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Findings Report: Key

Informant Survey

Student Education

and Preceptorship

Karen Jenkins Student Placement, Education and Preceptorship Network

August 2011

Acknowledgements

Thank you to Cyndy Johnston, City of Hamilton Public Health Services and Kellie Flynn, Durham Region Health Department for assisting with the telephone surveys and to all members of the Student Placement, Education and Preceptorship (SPEP) Network for their help with developing the survey and this report. Additional thanks to Tim Westberg, Public Health Ontario, for his assistance with formatting this report.

Executive Summary .............................................................................................................................. 1

1.0 Introduction ................................................................................................................................... 2

1.1 Purpose ..................................................................................................................................................3 1.2 Key Informant Survey: Student Education and Preceptorship ..............................................................3

2.0 Demographics of Survey Respondents ............................................................................................. 4

3.0 Student Placements and Preceptors ................................................................................................ 4 3.1 Recruitment of preceptors ....................................................................................................................7 3.2 Preceptor selection criteria ...................................................................................................................8 4.0 Resources, Training and Tools ......................................................................................................... 9 5.0 Gaps/Needs Identified by Health Units .......................................................................................... 12

5.1 Theme 1 - Resources, Tools and Training ........................................................................................... 12 5.2 Theme 2 - Capacity - Student Placement Coordination ..................................................................... 14 5.3 Theme 3 - Organizational Culture that Supports and Values Student Placements and Preceptors .. 14 5.4 Theme 4 - Linkages with Universities and Colleges ............................................................................ 15

6.0 Coordination of Student Placements ............................................................................................. 15

6.1 Responding to student placement requests ....................................................................................... 16 6.2 Initial point of contact ........................................................................................................................ 16 6.3 Student placement process ................................................................................................................ 17

6.4 Decision making regarding student placement requests ................................................................... 17 6.5 Tracking system/database .................................................................................................................. 18 6.6 Partnerships with Universities/Colleges ............................................................................................. 18

7.0 Implications, Recommendations and Limitations ........................................................................... 19

Appendices

Appendix A: OAHPP Key Informant Survey – Student Education and Preceptor Support ...................... 21 Appendix B: SPEP Network Membership List (May 2011) ....................................................................... 29

Findings Report: Key Informant Survey, Student Education and Preceptorship 1

Executive Summary

In June 2003, a group of health units led by the Public Health Research, Education and Development (PHRED) Program created a committee for public health staff in the role of coordinating student placements. This group (formerly called the PHRED Connection) brought these individuals together for mutual support and to share resources. In January 2011, with the launch of the new Ontario Agency for Health Protection and Promotion (OAHPP) program model, this group, under OAHPP became the Student Placement, Education and Preceptorship (SPEP) Network. With the launch of the new OAHPP program model, all health units were invited to contribute to the development of a vision and a plan to help build a culture to support health units with coordination and provision of student placements and preceptor development. In order to gain an understanding of health unit needs and to identify gaps regarding public health student placements, a key informant survey was developed by the SPEP Network. Fluid Surveys was utilized to create the online survey and the survey was implemented in March 2011. Thirty-two of the thirty-six health units completed the online survey (88.9% response rate). A number of key themes surrounding the needs and gaps of health units emerged in the analysis of the survey results and these included the need for resources, tools and training along with the need for improved linkages with Universities and Colleges. Health units also identified that they were lacking capacity to provide student/preceptor training and to respond to student placement requests and to coordinate these requests. Lastly, health units identified the need for a culture in public health units that supports and values student placements and preceptors. Health Unit respondents indicated that they were in need of preceptor and student resources and tools that were web-based, centralized, evidence-based and easily accessible. A number of suggestions were made regarding preceptor training needs such as teaching strategies for preceptors and balancing workload for preceptors as well as a number of health units indicated the need for a preceptor acknowledgement/recognition program. Health Units identified the need for a centralized system within public health in Ontario that offers consistent policies and processes for student placement coordination that fosters collaboration across health units to share resources and reduce duplication. Many health units shared that they were lacking the capacity to coordinate student placements; create and disseminate resources, develop student policies and provide training. Health Units identified the need for a tracking system or database to track numbers of student placement requests and numbers of student placements. As well, health units identified a need to improve communication with universities so that students are better prepared for public health placements. Lastly, health units felt there was a lack of organizational support for student placements and preceptors and that there is a need within public health, to create a culture that recognizes preceptors and values student placements. As a result of the survey, and the support of the OAHPP, four additional health units have joined the SPEP Network. This report highlights the findings from the key informant survey. Findings will be utilized to inform the vision and planning of the Student Placement, Education and Preceptor (SPEP) Network.


