Of all the challenges in higher education arising from the Covid-19 pandemic, one of the most immediate has been the rapid adaptation of healthcare courses to allow student nurses, allied health professionals, medics and midwives to contribute their skills and time to health and care services.
National representative bodies for medical schools and healthcare faculties have worked intensively with regulators and the NHS to create a national framework for radically revised course structures. In nursing, midwifery and the allied health professions the vast majority of planned clinical placements for first year students have been cancelled as a result of the strain on services. Second and third year students however have been invited to opt-in to spend more time in clinical placements.
Stepping up to serve
Well over 25,000 nursing, midwifery and allied health students across around 80 universities have accepted major course changes in order to support service. In a departure from normal practice, contractual arrangements have been developed for students to enable some remuneration in recognition of the risk and disruption involved in these measures and to ensure that students are covered in the event of death in service.
Though guided by agreements reached nationally, the vast majority of the work involved in these changes is being shouldered by individual universities.
Students may be spending more time in practice, but universities retain overall responsibility for these experiences. This includes responsibility for quality assurance of the placement, assessment of suitability for attainment of learning outcomes and pastoral care of students. Not all students will be involved in the treatment of Covid-19 positive patients, but some will be exposed to clinical environments vastly different from those they have previously encountered. Without careful supervision and support, this could have implications for mental health and course attrition.
Moving into practice is a personal decision. There are students who are unable to engage in patient facing care at this time on account of their own health or family circumstances. In some instances, at the moment, students are willing and keen to enter practice but hospitals and other care providers feel that they cannot be accommodated. In these cases, universities are doing their best to find alternative ways for students to progress through their studies or, in the case of final year students, to move towards timely completion and full professional registration. Nevertheless, where placements are not an option, progression and completion may be delayed. This has important implications for students and faculties in the next academic year.
Hurray for healthcare faculties
University health faculty staff are engaged in a wide range of activities which could never have been foreseen at the start of the academic year. They are restructuring courses and developing online and distance learning provision while capturing these changes for professional regulatory bodies. Staff are helping students make informed choices about their role in service and negotiating with multiple health and social care providers to match these choices to service need.
Many faculties are working with local NHS providers to loan facilities or clinical equipment previously used in simulation and to provide training for previously registered professionals volunteering to return to service. Universities’ duty of care to students is being demonstrated at a distance through practical advice, enhanced tutorials, opportunities for reflection and mental health support but also out in clinical practice where some academic staff have moved to support student learning or provide front-line care.
Healthcare faculties are currently working to recruit the next cohort of healthcare students using online video interviews. Interest in health careers has soared judging by the number of visits to the NHS Health Careers website but the clinical environment and capacity for placements is uncertain. Programmes may need to undergo a dynamic process of restructuring for many months to come as universities work to accommodate both the impact of summer 2020 emergency course amendments and new demands on service from future waves of Covid-19 infection.
Almost all aspects of university healthcare provision are affected, including apprenticeships, post-registration education and research. As senior leadership amends financial models in a highly uncertain environment, researchers are designing investigations into the impact of the epidemic.
University staff may not feature in many minds as the public gathers to clap for carers every Thursday night, but the contribution of the higher education to the current emergency can be in no doubt.
