Clinical placements in private practice for physiotherapy students are perceived as safe and beneficial for students, private practices and universities: a national mixed-methods study

Question: What are the extent and characteristics of clinical placements in private practice for physiotherapy students? What do university clinical education managers perceive to be the benefits, risks, barriers and enablers of clinical placements in private practice for physiotherapy students? What training and support are available for private practitioners? Design: Mixed methods study combining a national survey and in-depth, semi-structured focus group interviews. Participants: Twenty clinical education managers from Australian universities who had graduating students in entry-level physiotherapy programs in 2017 (95% response rate) responded to the survey with data on 2,000 students. Twelve clinical education managers participated in the focus groups. Results: It was found that 44% of physiotherapy graduates in Australia in 2017 completed a 5-week private practice placement. Private practice placement experiences were perceived to be safe and beneficial for students, private practices and universities. The main risks identified by clinical education managers were related to the quality and consistency of the student's experience on placement and not risks to service or clients. The main perceived barriers were time costs (both practitioner and university clinical education managers) and perceived lost earning capacity. Clinical education managers emphasised that more time and resources to establish and support private practitioners would enable them to reduce risk and overcome barriers to increasing private practice placement capacity and quality. Engaging private practitioners and working collaboratively appear vital for establishing, monitoring and supporting private practice placements. Conclusion: By working collaboratively, universities and private practice physiotherapists can enhance private practice placement capacity and quality

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

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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

Confidence and Attitudes Toward Osteoarthritis Care Among the Current and Emerging Health Workforce: A Multinational Interprofessional Study.

Objective: To measure confidence and attitudes of the current and emerging interprofessional workforce concerning osteoarthritis (OA) care. Methods: Study design is a multinational (Australia, New Zealand, Canada) cross-sectional survey of clinicians (general practitioners [GPs], GP registrars, primary care nurses, and physiotherapists) and final-year medical and physiotherapy students. GPs and GP registrars were only sampled in Australia/New Zealand and Australia, respectively. The study outcomes are as follows: confidence in OA knowledge and skills (customized instrument), biomedical attitudes to care (Pain Attitudes Beliefs Scale [PABS]), attitudes toward high- and low-value care (customized items), attitudes toward exercise/physical activity (free-text responses). Results: A total of 1886 clinicians and 1161 students responded. Although a number of interprofessional differences were identified, confidence in OA knowledge and skills was consistently greatest among physiotherapists and lowest among nurses (eg, the mean difference [95% confidence interval (CI)] for physiotherapist-nurse analyses were 9.3 [7.7-10.9] for knowledge [scale: 11-55] and 14.6 [12.3-17.0] for skills [scale: 16-80]). Similarly, biomedical attitudes were stronger in nurses compared with physiotherapists (6.9 [5.3-8.4]; scale 10-60) and in medical students compared with physiotherapy students (2.0 [1.3-2.7]). Some clinicians and students agreed that people with OA will ultimately require total joint replacement (7%-19% and 19%-22%, respectively), that arthroscopy is an appropriate intervention for knee OA (18%-36% and 35%-44%), and that magnetic resonance imaging is informative for diagnosis and clinical management of hip/knee OA (8%-61% and 21%-52%). Most agreed (90%-98% and 92%-97%) that exercise is indicated and strongly supported by qualitative data. Conclusion: Workforce capacity building that de-emphasizes biomedical management and promotes high-value first-line care options is needed. Knowledge and skills among physiotherapists support leadership roles in OA care for this discipline