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Bainbridge L, Briffa K, Burton E, Hill KD, Fary R. Physiotherapists' decision-making about transition to independent walking in hospital after stroke: a qualitative study. Disabil Rehabil 2024; 46:3323-3331. [PMID: 37578096 DOI: 10.1080/09638288.2023.2245757] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2023] [Revised: 07/30/2023] [Accepted: 08/03/2023] [Indexed: 08/15/2023]
Abstract
PURPOSE Physiotherapists working in hospitals have a key role in decisions about when a person with stroke is safe to walk independently. The aim of this study was to explore the factors influencing decision-making of physiotherapists in this situation. METHODS A qualitative design with semi-structured interviews and reflexive thematic analysis was used. Fifteen physiotherapists with recent experience working in inpatient stroke rehabilitation participated. RESULTS Multiple factors influence decision-making about walking independence after stroke in hospitals. Four themes were identified: (1) Assessment of walking safety involves observation of walking function and consideration of complex individual factors; (2) Perspectives on risk vary, and influence whether a person is considered safe to walk; (3) Institutional culture involves background pressures that may influence decision-making; and (4) Physiotherapists adopt a structured, individualised mobility progression to manage risk. Physiotherapists consistently use observation of walking and understanding of attention and perception in this decision-making. There can sometimes be a conflict between goals of independence and of risk avoidance, and decisions are made by personal judgements. CONCLUSIONS Decision-making about independent walking for people in a hospital after a stroke is complex. Improved guidance about clinical assessment of capacity and determining acceptable risk may enable physiotherapists to engage more in shared decision-making.IMPLICATIONS FOR REHABILITATIONRegaining independence in walking after a stroke comes with the potential risk of falls.Assessment of walking safety should be specific to the complexity of the situation and consider perception and cognition.Benefits of activity and autonomy, and the risk of falls need to be considered in decisions about walking independence.Patients with the capacity to understand consequences and accept risk can be active participants in determining what is sufficiently safe.
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Affiliation(s)
- Liz Bainbridge
- Curtin School of Allied Health, Curtin University, Perth, Australia
| | - Kathy Briffa
- Curtin School of Allied Health, Curtin University, Perth, Australia
| | - Elissa Burton
- Curtin School of Allied Health, Curtin University, Perth, Australia
- enAble Institute, Curtin University, Perth, Australia
| | - Keith D Hill
- Rehabilitation, Ageing and Independent Living (RAIL) Research Centre, Monash University, Melbourne, Australia
| | - Robyn Fary
- Curtin School of Allied Health, Curtin University, Perth, Australia
- enAble Institute, Curtin University, Perth, Australia
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2
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March MK, Dennis SM, Caruana S, Mahony C, Elliott JM, Polley S, Thomas B, Lin C, Harmer AR. Boosting inpatient exercise after hip fracture using an alternative workforce: a mixed methods implementation evaluation. BMC Geriatr 2024; 24:149. [PMID: 38350882 PMCID: PMC10865645 DOI: 10.1186/s12877-024-04730-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2023] [Accepted: 01/19/2024] [Indexed: 02/15/2024] Open
Abstract
BACKGROUND Hip fracture has a devastating impact on individuals and is an increasing burden for health systems and society. Compared to usual care, increased physiotherapy provision has demonstrated efficacy in improving patient and health service outcomes in this population. However, physiotherapy workforce challenges prevent sustained implementation. METHODS Our aim was to evaluate the safety, feasibility, acceptability, effectiveness and implementation cost of thrice daily physiotherapy for patients in the acute care setting after hip fracture at two public hospitals. We added twice-daily exercise implemented by an alternative workforce, to usual care consisting of daily mobility practice by a physiotherapist. Sites identified their preferred alternative workforce, with pre-registration physiotherapy students and allied health assistants chosen. We used a mixed methods approach, using the Consolidated Framework for Implementation Research (CFIR) as a determinant framework to guide implementation planning and data collection. We compared hospital length of stay data to a reference cohort. RESULTS We recruited 25 patients during the study period. Acute care hospital length of stay decreased from 11 days in the reference cohort to 8 days in the BOOST cohort (mean difference - 3.3 days, 95%CI -5.4 to -1.2 days, p = 0.003). Intervention fidelity was 72% indicating feasibility, no safety concerns were attributed to the intervention, and uptake was 96% of all eligible patients. The intervention was acceptable to patients, carers and healthcare providers. This intervention was cost-effective from the acute orthopaedic service perspective. CONCLUSION Higher daily frequency of physiotherapy can be safely, feasibly and effectively implemented by an alternative workforce for patients in the acute care setting following hip fracture surgery.
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Affiliation(s)
- Marie K March
- Physiotherapy Department, Blacktown Mt Druitt Hospitals, Western Sydney Local Health District, Blacktown, NSW, Australia.
- Sydney School of Health Sciences, Faculty of Medicine and Health, University of Sydney, Camperdown, NSW, Australia.
| | - Sarah M Dennis
- Sydney School of Health Sciences, Faculty of Medicine and Health, University of Sydney, Camperdown, NSW, Australia
- South Western Sydney Local Health District, Liverpool, NSW, Australia
- Ingham Institute of Applied Medical Research, Liverpool, NSW, Australia
| | - Sarah Caruana
- Physiotherapy Department, Blacktown Mt Druitt Hospitals, Western Sydney Local Health District, Blacktown, NSW, Australia
| | - Christopher Mahony
- Physiotherapy Department, Hornsby Ku-ring-gai Hospital, Northern Sydney Local Health District, Hornsby, NSW, Australia
| | - James M Elliott
- Sydney School of Health Sciences, Faculty of Medicine and Health, University of Sydney, Camperdown, NSW, Australia
- The Kolling Institute, St Leonards, NSW, Australia
| | - Stephanie Polley
- Department of Rehabilitation and Aged Care, Blacktown Mt Druitt Hospitals, Western Sydney Local Health District, Blacktown, NSW, Australia
- Department of Aged Care, Hornsby Ku-ring-gai Hospital, Northern Sydney Local Health District, Hornsby, NSW, Australia
| | - Bijoy Thomas
- Department of Orthopaedic Surgery, Blacktown Mt Druitt Hospital, Western Sydney Local Health District, Blacktown, NSW, Australia
| | - Charlie Lin
- Department of Orthopaedic Surgery, Hornsby Ku-ring-gai Hospital, Northern Sydney Local Health District, Hornsby, NSW, Australia
| | - Alison R Harmer
- Sydney School of Health Sciences, Faculty of Medicine and Health, University of Sydney, Camperdown, NSW, Australia
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Roth L, Le Saux C, Gilles I, Peytremann-Bridevaux I. Factors Associated With Intent to Leave the Profession for the Allied Health Workforce: A Rapid Review. Med Care Res Rev 2024; 81:3-18. [PMID: 37864432 PMCID: PMC10757398 DOI: 10.1177/10775587231204105] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2023] [Accepted: 09/11/2023] [Indexed: 10/22/2023]
Abstract
Shortages of satisfied and well-trained health care professionals are an urgent threat for health systems worldwide. Although numerous studies have focused on retention issues for nurses and physicians, the situation for the allied health workforce remains understudied. We conducted a rapid review of the literature on allied health workers to investigate the main reasons for leaving their profession. 1,305 original research articles were retrieved from databases MEDLINE, CINAHL, PsycInfo, and Epistemonikos, of which 29 were eligible for data extraction. Reviewed studies featured mainly pharmacists, psychologists, dietitians, physical therapists, emergency medical professionals, and occupational therapists. We categorized 17 typical factors of the intent to leave as organizational, psychological, team and management, and job characteristics. The relative importance of each factor was assessed by measuring its prevalence in the selected literature. By revealing common themes across allied health professions, our work suggests actionable insights to improve retention in these vital services.
