transitional models, including their preferred learning styles

Martin et al. (2004) [25]

United Kingdom

Occupational Therapy

Qualitative

Collaborative 1:1; 2:1; 3:1 placement model

To determine the impact of different models of practice placement (1:1, 2:1 & 3:1) on the quality of education for students and on the quality of the experience for educators in Occupational Therapy

- a general preference on the 2:1 model

- peer support in the 2:1 & 3:1 clinical placements

- peer learning opportunities

- time for facilitating learning in the 1:1 model was more

- essential for adequate planning in all the models

- practice educators need to familiarise themselves with new approaches to peer learning

- higher education institutions should continue to inform students and practice educators of the benefits of being associated with multiple placement opportunities

- design authentic placement opportunities informed by the environment

- research on different models for placement models for different settings

Alpine et al. (2019) [26]

Ireland

Physiotherapy

Quantitative

Collaborative

2:1 model

To evaluate practice placements using 2:1 supervision and implementation models by students and practice educators

- shared learning experience was identified as a benefit of the model

- peer support environment

- the development of peer evaluation and feedback skills by students

- it is essential to match students with appropriate clinical placement models

- clear guidance to students on the provision of peer feedback and support for educators in providing feedback to two different students

Moore et al. (2003) [27]

United Kingdom

Physiotherapy

Qualitative

Collaborative 1:1, 2:1 and 3:1 placement models

To compare experiences of clinical educators and students using different clinical placement models

- success of a placement model is dependent on planning

- all placement models have a place in physiotherapy education although there was a general preference for the 2:1 placement models

- it is essential that placements be well planned

- enough time should be made available for the educator to meet individual students

- sufficient patients are made available for students

Price and Whiteside (2016) [28]

Australia

Occupational Therapy

Qualitative

Collaborative 2:1 model

To examine supervisor experience in a trial of the new model, namely the 2:1 model

- strategies, such as consulting evidence, being prepared, setting joint tasks, seeking support, and adopting a positive attitude

- supervisors should seek out research and practitioner knowledge and guidance

- supervisors should plan and identify learning opportunities in advance

- individual supervision should be made available for students

- organisational and collegial support should be mobilised and formalised

- ensure patients are comfortable with student numbers

- communication between students and supervisors

- positivity and pragmatism

O’Connor et al. (2012) [29]

Ireland

Occupational Therapy

Qualitative

Collaborative 2:1 and 1:1 placement models

To describe the perspectives of clinical educators and students who participated in both the 1:1 and 2:1 models of clinical education across Occupational Therapy and Physiotherapy

- learning experience from the 2:1 models was better than from the 1:1 model

- 1:1 model were easier and better to organise compared to the 2:1 model

- relationships enhanced the function of the models, between supervisors and also among students (2:1 model)

- further research may be warranted to explore the timing of different clinical education models

- need for different types of preparation per model

- need to increase the emphasis on formative assessment

- essence of preplanning to enhance the implementation of the model

- educators need to be aware of individual students’ learning needs to avoid student dissatisfaction

Barnett et al. (2010) [30]

Australia

Nursing

Qualitative

Collaborative university and rural hospital partnership

To develop and evaluate a collaborative model for clinical education that would increase the capacity healthcare agency to accommodate student placements and improve workplace readiness

- the model resulted in 58% increase in the number of students and 45% increase in capacity of placements over a a four-year period

- students valued access to and working one on one with preceptors

- staff was approachable

- there is a need to test models of preceptorship that could build the capacity of a hospital when there are fewer full-time and more part-time RNs available as preceptors

Didion et al. (2013) [31]

United States

Nursing

No design reported

Collaborative integrated clinical education model

To describe the implementation of a clinical teaching model

none described

- strong partnership between the university and a larger integrated healthcare environment

Taylor et al. (2015) [32]

Australia

Nursing

Multiple methods

Collaborative The Hospital and University Learning Investment Project (TULIP) model

To describe students’ perceptions, preceptors’ understanding and organisations’ partnership capacity and capability over a three-year period

- staff and students ready to learn together because of collaboration and multi-pronged collaboration

- partnership approach

- increase placement capacity

none reported

Svejda et al. (2012) [33]

United States

Nursing

Qualitative

Collaborative partnership model

To describe the pilot outcomes of implementation of a partnership model

- enthusiasm in participating in pilots

- need to adapt the model in the changing healthcare environments

Gilmour et al. (2013) [34]

