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Training healthcare professionals to be ready for practice in an era of social distancing: A realist evaluation

Lefroy, Janet; Bialan, Jessica; Moult, Alice; Hay, Fiona; Stapleton, Claire; Thompson, Jessica; Diggory, Kate; Mustafa, Nageen; Farrington, Julia; Aynsley, Sarah; Jacklin, Simon; Winterton, Adam; Cope, Natalie

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Jessica Bialan

Alice Moult

Claire Stapleton

Jessica Thompson

Kate Diggory

Julia Farrington

Sarah Aynsley

Simon Jacklin

Adam Winterton

Natalie Cope


Background Programme changes due to the COVID-19 pandemic have impacted variably on preparation for practice of healthcare professional students. Explanations for such variability in outcomes between institutions and healthcare professions have yet to be explored. The aim of our study was to understand what clinical learning, whilst under socially distanced restrictions, worked and why (or why not). Methods We conducted a realist evaluation of the undergraduate healthcare programmes at one UK university in 2020-21. The initial programme theories to be tested in this study were derived from discussions with programme leads about the changes they implemented due to the pandemic. Study participants were students and teaching faculty. Online interview transcripts were coded, identifying why the interventions in the programme had worked or not. This resulted in a set of ‘context-mechanism-outcome’ (CMO) statements about each intervention. The initial programme theories were refined as a result. Results and discussion 29 students and 22 faculty members participated. 18 CMO configurations were identified relating to clinical skills learning and 25 relating to clinical placements. Clinical skills learning was successful whether in person, remote or hybrid if it followed the steps of: demonstration – explanation – mental rehearsal – attempt with feedback. Where it didn’t work there was usually a lack of observation and corrective feedback. Placements were generally highly valued despite gaps in experience. Being useful on placements was felt to be good preparation for practice. Participant explanations from junior students about the value of various modes of induction to clinical workplace activity may also be relevant post-pandemic.

Journal Article Type Article
Deposit Date Oct 4, 2023
Publicly Available Date Oct 4, 2023
Journal Research Square
Publisher Research Square Company
Peer Reviewed Not Peer Reviewed
Publisher URL


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