Clinical Education

Background and purpose

The profession needs to address ways of increasing the provision of clinical education placements in order to satisfy increased demand. To help resolve some of the difficulties in finding extra placements, this study aimed to identify qualities and abilities that clinical educators consider important to possess and to further identify the grade of physiotherapist considered best able to provide these to students. Exploration of this and of a team model of supervision could lead more physiotherapists to become clinical educators.

Method

A survey research method used two questionnaires. An analysis of the results of the first questionnaire informed the design of the second questionnaire.

Findings

Clinical educators possess a wide range of abilities and qualities that demonstrate an understanding of teaching and learning. These include the approach and process of teaching and learning and their role in continuing professional development, and also the ability to manage and organise placements and to facilitate students' learning. Physiotherapists of all grades were considered able to demonstrate and use some of these.

Conclusions

Physiotherapists of all grades are thought capable of bringing to student education some of the abilities and qualities of clinical educators. Adopting a team approach to clinical supervision may help address some of the problems in placement availability and management. This could provide opportunities for more clinicians to benefit from the advantages of being clinical educators.

Introduction

The growth in the number of therapists which was announced in the National Health Service Plan (DoH, 2000) is being addressed within the physiotherapy profession as a number of higher education institutions have increased their intake of undergraduate students. However, in 2001, the director of education at the Chartered Society of Physiotherapy stated that the demand for clinical placements for the increased number of students is an additional burden on a system which is already finding it difficult to accommodate existing student numbers (CSP, 2001). At the same time, the profession is exper-iencing difficulties with recruitment and retention (Carrington and Moran, 2001).

As a way of accommodating more students, individual clinical educators are being asked to increase the number of students they supervise at any one time. This is often perceived by clinical educators as detrimental despite research evidence to the contrary (Ladyshewsky, 1993, 1995; DuPont et al, 1997; Baldry Currens and Bithell, 2000), and the pool of clinical educators may feel exploited by a demand to increase their workload. Further problems may arise if the profession is unable to retain existing clinical educators within the workforce.

Without a change in patterns of student clinical supervision, there are likely to be major problems in accommodating increased numbers of undergraduate students. A possible solution could be to increase the number of clinical educators, or change the model of facilitation of learning, or do both.

The Core Standards of Physiotherapy Practice (CSP, 2000a, page 13) states: ‘There should be a systematic, proactive and responsive approach to the provision of clinical education’. However there does not appear to be any consistency among healthcare providers in their systems for providing suitable clinical placements, and the provision can vary even within individual departments. Moreover although the Chartered Society of Physiotherapy cites in its Validation Guidelines that ‘Clinical education is part of the responsibility and role of all clinical practitioners’ (CSP, 2000b), there does not appear to be a systematic process in place which either encourages or leads a clinician to take on the role of educator.

Providing the theoretical element of a degree programme in physiotherapy requires only a comparatively small number of academic staff within a higher education institution. The clinical education element however requires large numbers of clinical educators so that students can gain experience in a range of clinical settings. In addressing this the Chartered Society of Physiotherapy says: ‘Anywhere a physiotherapist works is potentially suitable for a clinical education placement as a means of gaining a broad range of skills’ (CSP Validation Guidelines, 2000b). Higher education institutions should therefore have opportunities to place students within a wide variety of settings, which would increase the availability of place-ments and hopefully increase the number of clinical educators.

In 1995, Maxwell found that clinical educators considered that staff shortages, funding and service pressures were contributory factors in the shortage of clinical placements – views which are still expressed when requests are made for extra placements. Within the West Midlands, the number of commissioned physiotherapy student placements rose from 186 in 2000 to 286 in 2002, and despite the two directives from the Chartered Society of Physiotherapy cited above, there are still many problems to overcome in acquiring enough place-ments and educators.

In order to address some of these problems, an investigation of current clinical education provision for phy-siotherapy students at Birmingham University was carried out in order to identify:

• Why clinicians choose to become educators.

• The grade of clinical educators and where they work.

• The abilities and qualities that clinical educators perceive that they bring to clinical education. This may identify aspects within the role that could also be offered or shared by others, and hence help to increase the size of the pool of educators.

This paper presents and discusses the results from this study and suggests strategies that might increase the number of clinical educators, taking into con-sideration personal and professional development and changing models of supervision.