workload_estimates

Guidance on clinical workload while on placement

Course placement guidelines indicate that trainees should be undertaking at least 8 coherent clinical activities at any one time. The nature and content of the clinical activities will vary, reflecting the work on offer in the placement.

Defining the unit of work

Although the phrase 'coherent clinical activities' might seem slightly opaque, it indicates that the calculation of workload is not based solely on client contacts; it includes a range of clinical activities. Some examples would be:

• a therapy session with an individual
• a therapy session with an established group
• an assessment session with an individual
• an assessment clinic in which the trainee is an active participant
• a team meeting in which the trainee is an active participant
• conducting the service-related research project
• conducting a teaching session for staff

Variations on the expected workload

In some settings the pattern of service delivery might mean that trainees undertake fewer "pieces" of work. Examples might be where:

• each client contact requires a lot of contact time (for example, intensive assessments prefaced by liaison with other professionals, followed by feedback to the client and by further liaison)
• there is a model of intensive supervision associated with each case

Upper limits to the expected workload

There is no formal upper limit, because there are settings where the work is composed of multiple high-volume, low intensity contacts. However, it is assumed that trainees and supervisors will negotiate workloads and ensure that these are not inappropriately high.

Meetings

Trainees often attend meetings. Where their role is as an active member of the meeting, actively contributing to clinical decision-making in relation to their own and other cases, this can constitute a 'piece' of work. However, if their role is closer to an observer, or they are not expected to contribute, then it does not usually count.

Preparation for clinical activities

Some pieces of work require considerable advance preparation, and this should be recognised. However, it is important to consider whether this preparatory work is always associated with the activity, or whether it creates a temporary "blip" in the workload. For example, setting up a therapeutic group often involves assessing a large number of clients, but once it is running a group usually constitutes a single piece of work.

Calculating the workload

Calculating the workload is straightforward if the placement comprises 1-2-1 clinical contacts. However, in most settings placement content is a mix of direct and indirect activity. This means that calculating the workload requires both the supervisor and the trainee to exercise judgment. A rule of thumb is that trainees should be fairly busy and their diaries fairly full, but they should also have enough 'downtime' for preparation and for clinical study.

Examples of appropriate workloads could be: