Quality Education for a Healthier Scotland
Contact Details
Margaret Conlon
Lecturer and Teaching Fellow
Edinburgh Napier University
m.conlon@napier.ac.u
Pat Bradley
Programme Leader/Teaching Fellow
Stirling University
p.j.bradley@stir.ac.uk
Quality Education for a Healthier Scotland
New Approaches to Practice
Placement Provision
Hub and Spoke Models and their impact on Practice
Learning and Mentoring
Quality Education for a Healthier Scotland
What is a Hub and Spoke
Placement?
The history
The concept
The purpose
Quality Education for a Healthier Scotland
The Hub
• The core of
learning from which
is pivotal to all other
learning
experiences
• The glue that
directs and holds
the spokes
Quality Education for a Healthier Scotland
The Spokes
Led by:
• Student learning
• Patient journey
Informs:
• Deep learning
• Integrated & active learning
Offers:
• Continuity
Creates:
• Capacity
Quality Education for a Healthier Scotland
Robert Gordon University
MODEL – Whole curriculum approach. Two contrasting HUB
settings returning each year. Same mentor in each HUB for
whole course.
STUDENTS: First, second and third year undergraduates
HUB: A single practice learning placement that students return
within a year or across a number of years. The primary learning
environment
SPOKEs: reflect service users’ journey & experiences through a
range of services and determined by Hubs. Emerge from the
HUB, determined by HUB mentors, students and service users
Quality Education for a Healthier Scotland
Hub and Spoke: Whole Programme Approach
Stage 1
stage 2
stage 3
• CPN, Older
Adult Services
• CPN, Older
Adult Services
• CPN, Older
Adult Services
stage 1
stage 2
stage 3
• Adult Acute
Admission
• Adult Acute
Admission
• Adult Acute
Admission
Quality Education for a Healthier Scotland
Edinburgh Napier University
MODEL: specific clinical pathway: CAMHS
STUDENTS: Ten third year mental health undergraduate nursing
students
HUB: two contrasting ten week placements. Different mentor in
each.
SPOKEs: voluntary; educational; primary care; and social care
settings. Ten exemplar SPOKEs prepared in advance &
additional SPOKEs found, negotiated and regulated by student.
Between 1 and 10 days in length
Quality Education for a Healthier Scotland
Hub and Spoke: A Service Centred Model
Spoke
Two:
School
Base
Spoke
One:
Parent
Support
Group
Spoke Two:
Supported
Accommodation
Spoke One:
Early
Psychosis
Service
Hub One:
Community
CAMHs
Hub Two: In
patient Unit:
Young People
Quality Education for a Healthier Scotland
Stirling University
MODEL: One HUB setting and same mentor for first year.
STUDENT: Forty six first year undergraduate: Adult, Mental Health
& Learning Disability
HUB: Defined by geographical location.
SPOKEs: complimentary, contrasting learning experiences
relating to the HUB service
Quality Education for a Healthier Scotland
Hub and Spoke: Pathways Approach
Hospice
Specialist
Support
Nurses
Radiology
Gynaecology
Ward
Theatre and
Recovery
Room
Oncology
Ward
Infection
Control
Out Patient
Treatment
Quality Education for a Healthier Scotland
Method of Spokes Definition and Organisation
Case Study One: Hierarchy of Learning
Case Study Two: Organisation and
facilitation
Case Study Three:
Length of experience and service user
journey
1st level: Spoke relates to and ‘follows’
individual client journey and is likely to be
located in third sector; education or social
care setting
Internal SPOKE Model – Responsibility for
planning & arranging SPOKEs & reporting
on student progress accepted and managed
by HUB mentor.
Insight SPOKEs – short visits (½ - 3 days)
to services or organisations service user is
accessing for a particular reason, e.g. a
health improvement clinic
2nd level: Spoke relates more generally to
client population and is likely to be located
in third sector; education or social care
setting
Facilitated SPOKE Model – Responsibility
for planning & arranging SPOKEs and
reporting on student progress was led by
PEFs for the HUB in liaison with HUB and
SPOKE mentors and the student.
Regular
Attachments
–
ongoing
experiences to services accessed by
service users, ½ day or full day per week for
duration of a Hub e.g. psychotherapy
department or an annual return. e.g. to an
island community the ward based Hub
receives service users for care and
treatment.
3rd level: Spoke directly relates to hub: so,
hub=spoke and spoke=hub and is located in
primary or secondary care health setting
Fixed SPOKE Model – Responsibility for
planning & arranging SPOKEs was
accepted & discharged by the University
campus placement coordinator.
Block Spoke Experiences - up to 4 weeks,
e.g. Spokes where significant travel is
required or there is a reciprocal Hub
exchange in place for the duration of the
course, e.g. eating disorders in-patient unit
& acute admission ward.
Quality Education for a Healthier Scotland
Impact on learning
1. Contrasting but complementary hubs enable practice learning aligned
to patient journey
2. Reconfiguration of mentor relationship and placement extended and
deepened student learning
3. Students sense of belongingness within pathways promoted a deeper
learning experience
4. Hub and Spoke model promotes opportunity for interagency and multi
professional learning
5. Hub and Spoke model provides learning opportunities beyond
secondary and acute care environments
Quality Education for a Healthier Scotland
Benefits
• Learning is aligned to ideals of contemporary nursing
• Review and reorganisation of placement learning
produces opportunities
• Mentors/mentoring process
• Enhanced Student experience has a positive effect
on retention
• Placement capacity is enhanced
Quality Education for a Healthier Scotland
Challenges
• Planning & implementing change with current climate
• Shifting culture towards being innovative and future focused
• Establishing the model that fits the job
• Mentor/student Preparation and support specific to pathway
• Review of documentation in a way that supports individual
student learning
Quality Education for a Healthier Scotland
Key Messages
Quality Education for a Healthier Scotland
Key Messages
• Aim for creating GOLDSTANDARD learning experiences (not by
resources) - It is timely to re-focus the nature & ‘look’ of practice
learning
• Look widely! Think beyond secondary care across fields of
practice and within care specialities and population groups.
Disseminate and evaluate
• Long lead in times are require for successful implementation
• Nurture your mentors and PEF’s!
• Aim for consensus among all and collective enthusiasm:
changes in practice learning model needs championed &
supported
• Disseminate widely!
Quality Education for a Healthier Scotland