Findings Report Key Informant Survey, Student Education

and Preceptorship (April 2011) Student Placement, Education and

Preceptorship Network

1.0 Introduction

Over the past decade there has been an increased demand for public health placements as a result of new and emerging public health issues such as SARS (Severe Acute Respiratory Syndrome), H1N1 and childhood obesity. The SARS crisis resulted in a review of the public health human resource capacity. A report entitled Building the Public Health Workforce for the 21st Century1 calls for a ten-year plan to strengthen the workforce that includes attracting highly skilled and motivated people (Public Health Agency of Canada, 2005). Student learning placements and in particular the preceptorship model has become the leading approach to practice education in many health disciplines. As well, there has been an increasing numbers of distance education programs that require students to find placements in their own local communities. According to Valaitis, Rajsic, Cohen, Leeseberg Stamler, Meagher-Stewart, and Froude (2008)2 there is a decreased supply of preceptors and community clinical placement opportunities. A report entitled Public Health Nursing Education at the Baccalaureate Level in Canada Today3, released in November 2006 by the Canadian Association of Schools of Nursing (CASN), highlights the growing number of nursing students who require community placements and the shortage or limited capacity for student placements within public health. In January, 2011 The Student Placement, Education and Preceptorship (SPEP) Network consisted of representatives from 13 health units. Under the leadership of the Ontario Agency for Health Protection and Promotion, the SPEP Network expanded. The goals of the OAHPP are as follows:

Strengthen the public health system by enabling evidence-informed practice that is responsive to the needs and emerging issues of health units and uses the best available evidence to address them.

Support health units in generating, accessing and using public health knowledge.

Facilitate collaboration and provide system-level supports while building on and aligning with local, regional and central capacity.

1 Public Health Agency of Canada. (2005). Building the public health workforce for the 21

st century (ISBN 0-662-69525-9). Retrieved

from http://www.phac aspc.gc.ca/.../building_the_public_health_workforce_fo_%20the-21stc_e.pdf 2 Valaitis, R. K., Rajsic, C. J., Cohen, B., Leeseberg Stamler, L., Meagher-Stewart, D., & Froude, S. A. (2008). Preparing the community

health nursing workforce: Internal and external enablers and challenges influencing undergraduate nursing programs in Canada. International Journal of Nursing Scholarship, 5(1), 1–21. 3 Canadian Association of Schools of Nursing (CASN). (November, 2006). Final report—Public Health nursing education at the

baccalaureate level in Canada today. Retrieved from http://casn.ca/en/Public_Health_123/items/1.html

http://www.phac/


1.1 PURPOSE

Applied research and program evaluation, education and professional development, and knowledge exchange are critical functions that support public health practice. Since January 2011, the Ontario Agency of Health Protection and Promotion (OAHPP) has played a greater role in supporting public health units to address these functions. This role arises from the transfer of the provincial share of funding for the former Public Health Research, Education and Development (PHRED) program to OAHPP. With the development of the new program model and to ensure that the student placement and preceptor support activities was grounded in the needs and experiences of the field, an informal survey was developed. This key informant survey was designed: to gain a better understanding of the needs of health units; to identify gaps regarding the coordination of student placements, student education and preceptor supports, training and resources; to raise awareness and inform the priorities of the network; and lastly, to guide the role of the student and preceptor liaison.

1.2 KEY INFORMANT SURVEY: STUDENT EDUCATION AND PRECEPTORSHIP

The survey was developed by the SPEP liaison and members of the Network and consisted of 24 questions that took approximately 30 minutes to complete (see Appendix A for the survey tool). The survey was implemented using web-based survey tool (Fluid Surveys) throughout March and April, 2011. All 36 Ontario health units were contacted in order to determine who, from that respective health unit, responds to student placement requests, to introduce the OAHPP new model, the SPEP Network and the purpose of the survey. Completing the survey was voluntary and respondents were informed that their identifying information would remain confidential. A follow-up interview time was booked with either an SPEP Network member who assisted with making the initial phone call to introduce the survey. Respondents either completed the survey on the phone with the SPEP Network member or were sent the link to the survey to complete themselves. In some cases, one health unit completed more than one survey given the complexity and extent of its student placement activities. As a result of the survey, and the support of the OAHPP, four more health units have joined the SPEP Network (see Appendix B for current membership list). The following report summarizes the findings from the survey. Some of the survey responses are presented using tables from Fluid Surveys, however qualitative responses were reviewed and are presented according to common thematic structures. The survey results in this report are summarized and presented under the following sections: Section 1.0 - Introduction Section 2.0 - Demographics of Survey Respondents Section 3.0 - Student Placements and Preceptors Section 4.0 - Resources, Training and Tools Section 5.0 - Gaps/Needs Identified by Health Units Section 6.0 –Coordination of Student Placements Section 7.0 –Implications and Recommendations


2.0 Demographics of Survey Respondents

Each of the 36 health units in Ontario were contacted by phone or email and invited to complete the survey. Thirty-two of the 36 health units completed the survey either online or on the phone. In total, 40 surveys were completed. A number of health units had more than one individual complete the survey. Of the 40 responses, two individuals from four health units each completed a survey and three individuals from one other health unit each completed a survey. The survey respondents were a mix of males and females representing a variety of disciplines and positions from health units such as human resource managers, student education coordinators, program managers and public health nurses.

3.0 Student Placements and Preceptors

The majority (77%) of health units provide formal preceptored placements. Fifty-seven percent provide internship placements. Almost half (46%) provide informal observational experiences and 46% provide co-op or paid placements. Thirty-seven percent provide work study placements and 23% percent provide all of the above mentioned types of placements. Under the other response, some health unit respondents indicated they also provide high school student placements, post graduate medical resident placements and paid summer student public health inspector student placements. See table below. Table 1. Types of student placements in health units

Ninety-one percent of health unit respondents provide nursing student placements. Eighty percent provide nutrition and environmental health, followed by dental, medicine, health promotion, health sciences, midwifery, communications/media, social work and lab technicians. Under the other category, 23% indicated

Response Chart Percentage Count

Formal preceptorships (>2 weeks

with formal evaluation)

77% 27

Internships (student functions as a

member of the workplace team –

some faculty contact and support )

57% 20

Informal observational

experiences ( 1-2 days to observe)

46% 16

Co-op/paid placements

(employment with education

component)

46% 16

Work study (student employed as

unlicensed personnel – student

learning while an employee)

37% 13

All of the above 23% 8

Other 14% 5

Total Responses 35


they also provide placements for information technology, dental hygienists, dental assistants, business administration, accounting, human resources, public relations, epidemiology and medical secretary students.

