Workplace training is crucial in preventing another Mid Staffs, but we know little about what works

Karen Schucan Bird and Mark Newman

The public inquiry into the breakdown of care at Mid Staffordshire NHS Trust highlighted the important role of education and training in ensuring that similar failures were prevented in the future. It was one of many reports that have recently highlighted the importance of workplace-based learning for the delivery of a modern health service. The Willis Commission on nursing education, for instance, emphasised the importance of the work placements provided by the NHS.

Learning ‘on the job’ is an essential part of the training to become a doctor, nurse or other healthcare professional in the UK. Workplace-based learning is built into training from the early stages. Before registering as a nurse, for example, students must spend half of their time caring for the public in a clinical or public health setting. Work placements are expected to ensure that professional standards and capabilities are passed down to the next generation of healthcare workers. Work-place based learning is vital for healthcare students but what do we know about its effects?

Very little it seems. Whilst work placements are an integral part of professional training, little UK research allows us to confidently assess their impact. This is the finding of a new report from the IOE’s EPPI Centre that described the state of UK research on workplace-based learning for students of the healthcare professions. Our systematic review of recent research only found a handful of studies (six) that examine whether work-place based learning actually serves to improve student attitudes, skills or knowledge. No studies at all were found that reported on the impact of work-place based learning on patients, hospitals or other NHS organisations. The effects of placements on patient health and treatment, for example, remain unexamined.

This report used systematic methods to search and identify all relevant empirical studies in the field. Searching comprehensively across databases and websites, the report found 117 studies focused on work-based learning in UK settings for students of the healthcare professions. These studies were then subject to a descriptive analysis in order to generate a picture of what the research looked like between 2003 and 2013.

So if the research doesn’t tell us much about the effects of workplace-based learning, what does it report? The majority of studies tell us something about the experiences and views of those undertaking a work placement. 95% of the studies included in the report examined the perceptions of the placements by students, educators or patients. These studies covered various professions, but nurses’ experiences were most prominent in the literature.

On the basis of these findings, we argue that we need more research that uses quantitative, independent measures of outcomes to investigate the impacts of work-placed based learning. This will complement and extend the existing research base so that we can develop a more thorough understanding of how to support and promote effective workplace learning opportunities for students in the healthcare professions.

 

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Posted in Evidence-based policy, Further higher and lifelong education
2 comments on “Workplace training is crucial in preventing another Mid Staffs, but we know little about what works
  1. educationstate says:

    “Work-place based learning is vital for healthcare students but what do we know about its effects? Very little.”

    This pretty much sums up the evidence-based policy community. Because something hasn’t been given the quantitative once over, it doesn’t count as ‘robust’ knowledge.

    Some advice for said community: don’t keep telling practitioners that they are suffering from a knowledge deficit when clearly there isn’t one (for how are institutions run? Magic?). Instead, offer to support them with further information. Hardworking, underpaid, time-poor professionals will be much more appreciative if you do.

    And remember the real reason for MidStaffs: managerialism, to which incidentally EBP is very closely allied.

    • Mark Newman says:

      Thanks for responding to this ‘educationstate’. As you point out many healthcare staff are supporting learning in healthcare workplaces and working very hard to try and provide supportive workplace learning environments in challenging conditions. However they do this in many different ways and because they conditions are so challenging it is important that we ask questions about how we can best use the resource provided by these experts to support learning. I think our reference to the report on Mid Staffordshire Trust was not meant to imply an endorsement of its claims but rather to highlight the incongruity between what was stated in the report and subsequent action by funders and commissioners such as HEE to provide serious investment in researching workplace learning in healthcare. There may well be as you suggest many other issues that could be debated and discussed about the report and subsequent actions by providers, funders, the DoH and others.

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