First year Master of Occupational Therapy (MOT) students complete a unit (OCCP5256) that involves high fidelity simulation learning. The unit focuses on the development of professional reasoning and communication skills.
Students work in small teams in an environment that mimics a hospital, and are allocated a caseload of two clients who are played by medical actors. Registered occupational therapists are employed to supervise the students and facilitate their learning as they plan, carry out and reflect on information gathering, goal setting and education with their clients. To successfully engage in this process, students need to build rapport with their clients, and effectively communicate with clients, peers, and educators. Over the course of the subject, it was identified that students primarily from, but not limited to, non-English speaking backgrounds (NESB) were having difficulty communicating in a professional manner that builds rapport as expected in Australian healthcare contexts.
The opportunity
At the beginning of semester 2 of 2023, the MOT team referred to the Learning Hub six students who were identified as struggling to meet the communication criteria used to assess students in their early clinical placement. Shown below is an example of that communication criteria from the Evaluation of Foundational Placement Competencies (EFPC).
One of the Learning Success Advisors (LSAs) volunteered to support this cohort, in large part due to their background in advising for language learning (ALL) which was perceived to be of use to the referred cohort. Advising practices vary, however, ‘advising’ in this context refers to a dialogic process whereby the learner and advisor work in collaboration to identify needs, negotiate a path toward goal attainment and reflect on the process as it unfolds. Advising practices were utilised during individual consultations to help referred students to create individualised learning plans. Requests for consultations increased and soon students were engaging in weekly reflections with the LSA. It was during these reflective conversations that a shared set of concerns became apparent:
- Am I the only one struggling with clinical communication?
- Who can I practice with?
- How do I be more conversational and empathetic?
Given the commonalities, a need was identified. The LSAs put together a series of workshops addressing the concerns raised and invited the students to participate. Five of the six students joined and the first iteration of the clinical communication workshops were delivered face-to-face in a spare classroom in the Wentworth building at the end of semester 2, 2023.
The offerings
Trialling the workshops
The first iteration of the clinical communication workshops were informed by the questions raised by the students themselves, a collection of self-directed learning tools and literature around preparing students for placement in Australian clinical settings.
The four workshops were relatively informal with a few slides to guide the session, plenty of discussion, roleplay activities and questions about cultural norms (e.g. Is it really OK to joke with clients?). Student feedback was positive with many enjoying the structure and opportunity to practice by role playing with their peers.
Expanding the workshops
Feedback from the students and unit coordinators was positive following the initial workshop series. This led to the continuation and expansion of the workshops with an additional two workshops – clinical handovers and an extended roleplay workshop for students to bring together all the skills they had learned and apply them in longer conversations with ‘clients’. Participation rose from 6 to 10 students and to make access easier, the workshop materials were hosted on the Learning Hub’s canvas site.
In semester 2 of 2024, the workshops were taken up by the Faculty of Medicine and Health and expanded once more as part of the Accelerated Communication Excellence (ACE) program. With the intention to prepare students from different disciplines (e.g., Exercise Science, Occupational Therapy, Radiology) at both the undergraduate and postgraduate level for clinical placement, a 50% attendance rate was mandated for those who had not successfully passed an earlier component of the ACE program. Interested parties across the disciplines could also choose to opt in – an opportunity that was accepted largely by MOT students. A total of 75 students joined the workshops.
Stories of success from the MOT faculty members
Following participation in sessions at the Learning Hub, students were able to return to simulation learning with specific strategies for how they were going to change their approach to rapport building and communicating with clients, they now had a map with directions on how they could improve their clinical communication skills to the required competency.
Word spread quickly as we spoke to other academics about how we were supporting students in simulation in this area.
Stories of success from the learning support advisors
There is a folder on a computer. In this folder are screenshots and photos, each a message of appreciation or celebration of success. They represent the value these clinical communication workshops and consultations held, and continue to hold, for MOT students. Successes have included:
- Student A who emailed to say she felt reinvigorated after realising that she was not a deficient speaker of English but that she was learning a professional skill that had its own purpose, was client-dependent and which required a holistic, person-centred mindset.
- Student B who borrowed the roleplay activities used in the workshops for independent practice. His ‘client’ ranged from generative AI to practice sessions with his classmates who appreciated the opportunity to gain peer-feedback.
- Student C who reported an increase in confidence in applying empathetic communication skills to situations she usually felt hesitant to say anything (e.g., when clients were sad or resistant).
- Student D who realised that not only did she have the language ability, but that it was sometimes okay to joke with clients (The same student who asked, “Is it really OK to joke with clients?”).
These successes are only a fraction of the stories observed or shared by students. Perhaps the greatest success was the space that developed in which students could feel seen, heard and comforted by the people around them.
Looking forward
MOT faculty members and the Learning Hub will continue to collaborate in 2025. Semester 1 will see the introduction of a Clinical Communication for the Health Sciences offering that is open to all interested parties. For details, students should visit the Learning Hub website. One-to-one consultation will continue. Staff who wish to refer a student for a consultation should use the Learning Hub Student Referral form or invite students to visit the Learning Hub Canvas page for academic language and learning resources.
Thank you to Rene Fraser, Celine Serrano-Diaz and Rebecca Barton for their contributions to this article. Your passion for supporting students is unparalleled.