Table 2. Student placements in health units: Undergraduate


Nursing 91% 32

Nutrition 80% 28

Environmental Health 80% 28

Dental 54% 19

Medicine 46% 16

Health Promotion 43% 15

Other, please specify: 37% 13

Health Sciences 26% 9

Midwifery 26% 9

Communications/Media 23% 8

Social Work 20% 7

Lab Technician 3% 1

Total Responses 35

Thirty-three of the 40 respondents indicated they provide placements for graduate students. Fifty-eight percent provide graduate student placements from masters of public health, followed by 55% dietetic interns, followed by nursing, community medicine, nutrition, epidemiology and nurse practitioner graduate students. Other types of graduate students included sociology and rural health.


Table 3. Student placements in health units: Graduate


Public Health 58% 19

Dietetic Intern 55% 18

Nursing 48% 16

Community Medicine 39% 13

Master of Nutrition 36% 12

Epidemiology 33% 11

Nurse Practitioner 21% 7


Total Responses 33

Respondents were asked to indicate approximately how many student placements their health unit provides on an annual basis. The responses indicated a wide range from 3 placements to 250 placements. Some respondents reported only nursing student placements and others reported all disciplines.

Table 4. Number of student placements per health unit per year

Number of Student Placements * Frequency

1-10 15

11-20 3

21-30 4

31-40 1

41-50 3

51-60 0

61-70 1

71-80 0

81-90 3

91-100 0

// //

100-200 1

200-300 1

300-400 1

*Note: The numbers reported in the table above are approximate. Some are based on numbers of nursing placements only, while others are based on all disciplines; some are based on full-time preceptored placements while others include individual preceptored placements, group placements, observations and job shadows.


Sixteen of the 31 responses (50%) indicated that the number of student placements had increased over the past five years. Three respondents stated the placements have increased for their health unit especially in nursing. A number of respondents included the reason for the increase as follows:

health unit more open to students

the hiring of a research scientist resulted in increased graduate student placements, including Master

of Public Health students

limited infant/maternal/child placements in acute care resulting in more public health placements

local college/university’s increase intake of health discipline students resulting in the need for more

student placements

amalgamation of St. Lawrence College with Laurentian University resulted in expanded scope beyond

traditional nursing, nutrition and inspection which increased need for more placements

Twelve respondents (37.5%) indicated that “no” the number of placements had not increased or that they were fairly consistent over the past five years. Two health unit respondents indicated that placements had decreased due to program review, H1N1 and changes in organizational requirements. Two respondents indicated they were “not sure”.

Table 5. Change in student placement numbers over the past 5 years Responses 31

Number of student placements has increased over the past 5 years 16

Number of student placements has decreased over the past 5 years 2

No change – remained consistent 12

Not sure 1

3.1 RECRUITMENT OF PRECEPTORS

Health Units were asked how they recruit or enlist preceptors and of the thirty-four responses to this question, 88% indicated that staff volunteer to be a preceptor. Twenty-six percent indicated that it is an agency expectation and that everyone is expected to take their turn. An additional 12% indicated that being a preceptor is an agency expectation and this expectation is included in job descriptions. Three percent indicated that this was an agency expectation, included in staff position and that their agency monitors this. Of the thirty-four responses, 18% responded “other”. Within these “other” responses, one health unit indicated that a mixed approach was used for recruiting preceptors depending on the situation. Such as they might approach a specific staff member because of the work they do and the fit with the student’s learning needs. Another health unit indicated that if someone identified on their performance appraisal that being a preceptor was a learning goal, then their supervisor/manager might identify the individual as a potential candidate. Respondents indicated more than one response to this question.


Table 6. Process of recruiting/enlisting preceptors


Staff volunteer 88% 30

Agency expectation/staff are

expected to take their turn

26% 9



expected to take their

turn/included in position

descriptions

12% 4


expected to take their

turn/included in position

descriptions/Agency monitors

3% 1

Total Responses 34

3.2 PRECEPTOR SELECTION CRITERIA

Respondents were asked if they used any type of selection criteria for choosing preceptors. Sixty-five percent said “no” and 38% said “yes” they use selection criteria. Respondents that said “yes” were asked to describe the criteria they used. These responses included that staff who wish to be a preceptor need to have the following: two years of experience in public health; one year experience in current role; completed preceptor training; demonstrated excellence in practice; understanding of adult learning principles; effective communication skills; critical thinking and problem-solving skills and leadership skills. Table 7. Health Unit use of criteria for selecting preceptors


