1. Spending equal time with Band 5’s and seniors. Spending time with more junior staff is great for students because they may feel they can ask more ‘silly questions.’ However ‘dumping’ the student with other staff the entire time due to own time pressures and restraints does not expose that student to your own clinical expertise, knowledge and experience.
2. Initiative: Yes, students should use initiative but what many seniors forget is that some initiative, to a degree, is learned. For example if you have written reflection every 3 months for 10 years then when you get a free slot of time you will automatically think to fill it by doing that.
Lets show a non medical example.
On my first lesson at a riding school I was asked to put a horse out in the field (1st on the left). I had read many books, loved horses and cared about horses. I did so and half an hour later heard my name being called.” What are you doing? You have put it out with another horse and its got its head collar on?! Why didn’t you use your initiative and put it in the second field and take the head collar off?”
Why didnt I?
a) The field had two sections. I had previous knowledge of horses being put out together in a field, hundreds of pictures during my childhood of them roaming in fields together.
b) I had no previous experience of horses kicking and injuring each other. I had no experience/knowledge of horses injuring themselves with a head collar on.
c) It was a new environment and I didn’t have knowledge of their protocols.
So was I lacking initiative? I should have asked and specified exactly where to go/ what exactly to do, but again, would I have been met with a large sigh and impatience or marked down for lack of initiative?”
My point is, if you have years of experience and are used to doing your job, lit reviews, reading, reflective writing in free time and know this is acceptable behaviour then you are more likely do do this. For those who do not know they may well “hang around” awaiting instruction in fear of being marked down/doing something wrong. Never forget the layering of knowledge you have achieved over the years and the in depth multi faceted understanding that students are so desperately trying to cram in in the 3 years of their degrees to prepare them for the working world.
One good way to resolve these issues could be to have a resource that students can go to that shows different types of CPD and you can explain guidelines/what is expected from students. With such an overload of information something written can make preparation easier. Following a phone conversation with my educator I spent a panicked week trying to read up on ‘necofemia’ which I could find no where – What she was actually referring to was ‘neck of femur (fractures)’
3. Communication with your own boss: There needs to be good communication and understanding from all parties that students should get a decent amount of one to one learning time to practice skills. One of the biggest complaints is that hands on skills and assessment are weak with students. So take time to go through one aspect of this so that the student can practice, learn and develop. Yes students are with you to gain exposure but part of the learning experience is preparation. I was asked to assess a day 1 post op knee replacement (6 months into my first year) when all we had learnt was anatomy, sociology and some physiology. Looking back yes, static quads, straight leg raise, knee bends seem pretty straight forward now but I was too busy trying to memories my normal values of blood pressure, oxygen and heart rate. Storing information is hard – learning and layering/integration of knowledge needs to be better utilised.
4. Approachability: Explain to students day one that you are happy to answer questions. If you would rather they ask questions after the treatment then provide these guidelines at the beginning. It is sometimes a good tip that they write the question down on a pad so they don’t forget them. If you want the student to find the question out this is ok but sometimes it is helpful to have the answer immediately to help with brain mapping and memory (3 day, 3 week, 3 month rule). Cast your mind back to when you were on placement – one on my educators had me doing 3 hours of reading a night (my worst placement and I learnt the least).
5. Explain. Demonstrate. Practice. Development of a skill is not easy and although something might seem obvious to you even assisting an elderly patient out of bed there is a lot to consider (obs/conditions/ability/likelihood to faint/risk assessment/etc).