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Clinical education is a key component to learning in the health professions.
This qualitative study investigated how physiotherapy students and clinical educators perceived their respective roles in learning and teaching clinical skills during students' first clinical placements.
Separate physiotherapy student and educator focus groups were conduct...
Context in source publication
Context 1
... participants (in separate educator and student focus groups) were invited to consider and discuss the learning or teaching process, including definitions of their respective roles and factors that had facilitated or hindered their role as a student or educator (Table 1). These questions were developed by the authors, in consultation the head of clinical education in the University of Melbourne, School of Physiotherapy, and from a review of the key themes in the literature about the nature of and challenges to clinical teaching and learning. ...
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Objectives:
The opportunity for student self-reflection and the accuracy of that reflection are critical to the acquisition of professional competencies. The relationship between student-clinician agreement and clinical performance in physiotherapy students has not yet been investigated. The aim was to determine whether a simple measure of student...
Citations
... [7] It is central to the curriculum and the value of clinical education is undisputed by all scholars. [3,[8][9][10][11] Peer review evaluation is an important subjective, but incomplete, quality assurance process. The structure and processes of clinical education are not fully reviewed in our current review system. ...
... [14,15] Also, there is no standard way to assess consensus. [10,14] Three Delphi rounds are generally recommended. [14,15] The first Delphi round comprises unstructured, open-ended questions. ...
Objectively evaluating the quality and effectiveness of a physiotherapy clinical education programme has been unsuccessful to date, due to its complexity and the lack of a standardised tool. We undertook to develop a standardised programme evaluation tool and used the Delphi method to obtain consensus (set at 80%) to determine the face and content validity of the items and domains of the tool, the scoring system and a name for the tool. Academics, clinical physiotherapists and clinical physiotherapy educators participated in the Delphi rounds. Three Delphi rounds ensued: in Delphi round 1, a 71% response rate was obtained and 49 questions obtained 80% consensus. In Delphi round 2, a 91% response rate was obtained and 59 questions obtained 80% consensus. In Delphi round 3, a 42% response rate was obtained, several names were suggested, and the scoring system was established. The provisional tool of 85 items ultimately emerged as the Vaneshveri Naidoo Clinical Programme Evaluation Tool (VN-CPET).
... The foundations of physiotherapy education that aims to prepare graduates for contemporary practice, are also continuously evolving (ERWCPT, 2020). As highlighted by World Physiotherapy (2021), professional practice education under the supervision of appropriately qualified instructors, is an essential element of physiotherapist entry-level education programs, as it enables students to work with clients, groups, and communities in authentic environments (Delany & Bragge, 2009;Ernstzen et al., 2009;Lewthwaite et al., 2022;Stoikov et al., 2022). Whether the stage be education or professional practice, one of the constant phenomena encountered in physiotherapy is the learning and teaching of human movement, which is considered an essential element of health and well-being (e.g., Hopper et al., 2019;Ogden et al., 2009;Wikström-Grotell, 2016;World Physiotherapy, 2021) In the literature, several authors have identified human movement as the principal phenomenon in physiotherapy discourse. ...
Purpose
Human movement is essential for health and well-being. Understanding human movement is pivotal in physiotherapy, but also an important element of physiotherapy education. This review identified, critically appraised, and synthesized the available evidence on learning and teaching human movement in physiotherapy as perceived by students, therapists, and instructors.
Methods
The databases MEDLINE, CINAHL, ERIC, PsycINFO, MEDIC and FINNA, were searched. The search was conducted in March/April 2020 and updated in March 2022. The systematic review followed the JBI methodology for systematic reviews of qualitative evidence and was conducted in accordance with an a priori protocol.
Results
The overall quality of the 17 included studies was scored low on ConQual but dependability and credibility were rated as moderate. Four synthesized findings aggregated from 17 categories and 147 findings described the perceived significance of 1) being present in movement, 2) movement quality, 3) movement transfer, and 4) contextual factors for the learning or teaching of human movement in physiotherapy.
Conclusion
The synthesized findings indicate that the perceived significance of contextual factors, movement quality and transfer, and being present in movement should be considered in all learning and teaching of movement in physiotherapy. However, the evidence of the review findings was evaluated as low-level, which should be considered when applying these results to physiotherapy education or practice.
