Finding your feet: student participation during initiation of international clinical placements: Student participation during initiation

Abstract

Introduction International placements challenge students to find the right level of participation, as local practices, language and time pressure may affect their engagement in patient-related tasks or team activities. This study sought to unpack the initiation process during international clinical placements with the ultimate aim to achieve active student participation. Methods Following a constructivist grounded theory approach, we conducted two individual interviews with 15 undergraduate healthcare students (before departure and whilst on placement). To identify emerging themes, we applied an iterative process of data collection and constant comparative analysis. Several team discussions informed further analysis, allowing us to reach a more conceptual level of theory. Results From our findings we constructed a fourphase model of healthcare students' initiation of international clinical placements, which brings into focus how the phases of 'orientation', 'adjustment' and 'contribution to patient care' build up towards Note: For purposes of enhanced coherence and legibility, quotes have been subject to light editing before journal submission. The authors, however, based their analysis on the original, raw transcripts. Original transcripts are available upon request from the first author. The authors alone are responsible for the content and writing of this article.

International short‐term placements in health professions education—A meta‐narrative review

“…Various challenges, such as emotional shock 91,105,106 and language barriers, 96,101,107 may impede the learning process, which is promoted by building relationships with the host community, home faculty and peers 99,106,108–110 . Similarly, interpretivist studies in allied health describe a sequence of stages in the process when students adapt to the workplace and develop cultural competence using problem solving and creativity to overcome initial challenges 111–117 . In both health professions, interpretivist studies report a positive impact on a range of outcomes, such as global awareness 112,114,118–121 and increased confidence in the professional role, 102,115,120,122–124 whereas positivist studies show a positive effect on cultural competence 125–133 …”

“…99,106,[108][109][110] Similarly, interpretivist studies in allied health describe a sequence of stages in the process when students adapt to the workplace and develop cultural competence using problem solving and creativity to overcome initial challenges. [111][112][113][114][115][116][117] In both health professions, interpretivist studies report a positive impact on a range of outcomes, such as global awareness 112,114,[118][119][120][121] and increased confidence in the professional role, 102,115,120,[122][123][124] whereas positivist studies show a positive effect on cultural competence. [125][126][127][128][129][130][131][132][133] By contrast, only one positivist study has a strong focus on this outcome in medicine, reporting a significant increase in cultural competency in travelling students.…”

Resident training in psychopathology and uncertainty in a clinical situation

“…The transition implies a change in the residents’ role from being active agents to passive spectators in the discussion, and in such contexts, learning shifts from being instructional to observational. Wijbenga et al (2020) specified the importance for healthcare students to be oriented, adjusted, contribute to patient care, and feel a sense of belonging. In that study, several factors that induced active student participation in practice were identified, such as a favorable workplace setting, opportunities for learning, and a local support network.…”

A qualitative analysis of vertical leadership development amongst NHS health-care workers in low to middle income country settings

“…Four stages are needed to create a sense of belonging in participants who complete international placements-orientation, adjustment, contribution and belonging ( Wijbenga et al , 2020 ). The IGH programme compares favourably due to its provision of an induction programme, in-country orientation and local mentorship and; the planning and implementation of a local project; although more could be done.…”