Ruth Heffernan and Victoria Grundy share their experience of providing a virtual placement with the health visiting team for pre-registration student nurses.
In 2020, the NMC changed its standards for first-year undergraduate students of pre-registration programmes in response to the Covid-19 pandemic. This change recognised the pressures on the health and care workforce during that period and allowed for the required overall 50-50 split of theoretical and clinical hours to be made up over the remainder of the programme.
I am employed as a lecturer in adult nursing at the University of Manchester but come from a health visiting background. I worked closely with Victoria, who supported our student nurses in their community placements at a partner trust (Tameside and Glossop). In January 2021, we were asked to develop a bespoke virtual health visiting placement. A small number of our students remained clinically vulnerable and were unable to return to the learning environments as vaccinations were not then readily available.
Victoria agreed to support the students through this virtual learning experience with the health visiting team. We wanted our students to have an authentic experience with health visitors. We also wanted them to experience the difficulties faced by the service as the pandemic unfolded. The virtual health visiting team was based in a virtual learning environment called Jubilee Street.
Working collaboratively and using this virtual platform enabled our students to experience a meaningful learning opportunity and gain valuable practice-related hours
Jubilee Street is a virtual community with a diverse population reflecting a typical community in the centre of Manchester. It was originally created by my colleagues in the university to facilitate learning in modules including public health and collaborative care planning, and it was used to facilitate a community nurse placement during the lockdown in the summer of 2020.
I created a three-week remote placement with the health visiting team and, working closely with a HV colleague, we sought to reflect the delivery of real health visiting community services during lockdown.
A welcome pack introduced the students to the requirement of the placement; this included the expectation that the student will demonstrate the professional values expected of all students on placement. The pack explained that due to the ongoing pandemic, they would be working remotely and undertaking activities as they would in a real-life placement. All virtual learning resources were accessed via our online learning platform (Blackboard). As this was a simulated practice placement, students did not have a practice supervisor or assessor so the community HV and I acted in this capacity. The intention was that students would have an interactive, meaningful experience based on engagement with the households of Jubilee Street. We met with the students every morning and discussed the planned activities for the day. We also met some evenings for a debrief session.
Week by week
Each week of the placement had a theme, beginning with the core principles of health visiting practice, then developing their communication skills and, finally, exposing them to the complexities faced by HVs.
In week one, we used case studies to learn about universal health visiting provision. The focus was on normal child development and the universal services on offer for all families. Students participated in activities that closely linked to the experiences they would have if they were with the health visiting team in practice. They learned about social and emotional development in early childhood, responsive feeding, the childhood immunisation schedule and the developmental assessments that babies and children have through the service. They worked together to provide a piece of work at the end of each week to demonstrate their learning. The aim was to make the experience as close as possible to the genuine experience that they would have with the health visiting team.
Week two focused on therapeutic communication techniques, and the students were introduced to motivational interviewing (MI).
In the third week, students were exposed to the more complex situations they might experience on placement with a HV. These learning experiences included examining cases of domestic abuse, safeguarding and perinatal mental health. We held daily morning and afternoon debrief sessions. These debriefs acted as an essential part of the learning as students were exposed to potentially distressing case studies.
The real benefits
Students were awarded practice-related hours for this virtual placement, therefore we were required to closely monitor their engagement with the learning. To evidence their engagement we asked the students to be present for the daily debrief. We also required them to submit a practice-focused piece of work at the end of each week that demonstrated their engagement. To support the virtual placement approach, these were resources they may have created in practice – a presentation on one of the key roles of the HV, a reflection of an MI-based discussion, and a health promotion activity.
During the virtual placement the students worked closely as a team. They liaised with each other to develop a research-based educational learning resource for other students/learners related to what it is currently being covered in placement. For example, they re-wrote the Student Information Pack and created a resource pack containing information on the Healthy Child Programme, immunisation, infant feeding, public health and so on. They shared resources by facilitating peer teaching and learning sessions. This aided the learner’s development of communication and presenting skills.
The virtual placement was evaluated well, and students said they had learned a great deal about the work HVs do and that it felt as close to possible like a placement with the service. HVs continue to work in extremely difficult circumstances and supporting students can remain a challenge.
Working collaboratively and using this virtual platform enabled our students to experience a meaningful learning opportunity and gain valuable practice-related hours. Elements of the learning have been adopted by practice staff to support students when they are placed with health visiting teams, and we continue to use the virtual community in Jubilee Street in other aspects of the students’ learning journey.
Ruth Heffernan is lecturer in nursing at the University of Manchester; Victoria Grundy is infant feeding health visitor at Tameside and Glossop Integrated Care Foundation Trust.
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