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Affiliation(s)
- Leonard Roth
- Centre for Primary Care and Public Health (Unisanté), University of Lausanne, Switzerland
| | - Clara Le Saux
- Centre for Primary Care and Public Health (Unisanté), University of Lausanne, Switzerland
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Evans K, Papinniemi A, Vuvan V, Nicholson V, Dafny H, Levy T, Chipchase L. The first year of private practice - new graduate physiotherapists are highly engaged and satisfied but edging toward burnout. Physiother Theory Pract 2024; 40:262-275. [PMID: 35983750 DOI: 10.1080/09593985.2022.2113005] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2022] [Accepted: 08/08/2022] [Indexed: 10/15/2022]
Abstract
BACKGROUND A greater understanding of physiotherapists' work-life during their first year of work in private practice, and whether their experiences are mediated by personal traits, may provide valuable information to support their transition and retention. OBJECTIVES Describe the first year of practice for graduate physiotherapists in terms of employee engagement, job satisfaction, performance, and burnout, and evaluate the relationship between these measures and personal traits (resilience, grit, mind-set). DESIGN One-year longitudinal mixed-methods study. METHODS Twenty new graduate physiotherapists completed questionnaires evaluating resilience, grit, and mind-set within 1-week of commencing employment. Engagement and job satisfaction were evaluated at 3, 6 and 12-months, and burnout evaluated at 12-months. Performance data (number of patients seen, revenue) were collected throughout the year. Individual semi-structured interviews were conducted at baseline, 3, 9 and 12-months. RESULTS Engagement and satisfaction were high at all time points. At 12-months, burnout was at a medium level. Resilience was positively associated with job satisfaction at 6 (ρ = 0.56, p = .019) and 12-months (ρ = 0.54, p = .027). Engagement (ρ = -0.57, p = .04) and job satisfaction (ρ = -0.56, p = .03) were negatively associated with burnout at 12-months. All participants remained passionate about their work although increasing administrative burden and patient complexity contributed to feelings of burnout. CONCLUSIONS Resilience was positively associated with job satisfaction suggesting those with capacity to 'bounce back' were more satisfied and engaged with their job. Although moderate levels of burnout were reported at 12-months, those with higher job satisfaction and employee engagement had lower levels of burnout. Participants proposed practical strategies to help mitigate burnout.
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Affiliation(s)
- Kerrie Evans
- Faculty of Medicine and Health, University of Sydney, Camperdown, Australia
- Healthia Limited, Bowen Hills, Australia
| | - Amy Papinniemi
- Healthia Limited, Bowen Hills, Australia
- School of Health and Rehabilitation Sciences, University of Queensland, St Lucia, Australia
| | - Viana Vuvan
- School of Health and Rehabilitation Sciences, University of Queensland, St Lucia, Australia
| | - Vaughan Nicholson
- School of Allied Health, Australian Catholic University, Banyo, Australia
| | - Hila Dafny
- Caring Futures Institute, College of Nursing and Health Sciences, Flinders University, Bedford Park, Australia
| | - Tamina Levy
- Caring Futures Institute, College of Nursing and Health Sciences, Flinders University, Bedford Park, Australia
| | - Lucy Chipchase
- Caring Futures Institute, College of Nursing and Health Sciences, Flinders University, Bedford Park, Australia
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Forbes R, Wilesmith S, Dinsdale A, Neish C, Wong J, McClymont D, Lu A. Exploring the workplace and workforce intentions of early career physiotherapists in Australia. Physiother Theory Pract 2023:1-14. [PMID: 38014841 DOI: 10.1080/09593985.2023.2286333] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2023] [Accepted: 11/10/2023] [Indexed: 11/29/2023]
Abstract
BACKGROUND Previous research has indicated significant concerns regarding attrition of early career physiotherapists in Australia. Despite the importance of retaining skilled and experienced professionals within the profession, the workplace and workforce intentions of early career physiotherapists remain relatively unexplored. PURPOSE The aim of this study was to investigate and explore factors influencing the workplace and workforce intentions of early career physiotherapists in Australia. METHODS The Turnover Intention Theory was used to guide a whole-of-person qualitative exploration through semi-structured interviews with 14 participants. Transcribed interview data was subjected to reflexive thematic analysis. RESULTS Four themes were generated, constructed as questions to represent participants' temporary holding of intentions: 1) What drives me?; 2) Do my expectations align?; 3) Do my values align?; and 4) What does the future hold? CONCLUSION Early career physiotherapists' perspectives encompass diverse and varied experiences that reflect an alignment, or in some cases a misalignment, of the expectations, values and resulting practices of becoming and being a physiotherapist. Early career physiotherapists experience a range of challenges within their workplaces, including significant experiences of stress, yet they express an underlying commitment to the wider profession.
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Affiliation(s)
- Roma Forbes
- School of Health and Rehabilitation Sciences, St Lucia Campus, University of Queensland, Brisbane, Australia
| | - Sarah Wilesmith
- School of Health and Rehabilitation Sciences, St Lucia Campus, University of Queensland, Brisbane, Australia
| | - Alana Dinsdale
- School of Health and Rehabilitation Sciences, St Lucia Campus, University of Queensland, Brisbane, Australia
| | - Calum Neish
- School of Health and Rehabilitation Sciences, St Lucia Campus, University of Queensland, Brisbane, Australia
| | - Jonathan Wong
- School of Health and Rehabilitation Sciences, St Lucia Campus, University of Queensland, Brisbane, Australia
| | - Damian McClymont
- School of Health and Rehabilitation Sciences, St Lucia Campus, University of Queensland, Brisbane, Australia
| | - Andric Lu
- North West Hospital and Health Service, Queensland Health, Mt Isa, Australia
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Mak S, Hunt M, Riccio SS, Razack S, Root K, Thomas A. Attrition and Retention of Rehabilitation Professionals: A Scoping Review. THE JOURNAL OF CONTINUING EDUCATION IN THE HEALTH PROFESSIONS 2023; Publish Ahead of Print:00005141-990000000-00060. [PMID: 36881451 DOI: 10.1097/ceh.0000000000000492] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/18/2023]
Abstract
INTRODUCTION Attrition is defined as a permanent departure from one's profession or the workforce. Existing literature on retention strategies, contributing factors to the attrition of rehabilitation professionals and how different environments influence professionals' decision-making to stay in/leave their profession, is limited in scope and specificity. The objective of our review was to map the depth and breadth of the literature on attrition and retention of rehabilitation professionals. METHODS We used Arksey and O'Malley's methodological framework. A search was conducted on MEDLINE (Ovid), Embase (Ovid), AMED, CINAHL, Scopus, and ProQuest Dissertations and Theses from 2010 to April 2021 for concepts of attrition and retention in occupational therapy, physical therapy, and speech-language pathology. RESULTS Of the 6031 retrieved records, 59 papers were selected for data extraction. Data were organized into three themes: (1) descriptions of attrition and retention, (2) experiences of being a professional, and (3) experiences in institutions where rehabilitation professionals work. Seven factors across three levels (individual, work, and environment) were found to influence attrition. DISCUSSION Our review showcases a vast, yet superficial array of literature on attrition and retention of rehabilitation professionals. Differences exist between occupational therapy, physical therapy, and speech-language pathology with respect to the focus of the literature. Push , pull , and stay factors would benefit from further empirical investigation to develop targeted retention strategies. These findings may help to inform health care institutions, professional regulatory bodies, and associations, as well as professional education programs, to develop resources to support retention of rehabilitation professionals.
