Australian osteopathic students' perceptions of interprofessional relationships

Osteopathic health care in aged care facilities: The experience of practitioners in an emerging practice setting

OBJECTIVES

Residential aged care facilities (RACFs) are an emerging practice setting for osteopaths in Australia. This study explored the experiences of osteopaths working in Australian RACFs, reviewed current trends and challenges and considers future developments.

METHODS

Purposive and snowball sampling were used to recruit osteopaths with experience working in RACFs. This was a qualitative descriptive study derived from verbatim interview transcripts. Data were analysed using a six-step thematic analysis.

RESULTS

Eight interviews were conducted during January 2023. Thematic analysis identified common experiences between participants. These included positive aspects of aged care, perceived challenges of working in aged care, exposure to age-specific conditions, benefits of working in multidisciplinary teams and perceived gaps in university education curricula in relation to geriatric populations.

CONCLUSIONS

Employment in RACFs may offer a satisfying employment experience for osteopaths, albeit hindered by policy and funding inadequacy. The respondents suggested enhancing pre- and postgraduate education to better prepare and encourage the profession to engage in this health service.

The osteopath-parent-child triad in osteopathic care in the first 2 years of life: a qualitative study

Background

Enactivism and active inference are two important concepts in the field of osteopathy. While enactivism emphasizes the role of the body and the environment in shaping our experiences and understanding of the world, active inference emphasizes the role of action and perception in shaping our experiences and understanding of the world. Together, these frameworks provide a unique perspective on the practice of osteopathy, and how it can be used to facilitate positive change in patients. Since the neonatal period is a crucial time for development, osteopaths should aim to create a therapeutic relationship. Arguably, through participatory sense-making, osteopaths can help the baby build a generative model (with positive priors) to deal with stress and needs throughout their life.

Aim

Since the literature considers that interactions with the environment, which enact the patients' experiences, depending on contextual factors and communication between patient and caregiver, this research explored whether there is a correspondence between the indications in the literature and clinical practice in the management of the mother/parent-child dyad during osteopathic care on children aged 0 to 2 years old.

Methods

Semi-structured interviews were conducted with a purposive sample of nine osteopaths with experience in the field of pediatrics. Interviews were transcribed verbatim, and constructivist grounded theory was used to conceptualize, collect and analyze data. Codes and categories were actively constructed through an interpretive/constructionist paradigm.

Results

The core category was the idea of the pediatric osteopath as a support for the family, not only for the child. Four additional categories were identified: (1) Preparing a safe environment for both children and parents, (2) Communication, (3) Attachment and synchrony, and (4) Synchronization.

Conclusion

Through participatory sense-making, osteopaths manage contextual factors to establish an effective therapeutic alliance through the osteopath-parent-child triad to facilitate the construction of the child's internal generative model to promote healthy development. The therapeutic encounter is considered an encounter between embodied subjects, occurring within a field of affordances (ecological niche) that allows the interlocutors to actively participate in creating new meanings through interpersonal synchronization. Participatory sense-making and the establishment of a therapeutic alliance through the osteopath-parent-child triad are crucial to promote healthy development in the child.

Australian chiropractic and osteopathic graduates' perceptions of readiness for transition to practice

OBJECTIVE

This is the second phase of a project. The aim was to explore Australian chiropractic and osteopathic new graduates' readiness for transition to practice concerning their clinical skills, professional behaviors, and interprofessional abilities. Phase 1 explored final year students' self-perceptions, and this part uncovered their opinions after 6 months or more in practice.

METHODS

Interviews were conducted with a self-selecting sample of phase 1 participant graduates from 2 Australian chiropractic and 2 osteopathic programs. Results of the thematic content analysis of responses were compared to the Australian Chiropractic Standards and Osteopathic Capabilities, the authority documents at the time of the study.

RESULTS

Interviews from graduates of 2 chiropractic courses (n = 6) and 2 osteopathic courses (n = 8) revealed that the majority had positive comments about their readiness for practice. Most were satisfied with their level of clinical skills, verbal communication skills, and manual therapy skills. Gaps in competence were identified in written communications such as case notes and referrals to enable interprofessional practice, understanding of professional behaviors, and business skills. These identified gaps suggest that these graduates are not fully cognizant of what it means to manage their business practices in a manner expected of a health professional.

CONCLUSION

This small study into clinical training for chiropractic and osteopathy suggests that graduates lack some necessary skills and that it is possible that the ideals and goals for clinical education, to prepare for the transition to practice, may not be fully realized or deliver all the desired prerequisites for graduate practice.

Chiropractic and osteopathic students' perceptions of readiness for transition to practice: The educational value of university clinic vs community and private clinics

OBJECTIVE

The objective was to determine final-year students' self-perceptions of readiness for transition to practice, professional identity, and experiences of interprofessional clinical practice. Findings will inform the clinical education curriculum.

METHODS

We used repeated measures individual case studies with a self-selecting sample from the total final-year student population at 2 chiropractic and 2 osteopathic programs offered by Australian universities. Cases were not compared. Amalgamated data are presented.

RESULTS

There were interviews with students in 2 chiropractic programs (n = 15) and 2 osteopathic programs (n = 13). Perceptions indicate that clinical education in university health clinics prepares them for transition to practice through scaffolded supervision of their consultations with reasonably healthy patients. Students perceived that other clinics (community clinics or private practices) prepared their readiness for transition to practice substantially better. Community clinics and private practices allowed students to consult people from diverse socioeconomic and cultural backgrounds and treat complex health care issues, and the model of supervision allows students a degree of autonomy. Students lacked a clear understanding of the behaviors that demonstrate their professionalism. Interprofessional learning activities were ad hoc and opportunistic.

CONCLUSION

University health clinics, private practices, and community clinics prepare students for transition to practice in different ways. Most students feel prepared. There is a clear indication that a focused discussion related to the development of students' understanding of competencies related to professionalism and another related to interprofessional clinical education in curriculum are needed.