Clinical Instructors' Perspectives on the Clinical Education of Internationally Educated Physical Therapists: Diversity's Impact on the Experience.

Purpose: The aim of this study was to understand the nature and extent of clinical instructors' (CIs') involvement in the clinical education of internationally educated physical therapists (IEPTs) while exploring CIs' perceptions of the similarities among and differences between IEPTs and Canadian-trained students. Method: In this qualitative descriptive study, 13 semi-structured interviews were conducted with CIs who were involved in a bridging programme for IEPTs. Data were coded using NVivo version 10, and common themes emerged through qualitative thematic analysis. Results: The majority of CIs perceived IEPTs' backgrounds to be diverse as a result of their varied previous clinical experience, physiotherapy scope of practice, and life stressors. Their diverse backgrounds contributed to the similarities and differences found in their skills, their personal motivation, and the education process, leading to successes and challenges in the clinical environment. Conclusions: Differences between IEPTs and Canadian-trained students stem from IEPTs' diverse backgrounds. Recognizing this diversity while demonstrating cultural competence will promote a successful clinical experience for both IEPT learners and CIs, which will ultimately facilitate the integration of IEPTs into the Canadian health care system.

Objectif : comprendre la nature et la portée de la participation des enseignants cliniques (EC) à la qualification clinique des physiothérapeutes formés à l'étranger (PTFÉ) tout en examinant leurs perceptions des similarités et des différences entre leur formation et celle des étudiants canadiens. Méthodologie : dans la présente étude descriptive et qualitative, les chercheurs ont effectué 13 entrevues semi-structurées auprès d'EC qui participaient à un programme de qualification destiné aux PTFÉ. Ils ont codé les données au moyen de la version 10 de NVivo et regroupé les thèmes communs à l'aide d'une analyse thématique qualitative. Résultats : la majorité des EC trouvaient le parcours des PTFÉ diversifié en raison de l'hétérogénéité de leurs expériences cliniques antérieures, de la portée de leur pratique et des éléments stressants de la vie. La diversité de ces parcours contribuait à des similarités et à des différences sur le plan des compétences, de la motivation personnelle et du processus de qualification, qui s'associaient à des réussites et des difficultés en milieu clinique. Conclusions : les différences entre les PTFÉ et les étudiants formés au Canada proviennent de l'hétérogénéité des parcours des PTFÉ. La prise de conscience de cette diversité, conjuguée à la compétence culturelle, favorisera une expérience clinique positive, tant pour les PTFÉ que pour les EC. Au bout du compte, elle facilitera l'intégration des PFTÉ au système de santé canadien.

Initiating communities of practice for teaching and education scholarship in hospital settings: a multi-site case study.

This article was migrated. The article was marked as recommended. Background and Rationale: Numerous calls have been made for faculty development programming to better address faculty members' ongoing needs, to situate training strategies within the workplace and to utilize social learning perspectives, communities of practice in particular. Reviews have pointed to a paucity of published qualitative research on faculty development communities of practice and, more generally, on the processes of change and the organizational contexts in which interventions are implemented. Intervention: An initiative was started to instigate education scholarship communities of practice in three highly distinct academic health care settings, to address faculty members' ongoing needs for community and, ultimately, to serve as a source of support for the application of new knowledge to routine education activities. A research project was launched jointly to describe the process and progress of attempting to develop communities of practice at the three sites and to identify common and unique influences on sites' progress. Data Collection: Phone interviews were conducted with group facilitators from each site following group meetings, for the duration of the initiative. Analysis: Multiple case study methodology was employed to describe and compare the processes and progress of attempting to initiate communities of practice at the three sites and to identify obstacles related to organizational context. Findings: All three sites made limited progress in developing a shared domain of interest and a shared history of regular interaction (i.e. regular meetings). Participants identified different professional backgrounds and different education practices as challenges to establishing shared interest. More prominently, they identified busy schedules, geographic barriers, and absence of protected time as obstacles to regular and consistent meetings. Discussion: Difficulty establishing shared interest and shared history are considered in light of the unclear meaning of "education scholarship", cognitive and ethical boundaries between professions, and time constraints within modern, highly complex academic healthcare settings. Conclusions: While CoPs may appeal as self-sustaining, low-cost alternatives to formal programming, limited progress is possible without institutional investment and allowance commensurate with the implied scope and challenges.

Physiotherapists' perceptions of and experiences with the discharge planning process in acute-care general internal medicine units in ontario.

PURPOSE: To examine discharge planning of patients in general internal medicine units in Ontario acute-care hospitals from the perspective of physiotherapists. METHODS: A cross-sectional study using an online questionnaire was sent to participants in November 2011. Respondents' demographic characteristics and ranking of factors were analyzed using descriptive statistics; t-tests were performed to determine between-group differences (based on demographic characteristics). Responses to open-ended questions were coded to identify themes. RESULTS: Mobility status was identified as the key factor in determining discharge readiness; other factors included the availability of social support and community resources. While inter-professional communication was identified as important, processes were often informal. Discharge policies, timely availability of other discharge options, and pressure for early discharge were identified as affecting discharge planning. Respondents also noted a lack of training in discharge planning; accounts of ethical dilemmas experienced by respondents supported these themes. CONCLUSIONS: Physiotherapists consider many factors beyond the patient's physical function during the discharge planning process. The improvement of team communication and resource allocation should be considered to deal with the realities of discharge planning.

Objectif : Étudier la préparation du départ des patients dans les unités de médecine interne générale des hôpitaux de soins actifs de l'Ontario du point de vue des physiothérapeutes. Méthodes : Une étude transversale portant sur l'utilisation d'un questionnaire en ligne a été envoyée aux participants en novembre 2011. Les caractéristiques démographiques des répondants et le classement des facteurs ont été analysés par statistique descriptive et l'on a procédé à des tests-t pour déterminer les différences entre groupes (compte tenu des caractéristiques démographiques). On a codé les réponses aux questions ouvertes de façon à dégager des thèmes. Résultats : La mobilité était considérée comme le principal facteur de la détermination de la préparation au départ. Les autres facteurs ont inclus la disponibilité des moyens de soutien social et des ressources communautaires. La communication entre les professions a été jugée importante, mais les processus étaient souvent informels. Les politiques sur le départ, la disponibilité au moment opportun d'autres options sur le plan du départ et les pressions exercées en faveur du départ hâtif ont une incidence sur la planification du départ. Les répondants ont aussi signalé un manque de formation en planification des départs et des anecdotes portant sur les dilemmes éthiques vécus par les répondants ont appuyé ces thèmes. Conclusions : Les physiothérapeutes tiennent compte de nombreux facteurs en plus de la fonction physique du patient au cours du processus de planification du départ. Il faudrait envisager d'améliorer la communication et la répartition des ressources au sein de l'équipe pour faire face aux réalités de la planification des départs.