This research aimed to identify the factors that impact upon clinical educators’ capacity to engage in the role in the context of podiatry. Findings revealed factors which increase the capacity of clinical educators in this role to include: being provided with protected time to engage in preparation and support of students; having a current or previous relationship with the university which goes beyond the clinical educator role; having assessment and sign-off responsibilities for students; and volunteering for the role. In addition to identifying individual factors which influence the capacity of clinical educators to engage in the role, the research produced a model capable of predicting individual clinical educators’ performance in relation to capacity to engage. The model accounts for 43 % of the predictive variability of capacity of clinical educators to engage with the role and, therefore, has utility in identifying opportunities for placement planning, organisation and support - resulting in more effective practice placement.
The findings of this study are supportive of Jokelainen et al.  who found protected time to be valued by clinical educators. The mentorship role is a major responsibility for the clinical educator both in terms of the student’s placement experience and their progression within the clinical environment. Ideally time should be embedded within the timetable for the clinical educator and student, outside the podiatrist’s clinical responsibilities, to engage with mentoring. This may include reflecting on the day’s or week’s events to contextualise experiences and reinforce theory, providing pastoral support and setting new goals and learning opportunities in partnership with the student.
This study has shown that where the clinical educator has a previous or existing relationship with the university, capacity for mentorship is increased. This result supports previous work where loyalty links have been established with a place of previous study or where endeavours which result in the attainment of an award are currently being undertaken . This type of allegiance can be conceptualised as brand loyalty, with the University representing the brand. The students’ relationship with ‘using the brand’ appears to create a sense of loyalty which extend to actions beyond graduation .
Where clinical educators undertake the responsibility for signing-off learning outcomes there was found to be an increase in capacity for the role . Assessment of competency is integral to the role and often necessitates liaison with other clinical educators regarding their assessment of student capabilities conferring considerable extra responsibility to the clinical educator who will decide on students’ ability to progress. The placement process may be more challenging for some students than for others, and ultimately be more rewarding for the clinical educator when a successful achievement of summative assessment is reached. Where clinical educators are not given this responsibility it may have a negative effect, with the clinical educator having spent time developing a student, but without recognition of this substantial investment.
Volunteering for the clinical educator role increased capacity scores. It would seem natural that individuals that choose to undertake a role are more likely to be well disposed towards it, as it is perhaps viewed as vocational rather than compulsory . A requirement for an increase in placements allocations may result in staff having to take on these roles. This may be counter-productive as unwilling staff are unlikely to mentor students effectively, and may even impact on student attrition.
The insignificant results concerning the clinical educator’s education and experience are surprising, especially given evidence in other professions of the importance of qualifications on student learning (e.g. Nasr et al. . This finding may reflect the homogeneity of variance associated with the sample which may not be reflective of samples in previous research. It is possible that less experienced staff are better able to understand the perspective of students than their more experienced colleagues, thus they off-set a lack of experience with an increased enthusiasm for the role.
The CECE scale provides a useful tool to examine the engagement of clinical educators in students’ learning. Further research using the scale with podiatrists both in the UK and internationally would provide important comparative data. The scale could also be adapted for use with other health professionals engaging in clinical education; this would be beneficial given the multi-professional context within which both practitioners and students frequently work. Building the body of work involving the CECE would yield larger samples thereby enabling more sophisticated statistical analyses with greater power. Given that the CECE scale is self-report, it would be important for future research to also measure aspects of the clinical environment independently (e.g. the ratio of educators to students; clinical caseload; student feedback).
Further research to explore other factors that impact upon capacity to engage in the role of clinical educator is required which surveys all podiatrists who undertake clinical education. Other possible factors which affect capacity could be included, such as the total number of students mentored each year by an individual clinical educator, perhaps from other health professions or universities and possibly on an ad hoc basis. Factor and Rasch analysis with a larger number of respondents may then be possible, to further develop and validate the CECE scale. Further testing of the model would also be beneficial. The CECE scale could be adapted and utilised with other healthcare professionals, increasing the sample size and inclusive of an international perspective. There is also scope to include other dimensions in the CECE scale, such as clinical educators’ perception of the responsibilities and ambit of the role. This work has the potential to provide guidance to the organisation and to inform the resourcing of healthcare students’ placements more generally.
While this research has contributed new knowledge in the area of podiatry training, the study suffers a number of limitations. First, the sample comprised of podiatrists from a single region of the UK, which limits the generalisability of the findings. Although the sample was drawn across both rural and urban placement contexts within a range of organisational environments of varying sizes, it is possible that regional variation may impact clinical education practice. Second, while the response rate to the survey was satisfactory, it is possible that non-respondents may have differed from respondents in relation to characteristics that were relevant to capacity to engage. The research findings, therefore, need to be interpreted with some caution. As with much survey research of this nature, the study assessed the perceptions of clinicians as to the barriers and facilitators to their engagement with the clinical educator role. Such perceptions are important as they describe the lived experience of clinicians and will affect their practice. Nevertheless, perceptions are not necessarily accurate reflections of the external environment.