Exploration of the contribution of physiotherapy students to the delivery of health services: a qualitative study.

OBJECTIVE: To understand the perspectives of physiotherapists on the contribution of students to the delivery of health services during clinical placements. METHODS: Focus groups with a semi-structured interview guide were completed separately with new graduate physiotherapists reflecting on their student experience and experienced physiotherapists from five Queensland public health-sector hospitals. Interviews were transcribed verbatim in preparation for thematic analysis. Interview manuscripts were read independently and initially coding completed. Codes were compared and further refinement of themes occurred. Themes were reviewed by two investigators. RESULTS: There were 38 new graduate participants across nine focus groups and 35 experienced physiotherapists across six focus groups who participated in this study. Students participate in a range of activities during clinical placements some of which contribute to delivery of health services and others which support student learning. Three major themes were identified: 1) tangible student contribution; 2) non-tangible student contribution; and 3) factors that influence the student contribution. CONCLUSIONS: Overwhelmingly, both new graduate and experienced physiotherapists felt that students do contribute to the delivery of health services however careful consideration of a variety of factors is necessary to maximize the student contribution.

A collaborative clinical placement model for physiotherapy students results in equivalent (or greater) direct patient care activity than that delivered by physiotherapists alone: an observational study.

BACKGROUND: The demand for physiotherapy clinical placements is rising which requires innovative approaches and an understanding of clinical placement models. OBJECTIVE: To determine physiotherapy student contribution to direct patient care activity during a collaborative clinical placement model. Secondary aims determined the impact of clinical area and clinical educator to student (CE:student) ratio and if a group of students could reach equivalent direct patient care activity of a junior or senior physiotherapist. METHOD: Physiotherapy student, and junior and senior physiotherapist occasions of service (OOS) were collected from five Queensland Public Health Sector hospital information management systems from four physiotherapy clinical areas (i.e. cardiorespiratory, musculoskeletal, neurorehabilitation, and orthopedics). Number of days of clinical activity was recorded to provide average OOS/day. RESULTS: Across a 5-week clinical placement a group of physiotherapy students in a collaborative clinical placement model provided on average 10.6 OOS/day (95%CI 10.1-11.2). In three (75%) clinical areas, a group of students participating in higher CE:student ratios produced more OOS/day. Clinical area and CE:student ratio predicted 39% of the variance in student average OOS/day. On average a group of students reached the equivalent direct patient care activity of a junior and senior physiotherapist by week two of a 5-week clinical placement. CONCLUSION: Physiotherapy students in a collaborative clinical placement model met or exceeded the direct patient care activity of a physiotherapist, irrespective of clinical area and CE:student ratio.

The transition from physiotherapy student to new graduate: are they prepared?

Background: The transition from physiotherapy student to new graduate poses many challenges. In other health disciplines concerns have been raised about new graduate preparedness for practice.Objective: To explore the perspectives of new graduate and experienced physiotherapists on the transition from student to new graduate.Methods: Semi-structured interviews were conducted with 15 focus groups; nine new graduate groups and six experienced physiotherapist groups. Interviews were transcribed in preparation for thematic analysis whereby researchers examined transcripts independently and identified codes. Codes were compared and themes developed, discussed, and refined. Themes were reviewed by all authors.Results: Four themes emerged surrounding the transition from physiotherapy student to new graduate: 1) preparedness for practice; 2) protected practice; 3) independent and affirmation of practice; and 4) performance expectations. Both groups identified increased caseload volume and complexity were challenging, and that students were typically protected from realistic workloads. New graduates at times felt unprepared for their new roles and highlighted that coping with change in independence and managing expectations of themselves was difficult. Strategies identified that may assist the transition from student to new graduate included organizational, clinical placement experiences and building self-efficacy.Conclusions: Challenges are experienced during the transition from physiotherapy student to new graduate. To enhance this transition a multifactorial approach is required that includes all key stakeholders and strategically targets challenges associated with the student transition to new graduate.

Changes in direct patient care from physiotherapy student to new graduate.