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Affiliation(s)
- Susanne Mak
- Ms. Mak: Assistant Professor (professional), School of Physical and Occupational Therapy, McGill University, Montréal, Québec, Canada, Institute of Health Sciences Education, McGill University, Montréal, Québec, Canada, and Centre de recherche interdisciplinaire en réadaptation du Montréal métropolitain, Montréal, Québec, Canada. Dr. Hunt: Associate Professor, School of Physical and Occupational Therapy, McGill University, Montréal, Québec, Canada and Centre de recherche interdisciplinaire en réadaptation du Montréal métropolitain, Montréal, Québec, Canada. Ms. Riccio: Physical Therapist, PhysioMobile Inc., Montréal, Québec, Canada. Dr. Razack: Professor, Institute of Health Sciences Education, McGill University, Montréal, Québec, Canada and Department of Pediatrics, McGill University, Montréal, Québec, Canada. Ms. Root: Assistant Professor (professional), School of Communication Sciences and Disorders, McGill University, Montréal, Québec, Canada. Dr. Thomas: Associate Professor, School of Physical and Occupational Therapy, McGill University, Montréal, Québec, Canada, Institute of Health Sciences Education, McGill University, Montréal, Québec, Canada, and Centre de recherche interdisciplinaire en réadaptation du Montréal métropolitain, Montréal, Québec, Canada
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Nepal GM, Acharya RS, Coppieters MW, Bimali I, Poudel S, Chaudhary B, Sharma S. The physiotherapy workforce in Nepal: A national survey. J Eval Clin Pract 2023; 29:69-82. [PMID: 35822869 PMCID: PMC10084353 DOI: 10.1111/jep.13729] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/19/2022] [Revised: 06/05/2022] [Accepted: 06/09/2022] [Indexed: 01/18/2023]
Abstract
BACKGROUND Physiotherapy is a relatively young profession in Nepal. Education standards, and workforce organization and representation have improved in recent years, but there is no detailed workforce data to support decision-making and long-term planning. Therefore, this study aimed to describe the demographic characteristics, physiotherapy practice areas, settings and employment characteristics of physiotherapists in Nepal; and to document job satisfaction and the factors that influence it. METHODS In a cross-sectional survey, we asked Nepali physiotherapists about their sociodemographic characteristics, employment or physiotherapy practice area and settings, and job satisfaction. We assessed the associations between sociodemographic factors and job satisfaction among physiotherapists using univariable and multivariable logistic regressions. We invited all Nepali physiotherapists to participate via email, social media and visits to hospitals. RESULTS Of the 1120 physiotherapists who were contacted, 52% (female: 287; male: 293) completed the survey. The majority of the participants (75%) were less than 30 years old. The majority (73%) held a Bachelor of Physiotherapy degree. Eighty percent were employed at the time of data collection; 58% had 1-4 years of experience. The majority (77%) practiced in or near the capital Kathmandu. Most physiotherapist worked either in private hospitals (46%) or in private physiotherapy practices (26%), rehabilitation centres (19%) and 11% practiced in public hospitals. The most common areas of practice were musculoskeletal physiotherapy (90%) and adult neurology (67%). More than half of the physiotherapist (53%) felt that they were underpaid and 41% were not satisfied with their current job status. The majority of the physiotherapists (67%) reported that they participated in continuing professional development activities. Multivariable logistic regression showed that physiotherapists who had a higher remuneration were more likely to be satisfied with their job. CONCLUSIONS The majority of the physiotherapy workforce in Nepal is well-educated, young and at an early career stage. Most physiotherapists work in musculoskeletal and adult neurological physiotherapy, in private practices or private hospitals near Kathmandu. Job dissatisfaction was common and was related to low annual income. This first nationwide survey described the current physiotherapy workforce and provides comparison data for future physiotherapy workforce surveys.
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Affiliation(s)
| | | | - Michel W Coppieters
- Menzies Health Institute Queensland, Griffith University, Brisbane & Gold Coast, Australia.,Amsterdam Movement Sciences, Faculty of Behavioural and Movement Sciences, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - Inosha Bimali
- Kathmandu University School of Medical Sciences, Dhulikhel, Nepal
| | - Sajana Poudel
- Madan Bhandari Hospital and Trauma Center, Morang, Nepal
| | | | - Saurab Sharma
- Centre for Pain IMPACT, Neuroscience Research Australia, Sydney, New South Wales, Australia
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Dickson C, de Zoete RM. High-level physical therapy and workforce attrition: A paradox? Braz J Phys Ther 2022; 26:100432. [PMID: 35985057 DOI: 10.1016/j.bjpt.2022.100432] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/07/2022] [Accepted: 08/01/2022] [Indexed: 11/28/2022] Open
Affiliation(s)
- Cameron Dickson
- The University of Adelaide, School of Allied Health Science and Practice, Adelaide, Australia.
