New innovations in the development of practice placement education for student dietitians
3.5 Education for practice placement educators must be within a process which acknowledges and uses their experience and is specific and developmental to the assessment process being used
Practice placement educators see training for themselves as having the greatest potential to assist in assessment (Figure 3). A lot of expertise in assessing students exists within each site. However, greater information and understanding of the assessment process is sought. In addition, the practice placement educators would like more power to make changes.
3.6 Self-directed learning, self-assessment and reflective practice are skills which need to be viewed as outcomes of practical training
The benefit to professional practice of developing skills in self-directed learning, self-assessment and reflective practice is recognised by both the practice placement educators and students alike though both groups acknowledge that they are unpractised in these skills. The practice placement educators would like students to be better able to self-direct their learning but report difficulty in knowing how to give the necessary information so that the student can self-direct. Students ‘prefer to be told what to do’ rather than to reflect or self-assess although there is evidence that these skills develop during practice placement.
The focus of this paper has been on describing how the study participants understand and make sense of the experiences of practice placement. It is important to note that the researchers’ knowledge and experience have an impact on the findings (see Ritchie and Lewis 2007). Therefore, the experiences and opinions described are explored using the authors’ understanding as well as that of the participants. The response rate of 62% and the level of detail provided indicate the interest in the topic of practice placement education among those involved in the education of student dietitians.
Exploring the data under the six themes reveals information from both the perspective of the practice placement educators and the students in relation to the challenges and the strategies to meet these challenges that the assessment of skill acquisition raises. Strong patterns with sound theoretical grounding have emerged.
The first of these raises the ‘competence’ versus ‘performance’ debate. The distinction between competence as being able to ‘show how’ and performance as being able to ‘do’ is described by many researchers (see Rethans et al. 2002; Watson et al. 2002; Wilson 2007). It makes apparent the gap that students need to bridge when moving into practice placement and highlights the lack of understanding of this ‘natural gap’. The practice placement educators believe the HEI staff have a different understanding of the students’ needs on entering placement and as a consequence spend a lot of time revising theory and bringing the ‘students up to speed’ so that they are ready for patient encounters. They also complain of lack of clear guidelines on implementation of the assessment process in the placement setting. The literature also reports similar disquiet between academia and practice placement; ‘the challenges involved in assessing practice were perceived to be compounded by limited active participation of academic staff in clinical practice and restrictive university regulations’ (Norman et al. 2002: 135). Issues such as ‘lack of power to make changes’, poor level of post-graduate training, procedural inconsistency, unclear definition of terms and high subjectivity all indicate the need for training the practice placement educators and for collaboration between the HEI and the practice placement settings on all issues pertaining to student training and assessment. Such training could facilitate understanding and collaboration between the HEI and the practice placement sites, leading to agreement on the needs of students on the commencement of practice placement.