Carry on students

So we’re now here in ‘the new normal’. Every paper I read (online) overuses the phrase ‘strange and unprecedented times’. And while I groan each time I see those words written down, to be honest I can’t do any better. These are indeed strange and unprecedented times. 

I caught up with colleagues working in practice about a week ago. It may have been longer because there’s something about the ‘new normal’ that while time is flying by, the days also blur. One particular colleague – an MSK physio – was telling me his service had been reconfigured three times in as many weeks. I’ve also heard from colleagues who would desperately love to see a patient and have no idea where they’ve all disappeared to.  

And in the middle of all this strangeness we’re all trying to find ways to deliver what we’ve always done – just differently. 

We’re all acutely aware that services will need to resume, and that the workforce still needs to grow. We had a shortage of physios prior to Covid-19, and with the profession shining during the pandemic, that need will only intensify.  

Which is why I wanted to take the time to talk to students directly. While the world around us has changed overnight, you still need to carry on with, and complete, your studies.  

All change 

Firstly I want to talk about your lecturers. Particularly how they have responded and continue to respond to the situation. It’s worth saying that you’ll see we’ve addressed many of your queries about your programmes directly within the Covid-19 student FAQ on CSP website and we’ve also been responding to you in real time through Instagram live sessions, Tweet chats and podcasts (with thanks to Jack Chew for his support with the latter). I wanted to talk about it here in Frontline because when you’re in the middle of change sometimes it’s helpful to hear a message more than once.  

I’m sure you know this already, but your lecturers are amazing. I have been working closely with them over these last few months as they’ve responded to changing directives, guidance and advice with pace, creativity and sheer determination to make sure that while your university environment has radically transformed overnight, the learning experience remains high quality – just different.  

I want to assure you that although delivery of your programmes is now different to how it was before, your lecturers have put so much thought into what you are now experiencing. They’ve brainstormed amongst themselves as teams, then collectively they’ve met weekly to test out their ideas and thinking with their colleagues at different universities as well as with the education team here at the CSP. My main job at the CSP is ensuring that every accredited programme is fit for purpose so I’ve been part of all of those conversations and I’ve seen the energy, effort and thought that has gone into every change that’s been made. Every one of your universities have sought advice. They’ve been receptive to challenge, open to new ideas and have very definitely been working together to problem solve and help each other think through the implications of this pandemic on your learning experience in its entirety. 

Navigating change 

I penned a piece towards the end of last year about managing change. I obviously didn’t have a pandemic in mind when I was writing it but actually the principles are sound. I often end my more reflective pieces with a suggestion for you to bookmark the article and come back to it at a later date. This might just be that time. Two of the points I made about managing change were: just going with it and finding things to keep yourself afloat while you navigate that change. For this article, I asked one of your peers Emily Fender to talk about her experience on placements. Emily makes a great point that’s applicable to more than placements, and certainly one that chimes with the article.

None of us have been here before, and nothing could have prepared us for it. It’s normal to feel up-ended. Not just within your studies but about everything right now. We’re all unprepared but we’ll get through it and, as Emily says, we’ll even be surprised by how much we discover we’re capable of. Resilience is a word that gets bandied around a lot but change, and especially this society-altering change, highlights why resilience is so necessary and an essential part of your curriculum.  

If, rightly, you see learning itself as a valuable skill to develop, then it’s also okay that your lecturers don’t have all the answers immediately. What they do have is the experience and creativity to make this work, while you all learn together how to navigate this.  

You’re getting a first-hand experience into how skilled physiotherapists are at dealing with the unknown and problem-solving in action. Both fundamental to ‘being a physiotherapist’ whether clinical, research, policy, or education. 

Let’s talk about placements  

There’s such a different picture across all four countries and even across and within programmes at the same university. I know some of you will have experienced recent placements being rearranged or reconfigured. Some of you will be out on placement now, and some will be getting ready to go out. Whenever and however you end up going on placement and whether or not you experience being part of the temporary register will be dependent on so many factors (including your personal choice) so I’m not going to try to unpick this in the article. My colleague Gill Rawlinson’s podcast does a fantastic job of explaining all of this so please have a listen – just follow the link above.   

Instead I want to bust some myths. For some reason there are still one too many that cling on around placements, despite our best attempts to dispel them.  

I’m not just talking about the outdated notion of labelling placements as ‘core’, but also about the idea that placements only count if they are clinical or that they only happen in the NHS. If you do get offered a placement in the charitable, independent or private sectors, and if you get a chance to do something different like join a service that’s operating virtually (offering remote consultations for example) or a research, or policy placement, please know that CSP has been actively encouraging this type of diversity for a long time and not for any capacity reasons but because they are valuable experiences in their own right. 

Because not all placements are clinical, if you are shielding (for whatever reason) then these experiences can offer amazing learning opportunities while offering a lower risk of exposure than a clinical setting. These types of placements may now be coming to the fore because of Covid-19, my hope however is that such experiences are seen as standard.  

Although physiotherapy is a dynamic responsive profession, when it comes to placements, (dare I say it) OTs have historically been more daring. I’ll pick that up in the next article with those who offer placements, but if you study alongside OT students ask them about their ‘role emerging placements’. Imagine heading off into a placement where physiotherapy input could make a difference but as of yet there isn’t any, which makes you the only physio – and you’re still a student.  

But back to the current situation. The whole profession has reconfigured itself overnight and wherever you are, you’ll get to experience that responsiveness first-hand. If you are out in the NHS like Emily, you’ll get a taste of the unknown as you’ll be experiencing an entire healthcare system in the midst of that change. You may well be working in teams that have been reconfigured, or grappling with how to restart services that have been stood down, or managing the rehab needs of patients  
post-Covid. You may indeed find yourself being given greater autonomy, managed at arms-length and your grades determined by the whole multi-disciplinary team (including the support workers). 

All of this is okay, because if we strip placements back to the bone: they are simply meant to be real-world learning experiences where you can practise being a physiotherapist.  

In her own words 

Being on a student placement during a pandemic is an experience I will never forget. None of us have dealt with a pandemic before and it isn’t something they can teach at university. Going into the placement did I feel prepared? Not at all, from the offset I felt very out of my comfort zone with placements cancelling at the last minute, and the fear I was putting mine and my family’s health at risk. But am I glad I had the opportunity? Absolutely, I have had the best opportunity to be adaptable and flexible within a working environment, supported by the whole MDT with a camaraderie incomparable to a non-coronavirus placement.

I feel I’ve been challenged, and through the experience I’ve grown within my practice, and now I am more ready than ever to go onto the temporary register and help where I am needed. I am hugely grateful and lucky for the unique experience. 

• Emily Fender, second-year master's student, St Marys University, Twickenham