| | - Rutger Mj de Zoete
- The University of Adelaide, School of Allied Health Science and Practice, Adelaide, Australia. https://twitter.com/DrRdeZoete
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Chipchase L, Papinniemi A, Dafny H, Levy T, Evans K. Supporting new graduate physiotherapists in their first year of private practice with a structured professional development program; a qualitative study. Musculoskelet Sci Pract 2022; 57:102498. [PMID: 34971868 DOI: 10.1016/j.msksp.2021.102498] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/21/2021] [Revised: 11/29/2021] [Accepted: 12/20/2021] [Indexed: 10/19/2022]
Abstract
BACKGROUND The transition from physiotherapy student to working in private practice has been identified as challenging. However, very little is known about whether structured professional development programs impact on this transition. OBJECTIVES To describe new graduates' perceptions of a structured professional development program, termed the Recent Graduate Program (RGP), designed to support their transition into physiotherapy private practice. DESIGN Qualitative analysis of data from a one-year longitudinal mixed methods study. METHOD A total of 72 interviews were conducted over a one-year period with 20 new graduates from 19 private practices within one publicly listed allied health organisation. Semi-structured interviews were conducted before commencing work and at three, nine and 12 months. Interviews were recorded and transcribed verbatim prior to a conventional content analysis that aimed to acquire direct information from new graduates without imposing preconceived categories or theoretical perspectives. FINDINGS New graduates reported that the RGP supported their growth as a practitioner and facilitated their learning, particularly when complemented by the experiential learning from client interactions. The RGP met their expectations with the formal education program and regular mentoring sessions highly valued. Informal support from peers and senior clinicians, while not part of the RGP, was also perceived to facilitate their growth and confidence as a physiotherapist. CONCLUSIONS This study demonstrates that the provision of a structured transition program by a private practice employer was perceived by new graduates to facilitate their learning, confidence and self-efficacy. The RGP provides a useful model by which other practices may support new graduates.
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Affiliation(s)
- L Chipchase
- College of Nursing and Health Sciences, Flinders University, Adelaide, Australia.
| | - A Papinniemi
- Healthia Limited, Brisbane, Queensland, Australia
| | - H Dafny
- College of Nursing and Health Sciences, Flinders University, Adelaide, Australia
| | - T Levy
- College of Nursing and Health Sciences, Flinders University, Adelaide, Australia
| | - K Evans
- Healthia Limited, Brisbane, Queensland, Australia; Faculty of Medicine and Health, The University of Sydney, Sydney, NSW, Australia
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Peiris CL, Reubenson A, Dunwoodie R, Lawton V, Francis-Cracknell A, Wells C. 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. J Physiother 2022; 68:61-68. [PMID: 34933822 DOI: 10.1016/j.jphys.2021.12.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/26/2020] [Revised: 11/30/2021] [Accepted: 12/08/2021] [Indexed: 10/19/2022] Open
Abstract
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.
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Affiliation(s)
- Casey L Peiris
- School of Allied Health, Human Services and Sport, La Trobe University, Melbourne, Australia.
