Practice-based placement learning and innovation: Essential for the professional identities of tomorrow’s occupational therapists and the future of the occupational therapy profession

The current context of practice-based placement learning

Practice-based placement learning is an essential part of occupational therapy preregistration education. However, placement capacity challenges exist (Rossiter et al., 2023), which will only increase with the growth of preregistration program numbers. Quality innovative practice placements are needed to support workforce development (Thomas et al., 2022), offering a breadth of practice-based placement learning to prepare graduates for the future landscape of occupational therapy, but also helping to mitigate the placement capacity challenges.

Practice-based placement learning, professional identities, and employability

In a previous editorial “Doing being becoming—the synergetic relationship between employability and occupational therapy” (Taylor, 2021), I coined macro and micro professional identities and the importance of both levels of professional identity for individual occupational therapist’s employability. This current editorial reinforces the importance of the two levels of professional identity within the context of practice-based placement learning, to support the occupational therapists of tomorrow at a macro and micro level, from an individual employability point of view, and its impact on the future of the occupational therapy profession. A recent publication explored the student learning on a first practice placement (Grant et al., 2023) and reported four themes: learning about oneself, the profession, practices, and service users, which are all relevant for any practice-based placement learning. Alongside the macro professional identity development, a key element within each of the broader macro themes was the development of individual (micro) professional identities.

The role of the four pillars of practice

There are ever expanding opportunities for occupational therapists to practice in an increasing range of areas, at all levels, requiring practice-based placement learning to reflect these opportunities. The four pillars of practice is fast becoming embedded within preregistration occupational therapy education programs and is explicitly encouraged within practice-based placement learning (Chartered Society of Physiotherapy and Royal College of Occupational Therapists, 2022), in recognition of the need to prepare students to embrace the exciting and ever-growing opportunities within occupational therapy. The Royal College of Occupational Therapists (RCOT) Career Development Framework (RCOT, 2022) uses the four pillars as the bedrock for its structure—reinforcing its relevance at every level of occupational therapy practice.

The pivot for practice-based placement learning

COVID forced a pivot to alternative and innovative models of practice-based placement learning delivery to facilitate practice-based placement learning progression on preregistration courses. Evaluation has shown that some of the alternative and innovative models have facilitated quality authentic practice-based placement learning. At the recent RCOT Annual Conference 2023, Carolyn Hay—Head of Education RCOT—stated “there is no such thing as a traditional placement.” Quality assurance of the learning journey is the key consideration for any practice-based placement learning, supported by a robust pedagogical design and delivery, with the usual RCOT approved practice-based placement learning outcomes (anchors) at the heart of its design (Taylor, 2023). Two models of practice-based placement learning that have been implemented and evaluated at the University of East Anglia are the Peer-Assisted Learning (PAL) and the Peer-Enhanced e-Placement (PEEP)—supporting the development of both macro and micro professional identities.

Practice-based placement learning model examples

• PAL placements support a 2:1 model of supervision of learners to practice educator, with the learners supporting each other in their own learning, as well as the educator. PAL has been shown to have positive results for both learners and practice educators alike, as well as assisting with placement capacity challenges (Tai et al, 2021) as promoted by the “Everyone needs a PAL” campaign (A place to talk occupation, 2022). Specifically, PAL placements have been found to support students’ problem-solving, professional reasoning skills, team working, and leadership attributes (Tai et al., 2021).

• The PEEP was initially created as an emergency response to covid suspended placements but has been developed since into a sustainable quality practice placement option, being used by multiple professions across the United Kingdom. The PEEP model design and delivery harnesses evidence-based peer group and online pedagogy, facilitating collaboration between employers, and higher education institutes, throughout its design and delivery (Taylor and Salmon, 2021). The PEEP challenges the need to always be physically in the workplace setting for practice-based placement learning and offers flexibility to design bespoke PEEP content that is needed for leaners at a local level. Many PEEPs have been evaluated over the last 3 years—learners consistently meet the placement learning outcomes and exceeded them in areas such as team working and professional/critical reasoning.

The PAL and PEEP demonstrate the potential of alternative and innovative practice-based placement learning models to support learning and the development of their professional identities at a macro as well as a micro level.

The future of practice-based placement learning

Preregistration learners are key to help to shape the future of the occupational therapy profession. We need graduates who are rounded in their macro as well as micro professional identities to know who they are and what they can bring to the workplace and wider society and what the workplace can offer them as occupational therapists. What do we want the future of occupational therapy to look like? Preregistration practice-based placement learning plays a crucial part in shaping preregistration learner career aspirations, which will ultimately impact on the future of occupational therapy. Practice-based placement learning experiences are needed within clinical environments, leadership, research, and education—the four pillars of practice—online or in person/face-to-face, spanning health, social care, voluntary, charity, education, and private sectors. Maximum exposure across the full and emerging spectrum of occupational therapy practice is needed for graduates to appreciate, make, and take opportunities that exist and will exist for the occupational therapy profession in the future.

What contribution can you make?

Are you an occupational therapist who has not previously been a practice educator because you thought that your area of practice was too niche or not within the National Health Service or social care sector, and not suitable for preregistration learners? Please think again.

Are you a retired occupational therapist or an occupational therapist working part time who thought you could not be a practice educator, but could support long arm supervision for role emerging placements or placement models such as a PEEP? Please think again.

Are you an occupational therapist working in a research, leadership, or education role and have not yet offered to be a practice educator? Please think again.

For those of you who are currently practice educators—thank you for your contribution and impact on preregistration learners, but have you been taking one student at a time thinking that a 2:1 placement model, such as a PAL would be too demanding? Please think again.

We all have a part to play in practice-based placement learning, facilitating the development of macro and micro professional identities across the four pillars of practice, for tomorrow’s occupational therapists. What role do you think you can you play? Please look at the RCOT website for further information and contact your local higher education provider to see what opportunities there are for you to contribute to practice-based placement learning and the future of occupational therapy.