Introduction
Following our previous blog post on mental health and wellbeing in work-based learning and apprenticeships a dedicated event took place online on 25 March 2025 facilitated by the Practice, Tuition Training and Development Team within Associate Lecturer Support and Professional Development (ALSPD). Readers from within the Open University can view the event recording here.
The event featured three distinct parts which we consider below whilst also considering the reflective questions Jenny Hillman posted in our blog those being:
- In the HE sector, do we have a nuanced enough understanding of the unique mental health and wellbeing challenges that might exist for those undertaking work-based learning and/or apprenticeships? How can we best enhance our understanding using insights from our staff and students?
- Do the interventions that universities have designed for mental health and wellbeing support in recent decades meet the needs of learners undertaking placements or with substantial workplace commitments?
Scholarship on Mental Health and Wellbeing at the Open University
Professor Joan Simons, Head of the School for Health, Well-being, and Social Care in the faculty of Wellbeing, Education and Language Studies (WELS), shared insights from her research on supporting students with mental health difficulties. Joan’s three-year project involved interviews with 39 Associate Lecturers and focus groups with OU students who declared mental health conditions. She reported on her findings and facilitated discussions on the specific needs of work-based learning students. Internal reports on the project are available for Open University staff.
The OU is one of the largest providers of nursing apprenticeships in the UK and has a strong history of provision in health and social care. It was discussed that these types of courses can impact mental health and well-being in specific ways, for example through second-hand trauma. All agreed that it is vital for Practice Tutors (PTs) to prepare students/apprentices on these programmes for the nuances of health and social care workplace learning.
Proactive communication and effective use of student profiles
Effective communication and support structures through tuition is crucial for helping students with mental health conditions succeed. It was identified that ensuring learners can receive help without repeatedly having to share their issues across the institution would provide an enhancement to the support the OU provides to students.
Longer-term mechanisms for pastoral support
Attendees observed that the OU Practice Tuition role allows for continuous support at whole programme level rather than the module level . A strong effective tutorial relationship is advantageous for supporting workplace learners (Umeokafor and Soares, 2021; Marsden and Youde, 2012) and it is widely acknowledged in the literature that high-quality tutorial relationships can contribute to personalised and successful personal tutoring for students on traditional courses. This is an example of an enhancement that could be applied for all types of learners. It was noted, however, that external Professional Statutory Bodies like Nursing and Midwifery Council (NMC) can place restrictions on the level of continuous support provided in the tutor ‘in practice’ role.
Professor Simons raised development opportunities for staff delivering on work-based learning programmes as a priority. This will help to ensure that development focused on mental health continues to be available in different formats (workshops, online learning etc) . ALSPD facilitates online training alongside an events programme specifically related to supporting OU students, which is informed by internal Scholarship of Teaching and Learning (SoTL). Reflecting on this, we consider that we have further opportunities to use insights from staff and students to enhance our materials and further aid the nuance of understanding for the work-based learning student experience of mental health and wellbeing.
Support from the Mental Health and Wellbeing Team
The next session at our event was led by Joe Kirman from the Mental Health Casework and Advice Team (MHCAT) at the OU. Joe emphasised the team’s mission to enhance, not replace, existing support structures, and their focus on students with complex or severe mental health needs. The work of the MHCAT, like many institutional mental health casework teams in the sector, highlights the critical role of mental health support for students. At the OU, the team offer flexible, individualised support plans, including one-to-one sessions, risk assessments, and coping strategies, without requiring formal diagnoses. They also provide an advice service for staff, helping to ensure a holistic approach to student wellbeing.
