Individual student characteristics and attainment in pre registration physiotherapy: a retrospective multi site cohort study

The experiences of home-domiciled and international ethnic minority students on a pre-registration speech and language therapy training programme: A qualitative study

BACKGROUND

Attainment inequalities exist for ethnic minority students graduating from higher education institutes (HEIs) in the UK. Previous research has investigated the outcomes and experiences of students from ethnic minority backgrounds on health and social care programmes. However, studies exploring ethnic minority speech and language therapy (SLT) students' experiences have only focused on international students and were conducted in Australia. No known studies exploring the experiences of both home-domiciled and international SLT students from ethnic minority backgrounds have been conducted in the UK.

AIMS

To explore the experiences of home-domiciled and international ethnic minority students on a SLT training programme and to identify ways to improve these experiences.

METHODS & PROCEDURES

All SLT students attending a pre-registration postgraduate course who identified as being from an ethnic minority background were invited to participate. Two focus groups, one for three international students and one for six home students, were conducted. Data were analysed using reflexive thematic analysis.

OUTCOMES & RESULTS

Three themes were identified that illustrated students' current experiences and how experiences could be improved: (1) feeling an outsider, explores students' sense of belonging in SLT education; (2) finding ways to manage, describes the strategies used by students to cope with their experiences of marginalization, and how adopting these strategies impact on their well-being; and (3) promoting inclusion, explains how the training programme could be modified to improve the experience of ethnic minority students.

CONCLUSIONS & IMPLICATIONS

A better understanding of the experiences of ethnic minority SLT students can help others to support them more effectively. The findings suggest that making changes to SLT training programmes could improve ethnic minority students' outcomes and experiences. These include: more training for staff and students, support groups for ethnic minority students, sharing lived experiences of students and experienced SLTs from ethnic minority backgrounds, and clearer ways of reporting racist incidents. International students would benefit from receiving more information on HEI support services and cultural practices in the UK.

WHAT THIS PAPER ADDS

What is already known on this subject Previous studies have investigated the experiences of ethnic minority students on a range of HEI programmes, including those for students of physiotherapy and occupational therapy. The only studies investigating the experiences of ethnic minority SLT students are those exploring how international SLT students in Australia can be supported on professional placement. What this paper adds to the existing knowledge This study explores the experiences of home and international SLT students in the UK who identify as being from minority ethnic backgrounds. Findings suggest that these students feel like outsiders, affecting their sense of belonging. The need to find and implement strategies to manage their feelings of marginalization impacts on their well-being. What are the potential or actual clinical implications of this work? The findings suggest measures to promote the inclusion of ethnic minority SLT students to improve their experiences and support their well-being. These include more training for all staff and students and the creation of a 'lived experiences library' where students and experienced SLTs from ethnic minority backgrounds could share positive experiences as well as ways of dealing with challenges. Clearer ways of reporting racist incidents would be beneficial for all students. International students would benefit from receiving more information on HEI support services and cultural practices in the UK. It is important that ethnic minority SLT students are involved in developments that aim to improve their experiences.

Overcoming barriers to equality, diversity, inclusivity, and sense of belonging in healthcare education: the Underrepresented Groups' Experiences in Osteopathic Training (UrGEnT) mixed methods study

BACKGROUND

Individuals from minority groups have historically faced social injustices. Those from underrepresented groups have been less likely to access both healthcare services and higher education. Little is known about the experiences of underrepresented students during their undergraduate studies in osteopathy in the UK. The aim of this project was to explore awareness of cultural diversity and beliefs about patients from underrepresented groups in current osteopathic educational environments and evaluate students' preparedness to manage patients from diverse groups. The project also aimed to investigate the educational experiences of students from underrepresented backgrounds during their training and their opinions on changes that could support better levels of recruitment and achievement. The findings were discussed with stakeholders in interactive workshops with the aim to develop recommendations for action and change.

METHODS

A transformative action research paradigm informed this mixed methods project. It included: 1/ a survey of students from all seven osteopathic educational providers in the UK using the Multidimensional Cultural Humility Scale (MCHS); 2/ a series of focus groups with students from underrepresented groups (women, students with disabilities, students from minority ethnic backgrounds, and students identifying as LGBTQIA+); and 3/ a workshop forum to discuss findings.

RESULTS

A total of 202 participants completed the MCHS and demographic questionnaire and seven focus groups were conducted. A model was developed to describe participants' training experiences comprising two main themes: institutional contextual obstacles (with four sub-themes) and underrepresented students' conceptual understanding of Equity, Diversity and Inclusion (EDI). Recommendations for change identified in the workshops were based on three topics: institutions, staff, and students.

CONCLUSION

Our findings confirm conclusions from other institutions that staff education is urgently needed to create and maintain equitable, inclusive environments in osteopathic educational institutions in the UK to support all students, particularly those from underrepresented groups. Institutional EDI processes and policies also need to be clarified or modified to ensure their usefulness, accessibility, and implementation.

