A Handbook for Teaching and Learning in Higher Education Enhancing academic and Practice

Nursing and midwifery
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will have a facilitated reflection session to help them examine how well they are
planning and delivering care, and to discuss emergent issues relating to teamwork.
Feedback from patients and students is usually very positive, although
students sometimes report conflicting feelings with respect to developing their
own profession-specific competence and developing interprofessional teamwork
competences. Facilitators report their role as quite draining, so most initiatives
rotate facilitators to prevent burnout. Universities may find that learning
experiences such as these are vulnerable to difficult-to-predict changes in the
clinical area; for example, reconfiguration of services may leave the area without
appropriate staff to provide supervision or the caseload may change such that it
becomes too complex for student teams. Constant communication between staff
and managers in the clinical area and programme leaders within the university
is the only way to ensure that everyone has as much notice as possible about
impending changes and their likely consequences.
Similar interprofessional student placements have been described elsewhere,
such as interprofessional student teams assessing and providing care for
outpatients in ambulatory care clinics in the USA (Dienst and Byl, 1981). Again
in the USA, Hayward (2005) describes students, supported by university tutors,
using a mobile clinic to provide care and advice for older people who otherwise
have limited access to services of this type.
(Della Freeth, St Bartholomew School of Nursing and Midwifery,
City University London)
User and carer involvement
It is essential that insights from service users and carers are integrated into programmes
(DoH, 2001; NMC, 2004a, 2004b). This should commence when programmes are being
designed by including a range of users and carers in the development groups. Where
possible they should also be included in programme management teams. Users and carers
can contribute to teaching in a variety of ways: this may include joining classes and
discussing their experiences. This offers the advantages of interactivity and a discussion
that unfolds as participants learn more about each other but it can be a demanding
commitment for service users and the university staff who support them; it may also be
intimidating for very junior students. Written or recorded testimonies can be excellent
resources for individual study or group work; and perhaps assessment too. Sometimes
you will want to create your own recordings to suit your programmes’ needs, but many
user and carer experiences are freely available in databases of reusable learning objects
(RLOs). For example, the charity DIPEx (2007) has created an extensive repository of
personal experiences of health and illness.
One currently underdeveloped area is the inclusion of service users and carers in
assessment. It is relatively common for students to be asked to discuss users’ and carers’