Employment

Work-based learning
Workplace-based learning for healthcare students
Interventions for people with mental health problems
References

Work-based learning

A systematic review [2] found that:

Benefits of work-based learning to students include gaining new and improving existing skills such as personal (e.g. increased confidence), problem-solving and communicative skills; adapting existing knowledge and skills to the needs of new situations in the workplace; managing their own learning; and applying theory in practice.
Benefits of work-based learning to employers were their recognition that students’/employees’ skills had improved.
Management of work-based learning: issues here concerned the actors involved – students, employers, institutions/academics. For students, difficulties arose in organising placements. For employers and institutions, for example, the need to create opportunities to meet and adequately brief all involved about the aims and responsibilities of placements was emphasised.
Realism of work-based learning (WBL) activities was highlighted as helping the achievement of WBL outcomes – for example, through ‘live’ projects.
Academic staff development can arise from tutors’ close working relationship with employer organisations, resulting in valuable insights into the workings of organisations and thus enhancing students’ learning experiences and outcomes.
Barriers to engaging employers included lack of interest, lack of understanding, and lack of ability through time and work pressures on the part of employers, and the unnecessary use by institutions/academics of academic language and terminology.
Size of employer organisation: co-operation between educational providers and SMEs can be time-consuming; there is some evidence to suggest that engaging employers through employer networks is more beneficial.

Work-based learning for healthcare students

A systematic map [4] identified 117 UK studies about workplace-based learning for undergraduate/pre-registration healthcare students published between 2003 and 2013. The majority of studies (n = 111) focused on students' views or experiences of workplace-based learning. Very few studies (n= 6) investigated the impacts of workplace-based learning (using quantitative measurements of change in student attitudes, knowledge or skill). There were no studies that measured impacts on organisational practice or patient/client outcomes. The highest number of studies focused on nursing students (n = 52) and there were relatively fewer studies examining students in medicine (n = 13), dentistry (n = 11) and midwifery (n = 10). Studies of workplace-based learning for students of the allied health professions were also limited in number (e.g. four physiotherapy studies). Eighteen studies focused on workplace-based learning in an inter-professional context. The majority of studies used qualitative data collected using questionnaires and interviews.

Interventions for people with mental health problems

A systematic rapid evidence assessment [1] found that while there is evidence to suggest that ‘employment’ interventions can be implemented and are popular and acceptable, there is no evidence that they are effective in improving employment prospects for people with common mental health problems.

The evaluations of ‘employment’ interventions tended to be less robust than those evaluating ‘mental health’ interventions.

However, there is evidence to suggest that ‘mental health’ interventions can improve employment status, especially for those already employed. The following conclusions were reached:

Improvements in people’s mental health are associated with better employment outcomes.
Receiving recommended primary care improves employment outcomes.
Interventions to improve guideline implementation and adherence can improve employment outcomes.

However, the above may not be applicable for those currently unemployed.

One review [3] using the social model of recovery stressed the importance of individuals having opportunities to take control of their lives and to engage in all levels of society regardless of whether mental health symptoms persist. The review aimed to:

synthesise research evidence on the process and impact of vocational and training interventions that are employing recovery approaches, in community-based adult mental health services
survey current practice to identify vocational and training interventions being delivered in community-based adult mental health services in the UK that adopt recovery approaches.

The research evidence was not conclusive, with little evidence to suggest that different types of training and vocational interventions lead to differences in non-vocational outcomes.

The areas where there seemed to be consistent effects were:

voluntary work and supported education programmes impacting on participants’ self-reports of improved self-esteem
supported education helping participants’ ability to cope with the stress of studying
integrated services - most studies showed an improvement in engagement in daily living activities and a reduction in mental health symptoms
integrated services and voluntary work and education - most studies showed an improvement in quality of life.

The findings indicate that although training and vocational interventions are shown to have an impact on vocational engagement, vocational engagement is often weakly related to non-vocational outcomes. It is likely that programme effects on vocational and non-vocational outcomes are specific to the content and delivery of the programme. Another possibility is that people who use services need more time in employment, training or education before vocational gains can be generalised to other non-vocational domains.

In a practice survey, the same review [3] found that practitioners used both person-centred and strengths-based approaches; they aimed at and believed in working with people to build on their strengths, competencies, accomplishments, goals and motivation and provided support with the wider aspects of people’s lives including when they experienced setbacks in their mental health.

Attempts to provide opportunities for people who use services to support each other featured more as an ‘add on’ to services than being integral to service delivery. The relationship between people who use services and practitioners was the mechanism for providing person-centred and strengths-based approaches, but there appeared to be a tension between developing positive working relationships with people who use services, and the pressure regarding funders to have measurable outcomes such as the number of people working and ‘in a job’.

In many circumstances training and vocational services need to support people who use services to overcome barriers to employment. The most commonly cited issue was supporting people to navigate the complex and sometimes confusing route between receiving benefits and entering into employment or full-time education.

References

1. A systematic rapid evidence assessment: the effectiveness of interventions for people with common mental health problems on employment outcomes (2007)

2. Engagement in course development by employers not traditionally involved in higher education: student and employer perceptions of its impact (2008)

3. Supporting people in accessing meaningful work: the use of recovery approaches in community-based adult mental health services (2008)

4. Workplace-based learning for undergraduate and pre-registration healthcare professionals: A systematic map of the UK research literature 2003-2013 (2015)