Multiple stakeholder perspectives of factors influencing differential outcomes for ethnic minority students on health and social care placements: a qualitative exploration

BACKGROUND

Despite considerable efforts there continues to be a degree awarding gap within the United Kingdom (UK) between the proportion of White British students receiving higher classifications, compared to ethnic minority UK-domiciled students. Practice placement elements constitute approximately 50% of most health and social care programmes, yet surprisingly little research exists related to the factors which may contribute to ethnic minority student placement outcomes or experiences. This study bridges this evidence gap by exploring factors influencing differential placement outcomes of ethnic minority students from the perspectives of key stakeholders.

METHODS

The study followed a descriptive qualitative research design and was multi-disciplinary, with participants drawn from across nursing, midwifery, social work and the allied health professions. Participants from four stakeholder categories (ethnic minority students, academic staff, placement educators and student union advisors) were invited to join separate focus groups. Focus groups were recorded and transcribed and analysed thematically.

RESULTS

Ten separate focus groups [n = 66] yielded three primary themes: 1) recognition, which highlighted stakeholder perceptions of the issues [sub-themes: acknowledging concerns; cultural norms; challenging environments]; 2) the lived experience, which primarily captured ethnic minority student perspectives [sub-themes: problematising language and stereotyping, and being treated differently]; 3) surviving not thriving, which outlines the consequences of the lived experience [sub-themes: withdrawing mentally, feeling like an alien].

CONCLUSION

This study presents a rich exploration of the factors affecting differential outcomes of ethnic minority students on practice placements through the lens of four different stakeholder groups. To our knowledge this is the first study in which this comprehensive approach has been taken to enable multiple viewpoints to be accessed across a wide range of health and social care professions. The issues and challenges raised appear to be common to most if not all of these disciplines. This study highlights the urgent need to value and support our ethnic minority students to remove the barriers they face in their practice learning settings. This is a monumental challenge and requires both individuals and organisations to step up and take collective responsibility.

Gender matters in physiotherapy

The World Health Organization states that gender has implications for health across the course of a person's life in terms of norms, roles and relations. It also has implications in rehabilitation. In this article, we argue the need of gender perspectives in the field of physiotherapy; gender matters and makes a difference in health and rehabilitation. We highlight a number of central areas where gender may be significant and give concrete examples of social gender aspects in physiotherapy practice and in diverse patient groups. We also discuss why it can be important to consider gender from an organizational perspective and how sociocultural norms and ideals relating to body, exercise and health are gendered. Further we present useful gender theories and conceptual frameworks. Finally, we outline future directions in terms of gender-sensitive intervention, physiotherapy education and a gendered application of the ICF model. We want to challenge physiotherapists and physiotherapy students to broaden knowledge and awareness of how gender may impact on physiotherapy, and how gender theory can serve as an analytical lens for a useful perspective on the development of clinical practice, education and research within physiotherapy.

Factors influencing student choice of a degree in physiotherapy: a population-based study in Catalonia (Spain)

Background

In other healthcare professions, there has been extensive research into students' motivation, but studies aiming to determine what leads individuals to choose a degree in physiotherapy are scarce. This research study had three main objectives: to obtain a sociodemographic profile of first-year physiotherapy students in Catalonia; to determine the factors that lead individuals to choose a degree in physiotherapy; and to determine potential differences, according to gender and country of origin.

Methods

This is an observational, cross-sectional, multicentre study. Data were collected by means of a self-administered, ad-hoc questionnaire, consisting of 15 Likert scale questions, options ranging from "not influencing at all -1-" to "extremely influencing -5-". Ten out of the twelve universities in Catalonia (Spain) that offer a degree in physiotherapy participated in this study. The sample consisted of 941 first-year physiotherapy students (55.2% men; mean age 20.1, SD: 3.4).

Results

The most determinant factors leading individuals to pursue a degree in physiotherapy were: helping others (95.6%); the relationship between physiotherapy and sports (79%); physiotherapy involving manual work (76.4%); and it being perceived as providing multiple job opportunities (75.9%). Male and French students were attracted due to its relation to sports (MD = 0.369, p < 0.001 and MD = 0.130, p < 0.027), perception of it being an easy degree (MD = 0.148, p < 0.001 and MD = 0.091, p < 0.037), admiration for a known physiotherapist (MD = 0.223, p = 0.006 and MD = 0.265, p = 0.001), employability (MD = 0.297, p < 0.001 and MD = 0.706, p < 0.001), good income (MD = 0.190, p = 0.002 and MD = 0.609, p < 0.001) and social recognition (MD = 0.164, p = 0.011 and MD = 0.286, p < 0.001). Helping others (MD = -0.149, p < 0.001) and interest in the sciences (MD = -0.164, p = 0.030) were more determinant for female students. Male students were more guided by recommendation (MD = 0.234, p = 0.001) and to complement previous studies (MD = 0.237, p = 0.016). French students tended to present more interest in the selection of physiotherapy as a wish since childhood (MD = 0.595, p < 0.001), due to its multiple job opportunities (MD = 0.427, p < 0.001) and because of manual work, and did not choose it to complement previous studies (MD = -1.122, p < 0.001).

