The need to support increasing numbers of learners on Practice-based Learning and to equip learners with a broader range of employability skills including; collaboration, team work, leadership, and research, supports the development of multiple supervision models of practice education. One size does not fit all – there is not one set supervision model for learners on Practice-based Learning. Rather a range of creative options are available to suit the setting and the learner, facilitating the experience needed for learners to complete their studies and register to practice as dietitians.
The BDA promotes the use of a variety of learner supervision models when facilitating Practice-based Learning and encourage the range of options to be become a normal part of education and training:
- Supervisor learner ratio 1:1
- Peer Assisted Learning (Collaborative model)
- Split/share models
- Blended Practice-based Learning
- Technology Enabled Care (TECs)
- Long-arm supervision
It is important to choose the model that best suits the Practice-based Learning opportunity and this requires skilful and comprehensive planning by the HEI and practice educator.
Supervisor/learner ratio 1:1
This involves one learner with one educator at a time. Advantages include the opportunity for the educator to tailor teaching to learner needs, enable the learner to get used to working with one educator and if space is of a premium for example home visits one learner may only be allowed.
Challenges associated with this approach may relate to the intensity level for both educator and learner (particularly if there are a clash of personalities), limited practice educator time and lack of opportunities for peer learning. This approach does not easily lend itself to Practice-based Learning expansion.
Peer Assisted Learning
The Peer Assisted Learning (PAL) model (sometimes referred to as the collaborative model) is when two (or more) learners are supervised by one practice educator within a specific setting. (Dawes and Lambert 2010). The model emphasis is on peer and self-directed learning as the learners support each other and work together, enabling the development of different skill sets. The practice educator moves between supervision and facilitation. It is important to note that the overall responsibility for the service user remains with the practice educator. This approach is very useful when Practice-based Learning capacity is challenging.
Advantages of this approach include the ability to encourage teamwork [both within the dietetic profession and as part of an multidisciplinary team (MDT)] and for learners to reflect daily and share their reflections. It stresses the importance of valuing the opinion of others. For supervisors, this can support caseload management, offer CPD opportunities and allow larger pieces of work to be tackled.
Peer Assisted Learning Activity
- Re-feeding Syndrome (B&C Pracice-based Learning (placement))
- Introduction to caseload management (end of B Practice-based Learning)
- Orientation to Catering Systems
- Writing Clinical Letters (B/C practice-based Learning)
- Taking a diet history (B Practice-based Learning)
- Estimating service users (patients) weight, height and BMI (B/C Practice-based Learning)
- Medical Notes (B Practice-based Learning)
- Medication (B Practice-based Learning)
- Nutritional Supplements (B Practice-based Learning)
- Enteral Tube Feeds (B Practice-baseed Learning)
Split/Shared models
These models describe situations where one learner is shared between two or more members of a team, ideally with one lead educator to co-ordinate activities. This can be beneficial for part time staff or enabling a learner to have Practice-based Learning with two teams in different settings.
Blended Practice-based Learning
Blended Practice-based Learning models may offer a mix of virtual Practice-based Learning (utilised frequently during the COVID-19 pandemic) and more established models of face-to-face Practice-based Learning. Advantages of this approach relate to the flexibility in training models, including the ability to teach learners virtual working skills, mirroring and ensuring that learners are acquiring skills that make them work ready in today’s climate. It also has the benefit of reducing travel time.
Challenges may arise if learners are left isolated during the virtual elements, reliant on IT for elements of Practice-based Learning or lack opportunity for office chat and learning through observing. It is important that reflection is built into Practice-based Learning and that learners know the boundaries between the Practice-based Learning and home environment.
Blended Practice-based Learning example.
Technology Enabled Care (TECs) Practice-based Learning (previously known as digital, telehealth, virtual and remote)
This Practice-based Learning can take many different forms, but they all involve delivering service user care where the user is not in the same room as the clinician. The learners may be in a clinical or non-clinical setting with a practice educator, at home delivering care either via a virtual platform or over the telephone. By putting learners in these settings, it has the advantage of presenting opportunities for exposure to digital skills.
Long-arm supervision
Most learners are supervised by a registered dietitian in the Practice-based Learning setting. However, some settings may not have existing established dietetic roles and therefore it may not be possible for a learner to have the support from a dietitian employed by the Practice-based Learning provider, in the role of practice educator. In such cases, supervision and assessment of dietetic specific skills during Practice-based Learning must be provided by a dietitian outside the Practice-based Learning provider. This is known as long-arm supervision and commonly the dietitian providing the long-arm supervision will be employed by the education provider as an educator. Support and advice are provided through a mix of face-to-face meetings and distance communication, via the telephone, video calls, email, or other means, depending on the learner’s preferences. Visiting the learner in their practice-based learning setting is recommended, particularly for settings where dietetic roles are still emerging.
There are identified benefits to Practice-based Learning of this kind: learner value autonomy and the ability to demonstrate the positive outcomes of enhanced dietetic provision e.g. by providing more dietetic advice than is currently available. It is important to note that this style of supervision will not suit every learner and the HEI should decide on the appropriacy of these Practice-based Learning for specific learners.