My first paediatric leadership placement delivery.

This was published in the APCP Newsletter in March 2021.

I just wanted to write a little note of encouragement about being brave; if, like me you’re in a non-clinical/ patient facing role it's a challenge to know how to offer a non-traditional placement and meet some of the HPC standards of proficiency!

 I have supported our teams to really think about alternative models of practice placement delivery over the past couple of years; with unregistered clinical educator training, delivery of long arm mentoring placements in main stream schools, research placements and recently (thanks Covid) TEC placement delivery. I’m not going to talk much about the barriers, but focus on busting any myths and motivating you to be brave and have a go at delivering a diverse placement; just talk to your local HEI about the possibilities.

 Myths:

  • Placements need to be clinical; so we are trialling/developing both full leadership placements in my trust, and split ones; I have now supported two placements, but this was the first paediatric physiotherapy specific one and I chose to make it two day clinical in a child development service , three day physiotherapy professional leadership split.
  • Students aren’t ready for leading; we have to work closely with the HEIs to ensure students are both ready for this type of placement, and also supported and selected either because they already show great leadership, or are keen to develop an understanding about what leadership is.
  • It’s not my job to be a clinical educator/I can’t teach them anything; its everyone’s responsibility and you have LOTS to share!; we need to INCREASE capacity and diversify if we are to generate enough placements to meet growing demand. We have to be thinking about succession planning, and embedding professional skills in our future workforce from the start.
  • I can only take physiotherapy students;  no reason you can’t take any AHP student as a leader, again think how powerful multi-professional placements can be for clinicians and patients too.
  • Paediatrics/leadership is too specialised; leadership is for everyone at all levels in all areas of physiotherapy and patient care; lets embed it as early as possible and develop authentic, compassionate and resilient practitioners fit for all career types, in all sectors and with an opportunity to embed life long skills such as strategic and system understanding, social competence, service orientation, project management skills and awareness of leadership in action.

Like you, I have been honoured to have been supported and invested in as a clinician, and I would have loved to have understood my potential as a leader in parallel to this and had skills to cope with and thrive in being an influencer, manager, and compassionate therapist; rather than it being an afterthought as I progressed in my career.

 

So please, consider giving it a go. I’d love to hear from you if you are… @ d.wilson20@nhs.net.  Debs_Wilson (Twitter handle)

And if you see potential; sign post students to further career defining opportunities at HEE or the council of deans.

 

Resources:

Twitter @councilofdeans student leadership programme #150Leaders @150leaders @BurdettTrust

https://councilofdeans.org.uk/studentleadership/ahp-leadership

#AHPpracticelearning #innovation #AHPleadership #AHPfaculty @WeAHPs @NHS_HealthEdEng

NHS HEE graduate and student placement scheme hee.nhs.uk

https://www.leadershipacademy.nhs.uk/resources/healthcare-leadership-model/nine-leadership-dimensions/

https://www.kingsfund.org.uk/sites/default/files/2018-07/Leadership_in_todays_NHS.pdf

https://improvement.nhs.uk/documents/6054/NHSI_DEVELOPING_AHP_LEADERS_FINAL.pdf

https://www.csp.org.uk/frontline/article/being-leader-leadership-cpd


Who I Was at the Start

I had always wanted to try paediatrics to help me understand whether it is something I would like to do in the future. Being offered the option to try both paediatrics and leadership sounded interesting and exciting to me. Before starting the placement I wasn’t sure what the leadership side would look like but I’m a very flexible person and thought I’d be able to adapt to whatever it is. I knew my time would be split: 3 days of leadership and 2 days clinical each week, with most of my time, spent working virtually.

On the first day I remember Debs saying ‘it doesn’t matter what you end up doing, it’s about the journey’ - Initially, I felt confused by this, but as the placement progressed what she meant became clear.

My Journey

This placement was nothing like what I was expecting, in the best possible way. That being said it still had its challenges. In the first 2 weeks, I was all guns blazing, trying to do every task that was suggested to me. Then at week 3, I started feeling overwhelmed with the amount of work I had set myself to do. The realisation that I wasn’t going to be able to do it all in 6 weeks set in. It took a lot for me to share how I was feeling and by doing so I was supported to set new, more realistic priorities which allowed me to make the most out of the remainder of the placement. By going through this process I have developed skills and a new awareness that has enabled me to fly into future challenges with confidence.

Some of the key aspects of my journey were:

  • Understanding of self both as a student and as a leader and the awareness of the impacts I can have on others
  • Reflective practice
  • Prioritisation and time management skills
  • The understanding that leadership is embedded in everything we do
  • Clinical curiosity and the confidence to ask those difficult questions - are we doing the best we can for our patients and how are we evidencing that?

As the placement went on it became clear to me that leadership is embedded in everything we do, particularly as clinicians.

One of the key differences about this placement was that the pace of the work was entirely set by me. At first, I found this challenged my prioritisation and time management skills as well as my beliefs around what work is. I learned to set out what I wanted to achieve and then work towards that goal while still being realistic in what is achievable in 6 weeks. I also learned consistent review and reflection on the goals themselves, was key to making the right decisions. Discovering this process has given me new skills and made me feel excited to take the lead on project work in the future.

The exploration of reflective practice and exploring my creativity has been very impactful to not only my professional development but my personal understanding of self. Instead of dreading reflection, it is now something I look forward to! Reflection has helped me identify my learning needs, beliefs, strengths, areas for development and emotions which all play into my role as a student, a physio (in the future) and a leader. In this journey of reflection, I have had to be brave and explore my thoughts and feelings and the “why’s” of situations, particularly when I felt blockers in my confidence. Reflection was the best way to demonstrate my learning and progression throughout the placement. In understanding myself, I was able to define what authenticity is to me. I started to understand where I am willing to flex my leadership style. Without that authentic core, it is easy to end up being what everyone else wants you to be, rather than your true self. Which will eventually burn you out... especially if you’re a compassionate leader like me!

What I Actually Did

On my clinical days, I have been working with a fantastic band 6 physio, Emily, who was both supportive and creative in facilitating my learning. We used case studies to practise my skills before taking the lead on face-to-face and virtual sessions. By focussing on a few aspects of paediatrics, I got a strong grasp of the content and clinical reasoning, and I was able to work toward independence in assessing and treating by the end.

On leadership days I would work on one of three projects; Orthotics, compassionate leadership or five years forward. These projects built towards a presentation of my learning at the end. As part of the orthotics project, I created a survey to collect feedback from the child’s perspective, to help inform service development priorities. I also created a leaflet for parents/carers, which included information about the children’s orthotics service and important safety advice. The other two projects were much more open to interpretation so the rest of my time, on leadership days, was spent in meetings to observe different leadership styles in action. I researched change management models for service development and powerful questioning strategies. I also deeply explored myself, through reflection. By understanding service provision and the impact of the context on decision making, my clinical reasoning skills, both clinically and in leadership, have significantly improved.

What’s Next For Me?

I am looking at utilising my leadership skills in setting up group supervision for students, post-placement, to facilitate the development of reflection skills in my peers. This opportunity has changed my perspective and I am much more aware of who I am, the impact I have on others, and the consideration for the context. I can’t wait to apply all of this in my next placement starting in a week's time!

Conclusion

Overall this experience has been a transformational step in my journey both professionally and personally. I feel empowered to be a leader and I feel excited to share with others how they are leaders too!

If anyone has any further questions or comments please contact me @RachelChandler_ on Twitter.

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