The role of emotion in patient safety : Are we brave enough to scratch beneath the surface?

Healthcare professionals work in emotionally charged settings; yet, little is known about the role of emotion in ensuring safe patient care. This article presents current knowledge in this field, drawing upon psychological approaches and evidence from clinical settings.We explore the emotions that health professionals experience in relation to making a medical error and describe the impact on healthcare professionals and on their professional and patient relationships. We also explore how positive and negative emotions can contribute to clinical decision making and affect responses to clinical situations. Evidence to date suggests that emotion plays an integral role in patient safety. Implications for training, practice and research are discussed in addition to strategies to facilitate health services to understand and respond to the influence of emotion in clinical practice

Several strategies for clinical partners and universities are perceived to enhance physiotherapy student engagement in non-metropolitan clinical placements:a mixed-methods study

Question: What strategies can clinical partners and universities implement to enhance physiotherapy student engagement in non-metropolitan clinical placements? Design: Mixed-method research design combining focus groups and survey. Participants: First-year physiotherapy students from one university at the commencement of their course (n = 26); third-year and fourth-year students who had completed a non-metropolitan placement (n = 39 survey, n = 25 focus group); and clinical educators from three non-metropolitan clinical sites (n = 15). Intervention: The cohort of first-year physiotherapy students was surveyed to establish their perceptions regarding non-metropolitan clinical education placements. A survey and four focus groups were conducted with third-year and fourth-year students after they had attended non-metropolitan clinical placements, to explore recent experiences. Two focus groups were conducted with clinical educators regarding student engagement at non-metropolitan placements. Quantitative data were summarised with descriptive statistics. Qualitative data were analysed using thematic analysis, synthesising the perspectives of students and clinical educators. Results: At the commencement of their physiotherapy course, interest in undertaking a non-metropolitan clinical placement was higher for students with a non-metropolitan upbringing. Concerns about attending non-metropolitan sites included finances, change in living situation, and perceived inferior quality of clinical education. After completing a non-metropolitan placement, four themes were identified in an analysis of student and educator perceptions: individual factors, clinical experience, logistical challenges and strategies for success. Conclusion: Strategies that were perceived to enhance student engagement in non-metropolitan placements included: tailoring preparation for students, paired rather than individual placements, and near-peer presentations for physiotherapy students prior to undertaking non-metropolitan placements. Dedicated clinical coordinator positions at non-metropolitan sites and assistance in accessing affordable accommodation are likely to positively influence the student experience. [Francis-Cracknell A, Maver S, Kent F, Edwards E, Iles R (2017) Several strategies for clinical partners and universities are perceived to enhance physiotherapy student engagement in non-metropolitan clinical placements: a mixed-methods study. Journal of Physiotherapy 63: 243–249

Responding to emerging needs:Development of adapted performance indicators for physiotherapy student assessment in telehealth

Clinical placements in 2020 have been significantly impacted by the COVID-19 global pandemic. Ensuring that effective clinical placement opportunities continue during this time remains the priority of the Clinical Education Managers Australia and New Zealand (CEMANZ). Supporting educators to assess student competency when service delivery models are altered to embrace telehealth services, has been integral to achieving this. Telehealth has been widely adopted to maintain services and contact with patients during the pandemic. Physiotherapy clinical educators voiced concern about the applicability of the Assessment of Physiotherapy Practice (APP) tool in this emerging learning environment and sought guidance from University Clinical Education Managers. This paper describes representative consensus across Universities regarding use of the Assessment of Physiotherapy Practice (APP) tool and the development of adapted APP performance indicators for use in telehealth. Clinical educators can use these adapted performance indicators to guide assessment of student competency for students completing placements in a telehealth setting

How do interprofessional student teams interact in a primary care clinic? A qualitative analysis using activity theory

Practice based interprofessional education opportunities are proposed as a mechanism for health professionals to learn teamwork skills and gain an understanding of the roles of others. Primary care is an area of practice that offers a promising option for interprofessional student learning. In this study, we investigated what and how students from differing professions learn together. Our findings inform the design of future interprofessional education initiatives. Using activity theory, we conducted an ethnographic investigation of interprofessional education in primary care. During a 5 months period, we observed 14 clinic sessions involving mixed discipline student teams who interviewed people with chronic disease. Teams were comprised of senior medicine, nursing, occupational therapy, pharmacy and physiotherapy entry level students. Semi-structured interviews were also conducted with seven clinical educators. Data were analysed to ascertain the objectives, tools, rules and division of labour. Two integrated activity systems were identified: (1) student teams gathering information to determine patients' health care needs and (2) patients either as health consumers or student educators. Unwritten rules regarding 'shared contribution', 'patient as key information source' and 'time constraints' were identified. Both the significance of software literacy on team leadership, and a pre-determined structure of enquiry, highlighted the importance of careful consideration of the tools used in interprofessional education, and the way they can influence practice. The systems of practice identified provide evidence of differing priorities and values, and multiple perspectives of how to manage health. The work reinforced the value of the patients' voice in clinical and education processes