... Research confirms that active methods, such as simulating conversations with patients, modelling correct behavior and providing feedback, along with noticing areas with knowledge deficits and fostering the development of high levels of trust, communication competence, confidence and creativity (Elliott et al., 2015;Femiak & Czechowski, 2022;Kuk et al., 2015;Riste et al., 2018Ytreberg et al., 2014. Furthermore, they develop self-awareness, self-reflection and self-observation (Delany et al., 2009;Kuk et al., 2015;Pades-Jiménez et al., 2021). ...
... Training supervisors of clinical placements in leadership styles and teaching methods such as the BUILD model should be considered (Delany et al., 2009). Training in assertiveness, relationship building, and identification of students' needs are also suggested for supervisors (Clarke 2010;Delany et al., 2009;Nelson 2020;Stoller et al., 2013). ...
... Training supervisors of clinical placements in leadership styles and teaching methods such as the BUILD model should be considered (Delany et al., 2009). Training in assertiveness, relationship building, and identification of students' needs are also suggested for supervisors (Clarke 2010;Delany et al., 2009;Nelson 2020;Stoller et al., 2013). ...
Objective: The objective of this study was to answer the questions: 1) will the use of active methods in teaching workshops lead to an increase in indices of social competence in students? 2) do workshops conducted with active methods affect the development of social competence of women and men to the same extent? Methods: A pedagogical experiment with 140 first-year students (age: 18-26 years, with a mean age of 20.7 (SD 0.96) of the Faculty of Rehabilitation. The experimental group practised social skills using active methods. The control group studied the same content without active methods – based on text reading and analysis. We used the psychometric Social Competence Test, which has 3 parts: assertiveness, intimacy, and social exposure, and an overall index on a scale of 1 to 4. Result: Participation in the classes resulted in an increase in the subjects’ indices of competence for assertiveness (η ² = 0.13), intimacy (η2=0.07), social exposure (η ² =0.06), and overall index (η ² =0.12). Changes in indices of the competencies studied in the experimental and control groups were at a similar level, with a small effect (η ² =0.01). There was a small interaction effect for gender and workshop participation (η ² =0.01). Conclusion: Active methods used in teaching classes did not result in an increase in social competence indices in first-year physiotherapy students. The gender of the respondents was irrelevant to the effectiveness of the development of social skills in workshop classes; therefore, the content and methods of working with women and men should be the same.
... Physiotherapy clinical educators perform a critical role in clinical education by sharing their knowledge and expertise for the development of both professional and clinical skills. Specifically, clinical educators facilitate students to gain confidence in their clinical reasoning and application of theoretical knowledge in real-life situations, providing feedback as well as evaluating students' clinical performance and behaviours (Delany & Bragge, 2009). Physiotherapy students regularly report that the attitudes of their clinical educators, amount of direction, and the atmosphere of the learning environment play a large role in influencing their career goals as well as increasing their professional confidence (Laitinen-Väänänen et al., 2007). ...
... The importance of aligning teaching and learning expectations between students and clinical educators to achieve learning outcomes (Delany & Bragge, 2009) was supported by this study. Students felt challenged by the differences in documentation expectations from their educators across different clinical placement facilities. ...
Background : Clinical documentation is a critical form of communication in healthcare settings. As defined by the Physiotherapy Practice Thresholds, clinical documentation that complies with relevant professional and legal obligations is a requirement for all physiotherapists in Australia and New Zealand. Aims : The aims of this study were to explore the experiences of clinical documentation and perceived support and training needs for physiotherapy students whilst on clinical placement, from the perspective of students and clinical educators. Method : A qualitative approach was used to investigate physiotherapy student (n=18) and clinical educator (n=17) experiences and perspectives. Interviews from eight focus groups were professionally transcribed, and reflexive thematic analysis was applied to the data to determine common themes. Results : Four overarching themes were generated; 1) Recognising the value of documentation, 2) Variance of expectations, 3) Challenges in measuring performance, and 4) Clinical placement readiness and requirements. Conclusion : The main findings from this study identify the unique challenges that students experience to meet documentation requirements on clinical placement. This study highlights the shared responsibility of university education providers and clinical placement facilities to support students to understand the importance of clinical documentation and assist in improving their documentation skills.