No 65% 22

Yes, please describe 38% 13

Total Responses 35


4.0 Resources, Training and Tools

This section of the results explores health units’ current situation regarding preceptor and student training resources and tools as well as student placement coordination resources. Respondents indicated more than one response to this question. Of the 32 responses, 84% indicated they have access to orientation materials for both students and preceptors; 78% indicated they have access to affiliation agreements; 72% indicated they have the necessary evaluation tools; and, 68% have access to student/preceptor policies. Forty-seven percent of health units have access to preceptor acknowledgement resources and 44% have access to student training tools. Only 25% have a web page dedicated to students and preceptors. Under the “other, please specify” and “comments”, responses included other resources that were not listed such as, PEP modules (www.preceptor.ca), team preceptor model, RNAO preceptorship kit, University of Toronto practicum tools for students, checklist for preceptors and students and electronic files for students. See table 8 below.

http://www.preceptor.ca/


Table 8. Resources and tools health units currently have access to


Orientation materials/training (for

students)

84% 27


preceptors)

84% 27

Affiliation agreements 78% 25

Evaluation tools (student

placement/preceptor/mentor/advisor)

72% 23

Student/preceptorship policies (i.e.

police background checks, accident

reporting, confidentiality etc)

66% 21

Teaching/support tools to help staff

working with students? (ie. providing

feedback, developing learning

plans/objectives, conflict resolution)

56% 18

Preceptor acknowledgements (i.e.

recognition)

47% 15

Teaching tools for students (i.e.

student manuals, e-modules)

44% 14

A web page dedicated to

students/preceptors?

25% 8

Comments 25% 8


Total Responses 32

Respondents were asked whether they would be willing to share their resources and tools with the OAHPP and health units across Ontario and of the 28 responses, 24 said yes, 2 did not answer and 2 responded that they did not have any resources to share. Respondents were then asked which of the resources just listed, would they like to have access to and of the 30 responses, 80% indicated they would like access to preceptor orientation/training materials and evaluation tools. Seventy-seven percent indicated they would like access to orientation/training materials for students followed by 73% indicating they would like teaching/support tools to help staff. Sixty-three percent indicated they would like access to student/preceptorship policies and a web page dedicated to students and preceptors. Fifty-seven percent would like preceptor acknowledgement resource, 53% would like teaching


tools for students and 43% would like access to affiliation agreements. Of the 6 responses that indicated “other”, these responses included:

introduction to public health for students

staff time to develop resources

information about how other health units coordinate student placements

e-learning modules

Table 9. Resources and tools health units would like to have access to



preceptors)

80% 24

Evaluation tools (student

placement/preceptor/mentor/advisor)

80% 24


students)

77% 23

Teaching/support tools to help staff

working with students? (ie. providing

feedback, developing learning


73% 22

Student/preceptorship policies (i.e.

police background checks, accident

reporting, confidentiality etc)

63% 19

A web page dedicated to

students/preceptors?

63% 19

Preceptor acknowledgements (i.e.

recognition)

57% 17

Teaching tools for students (i.e.

student manuals, e-modules)

53% 16

Affiliation agreements 43% 13


Total Responses 30

Respondents were asked to indicate if they were aware of any new preceptor/student learning models. Of the 25 responses to this question, 13 indicated “no” they had not heard of any new preceptor/student models. Twelve respondents reported that they had heard of the following models: Preceptor Education Program PEP www.preceptor.ca (2007); ANDSOOHA Transition to PHNursing (2008); CIPHI Practicum Guidelines;

http://www.preceptor.ca/


Community Service Learning; www.preceptordevelopment.org; Dietitians of Canada; Health Promotion 101; McMaster University; and, Health Unit developed own orientation to public health.

5.0 Gaps/Needs Identified by Health Units

A number of questions asked about needs/gaps of health units regarding student placements/preceptor supports, training and e-learning within their own local health unit and in terms of the bigger picture of public health. Respondents were also asked how the SPEP Network could support health units. A thematic analysis was conducted on the combined qualitative responses from these questions. Themes are listed below according to their predominance in the responses with the most prominent theme being listed first. The themes were as follows: Theme 1 - Resources, tools and training; followed by, Theme 2 - Capacity – Student placement coordination; Theme 3 - Organizational culture that supports and values student placements and preceptors; and lastly, Theme 4 - Linkages with universities and colleges.

5.1 THEME 1 – RESOURCES, TOOLS AND TRAINING

The need for preceptor resources, tools and training was a predominant theme identified in a number of survey responses (Question #8 and #10). The types of resources and tools needed, in terms of priority, are identified as follows:

1. Training for Preceptors (not listed in any specific order)

Planning to be a preceptor – Where to begin

Teaching strategies for preceptors

Learning Styles

Coaching/Mentoring

Principles of Adult Learning

Students Today – Millennial Students-Two respondents indicated this topic

Dispelling the myths surrounding preceptoring

Privacy and Confidentiality

Communication

How to develop a learning plan

Building rapport

Role modeling professional behaviours

Evaluation and feedback for the weak student

Balancing workload for preceptors

Crucial conversations

Entry to practice competencies

Orientation to public health (ANDSOOHA document – nursing focused)

Developing learning objectives

Providing Feedback

Conflict resolution

Critical Thinking

Preceptor Education Program PEP www.preceptor.ca has these 4 learning modules which are interdisciplinary, but not specific to public health

http://www.preceptordevelopment.org/


2. Training for Students

Overview of Public Health- Introduction to the public health system for students - “A day in the lives of…” Roles of various public health disciplines.