| | - Alan Reubenson
- School of Allied Health, Curtin University, Perth, Australia
| | - Ruth Dunwoodie
- School of Health and Rehabilitation Sciences, The University of Queensland, Brisbane, Australia
| | - Vidya Lawton
- Faculty of Medicine, Health and Human Sciences, Macquarie University, Sydney, Australia
| | | | - Cherie Wells
- School of Allied Health, Exercise and Sports Science, Charles Sturt University, Port Macquarie, Australia
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Jessup B, Barnett T, Obamiro K, Cross M, Mseke E. Review of the Health, Welfare and Care Workforce in Tasmania, Australia: 2011-2016. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18137014. [PMID: 34209098 PMCID: PMC8297215 DOI: 10.3390/ijerph18137014] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/01/2021] [Revised: 06/28/2021] [Accepted: 06/28/2021] [Indexed: 11/16/2022]
Abstract
Background: On a per capita basis, rural communities are underserviced by health professionals when compared to metropolitan areas of Australia. However, most studies evaluating health workforce focus on discrete professional groups rather than the collective contribution of the range of health, care and welfare workers within communities. The objective of this study was therefore to illustrate a novel approach for evaluating the broader composition of the health, welfare and care (HWC) workforce in Tasmania, Australia, and its potential to inform the delivery of healthcare services within rural communities. Methods: Census data (2011 and 2016) were obtained for all workers involved in health, welfare and care service provision in Tasmania and in each statistical level 4 area (SA4) of the state. Workers were grouped into seven categories: medicine, nursing, allied health, dentistry and oral health, health-other, welfare and carers. Data were aggregated for each category to obtain total headcount, total full time equivalent (FTE) positions and total annual hours of service per capita, with changes observed over the five-year period. Results: All categories of the Tasmanian HWC workforce except welfare grew between 2011 and 2016. While this growth occurred in all SA4 regions across the state, the HWC workforce remained maldistributed, with more annual hours of service per capita provided in the Hobart area. Although the HWC workforce remained highly feminised, a move toward gender balance was observed in some categories, including medicine, dentistry and oral health, and carers. The HWC workforce also saw an increase in part-time workers across all categories. Conclusions: Adopting a broad approach to health workforce planning can better reflect the reality of healthcare service delivery. For underserviced rural communities, recognising the diverse range of workers who can contribute to the provision of health, welfare and care services offers the opportunity to realise existing workforce capacity and explore how ‘total care’ may be delivered by different combinations of health, welfare and care workers.
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Wells C, Olson R, Bialocerkowski A, Carroll S, Chipchase L, Reubenson A, Scarvell JM, Kent F. Work Readiness of New Graduate Physical Therapists for Private Practice in Australia: Academic Faculty, Employer, and Graduate Perspectives. Phys Ther 2021; 101:6157714. [PMID: 33686439 DOI: 10.1093/ptj/pzab078] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/09/2020] [Revised: 11/16/2020] [Accepted: 12/31/2020] [Indexed: 11/13/2022]
Abstract
OBJECTIVE The purpose of this study is to explore academic faculty, employer, and recent graduate perspectives of the work readiness of Australian new graduate physical therapists for private practice and factors that influence new graduate preparation and transition to private practice. METHODS This study used a mixed-methods design with 3 surveys and 12 focus groups. A total of 112 participants completed a survey, and 52 participated in focus groups. Descriptive statistics were used to summarize the quantitative data, and thematic analysis was used to analyze the qualitative data. Triangulation across participant groups and data sources was undertaken. RESULTS Australian new graduate physical therapists were perceived to be "somewhat ready" for private practice and "ready" by their third year of employment. Participants proposed that new graduates bring enthusiasm, readiness to learn, and contemporary, research-informed knowledge. New graduates were also perceived to find autonomous clinical reasoning and timely caseload management difficult; to have limited business, marketing, and administration knowledge and skills; and to present with underdeveloped confidence, communication, and interpersonal skills. Factors perceived to influence graduate transition included private practice experience, such as clinical placements and employment; employer and client expectations of graduate capabilities; workplace support; university academic preparation and continuing education; and individual graduate attributes and skills. CONCLUSION Australian new graduate physical therapists have strengths and limitations in relation to clinical, business, and employability knowledge and skills. New graduate work readiness and transition may be enhanced by additional private practice experience, employer and client expectation management, provision of workplace support, and tailored university and continuing education. IMPACT The number of new graduate physical therapists employed in private practice in Australia is increasing; however, until this study, their work readiness for this setting was unknown. This exploration of new graduate performance in private practice and transition can help to increase understanding and enhancement of work-readiness.
