Elsevier

Physiotherapy

Volume 86, Issue 12, December 2000, Pages 645-653
Physiotherapy

Professional articles
Clinical Education: Listening to different perspectives

https://doi.org/10.1016/S0031-9406(05)61302-8Get rights and content

Summary

Background and purpose

This study sought to identify and address attitudinal and organisational barriers to increased undergraduate clinical placements in one region. An understanding of the perspectives of key stakeholders was essential to the development of increased placement provision.

Methods

A qualitative research design used in-depth interviews and focus group discussions with four groups of key informants: service managers, clinical educators, recently qualified physiotherapists, and third-year physiotherapy students. Interviews were taped and transcribed, and data were coded and analysed. Transcripts and emerging issues were checked with informants to confirm accuracy and interpretation. Emerging issues were further tested with groups of peers.

Findings

Clinical education as a core role of professional physiotherapists was agreed in principle but found to be conditional and a secondary role in practice. The role carried little prestige, and clinical educators required greater support from managers and clinicians. Improved education and preparation for the role of clinical educator were requested. Benefits of students in the workplace were recognised, although their extent was uncertain. A standard method for calculating placement capacity was not found. Educators were reluctant to delegate their own caseloads to students. Non-traditional models of placement and supervision were not widely used or valued by managers and clinicians, although supported by students and recently qualified physiotherapists.

Conclusion

A complex picture emerged and no single solution to placement shortages was found. The perspectives of stakeholders are influenced by the differing pressures under which they experience clinical education. An understanding of these perspectives has informed a range of possible solutions to placement shortages.

Section snippets

Background and Purpose

Clinical education is a fundamental component of the undergraduate physio-therapy curriculum. Exposure to patients in the clinical situation offers a unique experience which cannot be replicated elsewhere. Clinical placements are a scarce resource and it has been increasingly difficult to ensure that sufficient numbers and varieties of appropriate clinical place-ments are sustained as the student population continues to grow. However, resolution of these difficulties is essential if the growth

Method

In order to explore the many issues underlying placement provision in clinical education, a qualitative research design was chosen which utilised in-depth interviews and focus group discussions with key informants (Gilchrist, 1992, page 77). The underlying assumption of this approach was that in order to define the attitudinal and organisational barriers to greater placement provision within the region, it was essential to achieve an understanding of the perspectives of the informant groups.

Summary of Findings

Different perspectives emerged from the data derived from interviews and focus groups with the four groups of informants. The perspectives of the different groups of informants on the core topics are presented under the following headings: clinical education as a core role of professional physiotherapists, recognition and support for clinical educators, value of students in the workplace, models of student supervision, and planning placement numbers. Additional data from the supp-lementary

Discussion

This study was carried out to facilitate understanding of the perspectives of those most closely involved with provision of placements. Data analysis made it possible to explore many issues which underpin clinical education. A picture emerged of a complex situation in which the different stakeholders legitimately have variable perspectives, and these are naturally influenced by the pressures experienced.

Although the numbers of direct informants in this study was small, peer groups of managers

Conclusion

This clinical education project was established to examine the provision of clinical placements for physiotherapy students in the former North Thames region and to attempt to resolve the endemic shortages. Although simple, definitive solutions are not immediately evident, listening to the perspectives has highlighted several issues which warrant further attention, and suggested strategies which may be helpful in meeting the needs of all parties involved. An understanding of stakeholders' views

Acknowledgements

The clinical education project described in this article was funded by the South Essex Education and Training Purchasing Consortium, and run in collaboration with the Physiotherapy Purchasing Sub-group and the undergraduate physiotherapy programmes at the University of East London, Brunel University, University of Hertfordshire and Colchester Institute.

The authors wish to thank all the physiotherapy service managers, clinical educators, junior physiotherapists and physiotherapy students who

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    Julie Baldry Currens MPhil MCSP is clinical education project co-ordinator at the University of East London. She jointly designed the study and authored this paper and carried out data collection and analysis.

    2

    Christine Bithell MA DipEd MCSP is head of the school of physiotherapy, Kingston University/St George's Hospital Medical School. She supervised the clinical education project, and jointly designed the study and authored this paper.

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