Clinical education in physiotherapy:  The experiences of final year students workplace-based learning at the University of Cape Town

Timothy, Nastassia

Clinical education in physiotherapy: The experiences of final year students workplace-based learning at the University of Cape Town

Master Thesis

2022

Abstract

Clinical education in the profession of Physiotherapy involves the teaching and training of students in real life clinical settings such as hospitals and clinics. The pedagogical support that Physiotherapy students receive in clinical settings is both formal and informal (Dornan, 2012). In the South African context and at the University of Cape Town (UCT), educational and professional support is provided to Physiotherapy students by both academic representatives from the university, clinical educators, and physiotherapy clinicians who are employed by the clinical site in which the clinical education occurs. The phenomenon of clinical education in Physiotherapy is well described in literature emanating from the global North, with fewer studies focused on the learning experiences of students in the South African context. Aligning with the need for curriculum transformation, specifically in this study landscape which is Physiotherapy at UCT, a better understanding of learning on the clinical platform is warranted. This study was conceptualised and conducted through an interpretivist lens and by drawing on the theoretical underpinnings of Lave and Wenger's (1991) Situated Learning Theory (SLT) and Communities of Practice (CoP). Encompassed within SLT is an understanding that learning is not isolated and internal but rather a social process which is dependent on interactions with others and the context in which the learning takes place (Jackson, 2007). Thus this study set out to determine how sociocultural and contextual elements influence learning experiences of final year Physiotherapy students during their clinical placements. This was done by the use of a qualitative, cross-sectional exploratory study design as this was determined to best capture the experiences of students (Austin & Sutton, 2014). Research data was collected by the use of both video diaries and follow-up semi-structured interviews with the six study participants. Discourse Analysis was used to analyse the data, using an analysis framework informed by concepts from both the theoretical framework and the literature review. The study results signify that for this cohort of participants, sociocultural influences, including influences of participation in the clinical site and the interactions and relationships with others, were more important than contextual influences such as the physical learning environment. Unanticipated findings included emotional and mental wellbeing and issues of power related to the physiotherapy clinician. Three main themes emerged from the evaluation of the study findings. Theme one: Student attributes and approach to learning; Theme two: Teacher attributes, skill and power and Theme three: Resources and support at clinical placement site. These themes were able to answer the research question for the study. What has been determined in this research study is that Physiotherapy students bring their own personal and learning attributes to the clinical placement which contribute to their development as a student physiotherapist and their ability to engage actively with learning opportunities. In addition the teacher, either a clinician or clinical educator, must have certain preferable qualities which allows for the development of good relationships between teacher and student, as well as fostering the student's ability to be agentic in maximising learning opportunities. Furthermore the study demonstrated that supported participation in physiotherapy practice allowed participants to learn, thus necessitating that the clinical site possess a culture which is accepting of students and their clinical learning. It is therefore of utmost importance that any limitation to student participation be addressed with urgency at the institution. Appropriate clinical sites must also be considered carefully in relation to the demands of the curriculum, the needs of Physiotherapy as a profession and the institutional culture of the placement.

Keywords

Health Sciences Education

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