Making the transition from physiotherapy student to interprofessional team member

"Learning by osmosis": the transformative social identity journey of physiotherapists developing psychologically-informed practice, a reflexive thematic analysis

BACKGROUND

Despite efforts to support physiotherapists in integrating psychosocial aspects of care to biological ones, clinical practice remains dominated by biomechanistic priorities. To facilitate change, attention and actions need to consider not only the individual level of the therapists but also the cultural and structural levels of the profession. How these multi-layered social dynamics shape practice have not previously been investigated. The Social Identity Approach (SIA) provides a relevant framework to this exploration.

AIM

This study aimed to identify the social identity processes involved in the development of psychologically-informed physiotherapy (PIP) to understand how they may influence practice change.

METHODS

Nine semi-structured interviews were conducted with self-identified psychologically-informed physiotherapists. A Reflexive Thematic Analysis informed by SIA principles enabled to consider meaning as the product of social processes.

FINDINGS

The analysis of participants' experiences in moving from a primarily biomechanistic practice toward the integration of psychosocial aspects of health demonstrated: 1) a transformative "mind-blowing" identity journey; 2) a journey that is not made in isolation; and 3) where leadership matters.

CONCLUSION

Changes in clinical practice involve dynamics at the collective level of the practice environment and of the physiotherapy profession itself, rather than solely at the individual level of clinicians. An understanding of these complex social processes at a managerial level could be important to better support leaders and clinicians in implementing PIP in clinical practice.

Forming and shaping of professional identity within pre-registration physiotherapy curricular: A scoping review

OBJECTIVE

The purpose of this review was to explore how professional identity is formed and shaped within pre-registration physiotherapy curricular.

DESIGN

A scoping review using the PRISMA guidelines from the Joanna Briggs Institute to capture a range of evidence describing how professional identity has been formed and shaped in pre-registration physiotherapy curricular.

DATA SOURCES

Databases searched included: PubMed 1996-Present, Embase 1974-Present, CINAHL 1961-Present, ProQuest Health and Medical Collection 1938-Present and Google Scholar (2004-Present). Additional studies were identified by scanning reference lists and hand searching for relevant articles.

REVIEW METHODS

The research team collaboratively designed the data charting table and two project leads independently extracted and screened the data as per guidance from the Joanna Briggs Institute Reviewers Manual. A meta-synthesis was conducted in this scoping review to identify common themes from qualitative research to provide a deeper understanding of literature. To ensure feasibility of collating results, components of pre-registration curricular in physiotherapy students describing associations of forming and shaping professional identity were charted.

RESULTS

A total of 21 articles were reviewed. Articles were categorised into three categories of shaping (5, 24%), forming (9, 43%) or forming and shaping (7, 33%). Five themes emerged from the meta-synthesis pertaining to forming and shaping professional identity: self, skills, curriculum, program, location.

CONCLUSIONS

This scoping review illustrates the evidence for multidimensional components of physiotherapy curricular involved to assist in shaping and forming professional identity in pre-registration physiotherapy students. The results of this review can provide a foundation level into the understanding of what professional identity is, although further research is required to understand how it could be best implemented in pre-registration physiotherapy curricular.

Professional and Personal Physical Therapist Development through Service Learning in Collaboration with a Prisoner Reinsertion Program: A Qualitative Study

There is a great concern whether Physical Therapy students upon completion of their educational program are ready and equipped with the requisite skills to construct and implement a successful patient intervention with culturally diverse groups. The purpose of this study is to describe the professional and personal physical therapist development of Physical Therapy students after participating in Solidarity Activities in Collaboration with a Prisoner reinsertion program as a service-learning course. A qualitative approach was used. A convenience sample of twenty physical therapy students doing service learning and one teaching professor were included. Student diaries were analyzed. Semi-structured interviews were done to explore five students' and the professor's judgements. Internal and external observations and filling out structure field-notes were also used as data triangulation in order to build the conceptual model. The main findings include that the application of knowledge and practice of skills in different environments are the most important skills attained with this service learning. Five key themes emerged from the data analysis, namely: application of knowledge, adaptation to different environments, improving communication with patients, assisting people and providing treatment with self-confidence. A recommendation is that Physical Therapy programs include workplace practice in different environments to enhance the development of professionalism among students.

Physiotherapy: an active, transformational, and authentic career choice

Background: This paper arises from a larger study exploring early professional socialization across five professions: physiotherapy, nursing; dentistry; pharmacy; and medicine. Purpose: To explore the process of physiotherapy student professional identity development and the evolution of expectations and views of interprofessional practice in the first year of their program. Methods: One-on-one interviews at three time points: after being accepted into the physiotherapy program and before classes began (T1; n = 12); after term one (T2; n=9) and on completion of year one (T3; n = 7). Analyses employed narrative methodology, guided by anticipatory socialization and professional identity theories. Results: At T1, participants described their path towards physiotherapy, indicating career satisfaction as the core of their choice. Expectations of practice aligned with the normative social positioning of the profession. T2 and T3 interviews revealed that their pre-entry conceptualization of practice was both challenged and positively reinforced, leading them either to being satisfied with, or questioning their choice. Clinical placements created the most meaningful opportunities to understand their roles both as individual professionals and members of a collaborative team. Conclusion: Findings revealed the complex process of professional socialization in physiotherapy students with implications for admissions and formal and IPE curricula.