Australia

Midwifery

Qualitative

Combination block and integrated 2 days per week

To compare students’ experiences between two undergraduate models of clinical placement

- student role

- facilitated learning

- belonging to the team

- no one model was favoured, the role of bad midwives influenced students’ experiences

none reported

Greenhill et al. (2018) [35]

Australia

Medicine

Qualitative

Combination block,

Longitudinal Integrated Clerkship,

Community and hospital-integrated learning

To determine the transformations students experienced within the sociocultural context of clinical practice

- self-awareness

- patient-centredness

- systems thinking

- self-care

- clinical scepticism

- understanding diversity from seeing people

- medical schools must include the learning objectives of critical thinking, clinical scepticism and system thinking in the clinical curriculum to promote a perspective change in their graduates

Patterson et al. (2017) [36]

Australia

Nursing

Quantitative

Combination traditional multi-facility clinical placement model (TMFCPM), the university fellowship programme (UFP) and the mixed programme (MP)

To examine perceptions of work-readiness of new graduate nurses who attended one of the following three clinical placement models:

- traditional multi-facility clinical model (TMFCPM)

- the university fellowship programme (UFP)

- the mixed programme (MP)

- only the university fellowship programme was significantly associated with better work-readiness

- students’ understanding of and integration with an organisation were better when transitioning to the graduate nurse role

- organisational partnerships enhance graduates’ work-readiness

DeMeester et al. (2017) [37]

United States

Nursing

Qualitative

Combination traditional learning models (TLM), hospital learning model (HLM) practice–education partnership (PEP)

To gain insight into the experiences of students, preceptors and staff member stakeholders in three clinical learning models: the traditional learning models, the hospital learning model and the practice-education partnership

- promotion of learning

- hindrances to learning

- preceptors’ perceptions of positive aspects

- preceptors’ recommendations for change

- staff perceptions of most and least effective aspects of clinical models

- inclusion of nurse, authenticity and non-comprehension

- further study to understand the findings related to the practice of clinical education better and more broadly

Henderson et al. (2006) [38]

Australia

Nursing

Quantitative

Combination facilitation model; preceptor model and the clinical education unit

To assess the perceptions of undergraduate nurses of the psychosocial characteristics of clinical learning environments within three different clinical placement models

-the preceptor model rated high on all measures of clinical learning inventory

- the facilitation and the clinical education unit yielded high scores on student numbers

- models required to be adapted to suit particular university curricula and clinical environments

Kumm et al. (2016) [39]

United States

Nursing

Quantitative

Combination models

Models not specified

To compare the perceptions of nurse preceptors of students’ proficiency during clinical immersion models

- no significant difference between immersion models

- competition for clinical sites as well as time and cost to support lengthy rotation offerings should be considered

Goslee et al. (2020) [40]

United States

Nursing

Multiple methods

Dedicated Education Units

To assess the perception of nursing students and clinical teachers of the quality of the dedicated education units clinical education model in primary care

- positive experiences with the DEU model

- learning needs were a priority due to continued communication and collaboration between staff nurses and staff members

none reported

Grealish et al. (2018) [41]

Australia

Nursing

Qualitative

Dedicated Education Units

To determine the feasibility of a clinical placement model

- feasibility is dependent upon aligning stakeholder expectation with the new model, clarify roles and responsibilities within clusters, develop strategies for collecting information about student performance

- clarification of roles and responsibilities to be continually negotiated

- further research into the model, its overall effectiveness and efficiency, as well as further research to find elements that are critical for implementation

- more research on how students, newly qualified nurses and staff learn in localised work units and practice pedagogies in practice

Hannon et al. (2012) [42]

United States

Nursing

Qualitative

Dedicated Education Units

To describe the experiences of nursing students when partnering with the same registered nurse throughout the clinical experience

- relationship building

- communication was essential between staff and university based educators

- adjustment of the timetables to enable student function

Mulready-Schick et al. (2013) [43]

United States

Nursing

Quantitative

Dedicated Education Units

To describe the effect of the dedicated education units in education quality in nursing students

- education quality and learning gains are significantly more positive for students clinically instructed in dedicated education units

- positive learning experience by students

- greater growth in clinical learning and development of nursing knowledge

- more time spent on instructional activities

- focused research on evaluation of clinical performance using standardised tools

Moscato et al. (2013) [44]