Students need a broadened as well as in depth exposure to public health

Social determinants of health

Population Health Promotion Model

Core Competencies

Training for students needs to include all disciplines and acknowledge various discipline-specific competencies (i.e. public health inspector students and public health dietician students)

Entry to practice competencies

Ontario Public Health Standards

Orientation to public health (ANDSOOHA document – nursing focused)

Other (responses from a number of questions)

Preceptor recruitment strategies – incentives, compensation

Preceptor Model for public health- interdisciplinary and specific to public health

Preceptor Conference

Workshops – lessons learned re preceptorships

Web space for students interested in public health

Paid student placements

3. Website or webspace

Centralized web space for resources and tools and to share new resources

To enable knowledge exchange and research related to preceptorships

To provide a forum for joint problem solving and discussion of issues 4. Recognition and acknowledgement of preceptors

Compensation for preceptors 5. Tracking system or database - to track number of requests/discipline/number of placements. (Note – the need for a tracking system identified seemed to be different from what is offered by HSPnet (Health Sciences Placement Network). Currently, HSPnet provides a database system which is a student placement request/accept database for universities/colleges to send placement requests to health agencies. As well, other features include the ability to create tracking reports and training tools are available however all universities and colleges would need to be members in order to create accurate tracking reports. 6. Student placement policies and organizational policies

Student placement policies (WSIB, driving students, auto insurance etc.)

Organizational policies regarding processes for responding to student placement requests and that encourage all staff to support the next generation of public health workers.

Not only did the respondents identify the need for resources there was also the need for easier access to resources. A number of health units indicated that they did not have the time to disseminate resources to staff and the lack of a student education coordinator role at their health unit has resulted in staff not knowing about preceptor resources and tools. The need for student resources and tools was also identified, however was not a predominant theme. The types of resources and tools identified as needed for students were as follows:

Introduction to public health for students


Orientation checklist for students

Social determinants of health, core competencies and students/preceptors, health

promotion/population health

Communicating with your preceptor

5.2 THEME 2 – CAPACITY: STUDENT PLACEMENT COORDINATION

Many of the respondents indicated that within their health unit there is a lack of capacity to coordinate student placements and provide preceptor supports in terms of time, capacity and funding. Time - Lack of time to train staff and make them aware of preceptor resources and tools as well as a lack of time to develop resources, tools and policies. “We need someone dedicated to coordinating the student placements, orienting staff and linking with universities”. “The gap is the lack of time to disseminate the resources and tools and deal with the preceptor needs.” Capacity – The number of student placement requests exceeds the number of staff willing to be preceptors. As well, some health units lack a dedicated staff person to communicate with universities and negotiate affiliation agreements as well as provide training for preceptors and students and to negotiate challenges. Respondents shared the following: “There is a lack of time and staff capacity to provide training and lack of time to provide staff with resources” Funding – Underlying the lack of time and capacity is the lack of funding to support positions to coordinate, manage student placement requests, student and preceptor training, communication with universities (i.e. negotiating affiliation agreements, etc.), as well as a lack of funding to support paid student placements and to back fill preceptor workload. “We need appropriate funding for public health/health professional students. Advocacy on behalf of health units to secure funding for student placements.”

5.3 THEME 3 – ORGANIZATIONAL CULTURE THAT SUPPORTS AND VALUES STUDENT PLACEMENTS AND PRECEPTORS

Underlying the above two themes and embedded within a number of responses was the need for public health units in Ontario to build a culture that supports and values student placements and preceptors. The following statements reflect this finding: “Re-create a culture that supports student learning” “Taking students contributes to the’ health’ of the health unit.” “It takes senior management commitment to support student placements and ensure that staff have the time to support students” “Supporting the next generation of public health professionals is “formally” written in public health programs and program standards however not operationalized at the day-to-day program level.” “Student placements are often seen as an “add on” versus a positive opportunity for personal growth and professional development – We need to change this this type of thinking in public health”


5.4 THEME 4 – LINKAGES WITH UNIVERSITIES AND COLLEGES

(Note- this theme was not as predominant as the above three themes) A number of health units described the need for better communication with university and colleges regarding the timing of student placement requests (i.e. earlier communication from schools regarding student placement requests so health unit can prepare) as well as a consistent and integrated approach to public health placements in terms of placement requirements, length and number of hours that matches the needs of the health unit. It was also identified that there is a need to link with universities and colleges regarding what they are teaching students about public health and for public health staff to be informed regarding course curriculum and student assignments.

6.0 Coordination of Student Placements

A number of questions explored whether or not health units had a designated staff person or person(s) who were “formally designated” as the student placement coordinator and whether or not this person was full-time or part-time and if they relied on an advisory committee for student placements. The following table summarizes these responses.

Table 9. Health units with a designated student placement coordinator

Total Responses 31

Formal designated position 16

Informal designation 6

Shared 5

No one designated 4

Some respondents indicated that sometimes coordinating student placements was shared between human resources and managers or between a director and managers, and in one case, each department took responsibility for organizing their own student placements. Respondents were asked if their health unit had a designated staff person coordinating student placements

and if yes, what portion of an FTE (Full-Time Equivalent) was allocated to this role. See table below for the

responses. Responses under “Other, please specify” included:

no official designation or time allotment

role split between a number of staff

varies depending on the time of year and based on need

often an ‘add on’ to a manager’s role

two respondents indicated their role was 0.1 FTE.


Table 10. Proportion of FTE designated to coordinate student placements



0.5 17% 5

0.25 13% 4

1.0 Full-Time 3% 1

0.75 0% 0

Total Responses 32

Respondents were also asked if they work with an with an internal or external advisory committee to advise on student placements. Of the 29 responses, 10 said “yes” and 19 responded “no”.