Nurse's perceptions of physiotherapists in critical care team: Report of a qualitative study

Background:

Interprofessional relationship plays a major role in effective patient care. Specialized units such as critical care require multidisciplinary care where perception about every members role may affect the delivery of patient care. The objective of this study was to find out nurses’ perceptions of the role of physiotherapists in the critical care team.

Methods:

Qualitative study by using semi-structured interview was conducted among the qualified nurses working in the Intensive Care Unit of a tertiary care hospital. The interview consisted of 19 questions divided into 3 sections. Interviews were audio recorded and transcribed. In-depth content analysis was carried out to identify major themes in relation to the research question.

Results:

Analysis identified five major issues which included role and image of a physiotherapist, effectiveness of treatment, communications, teamwork, and interprofessional relations. Physiotherapists were perceived to be an important member of the critical team with the role of mobilizing the patients. The respondents admitted that there existed limitations in interprofessional relationship.

Conclusion:

Nurses perceived the role of physiotherapist in the critical care unit as an integral part and agreed on the need for inclusion of therapist multidisciplinary critical care team.

Physiotherapy students' perspectives of online e-learning for interdisciplinary management of chronic health conditions: a qualitative study

BACKGROUND

To qualitatively explore physiotherapy students' perceptions of online e-learning for chronic disease management using a previously developed, innovative and interactive, evidence-based, e-learning package: Rheumatoid Arthritis for Physiotherapists e-Learning (RAP-eL).

METHODS

Physiotherapy students participated in three focus groups in Perth, Western Australia. Purposive sampling was employed to ensure maximum heterogeneity across age, gender and educational background. To explore students' perspectives on the advantages and disadvantages of online e-learning, ways to enhance e-learning, and information/learning gaps in relation to interdisciplinary management of chronic health conditions, a semi-structured interview schedule was developed. Verbatim transcripts were analysed using inductive methods within a grounded theory approach to derive key themes.

RESULTS

Twenty-three students (78 % female; 39 % with previous tertiary qualification) of mean (SD) age 23 (3.6) years participated. Students expressed a preference for a combination of both online e-learning and lecture-style learning formats for chronic disease management, citing flexibility to work at one's own pace and time, and access to comprehensive information as advantages of e-learning learning. Personal interaction and ability to clarify information immediately were considered advantages of lecture-style formats. Perceived knowledge gaps included practical application of interdisciplinary approaches to chronic disease management and developing and implementing physiotherapy management plans for people with chronic health conditions.

CONCLUSIONS

Physiotherapy students preferred multi-modal and blended formats for learning about chronic disease management. This study highlights the need for further development of practically-oriented knowledge and skills related to interdisciplinary care for people with chronic conditions among physiotherapy students. While RAP-eL focuses on rheumatoid arthritis, the principles of learning apply to the broader context of chronic disease management.

Interprofessional education in allied health: a systematic review

OBJECTIVES

During the past decade, several studies have systematically reviewed interprofessional education (IPE), but few have inclusively reviewed this literature. None has focused primarily on IPE in allied health, despite differences in recruitment and socialisation across the health professions. This systematic review seeks to uncover the best approach to pre-licensure, university-based allied health IPE to determine which aspects require modification in which contexts to provide optimal learning experiences.

METHODS

A systematic search of 10 databases was conducted for articles published in English, between January 1998 and January 2013. Studies were included if they used quantitative or qualitative methodologies to report on the outcomes associated with IPE in allied health. Two independent reviewers identified studies that met the inclusion criteria, critically appraised the included studies and extracted data relating to the effectiveness of IPE in allied health. Data were synthesised narratively to address the study aims.

RESULTS

Large gaps - relating to methods, theory and context - remain within this body of literature. Studies measured students' attitudes and understanding of other health professional roles, teamwork and knowledge in response to IPE interventions using patient scenarios, lectures and small-group work. Differences in power and curriculum placement were described as factors affecting IPE effectiveness.

CONCLUSIONS

Evaluation remains the primary aim within this literature. Few studies use theory, take an inductive approach to understanding the processes behind IPE or include detailed participant descriptions. Therefore, we suggest that IPE research is currently caught in an epistemological struggle, between assumptions underpinning biomedical and health science research, and those underpinning education studies. As part of a systems approach to understanding interprofessional socialisation, we call for researchers to take a realistic approach to evaluation that is inclusive of, and responsive to, contextual factors to explore how IPE leads to improved long-term outcomes in differing circumstances.