... One of the methods is a simulation of relations and dialogue with a patient. It allows for preparing the students for communication and establishing relationships with patients, experiencing difficult situations beforehand, and emotions related to them [4,8,25]. ...
... Such classes teach talking to patients to explain the treatment process, negotiating, and setting rules and boundaries. Simulated relationships with a supervisor and a medical staff should also be included in the process of acquiring communication skills prior to clinical activities [4]. Classes with simulation forms use methods of working with a group based on dialogue, verbal and non-verbal communication, and various forms of drama [3,12]. ...
... Helping the patient understand and encouraging them to follow the recommendations requires not only medical but, most importantly, psychological knowledge [15,21]. The implementation of active teaching methods in education is also a response to the need for students themselves to be more active and involved and to move away from their passive and receptive role towards educational constructivism [4,16,23]. ...
Study aim : In the education of physiotherapists, communication skills should be developed: this can be done by conducting special workshops. In the context of the COVID-19 pandemic, the need arose for replacing conventional forms of education with remote classes. Therefore, it was decided to test the effectiveness of a social skills workshop conducted using active online methods for second-year physiotherapy students.
Material and methods : The experimental factor was the contents of workshop classes taught online as part of the mandatory course included in the curriculum. The platforms Teams, Zoom, and the Messenger were used to carry out the experiment. The workshops used active learning methods: simulation of work situation, drama, peer feedback and interaction-based communication.
Results : The results obtained from 78 participants (pre-test and post-test, including 45 women) were analyzed. The age of the participants ranged from 20 to 22 years, with a mean of 20.7 years. A self-reported social skills questionnaire consisting of 17 statements was used. participation in the course resulted in a significant increase in the index of general communication skills of the students (Z = 5.11, p < 0.001, R = 0.582).
Conclusions : Online workshops using active teaching methods, which are an essential element of students of physiotherapy preparation for clinical work, can stimulate the development of their communication skills.
... Several scholars have attempted to do this, but were unsuccessful because clinical education is complex, diverse, and multidimensional (Higgs 1993;Jette et al. 2014;McCallum et al. 2013;Stachura, Garven & Reed 2000;Strohschein, Hagler & May 2002). The curriculum review process by academic departments largely focusses on the theoretical component (learning objectives, activities and outcomes), while the structure and processes of clinical education are largely overlooked; yet clinical education is a core component of a physiotherapy undergraduate programme Chetty et al. 2018;Delany & Bragge 2009;Higgs 1993;McCallum et al. 2013;Moghadam, Kashfe & Abdi 2017). ...
Background: Physiotherapy clinical education is complex. The dynamic learning milieu is fluid and multidimensional, which contributes to the complexity of the clinical learning experience. Consequently, there are numerous factors which impact the clinical learning experience which cannot be measured objectively – a gap which led to the development of our study.
Objectives: To develop, validate, and test the reliability of an assessment tool that evaluates the effectiveness and quality of physiotherapy clinical education programmes.
Method: A mixed methods approach in three phases included physiotherapy academics, clinical educators, and clinicians throughout South Africa. Phase One was a qualitative study: focus group discussions determined items and domains of the tool. Phase Two established the content and construct validity of the tool, a scoring system and a name for the tool, using the Delphi method. In Phase Three, factor analysis reduced the number of items, and the feasibility and utility of the tool was determined cross-sectionally.
Results: The Vaneshveri Naidoo Clinical Programme Evaluation Tool (VN-CPET) of 58 items and six domains was developed and found to be valid, reliable (α = 0.75) and useful. The six domains of VN-CPET include governance; academic processes; learning exposure; clinical orientation; clinical supervision and quality assurance and monitoring and evaluation.
Conclusion: The Vaneshveri Naidoo Clinical Programme Evaluation Tool is a valid, reliable and standardised tool, that evaluates the quality and effectiveness of physiotherapy clinical education programmes.
Clinical implications: This tool can objectively evaluate the quality and effectiveness of physiotherapy clinical education programmes in South Africa, and other health science education programmes, both locally and globally, with minor modification.
... Many studies highlight the importance of developing manual skills in a broad set of PT subjects because they are essential in the professional world [17,21]. This is the case of MT, where students have to acquire and fluidly apply a wide range of different techniques and maneuvers both on colleagues and patients [22,23] in order to be effective when assessing and treating patient´s pain experience [24]. ...
Introduction
In recent years, formative assessment has gained importance in health care education to facilitate and enhance learning throughout the training period. Within the frame of active methodologies, rubrics have become an essential instrument for formative assessment. Most rubric-based assessment procedures focus on measuring the effects of rubrics on teachers. However, few studies focus their attention on the perception that students have of the evaluation process through rubrics.
Methods
A cross-sectional survey study was carried out with 134 students enrolled in the pre-graduate Physiotherapy education. Assessment of manual skills during a practical examination was performed using an e-rubric tool. Peer-assessment, self-assessment and teacher´s assessment were registered. After completion of the examination process, students’ perceptions, satisfaction and engagement were collected.
Results
Quantitative results related to students’ opinion about e-rubric based assessment, students’ engagement, perceived benefits and drawbacks of the e-rubric as well as the overall assessment of the learning experience were obtained. 86.6% of the students agreed upon the fact that “the rubric allowed one to know what it is expected from examination” and 83.6% of the students agreed upon the fact that “the rubric allowed one to verify the level of competence acquired”. A high rate of agreement (87.3%) was also reached among students concerning feedback.
Conclusions
E-rubrics seemed to have the potential to promote learning by making criteria and expectations explicit, facilitating feedback, self-assessment and peer-assessment. The importance of students in their own learning process required their participation in the assessment task, a fact that was globally appreciated by the students. Learning experience was considered interesting, motivating, it promoted participation, cooperative work and peer-assessment. The use of e-rubrics increased engagement levels when attention was focused on their guidance and reflection role.
... Pik€ anen et al. [14] studied, among others, physiotherapy students and found that a dialogue about ILOs positively affected the student-supervisor relationship whereas a lack of dialogue made the supervisory relationship less functional. Furthermore, Delany and Bragge [15] show that an increasing congruence between students' and supervisors' perceptions of ILOs may enhance the outcomes of clinical education. Despite these studies, we know little about how physiotherapy students' supervisors use ILOs. ...
... In the early 1990s, Jarski et al. [33] found that physiotherapy students deemed it important to their learning that supervisors facilitated positive interpersonal relationships, but a supervisor's clinical skills were considered less important. Moreover, Delany and Bragge [15] reported that undergraduate physiotherapy students relationships with supervisors influenced students' confidence and interest in engaging in the learning process. A helpful strategy was when the supervisor provided time for reflection and was approachable. ...
... A supervisor's encouragement to move beyond the one-to-one relationship and engage with others in an independent manner supported the students' development of autonomy. This finding is in line with those of Delany and Bragge [15], who studied third-year physiotherapy students and found that they reached higher levels of selfconfidence and satisfaction in their learning encounters when they were involved in the departmental team and when other health professionals offered their perspectives. Thus, we believe that cultivating pedagogical environments that reflect the tenets of CoP is important in broadening students' learning and developing their autonomy; this demonstrates how a whole organization can contribute to students' professional development. ...
Background
Students’ experiences of the clinical learning environment are crucial to learning and professional development. Earlier research using the Undergraduate Clinical Education Environment Measure shows that students’ perceptions of supervision vary significantly between undergraduate programs, with physiotherapy students scoring higher than other students.
Objectives
We explored physiotherapy students’ experiences of supervisors’ preparedness, familiarity with learning outcomes, and supervision practices during their first clinical placement.
Methods
Individual semi-structured interviews were conducted with 13 physiotherapy students. The interviews were analyzed using qualitative content analysis according to Graneheim and Lundman.
Major findings
Within the latent theme A coherent whole throughout the placement, three manifest categories were found: Establishing a relationship, Fostering active participation, and Cultivating outcome-based learning. The students valued a supervisor who was prepared for the initial meeting and wanted to establish a relationship. When the students experienced a sense of trust, they dared to ask questions. The supervisors encouraged students to move beyond the one-to-one relationship and cooperate with others in the community to develop autonomy. Self-assessment enabled the students to identify their own learning needs and enhanced the possibility of achieving intended learning outcomes. The supervisors repeatedly returned to the learning outcomes.
