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Implementing 3rd-year learning disability student nurse-led clinics and evaluating self-efficacy and confidence

02 October 2023
Volume 34 · Issue 10



Workplace self-confidence and self-efficacy has been strongly associated with increased coping strategies, job satisfaction and resilience to workplace adversity (Bandura, 1982) which results in higher quality care delivery. The main aim was to evaluate the growth of confidence and autonomy in developing a Learning Disability professional identity within primary care settings, through student led clinics, utilising a long arm supervision approach.


An explorative hermeneutic phenomenology approach, using semi structured interviews was utilised to explore themes and experiences around self-efficacy and confidence in students, practice assessors and supervisors.


Long arm approach is an effective learning approach for students to develop their own autonomy in primary care clinics. However, placement planning and a supportive environment are vital for its success and for the student to build self-efficacy and autonomy in a primary care setting.

Conclusion and Implications

Increased confidence is viewed as a crucial factor in evolving role identity and managing change which are major factors in the preparation for registration and joining the healthcare workforce. The 3rd year Learning Disability nurse led clinics did have impact on workforce well-being by alleviating workload on quality outcomes and frameworks (QOF); prepared students for autonomous working; and increase practitioners’ confidence in using long arm supervision.

The Humber and North Yorkshire region is considered a ‘cold spot’ that faces a strong competition to attract nursing graduates and healthcare professionals. Also, due to the large geographical spread of the region, communities are heavily reliant on general practice to deliver a considerable proportion of their healthcare provision (Humber, Coast and Vale Health Care Partnership; Long Term Plan, 2019–2024).

Historically, student nurse placements have always been at a premium and more so for specialist training (NHS Employers, 2022). This alongside the lack of qualified nursing assessors, has put strain on Higher Education Institutions (HEI) and healthcare providers to find suitable learning disability practice-based placements to accommodate clinical learning as part of their undergraduate programme.

Learning Disability nursing placements are limited and often shared with other nursing disciplines that may not highlight their significant and specialist contribution to patients with a learning disability (Beckman., et al 2022).

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