United States

Nursing

Qualitative

Dedicated Education Units

To describe the replication of the dedicated education units at two universities in the United States

well replicated

none reported

McKenna et al. (2009) [45]

Australia

Midwifery

Qualitative

Innovative model home hospital clinical placement model

To explore health professional students’ clinical experiences and their impact on career intentions

- enhance familiarity with clinical staff

- increased knowledge retention

- students should undertake clinical placements in the same clinical setting for an extended period of time;

- further research in other professions and contexts should be done on benefits of bringing clinical experiences directly into the classroom setting to extend learning

Timm et al. (2021) [46]

United States

Multi-professionals (Nursing, Exercise Sciences & Graduate Counsellor Education)

Mixed method

Innovative model interprofessional faculty–student-led clinical education model

Evaluate how a new clinical education model, focused on interprofessional practice and service to the community, would provide clinical training for nursing and other education programmes effectively

- interprofessional growth and teamwork, unorthodox learning environment

- a culture of ‘team-ness’

- primary and secondary prevention, reaching underserved in the community,

- Investigation of strategies to enhance the faculty–student-led clinics, curricular development, and inform other programmes.

Mumford (2007) [47]

United Kingdom

Medicine

No method stated

Innovative model clinical academies

Evaluation of an innovative clinical placement model

- no deterioration in standards of student achievement

- positive rating from students

- students applauded the organisation and leadership

- universities to adopt this placement model

Kevin et al. (2010) [48]

Australia

Nursing

Multiple methods

Innovative model alternative weekly placements

Explore students’ experiences of an innovative model

- students learnt and felt supervised

- integration of learning

- sense of familiarity

- lack of time for clinical learning

- recognise the value of the sense of familiarity among students and the clinical staff

Fairbrother et al. (2016) [49]

Australia

Physiotherapy

Mixed methods

Innovative model capacity development facilitator (CDF) model

Evaluation of a pilot of the capacity development facilitator model through the identification of enablers, barriers and stressors in the clinical placement

- learning resources and support were identified as superior

- another set of ‘eyes and ears’ on site made the students feel comfortable

- stress levels were higher at the beginning of placement compared to the end, and students reported the support from the work and capacity development facilitator model helped them to manage stressors

- placement allocation data increased in student placement capacity ranging from 63 to 153%

- the introduction of the capacity development facilitator model and its evaluation in different contexts

- further research to ensure the cultivated, mutually beneficial relationships, improved student learning outcomes and enhanced services for consumers are maintained

Marshall et al. (2012) [50]

United Kingdom

Nursing

Mixed methods

Innovative model- ‘the sandwich approach to clinical placement’

To examine the implementation of an initiative that enabled third-year adult field student nurses the opportunity to spend the final year of education within the community setting

- confidence

- placement diversity

- knowledge, skills and diversity

- ensure the skills students are expected to achieve would cover those needed for the community setting

Campbell et al. (2019) [51]

Australia

Medicine

Quantitative

Longitudinal Integrated Clerkships

To compare first, the work locations (regional or more rural) of medical students, following registration as a medical practitioner, who had other types of rural training of comparable duration elsewhere, and second, students who had no rural training

- students who undertake the East Gippsland rural longitudinal integrated curriculum and additionally participate in rural training in other years (average rural training during 2.0 years) are the most likely group to subsequently work in smaller regional or rural towns

- students whose only rural training was through Longitudinal Integrated Clerkship platforms were more likely to be in rural practice than those who only trained in metropolitan areas

- the study revealed that medical students who undertake rural training for more than a year (non-Longitudinal Integrated Clerkships) were more likely to work rurally than students wholly training in metropolitan areas

-strong and influential locally representative leadership is a prerequisite for sustaining rural Longitudinal Integrated Clerkships programmes

Poncelet et al. (2014) [52]

United States

Medicine

Quantitative

Longitudinal Integrated Clerkships

To compare knowledge scores between students engaged in a LIC and those who were not

- scores at entering clerkship did not differ between the students

- clinical knowledge scores did not differ at the completion of the clerkship

- the clinical performance examination scores demonstrated significantly higher performance by Longitudinal Integrated Clerkship students in the data gathering domain

- the perceptions of the Longitudinal Integrated Clerkship students did not differ significantly from the traditional students

- Longitudinal Integrated Clerkships students received significantly higher internal medicine examination scores that traditional students

- communication and coordination

- contribution from experienced administrators

- partnerships could focus on longitudinal clinical experiences

- systems-based practice or population health experiences and curricula in a functional primary care system

Daly et al. (2013) [53]

Australia

Medicine

Qualitative

Longitudinal Integrated Clerkships

To illustrate the pedagogical and socio-cultural underpinnings of student learning theoretically within a longitudinal, integrated, community-engaged rural placement

- the physical and social geography shaped the scope and nature of student learning and socialisation experiences

- the placement comprised a series of interconnected learning spaces

- the variability in supervision was shown to limit student learning and active participation

- connectivity was a key process by which the boundaries between these learning spaces were identified, negotiated and crossed

- students can be coached to recognise the embedded Community of Practice and social networks

- medical educators need to work on developing reciprocal relationships

- it is also important to ensure that students receive practical guidance

Ogur et al. (2007) [54]

United States

Medicine

Multiple methods

Longitudinal Integrated Clerkships

Evaluate the Harvard Medical School- Cambridge Integrated Clerkship (HMS-CIC) clinical placement model

- 100% of the HMS-CIC students responded that “very often” or “often” they saw patients before diagnosis and decision for admission, compared with 20% of comparison group.

- 100% of the HMS-CIC students responded that they very often or often saw patients they treated after discharge

- students received feedback often and mentoring from faculty when compared to other students

- Objective Structured Clinical Examinations scores were similar and higher in some areas when compared to other students

- OSCE revealed that the HMS-CIC students had higher scores for communication.

HMS-CIC students found the year rewarding when compared to the other students

leadership and support and ongoing faculty development programme

Boardman et al. (2019) [55]

Australia

Nursing

Qualitative

Longitudinal integrated clerkships

To evaluate the perspectives of students and preceptors of the mental health integrated clinical learning model in an Australian metropolitan acute admission and extended care rehabilitation unit

- preparedness for practice

- maintaining a work–life balance

- perceived being part of the team

protracted learning

none reported

Hunt (2006) [56]

Australia

Occupational Therapy

No method stated

Project-based clinical placement models

Describe the project-based model and assessment outcomes

- raised profile of the profession

- autonomy and responsibility allow students to gain important professional and generic skills

- provision of an aspect of service that had previously been out of reach

- high level of satisfaction by students

- exploration of student experiences of project-based placement

Linnane and Warren (2017) [57]

Ireland

Occupational Therapy

Quantitative

Role-emerging

To generate views from occupational therapists and occupational students on the use of role-emerging placements in the Republic of Ireland

- wider gains of community

- promoting profession

- opportunity to transfer knowledge

- poor communication

- difficulty in assessment of students

- research on organisational culture, rigour and vigilance for learning

Roxburgh et al. (2012) [58]

United Kingdom

Nursing

Multiple-case study

Spoke and hub

To develop, implement and evaluate the impact of spoke and hub models of practice learning across geographically diverse locations

- belongingness

- different learning experience

- adaptability of skills at hub

- communication and teamwork

- logistical changes

-improved communication at hub

Thomas and Westwood (2016) [59]

United Kingdom

Nursing

Qualitative

Spoke and hub

To describe students’ experiences related to the spoke and hub model

- belongingness as a pair of hands to being part of a team

- broader understanding of patients’ journey, context, connection and continued learning

- mentors are helpful and enthusiastic

- some mentors need orientation to the placement model

-improved communication between hub and spoke

Grealish et al. (2013) [60]

Australia

Nursing

Mixed methods

Student-led

To determine the viability of (student-led placement) innovation by developing a preliminary understanding of what students were learning and exploring stakeholder perceptions about student learning

- knowledge scores increased after placement

- students reported deep learning

- enactment of complex concept e.g. professional identity and self-realisation, collegiality, willingness to share, responsibility, accountability

- designing the placement should have adequate infrastructure for large numbers of students

- further research in organisational learning culture where students are placed

O’Connor et al. (2019) [61]

Ireland

Physiotherapy

Qualitative

Student-led

To explore the challenges and facilitators of a community-based, student-led placement involving physiotherapy undergraduate students and community-based groups

- leadership, teamwork and ability to accommodate individual service user needs

- sense of anxiety regarding placement structure prior to commencement

- mutual and shared learning experiences

- challenges in embracing change

- continued engagement of service users in the design and implementation of the placement model