Table 11. Health units with student placement advisory committees

Number of Responses 29

Yes 10

No 19

6.1 RESPONDING TO STUDENT PLACEMENT REQUESTS

In order to gain a better understanding of the process each health unit engaged in to coordinate students placements, respondents were asked if they had a process for placing/orienting students at their health unit (i.e. who receives and reviews requests and how one determines whether or not to accept a student). Most health units have a formalized process for responding to student placement requests, however the process varied from health unit to health unit. The following summarizes the responses according to Initial point of contact and Student placement process.

6.2 INITIAL POINT OF CONTACT

A number of health units identified that student placement requests are received by a designated person who is the initial point of contact. This person collected the needed information and triages to the appropriate manager.

Some health units have a student education coordinator and for some it was someone in human resources or a director or manager. Two health units indicated that the initial point of contact is an online student placement request form/ application form.

One health unit indicated that within their partnership/affiliation agreement with their local university they have a set number of students who they provide placements for each term.

One health unit indicated they utilized HSPnet (Health Sciences Placement Network) to send out requests and receive responses from managers.


There were a few health units that identified that they did not have a formal process and student placements were handled on an ad hoc basis.

6.3 STUDENT PLACEMENT PROCESS

Health units who had student placement coordinators generally have a similar process whereby student placement requests are received by the student placement coordinator who then screens the student for appropriateness for public health and to find out areas the student is interested in working. The next step, involved contacting the program manager to recruit a preceptor from their team or service/program area, trying to match the student with the program. Once a preceptor is found, the student placement coordinator confirmed with the requesting university or college and then makes arrangements for the student’s placement, (i.e. completes paperwork such as affiliation agreement, begins to plan for orientation and acts as liaison for dealing with questions/challenges). There were a number of variations on this process and they were as follows:

One health unit indicated they utilized a decision tree to assess student placement requests and then if taking the student a formalized process is in place where requests are sent to “team liaisons” to recruit a preceptor and once preceptor was determined appropriate paperwork was completed and orientation arranged.

Another health unit indicated they utilized a team approach to make decisions regarding preceptors, setting up details re student placement and dealing with challenges.

One health unit indicated they utilized HSPnet (Health Sciences Placement Network) to send out requests and receive responses from managers.

One health unit sends out a request to teams to “sign up for” preceptoring students ahead of time, indicating the time of year they wish to have a student and the number of students.

One health unit sends out an “all staff” email in August to find out who is interested in providing student placements for the upcoming academic year and then a spread sheet is created with preceptor names and dates available for the year and as requests come in, the preceptors on the list are contacted.

One health unit indicated that two undergraduate nursing students are automatically placed in every department each school semester.

Another health unit with a student placement coordinator utilized an excel spreadsheet to send out to all management listing all of the students that are interested in completing a placement for that semester. Management then forwards this on to front-line staff. Preceptors volunteer. Once a preceptor is confirmed, the student placement coordinator provides them with the student's contact information and the student is required to set up an informal interview on their own. If the interview is successful, the student placement coordinator informs the student and draft a confirmation letter is sent to both the student and preceptor. All students are required to attend an orientation session prior to their start date.

Lastly, there were three respondents who indicated they provide paid student placements or provided student placements through an internship program (Public Health Inspectors and Dietetic Interns) and therefore the process is similar to the above but also involves coordinating with the internship program.

6.4 DECISION MAKING REGARDING STUDENT PLACEMENT REQUESTS

Health Units were also asked how they determine whether to accept a student or not. Of the 30 responses to this question, 18 (60%) responded that this decision was based on capacity (budget and staff availability). Twelve respondents indicated “other” responses as follows:

A six step decision tree is used

Manager has decision-making authority


Must be value added for staff and student

Important to ensure a fit between student learning/program objectives and placement

Agreement with University to provide a certain number of placements

Based on interview and evaluation

Based on interviews

Provide four nursing rotations per year, giving local University priority and then after that it’s whoever has requested first

Only accept students that potentially might be able to work in public health and give priority to local schools. Try to accommodate by geography.

6.5 TRACKING SYSTEM/DATABASE

Many health units indicated that they are in need of a tracking system (see gaps/needs of health units p. 14)

and it was interesting to note the number of health units that actually have a tracking system or database in

place to track number of student placements. Of the 31 responses, 12 (38%) responded “yes” and 19 (61%)

said “no”. See table below. Many of the health units who responded “yes” utilize an Excel spread sheet or

Microsoft Access to track student placements. One health unit indicated they utilize a calendar in outlook

maps. One indicated they utilized HSPnet and two indicated that their HR Manager kept track. One health

unit sends out a tracking form to all staff three times per year. A number of respondents indicated that they

would like a better tracking system as they feel they miss out tracking a number of student placements and

would like a system that tracks requests as well as actual student placements.

Table 12. Health units with a student placement tracking system

Number of Responses 31

No 19

Yes 12

6.6 PARTNERSHIPS WITH UNIVERSITIES/COLLEGES

The role of the student education coordinator for many health units is to establish partnerships/linkages with

universities/colleges and so respondents were asked if they had any formal linkages/partnerships with

colleges and universities. Of the 31 responses, 32% had partnerships that involved health unit staff who are

cross appointees with the college/university. A cross appointee works at the health unit but is on a cross

appointment list with a university whereby they may be called upon to provide presentations/lectures based

on a clinical area of expertise. Thirty-nine percent indicated they had no formal partnership. Twenty-nine

percent were involved in a research partnership and 19% were involved in a teaching/clinical instructor

partnership. See Table below. Under “Other, please specify”, 35% of respondents included a description of

some of the partnerships their health unit is involved in with universities/colleges. These included staff

responding to lecture/guest speaker requests and staff working as clinical tutors or clinical instructors. One

health unit indicated they were involved in a research initiative with their local university. A number of

respondents indicated more than one response to this question.


