Experiences of advanced clinical practitioners in training and their supervisors in primary care using a hub and spoke model

Abstract

Advanced clinical practitioners are in demand in primary care. This study looked at the experiences of participants in a hub and spoke training model using a qualitative approach Background: Advanced clinical practitioners (ACPs) have been fundamental in ensuring the provision of expert care, resulting in an increase in demand in primary care. This demand has incentivised innovation in approaches to education, to maximise the benefits of training with limited resources and harnessing the expertise in the workforce. Aim: To develop a method of educating and supervising advanced clinical practitioners in training (ACPiTs) in primary care settings situated in a novel hub and spoke environment. Methods: A qualitative approach with close methodological links to the philosophical work of Heidegger was used to capture the nature of existence and reality in the hub and spoke environment. Results: Three main themes emerged from the study: support; supervision; and vision. Conclusion: The hub and spoke format of training is a useful alternative to traditional methods in developing practitioners who work in a bespoke yet broad practice environment, such as primary care.

An international comparison of student nurse practitioner diagnostic reasoning skills

“…The use of a clinical supervisor provides an opportunity for students' to “reflect on and review their practice, discuss individual cases in depth, change or modify their practice … and review professional standards” (Care Quality Commission, 2013, p. 3), hence developing their diagnostic reasoning skills. Clinical supervision has been found to be a valuable tool for NP students (Gloster et al, 2020; Wilson & Taylor, 2019).…”

Advanced practice and clinical supervision: An exploration of perceived facilitators and barriers in practice

“…One solution is use of a clinical internship which ensures the protected time with a clinical supervisor and offers a structured approach to assessment of learning needs in clinical practice (Lee & Fitzgerald, 2008 ). A hub and spoke model has been proposed for primary care AP training, and the three themes identified were support, supervision and vision (Gloster et al, 2020 ). Another possibility is increasing the partnerships between higher education and health care (Haggman‐Laitila & Rekola, 2014 ) and undertaking further evaluation of clinical supervision models in advanced practice (Lee & Metcalf, 2009 ).…”

“…A recent study in primary care applied a ‘hub and spoke’ approach as an alternative to traditional supervision methods in primary care. This process used the strengths of both the General Practitioner (GP) and the AP (Gloster et al, 2020 ). The ‘hub and spoke’ primary care model is an organisation where a main well‐resourced hub is established that supplies intensive medical services and is complemented by satellite campuses/spokes.…”

“…The ‘hub and spoke’ primary care model is an organisation where a main well‐resourced hub is established that supplies intensive medical services and is complemented by satellite campuses/spokes. In the findings of their qualitative analysis, it was noted that trainee ACPs highly valued consistent clinical support from a range of designated GP supervisors and peers afforded by the ‘hub and spoke’ model, because they worked across different practice boundaries (Gloster et al, 2020 ). Trainee ACPs experienced better levels of clinical supervision when GP supervisors understood supervision requirements, and the vision of the trainee ACP role in primary care (Gloster et al, 2020 ).…”