Quality of practice-based learning

It provides our view on the quality of practice-based learning, including our regulatory requirements, and what we commonly see in programme design and delivery.

This information should be considered by education providers when developing new and existing programmes, linked to this area.

Our threshold requirements

Summary reflections 

Systems are in place to ensure that practice-based learning is initially approved and regularly monitored, to ensure it is of good quality and undertaken in a safe environment.

There are normally well-established audit processes for practice-based learning, covering areas such as availability of experiences, supervision expected, and whether relevant policies and processes are in place to ensure a safe and supportive learning environment. Audit tools normally include ensuring that appropriate staff are in place in the practice setting. These audits enable education providers to make specific judgements on the quality of practice provision and the safety of learners within that provision. There are also normally mechanisms to gather and act on feedback from learners and practice educators.

Strong strategic and operational relationships with practice partners were helpful in resolving any issues and maintaining or improving the learning experience to required standards.

Evidence shows an increased emphasis on the sustainability and resilience of practice-based learning specifically with regards to workforce pressures within practice settings. Education providers demonstrated how they adapted their quality processes in response to practice-placement capacity shortages, placement instability, and changes in learner need. This has led to increased use of alternative supervision models, enhanced simulation and a shift towards more response and risk-aware quality management.   

Education provider approaches 

To ensure and maintain the quality of practice-based learning, there are defined quality arrangements such as:

• initial and ongoing review and sign off of practice learning providers;
• embedding of arrangements into contracts; and
• feedback mechanisms for learners and practice partners.

Education providers also often consider external reference points and assessments relating to practice education, such as:

• National Education and Training Survey (NETS) results, only applicable for HEI education providers in England, which are focused on learner experience of practice-based learning;
• Care Quality Commission reports, to enable intervention and ,if needed, removal of learners, where practice education providers were failing;
• the NHS Education Contract 2021-2024, which is the “formal mechanism for the relationship between [Health Education England] HEE[1] and [practice education] providers”[2]; and
• regional groups, for example groups run by NHS England Workforce, Training and Education Directorate aimed at refining practice-based learning audit processes and addressing issues.

Education providers in Wales are part of a national placement allocation and quality model, (the All-Wales Placement Reference Group), which is overseen by Health Education and Improvement Wales. Education providers are also part of the All-Wales Student Healthcare PACT (Partnership, Accountability, Credibility, Trust), which is a set of pledges co-produced by education providers through the All-Wales reference group, to help empower positive learning experiences.

When proposing new programmes, education providers align proposed programmes with internal and external quality assurance assessments linked to practice-based learning.

Education providers have placed more emphasis on supporting and sustaining practice educators by offering training and refresher programmes. There has also been an increase in adaption of flexible supervision and delivery models such as long-arm supervision; peer or shared supervision and simulation-enhanced learning. This is particularly applied in areas where practice-based learning capacity is limited.  

Degree apprenticeships 

For degree apprenticeship programmes, in the 2024-25 academic year, we clarified our expectations and embedded these expectations for our stakeholders going through the approval process. This was to ensure named employers were in place at the point of programme approval. As part of this, we needed to understand which (and whose) policies / processes were taken into consideration through the application process and what happens if they differed. 

Our finding shows that for apprenticeship programmes, education providers were taking more explicit role in overseeing employer led practice-based learning. This has been achieved using enhanced monitoring of workplace learning environments and clearer articulation of individual, organisational, and shared responsibilities.  

Current sector focus and challenges 

There are challenges with the quality of practice-based learning, particularly stemming from needing to secure additional practice-based learning opportunities due to programme expansions. Education providers identify these challenges through existing quality mechanisms, which shows they are working well, and are able to put specific interventions in place where needed to ensure good practice-based learning experience for learners.

An area of increasing focus for education providers is the need to ensure that practice-based learning environments are inclusive, psychologically safe and responsive to an increasingly diverse learner groups. Education providers incorporate considerations of equality, diversity and inclusion into practice-based learning allocation, educator training, and quality monitoring, rather than treating these as separate or peripheral issues. 

Some education providers could do more to consider external assessments of practice education providers, and will set clearer expectations that all information about the quality of practice-based learning should be considered when making decisions about continuation of, and support for, learners in practice settings.

For English AHP education providers, sometimes it was difficult to interpret National Education and Training Survey (NETS) results, with low response rates for the exercise. 

Areas commonly explored further through our assessments 

Proportion of performance review assessments with quality activities / referrals