Remote / Telehealth Placements

Remote placements, through the use of technology, enable students to carry out their placement without needing to physically attend the practice site. This helps to overcome barriers such as lack of space, social distancing and travel that are currently impacting on placement provision, as well as importantly supporting students that are shielding or self-isolating.

Through the use of  digital technology students are able to join MDT meetings, shadow consultations, carry out assessments and interventions and engage in supervision from a distance. This means that they are able to meet their learning outcomes, just in a different way.

Many services are now recognising that they are likely to continue with on-line/ remote  service delivery in some way in the future. It is therefore really important that students develop these skills, and the confidence to work in this way, on placement so that they are effective practitioners in the future.

Ways that you could consider offering a remote placement:

  • Full time remote placement e.g. leadership, research projects, patient facing service delivery (using apps such as Teams, Zoom, accuRx) if service allows for this.
  • Student does part of their week on-site for face to face interactions and then does the other part remotely eg. writing up reports, doing a QI project, having supervision remotely, developing resources for your department, searching for and summarising evidence based research to support your assessments or interventions, creating training packages for support staff, carrying out their own e-learning, induction reading.
  • Having two students on placement and rotating them round so that when one is on -site the other is working on projects remotely and then swapping this around.  his allows for additional benefit of them peer working on projects.

 

At a webinar ‘Sharing stories about providing student practice-based learning during COVID-19 disruption’ useful presentations were provided that showed how to adopt remote/ blended learning placements:

The complete recording is available here: here (full length 1 hour 11mins).
• Claire Curtis: Overview of PrBL across Tayside: here
• Kath Sharp: 4:1 PrBL model:  here
• Sean & Kristen (Student presenters): here
• Kelsey Normand: Therapeutic Radiography: here

Health Education England have produced this really useful AHP Technology Enabled Care Services (TECS) Practice Based Learning Guide 

Royal College of Occupational Therapists’ Guidance and examples of remote placements: Remote Placement Model

Example from Leeds Beckett University of delivering remote placements can be found here

Connect Health have provided a wealth of remote Telehealth placement opportunities for physiotherapy students. Find out more here

The Royal College of Speech and Language Therapists provide useful examples of Telehealth placements. These are ideas that can be transferable to other professions: link here


Here is a piece written by three Occupational Therapy students who did their remote placement with the midwifery team, looking at the occupation of birthing and birthing spaces. Read this here


Below is an interview with an MSc Physiotherapy (Pre-Registration) student discussing her experience of partaking in one of the first remote placements at the University of Brighton.​

What area of physiotherapy was your placement? 

It was a paediatric community placement, but I was based in my bedroom. My hours were 8:30am -4:30pm- Monday to Friday​.

How often did you speak to your Educator?

I spoke to my educator every morning over Teams and then would have a couple of calls during the day to check in on how I was doing. As my placement went on, we spoke to each other less and less throughout the day. 

It was nice speaking to her on Teams as it felt I got an insight into her life as it was like I was in her house.

We would use the message function in Teams throughout the day, which was good because I could ask any questions using this function.  Sometimes it took a while to receive a reply, but this allowed me to work out the correct answer on my own, which really improved my clinical reasoning skills, compared to when you’re in a face-to-face situation your educator will answer your questions straight away.

How did you complete consultations with patients? 

Sometimes we completed consultations over the phone but most the time we would call the patient first to see if they were able to video call, they would then get a text with the link for the video call that they would need to click. They would then appear on my laptop screen to complete consultations. 

The consultations tend to be pretty normal but the subjective was more in depth as obviously you can’t complete any physical assessment. It  was good when they were younger children as you could get the parents to turn the camera round  and you could see the child in their home environment where they tend to participate more. My educator told me that it can be better as sometimes when children come into clinic, they are very shy and it takes them a while to come out of their shell. Over video the parents can tell them to do something and they will just do it.

Parents also sent in video footage of the child which was great as you could slow it down and it would be easier to analyse their gait. It was also good when learning as it would take me longer to analyse gait anyway. 

How did you write your notes? 

I was supplied with a NHS laptop which had RIO on it, this was the data base they used at this placement. This allowed me access and write notes at home. When completing reports I would email them to my educator and she would check it and email back changes.

For SOAP notes I would write them on RIO as an unvalidated note and then my educator would read it and change what was needed. This was nice as it came up that it was my notes.


Research:

OT News Oct 2020:

Rachael Kirtley, Ashley Lister & Emma Dawson: A Dynamic Approach to Recovery through Activity During a Crisis.
“Therapists created a recovery through activity programmes during COVID-19 for their mental health community service where patients attended virtually in their own home.”

“The therapy group consisted of activities: Skype, FaceTime or calls with family and friends, sharing positive posts on social media through social media apps, charity campaigns using online sources, joining a community group online or through social media, volunteering at home for a helpline such as the Samaritans.”

The programme was found to be versatile and could be applied and adapted for many different client groups.
Limitations of virtual practice is that therapists are unable to evaluate non-verbal communication, sensory issues or their narratives in the same way we would usually do.

 

OT News Sept 2020:

Emma Pope: Communication in a Time of Crisis
“Occupational therapists are using more communication technology on the wards, supporting patients to participate in zoom calls to speak to family members/Pets at Home and even to join a virtual church session streamed online.”

  • These zoom calls and virtual sessions helped the patients be more enthusiastic, engaged and take part in interventions.
    • It helped the occupational therapists understand the patient’s personality better, to assess needs in a less formal way.
    • It helped to reduce distress and helped to develop rapport.

“Therapists have supported elderly patients in accessing these on screen platforms such as FaceTime and it’s the new concept of a ‘virtual’ reality”