Table 13. Health unit partnerships/linkages with Colleges/Universities


No formal partnerships with colleges/universities

39% 12


Cross appointees 32% 10

Research partnership 29% 9

Teaching/clinical instructor partnership

19% 6

Total Responses 31

Respondents were also asked if their health unit is involved with teaching and/or research surrounding public health student education or preceptorship and to describe this involvement. Of the 31 responses, 24 indicated “no” they were not involved with teaching and/or research surrounding public health student education or preceptorship. Seven responded “yes” and described their involvement as follows:

Staff involved with teaching in various programs

Staff representative sits on Dietitians of Canada national preceptor training and support work group

Staff member part of “Preceptorship Program” at local university and assists with preparing and

delivering workshops

Health Unit provides preceptor training in conjunction with University

Partner with University to support graduate students completing thesis research

7.0 Implications, Recommendations and Limitations

Overall, many of the health units shared their appreciation for being given the opportunity to provide input into the planning and vision for student placements and preceptorships in public health and indicated the importance of networking and collaboration. Findings from this survey will be utilized to inform the vision and planning of the Student Placement, Education and Preceptorship (SPEP) Network. As a result of this survey, and the support of the OAHPP, six new health units have joined the SPEP Network and a few indicated that they would consider getting involved in the future. Ninety percent of health unit respondents indicated that they would like to be involved in, and would access and utilize a community of practice for student placements and preceptorships.

The following summarizes the key areas where health units indicated the SPEP Network could support them:

Development of new resources and tools

Creation of a “Knowledge/Resource Library” or centralized web space to house preceptor and student

resources and tools

Development of new resources and tools including e-learning/online training modules and workshops

for preceptors and students

Development of a tracking system/database to track number of student placement requests and

number of student placements


Provision of central supports for all health units – including ‘overarching’ policies and processes for

student placement coordination that links with Universities and Colleges and is a place for health units

to go to find answers to questions

Facilitating collaboration and networking between health units, academic institutions and professional

organizations

Based on the results of this report, it will be important for the SPEP Network to focus on making resources and

tools available and accessible to health units in Ontario and to create new resources and tools in response to

the needs/gaps identified in this report. It will also be important for the SPEP Network to collaborate and

utilize the supports currently available from the OAHPP to move forward with creating a student/preceptor

knowledge library and database for tracking student placements and to begin to build a culture within Ontario

health units that values preceptors and student placements.


Appendices

Appendix A: OAHPP Key Informant Survey – Student Education and Preceptorship Support

The purpose of this survey is to gain a better understanding of health unit needs and identify gaps regarding

public health student placements, resources, tools and supports. Your responses will be utilized for the

purpose of planning the OAHPP student education and preceptor supportive services. No identifying

information will be shared. A written report will be developed, including only aggregate data and will be

shared with OAHPP staff, the Student Placement, Education and Preceptorship Network and with participating

health units. This survey is voluntary and will take approximately 30 minutes to complete. For the purpose of

this survey, the term "preceptor" is used to describe the role of a staff member who assumes the

responsibility as a role model, counselor, resource person and/or student evaluator. Thank you.

INFORMATION

Date:

Name:

Health Unit:

Position/Title

Program/Service Area:

Telephone/extension

Email:

Person Completing Interview


SECTION 1 – STUDENTS AND PRECEPTORS

Question 1 What types of placements does your health unit provide?

Formal preceptorships (>2 weeks with formal evaluation)

Informal observational experiences ( 1-2 days to observe)

Co-op/paid placements (employment with education component)

Work study (student employed as unlicensed personnel – student learning while an employee)

Internships (student functions as a member of the workplace team – some faculty contact and support )

All of the above

Other ______________________

Question 2 What undergraduate disciplines do you provide placements for?

Nursing

Medicine

Nutrition

Dental

Health Sciences

Health Promotion

Environmental Health

Lab Technician

Social Work

Communications/Media

Midwifery ______________________

Other, please specify:

Question 3 Do you provide placements for graduate students? Please indicate below which programs you provide graduate student placements for.

Public Health

Community Medicine

Epidemiology


Nursing

Nurse Practitioner

Master of Nutrition

Dietetic Intern ______________________

Other, please specify:

Question 4 a) Typically, how many students are placed at your health unit on an annual basis? (calendar year)

Question 4 b) Has this number changed over the past five years? How so?

.

Question 5 a) a) How does your health unit recruit/enlist preceptors?

Staff volunteer

Agency expectation/staff are expected to take their turn

Agency expectation/staff are expected to take their turn/included in position descriptions

Agency expectation/staff are expected to take their turn/included in position descriptions/Agency

monitors

Other, please specify: ______________________

Question 5 b) Do you use selection criteria for preceptors?

Yes, please describe ______________________

No

Question 6 Does your health unit have any of the following student/preceptor resources or have access to these resources through another agency such as a university/college?

Orientation materials/training (for students)

Orientation materials/training (for preceptors)

Evaluation tools (student placement/preceptor/mentor/advisor)


Teaching/support tools to help staff working with students? (ie. providing feedback, developing learning


Teaching tools for students (i.e. student manuals, e-modules)

Preceptor acknowledgements (i.e. recognition)

Affiliation agreements

Student/preceptorship policies (i.e. police background checks, accident reporting, confidentiality etc)

A web page dedicated to students/preceptors?


Comments ______________________

Question 7 a)

Would you be willing to share any of the resources your health unit created with the OAHPP and all health

units? Please comment:

Question 7 b)

Which of the resources listed in Question 6 would you like to have access to? Please indicate.

Orientation materials/training (for students)

Orientation materials/training (for preceptors)

Evaluation tools (student placement/preceptor/mentor/advisor)

Teaching/support tools to help staff working with students? (ie. providing feedback, developing learning


Teaching tools for students (i.e. student manuals, e-modules)

Preceptor acknowledgements (i.e. recognition)

Affiliation agreements

Student/preceptorship policies (i.e. police background checks, accident reporting, confidentiality etc)

A web page dedicated to students/preceptors?



Question 8

What e-learning modules or workshop topics do you feel would be helpful for preceptors and students?

Question 9

Are there any new preceptor/student learning models or resources that you have recently heard about?

Question 10

What are some of your health unit’s needs or gaps regarding student placements/preceptor supports?

SECTION 2 - COORDINATION OF STUDENT PLACEMENTS

Question 11 At your health unit, are you formally designated as the student placement coordinator or informally designated as the student contact? Please comment.

Question 12 a) Are there others that help with coordinating student placements?

Yes

No

Question 12 b) Should they complete this survey as well?

Yes

No


Question 12 c) If yes, could you please share their email contact information below?

Question 13

If you have a designated person coordinating student placements and receiving student requests, what

portion of an FTE (Full Time Equivalent) is allocated to this role?

1.0 Full-Time

0.75

0.5

0.25


Question 14

Do you and/or others in your role work with an internal or external advisory committee? Please describe.

Question 15 a)

Do you have a process for placing students at your health unit? Please describe.

Question 15 b)

How do you determine whether to accept a student or not? Please describe.

Question 16

Do you have a system to track numbers of requests or placements annually? (i.e. a database to keep track

of student requests or number of student placements and discipline) Please describe.


Question 17

Please indicate below the formal linkages/partnerships your health unit has with colleges/universities?

Cross appointees (Work at the health unit but are on a cross appointment list with the university and may

be called upon to provide presentations/lectures based on clinical area of expertise)

Research partnership

Teaching/clinical instructor partnership

No formal partnerships with colleges/universities


Question 18

Is your health unit involved with teaching and/or research surrounding public health student education or

preceptorship? Please describe.

Question 19

How can the Student Placement, Education and Preceptorship network help support student placements

and preceptors at your health unit?

Question 20

In terms of the bigger picture of public health, what do you feel is lacking or what do you feel is needed to

support student placements and/or preceptor development?

Question 21

Would you be interested in becoming a part of the planning process with the Student Placement, Education

and Preceptorship network? This will include monthly teleconferences and maybe one or two in person

meetings in Toronto this year?

Yes

No - please comment ______________________


Question 22

Would you be interested in participating in a community of practice regarding student placements and

preceptorships? A community of practice is a less formal group, (most likely virtual) that will provide your

health unit with access to tools and resources as well as the opportunity to benefit from the shared

knowledge, skills and resources.

Yes

No - please comment ______________________

Question 23

Would you like a copy of the report when complete?

Yes

No

Question 24 Is there anything else you would like to add?

Thank you!


Appendix B: STUDENT PLACEMENT, EDUCATION AND PRECEPTORSHIP (SPEP) NETWORK MEMBERSHIP LIST (MAY 2011)

Chatham-Kent Health Unit

April Rietdyk Director, Public Health

Durham Region Health Department

Kellie Flynn PHN, Student Placement Coordinator

Elgin St. Thomas Health Unit

Janet McKillop Manager

City of Hamilton Public Health Services

Cyndy Johnston Student Placement Coordinator

Kingston, Frontenac and Lennox & Addington Public Health

Marie Traynor RD Dietetic Internship Coordinator/Research Associate

Leeds, Grenville and Lanark District Health Unit

Erin McLean Program Leader, Child Health

Middlesex – London Health Unit

Karen Jenkins PHN, Education Coordinator

Niagara Region Public Health

Angela Lorenzo Continuous Quality Improvement (CQI) and Education Specialist

Ottawa Public Health

Elizabeth Ryan PHN, Student Placement Coordinator

Oxford County Public Health and Emergency Services

Colleen Wilson Public Health Nurse

Porcupine Health Unit

Anne Jensen Human Resources Officer

Region of Waterloo Public Health

Colleen Rickert Coordinator, Support Services

Simcoe Muskoka District Health Unit

Mary Bouffard, PHN,Child Health Program Nursing Student Placement Coordinator

Sudbury & District Health Unit

Aisha Alladin Officer, Education Services


Thunder Bay District Health Unit

Alyson Jennings Human Resource Officer

Toronto Public Health

Cathy Goring Education Coordinator

York Region Community and Health Services

Marcia Annamunthodo Professional Practice PHN, Practice Enhancement Team

©Copyright Public Health Ontario, 2011

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