JCPSLP Vol 23 No 3

role and relationship was also explored by some UPEs following work which highlights the importance of the UPE relationship for student learning (Sweet & Broadbent, 2016); “perhaps it is more important to focus on the relationship than worry about the role?”. Perspective 3: Feedback Feedback has been described as “one of the most powerful influences on learning and performance” (Johnson et al., 2019, p.1) and its importance in clinical education has been widely acknowledged, most recently being cited as a core component of a pedagogy for placements in allied health professions (Penman et al., 2021). Additionally, the role of feedback in changing student behaviour in simulated placement learning is established and it is little wonder that UPEs chose to reflect on the feedback opportunities available. Focusing initially on feedback for students, one UPE noted the breadth of options offered by this simulated group placement: “I had designed the whole placement experience around a range of feedback opportunities, my intention to make this a really rich feedback experience ... with clear, directed chances for feedback giving as well as receiving”. Others, too, emphasised advantages of the situation noting that, for example, through role-play and peer learning, students “had opportunities to give constructive feedback to each other ... such an important skill” noted as a central element of evaluative judgement development in placement settings (Naidoo et al., 2021). Additionally, the benefits of this placement design for supporting students to develop their skills of professional noticing (Rooney & Boud, 2019) were highlighted in the context of “a clinical event which yields evidence of so many clinical skills and knowledge” with the support of a UPE with “high confidence in PE, academic and relationship building skills” attuned to both the academic and practice placement environments. Opportunities for UPEs to offer feedback in a variety of ways, “verbal and written, UPE-, peer- and individual-led” were also commented upon, with a particular benefit being the responsiveness that the placement design allowed, “it was useful to be able to respond quickly to a gap in their knowledge and then devise something specific to plug in that gap”. However, challenges within the simulated placement were also reflected upon with concern raised that the

whole experience was “less meaty” than a client-facing placement, but perhaps more revealingly that in traditional placements or standardised patient simulations students “would be getting feedback from the client and carer in terms of how they responded. I really missed that, because anything that comes from the client ... is really powerful learning.” This perceived increased value of feedback offered from the client or carer themselves as opposed to the UPE was explicitly noted, “when a client’s had a good session with a student, this means a lot more to the student than my feedback” which echoes previous considerations of worth. Feedback is and should be multi-directional in spite of its linguistic positionality, -back, and a number of UPEs commented on how they used the feedback they received from students in their rotations to support development of future iterations of the placement in real time. However, the challenges of an online delivery method to dialogue were also noted: the silence of a muted space in which people are not always able to even have their cameras on, was totally different in this situation than it had been in the months of online teaching preceding this. The dynamic conversation I was used to and hoped for in a clinical placement at times felt stilted, organised and regimented perhaps highlighting experiences of feedback as both design and as practice (see appendices 1 and 2). Implications and conclusion The creative placement using CSLE via an online video platform was judged to be successful overall as measured by its delivery, engagement, performance and continuity of clinical education by both the UPEs and students. It provided UPEs an opportunity to reflect on the complexity around their dual and multiple roles and responsibilities and on a broader scale, the impact of online learning on the development of clinical skills. The CSLE provided a valuable, novel and important component of clinical skills development, and COVID-19 has precipitated a critical debate around supervised face-to-face clinical placements; namely their value in contemporary society and their timing and frequency of occurrence. However, this impact may well be felt most on the role, relationships and challenges for UPEs and this conundrum deserves further consideration.

Appendix 1. 9 clinical competences to address via formative feedback C1 Reflective learning & personal organisation

C2 Student organises their own materials and activities using guided planning

C3 Interacting competently with clients, carers and professionals

C4 The student is able to gather appropriate material relevant to the client from a range of secondary sources

C5 The student is able to discuss and use appropriate methods of data collection and analysis

C6 The student is able to record client information

C7 The student is able to discuss the client’s speech, language, communication and/or swallowing profile (at a year 3 level of theory).

C8 The student is able to devise intervention/therapy tasks with guidance

C9 With support the student uses outcome measures discharge criteria and the relevant evidence base to inform the client’s management

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JCPSLP Volume 23, Number 3 2021

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