Conclusions
Physiotherapy students highly regarded supervisors who established a relationship and fostered active participation by being available, promoting student autonomy, and encouraging cooperation in the community. The continual use of intended learning outcomes helped students identify their learning needs and achieve the outcomes.
... Studies evaluating physiotherapy courses and teaching curricula aim to identify the most effective educational methods and existing deficiencies [4]. For example, based on student, educator and expert opinions, researchers reported there were needs for closer cooperation between health care workers and patients [5]; ongoing, evidence-based updates regarding physiotherapy interventions [6][7][8][9]; and cooperation between practicing physiotherapists and researchers carrying out empirical studies [10,11]. The related findings also show that it is necessary to consider international experiences [12] and the cultural specificity of learners [13] in designing local teaching curricula and to take into account the preferred learning methods of students in combination with their on-the-job training [14]. ...
Background
The approach to the education and professional advancement of physiotherapists is particularly relevant today. To date, no studies have compared the perceptions of physiotherapists regarding professional issues in geographically close European countries such as Poland and Germany. Therefore, this study’s purpose was to compare Polish and German physiotherapists’ perceptions related to their profession, entry-level education, and career opportunities.
Methods
We recruited 565 physiotherapists from Poland and 560 physiotherapists from Germany. An opinion polling method based on a questionnaire was applied in the study. The survey was conducted in 48 facilities located throughout the territories of the two countries. The assessment focused on the following three issues: 1) professional education (form and content of educational programs, organizational aspects, and effects of education); 2) professional development and career opportunities; and 3) the relationship between years of service and perceptions of professional education, career satisfaction and advancement opportunities.
Results
German respondents rated specific aspects of their education, development opportunities and professional careers more highly than their Polish counterparts ( p = 0.001). A highly significant negative correlation was identified in both groups between all the assessed aspects of professional education and years of service (0.9 ≤ |R| < 1, p = 0.001).
Conclusions
Opinions on their professions expressed by physiotherapists from closely neighboring countries, namely, Poland and Germany, were surprisingly disparate. Compared to their Polish colleagues, German physiotherapists viewed their experiences more favorably vis-a-vis entry-level education, career opportunities, and professional status. Further study is needed to establish whether these findings reflect actual differences, sampling bias, or other factors.
... Placements facilitate the translation of theory to practice and assist students to acquire the required standards of proficiency of their discipline (McAllister and Nagarajan, 2015). Supervision of students on placement is primarily provided by qualified AHSW practitioners based in a professional work-based environment, who are responsible for guiding learning by acting as a role model, providing learning directed opportunities and evaluating the student's performance in real-life practice (Delaney and Bragge, 2009). Supervisors are typically known as practice educators (PEs) and may be referred to as practice teachers, clinical educators, clinical preceptors or clinical mentors (O'Brien et al., 2019). ...
Purpose
Work-based placements are central to the university education of allied health and social work (AHSW) students. As a result of COVID-19, the clinical learning environment of students' work-based placements was dramatically altered resulting in numerous documented challenges. This inter-disciplinary study aimed to evaluate AHSW students' perceptions and experiences of completing a diverse range of work-based placements during COVID-19.
Design/methodology/approach
This study was a mixed-method inter-disciplinary study using an anonymous online survey consisting of multiple choice, Likert scale and free text questions. Mixed-methods design supported amalgamation of insights from positivism and interpretivism perspectives and enabled research questions to be answered with both breadth and depth. 436 students were invited to participate who were enrolled in five AHSW educational university programmes: speech and language therapy, occupational therapy, physiotherapy, radiation therapy and social work. Data collected was analysed using both quantitative (descriptive and analytical statistics) and qualitative (thematic analysis) methods.
Findings
118 students participated (response rate: 27%) representing a range of AHSW disciplines who attended diverse placement settings. While there was extensive disruption in the learning environment leading to increased levels of stress and concern, a triad of individual and systemic supports helped to ensure positive work-based placement experiences and student success for the majority of AHSW students during COVID-19: (1) university preparation and communication; (2) placement site and supervisor support; and (3) students' resilience and capacity to adapt to a changed work-place environment.
Originality/value
This inter-disciplinary study reports the work-based placement experiences from the professional education programmes of healthcare students during the COVID-19 pandemic, giving a unique view of their perspectives and learning during this unprecedented crisis.
