Introduction to coaching, the GROW model and C-PAL

We first began to develop our 'coaching and peer-assisted learning' model for University of Bedfordshire healthcare students in 2018 in partnership at the Luton & Dunstable Hospital.

Watch this video produced by the Royal College of Nursing on using a coaching approach as a Practice Supervisor:

Context: View the above video embedded on the www.rcn.org.uk page

C-PAL, five models

Having evaluated and fully researched the implementation of C-PAL within both an acute NHS hospital and in-patient mental health setting the University of Bedfordshire has now created the following five models of C-PAL:

1. Classic C-PAL

A mix of 1st, 2nd and 3rd year students look after a ‘bay’ or group of patients or clients within an in-patient setting. Final year students may coordinate care, under supervision and with input from a coach who supports all learners with ‘their hands behind their back’ only intervening when necessary to maintain patient safety and ensuring that there are regular ‘huddling’ [Also known as the CLiP model].

2. Horizontal C-PAL

A group comprising of students from the same year or cohort look after a ‘bay’ or group of patients or clients within an in-patient setting. Students are supervised by a coach who supports all learners and intervenes to support, direct, question and maintain patient safety. The coach initiates regular ‘huddling’.

3. Learner Dyad

A pair of students, either within the same ward, department or clinical/therapeutic team or located in two different care settings meet either daily, several times a week or weekly to engage in productive reflection, set new learning objectives review daily learning log sheets. Learner dyads might be created where students in different placements prepare each other to ‘swap over’.

4. Learner Triad

Three students, either within the same ward, department or clinical/therapeutic team or located in different care settings meet weekly to engage in productive reflection, set new learning objectives review daily learning log sheets. Students may be a mixture of 1st, 2nd or 3rd years. Where a final year student is present their role would normally be to provide peer coaching to junior students and lead the reflective discussions.

5. Learner Quad

Two students currently in placement and two other students currently in University or four students in placement from within the same department or from different wards meet weekly to engage in productive reflection, set new learning objectives review daily learning log sheets. Where a final year student is present their role would normally be to provide peer coaching to junior students and lead the reflective discussions.

Now complete the following:

• Read through the five C-PAL model descriptors above.
• Identify the key differences in the role of the Coach.
• Identify the role of Coaches and senior students in facilitating productive reflection.

One of the key lessons that the university has learnt is the need to provide a range of different C-PAL models so that C-PAL can be delivered flexibly taking into account the vast array of clinical and therapeutic practice settings within primary, acute and in-patient care.

The ‘GROW’ model

The ‘GROW’ coaching model is used as a mechanism for coaching conversations and goal setting using a reflection and solution focussed approach. Its less directive approach focuses on the use of questioning – rather than the Coach providing answers the student is encouraged to formulate their own solutions which the Coach or practice supervisor/assessor helps to bring out through questioning. This gives the student the opportunity to have more engagement, reflection and ownership of their learning.

Watch this video on the GROW model.

Facilitating productive reflection

It is important for Coaches to be able to facilitate productive reflection or, more simply, conversations that matter to ensure that learners can reflect on their learning at the end of each shift, receive feedback from their Coach and ensure that personal learning objectives have been met. Productive reflection is particularly important when students meet together as a dyad, triad or quad. The following questions have been designed to ensure that students are challenged to reflect on their role, practice and patient care and should be used by senior students who will be required to facilitate a learner triad or quad:

• Where are you with…?
• What do you think has just happened?
• What do you see?
• What did you hear/ observe?
• What have you learnt?
• What does it mean?
• How did you feel when…?
• What did you think would happen…?
• What might be the reason for that?
• What needs to happen next?
• When will you know you have got it right?
• What do you need to pay attention to?
• What might you consider?
• What would you do differently next time?
• What has been the muddiest point?
• If this were a story, what part would need to be told next?

Students who engage in coaching and peer-assisted learning are encouraged to complete a learning log sheet at the start of each shift or learning experience.

Download C-PAL Learning log sheet [DOCX]

"Take 5" Reflection - 'My'

Return to your reflection template:

Write your notes in the 'My' row of the reflection template.

Prompts

• What are my thoughts and feelings about becoming a Practice Supervisor?
• What concerns do I have about being a Practice Supervisor?
• What concerns do I have about other people involved with students?
• Who can help me make sense of the role of a Practice Supervisor?
• What impact have my values had on my support of students?
• What impact has my level of confidence had on how I support students?