Joe shared insightful case studies, based specifically onwork-based student cases at the OU. We apply the theory of experiential learning (Kolb etc) to the development of cross-faculty events so that Practice Tutor participants have the opportunity to reflect on learning from experience. The case studies used in Joe’s presentation were rooted in the experience of delivering multi-agency support by tutors and case workers. Case studies are an effective way to facilitate experiential learning, for example – see Kreber (2001) who also emphasises the importance of reflective practice in leveraging the educational benefits of case studies. The relevance of the case studies offered, which featured insights from interactions with work-based learning students, highlighted how this relatively new service can be used effectively to support this population of students within the OU. Crucially, the lack of requirement for formal mental health diagnoses removes a barrier to accessing this service. Joe also highlighted how his team were able to respond flexibly to meet learners needs, something that is important for work-based learning students /apprentices who have demands related to their employment alongside intense study requirements.
Discussion with Practice Tutors highlighted the importance of communication, collaboration with OU support staff, and empowering students/apprentices to advocate for their own needs. It was recognised again that, especially for work-based learning students, fear of stigma through disclosure of issues, potential complexities in the workplace, employer reaction and the possible scrutiny on ‘fitness to practice’ could be a barrier for learners to sharing of mental health issues.
Collaborative Activity: Developing a Taxonomy of Support
As Education Developers, we aim to facilitate a Community of Practice informed by the development of the concept by Wenger-Trayner and Wenger-Trayner (2015). To this end we regularly utilise participatory methods of learning and seek to enable development of practice through collaborative learning activities such as described below.
The online collaborative training activity used in this session, focused on identifying barriers and enablers for apprentices and work-based learners regarding mental health and well-being. This was intended as a practical exercise to extend the approach taken by Lister et. al (2022) which identifies the barriers and enablers related to student mental health in distance learning to the context of work-based, distance learning.
Key barriers identified and discussed included:
- Employer Understanding of Study Requirements. Employers often lack awareness of the time needed for apprentices to study. (Lomas, 2024)
- Apprentice and Student Belonging. Apprentices sometimes feel disconnected from their institutions, lacking a sense of belonging and student voice. (Umeokafor and Soares, 2021;Umeokafor and Okoro, 2023)
- Engagement with Tutors. Apprentices may perceive tutors as unapproachable or unaware of their specific contexts, affecting their willingness to seek help (Umeokafor and Soares, 2021; Marsden and Youde, 2012).
- Awareness of Available Support. Both employers and universities may not effectively signpost mental health support resources (Umeokafor and Soares, 2021).
Practice Tutor attendees engaged in activities using the online collaborative tools Padlet and Polls to prioritise these barriers based on their experiences of support needs. They also contributed reflections on barriers not mentioned in the literature. These included:
- Demands of work-based learning and study.
- Workplace pressure to prioritise ‘work’ over ‘study’
- Curriculum Design (e.g. timing of multiple assessment)
- Information overload during the induction period
- Insufficient support and supervision in placements
The potential enablers that tutors in attendance identified included:
- Diarised conversations timed for important course events to help with stress e.g off-the-job learning, preparing for End Point Assessment (EPA).
- Early discussion of concerns with the learner and/or appropriate institutional staff
- Building trust with student/apprentices e.g. through appropriate management of confidentiality.
- Listening to/observing clues from students – for example, late night emails and submissions, tiredness, over-concern about performance.
- Capturing data about relevant/important institution and workplace interactions related to mental health and updating the institutional student record to reflect issues.
Key Learnings and Reflections and Recommendations
Within the discussion and activity, it was apparent that the relationship between Practice Tutors and Student/Apprentices is critical. Tutors supporting work or practice-based learning at a distance work closely with students/apprentices in a 1:1 capacity. As with any dialogic relationship, trust and rapport should be established at the earliest opportunity. Trust can facilitate enhanced communication within learning environments, enabling students to express their specific support needs. The same might be applied to relationships between work-based learners and employers/workplace mentors (especially if that relationship is new).
Consideration of the key learnings of this event has articulated further reflections for us as educational developers, specifically:
- How can we ensure understanding of the complexity of the Practice Tutor role and professional work-based learning programmes across the institution?
