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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

Jessica Thompson

Julia Farrington

Sarah Aynsley

Adam Winterton


Programme changes due to the COVID-19 pandemic have impacted variably on preparation for practice of healthcare professional students. Explanations for such variability need exploration. The aim of our study was to understand what clinical learning, whilst under socially distanced restrictions, worked and why (or why not).

We conducted a realist evaluation of the undergraduate healthcare programmes at one UK university in 2020–21. 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 interventions 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 some deficiencies in student experience. Being useful on placements was felt to be good preparation for practice. If student numbers are to expand, findings about what works in distance learning of clinical skills and the value of various modes of induction to clinical workplace activity may also be relevant post-pandemic.

Journal Article Type Article
Acceptance Date Oct 22, 2023
Online Publication Date Dec 8, 2023
Publication Date Dec 8, 2023
Deposit Date Oct 4, 2023
Publicly Available Date Oct 4, 2023
Journal Advances in Health Sciences Education
Print ISSN 1382-4996
Electronic ISSN 1573-1677
Publisher Springer
Peer Reviewed Peer Reviewed
Keywords COVID-19 pandemic, Undergraduate healthcare students, Clinical preparedness, Placements, Clinical skills
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