Background: Clinical placements offer students an opportunity to provide direct patient care and are essential to develop safe and effective practitioners. It is unknown what changes in direct patient care activities are required as students transition to graduate physiotherapists. Objective: To determine the change in direct patient care activity from physiotherapy student to new graduate. Methods: Five hospitals provided clinical activity data from 412 physiotherapy students and 50 new graduate physiotherapists working in four physiotherapy clinical areas. Main Outcome Measures: Percentage of day spent in direct patient care, average occasions of service (OOS) per day and average length of one OOS (LOOS) for physiotherapy students and new graduates. Results: Students spent less time during their day providing direct patient care (24%, 95% confidence interval (CI) 19 to 29), performed fewer OOS (4.4, 95%CI 4.0 to 4.8) and had longer LOOS (18 min, 95%CI 13 to 23) compared to new graduates. This was consistent across all clinical areas. Conclusions: Physiotherapy student caseload is half that of a new graduate physiotherapist, with students taking longer to complete an OOS. Given this disparity in workload, active stakeholder engagement is essential to implement strategies that support and optimize the transition from student to graduate.

Corrigendum to: Clinical activity profile of preregistration physiotherapy students during clinical placements.

Objective The aim of the present study was to determine the clinical activity profile of preregistration physiotherapy students during clinical placements and their clinical activity contribution to health service delivery.Methods Clinical activity data for 2014 were obtained from five Queensland public sector hospitals providing preregistration physiotherapy students clinical education in three key clinical areas (cardiorespiratory, musculoskeletal and neurological) over four 5-week placement blocks. Data regarding the number of student occasions of service (OOS) and the length of the OOS (LOOS) were collected to determine the average OOS and LOOS per student in each clinical area.Results Twenty weeks of student data were collected from each hospital in each clinical area, representing 29.1% of cardiorespiratory, musculoskeletal and neurorehabilitation student placements. Students completed 19051 OOS. The average OOS per student per block for cardiorespiratory, musculoskeletal and neurorehabilitation placements was 98.3, 74.0 and 72.4 respectively. Two-way ANOVA revealed a main effect of weeks (F=402.1, P<0.001) and clinical area (F =1331.5, P<0.001) for LOOS.In addition, an interaction was found between clinical placement week and clinical area for LOOS (F=8.4, P<0.001).Conclusions Student clinical activity data are useful for understanding the student contribution to health services. Student contribution appears to increase throughout the clinical placement and consideration should be given to the clinical educator:student ratio to enhance overall student contribution.What is known about the topic? Quantitative data describing physiotherapy student clinical care activity during placements are limited.What does this paper add? This paper profiles physiotherapy student clinical care activity and the changes occurring over 5-week placements.What are the implications for practitioners? Physiotherapy students provide clinical activity for health services that changes over their 5-week placement. Student clinical activity should be considered when responding to placement demand and planning service delivery.

Clinical activity profile of preregistration physiotherapy students during clinical placements.

Objective The aim of the present study was to determine the clinical activity profile of preregistration physiotherapy students during clinical placements and their clinical activity contribution to health service delivery. Methods Clinical activity data for 2014 were obtained from five Queensland public sector hospitals providing preregistration physiotherapy students clinical education in three key clinical areas (cardiorespiratory, musculoskeletal and neurological) over four 5-week placement blocks. Data regarding the number of student occasions of service (OOS) and the length of the OOS (LOOS) were collected to determine the average OOS and LOOS per student in each clinical area. Results Twenty weeks of student data were collected from each hospital in each clinical area, representing 29.1% of cardiorespiratory, musculoskeletal and neurorehabilitation student placements. Students completed 19051 OOS. The average OOS per student per block for cardiorespiratory, musculoskeletal and neurorehabilitation placements was 98.3, 74.0 and 72.4 respectively. Two-way ANOVA revealed a main effect of weeks (F=402.1, P<0.001) and clinical area (F =1331.5, P<0.001) for LOOS.In addition, an interaction was found between clinical placement week and clinical area for LOOS (F=8.4, P<0.001). Conclusions Student clinical activity data are useful for understanding the student contribution to health services. Student contribution appears to increase throughout the clinical placement and consideration should be given to the clinical educator:student ratio to enhance overall student contribution. What is known about the topic? Quantitative data describing physiotherapy student clinical care activity during placements are limited. What does this paper add? This paper profiles physiotherapy student clinical care activity and the changes occurring over 5-week placements. What are the implications for practitioners? Physiotherapy students provide clinical activity for health services that changes over their 5-week placement. Student clinical activity should be considered when responding to placement demand and planning service delivery.