Conclusions

The desire to help and care for others, the relation to sports, and involving manual work are the predominant factors that lead students to pursue a degree in physiotherapy. Female students favour helping others and science, whereas male students favour its relation to sports, complementing studies, social factors (admiration, recommendation, friendship) and socioeconomic determinants such as employability, good income or social recognition. When compared to Spanish students, French students were more motivated by its connection to sports, social and socioeconomic factors and some vocational determinants such as being a wish since childhood and interest in a manual profession.

Students with specific learning disabilities experiences of pre-registration physiotherapy education: a qualitative study

BACKGROUND

Attainment gaps for students with disabilities have been noted in pre-registration physiotherapy courses in the UK. Previous research suggests disclosure, lack of staff knowledge and poor communication between University and placement sites may be relevant, but these are limited to small case studies with students with visual or physical disabilities. The purpose of this study was to explore disabled physiotherapy students' experiences of their education in order to elucidate factors that may influence success.

METHODS

Qualitative study drawing on phenomenological traditions. Four focus groups including 15 students with disabilities were conducted. Transcripts were analysed thematically. Procedures for transparency and rigour such as member checking and peer debriefing were implemented.

RESULTS

Three major themes were derived from data. "It was quite a relief" explores the personal and social implications of diagnosis. "They're not natural" focuses on academic assessment and the specifics of adjustments made and not made within that context. "My dyslexia doesn't switch off" explores the inaccessibility of the learning environment and dissects the contrast between the 24-h nature of having a specific learning condition and the somewhat piecemeal nature of adjustments during their education.

CONCLUSIONS

This study indicates that having a specific learning disability or anxiety creates a number of hurdles to success in physiotherapy education. Most were within the University setting and were perceived to result from staff ignorance or piecemeal approaches to inclusion. A lack of consistency alongside facilitated dialogue and acknowledgement of enhancements results in frustration, ambiguity towards disclosure and reinforcement of a deficit model. Such an approach belies the intention of the profession and the NHS and does not maximise the potential of widening participation.

Working hard to belong: a qualitative study exploring students from black, Asian and minority ethnic backgrounds experiences of pre-registration physiotherapy education

BACKGROUND

Previous research has demonstrated that attainment inequalities exist for students from Black Asian and Minority Ethnic (BAME) groups in pre-registration physiotherapy education. While previous research has explored students from BAME backgrounds experience of university, the context of physiotherapy is unique and is under researched. Therefore the purpose of this study was to explore BAME student experiences during their physiotherapy training.

METHODS

Using a phenomenological approach pre-registration BSc and MSc students from BAME backgrounds from two universities who had completed both academic and clinical modules were invited to participate. Focus groups followed a topic guide developed from the literature and were facilitated by physiotherapy educators from outside the host institution. They were digitally recorded, transcribed verbatim and analysed thematically. Analytical triangulation was adopted throughout the research process as a mechanism to enhance rigour.

RESULTS

Seventeen students participated from a range of self-identified BAME backgrounds that were also representative of age, gender and course. Themes derived from the data included: feeling an outsider in reflections of belonging, behaviours by others that marginalise BAME and personal strategies to integrate in physiotherapy despite the lack of power and influence. Collectively these themes demonstrate a range of challenges which students from BAME backgrounds face within both an academic and practice learning environment.

CONCLUSIONS

While this may not be surprising based on other disciplines, this study demonstrates that studying physiotherapy as a student from BAME background requires persistence to overcome a series of many implicit challenges. Understanding the experiences of students from BAME backgrounds presents unique opportunities to educate the profession and co-create opportunities for a more diverse profession with practitioners and educators as role models. There is a need for greater training for educators to listen to these students' voices and their stories, and understand where institutional structures and practices could be modified to enable BAME student inclusion in physiotherapy education and practice.

What does it take to graduate? A qualitative exploration of the perceptions of successful physiotherapy graduates from one university in the UK

Little is known about the complex factors that underpin persistence and success for preregistration physiotherapy students. This article presents findings from a qualitative study which explored the perceptions of eight recent graduates from one UK university about their experiences of their physiotherapy undergraduate degree program, and what they considered important in their success. Data were collected via one-to-one, semi-structured interviews. An in-depth thematic analysis was undertaken from which three overarching themes were inferred. First, successful learning was portrayed as a fundamentally social activity, embedded in tight learning communities of peers and tutors which conferred a firm sense of belonging. Second, participants recalled having a strong sense of commitment to their future identity as physiotherapists which may have helped them to resist some of the difficulties they encountered as students. Finally, a minority of these successful participants reported overcoming hardship on clinical placement by drawing on a range of personal and institutional resources. Crucially, these successful students' sense of belonging, and their alignment with the norms and values of the program, may have been critical to accessing and using these formal and informal resources.