Glasgow Caledonian University researchers have called for national change to “end a growing crisis” in NHS student placements, proposing a 2-1 student to staff ratio approach.

Placements for students on allied health professional (AHP) courses, including radiographers, paramedics and physiotherapists, currently operate as one student linked to one member of NHS staff.

As these placements account for a third of the average AHP student education programme, researchers are concerned that without change to the traditional approach, the NHS faces a future shortage of qualified AHPs.

Professor Katrina Bannigan, GCU Head of Occupational Therapy, Human Nutrition and Dietetics, and Anita Volkert, GCU AHP Practice Placements Lead and Occupational Therapy Lecturer, recently published a paper urging change to at least two students per member of staff. In this piece, they state that the current 1-1 approach is “unsustainable” and concluded that:

“New models of practice-based learning have been adopted and piloted, now is the time to take another bold step and implement a profession-wide approach to peer learning where a minimum of two students are involved in every placement.”

With fellow academics from Glasgow Caledonian University (GCU), they say the drafting of students to the frontline during the pandemic brought this crisis to a head – with many placements cancelled so students could support the NHS.

Professor Bannigan called for urgent support to change the placement model:

“During covid, universities in partnership with practice were incredibly creative with simulation and online placements and it’s extremely valuable but it just isn’t enough.

“It isn’t solving the underlying problem of supply and demand. We just don’t have enough placements for the students that we’ve got. It’s a national, UK and worldwide problem. Implementing this 2-1 model overnight could solve the placement crisis so we need the NHS to buy into this now.”

With around 4,500 AHP students in Scotland, Professor Bannigan is concerned that demand will not be met under the current approach if they cannot qualify all the students into their professional roles due to placement shortages.

Gail Nash, AHP Practice Education Programme Lead, NHS Education for Scotland, acknowledged the need for post-covid “placement recovery” while creating and delivering sustainable solutions to placement issues.

Ms Nash said NHS Education for Scotland are exploring peer-assisted learning and other placement models with AHP professionals across Scotland to find the best approaches for placement delivery.

Professor Bannigan and Volkert propose that if a 2-1 approach is adopted as standard practice, it could solve the placement problem “overnight” and “ready our workforce for the future”. Ms Volkert said that while such a rapid change may spark fear among staff with the perception that it may create more work, research shows it may in fact reduce workload.

Within the editorial, the GCU researchers explained:

“This is because this model uses a peer learning approach, rather than being two students working separately with an educator on a one-to-one model.

“Instead, students work together; they may have different skills sets from previous placements and life experiences which they can share and teach each other; they can offer each other informal support, and during any ‘down time’ that may crop up, they can spend time with each other.”

Professor Bannigan told healthandcare.scot that the approach better reflects the work environment students will enter into and can improve their learning environment. She said students will “learn how to work collaboratively” as a team and can focus on solving complex issues together. She added:

“This enables them to hit the ground running because it increases students’ autonomy, and enhances learning, skills and confidence.”

Professor Helen Gallagher, SHLS Vice-Dean welcomed the work of the GCU academics calling for change in practices at a national level. She said the growing demand means innovative supervision models must be created, evaluated and implemented to ensure “an excellent learning experience” for students and support their progression to “safe, caring and fit for purpose” professionals.

While the researchers are calling for urgent change, Professor Bannigan, who currently oversees six  occupational therapy students herself, also acknowledged the potential concerns of staff. She said:

“There is no denying this approach requires careful preparation and planning, and issues with incompatible students but with strategies in place it can work really well.”

Referencing research papers on peer-assisted learning, she explained that an associated increase in professional competence and self-confidence has been reported. She added:

“More allied health professionals are going to be needed in the next decade to support the health and well-being of a population where there will be higher levels of frailty, complex social justice issues that impinge on health, a greater emphasis on public health and more delivery through primary care. This is why we need this radical change.”

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