- How might we enhance development to enable PTs to relate effectively with our work-based learning students, whilst there are simultaneous pressures (related to compliance and funding) to adhere to within progress review meetings?
The relationship between learners, and communication and system strategies may have untapped potential to make a difference to learners with mental health difficulties. This could be paramount for work-based learning courses that utilise supported distance learning for some elements of the course How might we influence the development of digital material contexts to ensure they meet the needs of the work-based student population? Are there elements of our work-based learning provision that can be made less complex by further consideration of the student experience in the online community? What is unique about the work-based learner journey and their user interactions that we might not have considered? And, are these considered when new initiatives are deployed at institutional level?
Future Directions
As we have already mentioned in our previous post, mental health and wellbeing of those on work-based learning or apprenticeship programmes has received less attention than the experiences of students on other modes of study (Umeokafor and Okoro, 2023). There is a continuing need for SoTL which investigates mental health support for work-based learning students, and there are particular occupational areas that may require nuanced consideration. One of these areas discussed within our session, is the potential for students on certain courses to experience particular types of occupational stress. Within the current nursing apprenticeship, the placement experiences can have a negative effect on mental wellbeing with stressors such as workload and secondary traumatic experiences. Compassion fatigue is prevalent in professional learning in this area. Jack (2017) highlights how ‘it is important that educators recognise student’s susceptibility to compassion fatigue and provide appropriate support.’ For those that provide development to the educators we must question if we are providing relevant training, awareness and support systems that are targeted to help those work-based learning students particularly susceptible to occupational stress?
Conclusion
Our discussions in this blog may have raised additional questions for those supporting work-based learners in HE. A key theme is the importance of the relationship between the student and the university. The Practice Tutor plays a crucial role as the university’s representative, fostering support and trust through their relationship with the student.
Tutors can provide personalised and timely support and guidance essential for students with mental health issues. They act as connectors, raising awareness about mental health resources and referring students to appropriate services
a safe space for students to discuss their challenges. The personalised nature of the Practice Tutor role at the OU is prominent source of support for our work-based learning students. Targeted development and recognition of the significant challenges of work-based learning tuition is essential to continue to facilitate effective relationships and dialogue between students and the institution.
References
Jack, K. The meaning of compassion fatigue to student nurses: an interpretive phenomenological study. J of Compassionate Health Care 4, 2 (2017). https://doi.org/10.1186/s40639-017-0031-5
Kreber, C. (2001) ‘Learning Experientially through Case Studies? A Conceptual Analysis’, Teaching in higher education, 6(2), pp. 217–228. Available at: https://doi.org/10.1080/13562510120045203
Marsden, F. and Youde, A. (2012) ‘Fostering a transactional presence: a practical guide to supporting work-based learners’. In: Part-Time study: the new paradigm for Higher Education? UALL, Leicester, UK. Available at: Huddersfield Repository – University of Huddersfield (Accessed: 13 March 2025).
Umeokafor, N. and Soares, A. (2021). Delivery features of apprenticeship courses: The influence on the mental health and wellbeing of apprentices. Available at: Umeokafor-N-49833-VoR.pdf (Accessed: 11 March 2025).
Umeokafor, N. and Okoro, C. (2023). Mental health and wellbeing experiences of Higher Education apprentices. In: Digital Transformation of Health and Safety in Construction. University of Porto, Portugal, 21st – 22nd June 2023. CIB International Council for Research & Innovation in Building & Construction, Kanata, ON Canada, pp. 243-252. ISBN 978-9727523092. Available at: 43052_UMEOKAFOR_Mental_health_and_wellbeing_experiences_of_Higher_Education_apprentices.pdf (Accessed: 13 March 2025).
Wenger-Trayner, E. and Wenger-Trayner, B. (2015) An introduction to communities of practice: a brief overview of the concept and its uses. Available from authors at https://www.wenger-trayner.com/introduction-to-communities-of-practice.