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Affiliation(s)
- Cherie Wells
- Charles Sturt University Ringgold Standard Institution-School of Community Health, Port Macquarie, New South Wales, Australia
| | - Rebecca Olson
- The University of Queensland-Saint Lucia Campus Ringgold Standard Institution - School of Social Science, Saint Lucia, Queensland, Australia
| | - Andrea Bialocerkowski
- Griffith University Faculty of Health Ringgold Standard Institution-Griffith Health, Gold Coast, Queensland, Australia
| | - Sara Carroll
- Curtin University Ringgold Standard Institution-Faculty of Health Science, Perth, Australia
| | - Lucy Chipchase
- Flinders University, College of Nursing and Health Sciences, Adelaide, Australia
| | - Alan Reubenson
- Curtin University Ringgold Standard Institution-School of Physiotherapy and Exercise Science, Perth, Australia
| | - Jennie Mary Scarvell
- University of Canberra Faculty of Health Ringgold Standard Institution-Faculty of Health, College Street Bruce, Bruce, Australian Capital Territory 2601, Australia
| | - Fiona Kent
- Monash University Ringgold Standard Institution-Faculty of Medicine, Nursing, and Health Sciences, Clayton, Victoria, Australia
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13
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Lao A, Wilesmith S, Forbes R. Exploring the workplace mentorship needs of new-graduate physiotherapists: a qualitative study. Physiother Theory Pract 2021; 38:2160-2169. [PMID: 33882799 DOI: 10.1080/09593985.2021.1917023] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
Background: Mentorship plays an important role in an individuals' transition into the workforce, yet little is known of new-graduates experiences of workplace mentorship. The aim of this study was to explore new-graduate physiotherapists' experiences of mentorship during their transition into professional practice in Australia.Method: A qualitative study with an interpretive phenomenological analytical approach was used. Semi-structured interviews of fifteen employed new-graduate physical therapists were undertaken within their first three to six months of clinical practice.Results: Four key themes emerged from the data: 1) Advantages of individualized mentorship; 2) Supporting the needs of professional development through mentorship; 3) Mentorship is valued by new-graduate employees; and 4) Mentorship moderates perceptions of stress and anxiety.Conclusions: New-graduate physiotherapists perceive workplace mentorship as a critical factor during the transition from student to clinician, which extends to the broader workplace. New-graduates place a strong value on individualized mentorship to support their professional development, which can influence self-perceived stress and anxiety and their perception of the workplace.
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Affiliation(s)
- Andrew Lao
- School of Health and Rehabilitation Sciences, The University of Queensland, Brisbane, Australia
| | - Sarah Wilesmith
- School of Health and Rehabilitation Sciences, The University of Queensland, Brisbane, Australia
| | - Roma Forbes
- School of Health and Rehabilitation Sciences, The University of Queensland, Brisbane, Australia
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14
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van Vuuren J, Thomas B, Agarwal G, MacDermott S, Kinsman L, O'Meara P, Spelten E. Reshaping healthcare delivery for elderly patients: the role of community paramedicine; a systematic review. BMC Health Serv Res 2021; 21:29. [PMID: 33407406 PMCID: PMC7789625 DOI: 10.1186/s12913-020-06037-0] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2020] [Accepted: 12/21/2020] [Indexed: 12/19/2022] Open
Abstract
Background Healthcare systems are overloaded and changing. In response to growing demands on the healthcare systems, new models of healthcare delivery are emerging. Community paramedicine is a novel approach in which paramedics use their knowledge and skills beyond emergency health response to contribute to preventative and rehabilitative health. In our systematic review, we aimed to identify evidence of the community paramedicine role in care delivery for elderly patients, with an additional focus on palliative care, and the possible impact of this role on the wider healthcare system. Methods A systematic review of peer-reviewed literature from MEDLINE, Embase, CINAHL, and Web of Sciences was undertaken to identify relevant full-text articles in English published until October 3, 2019. Additional inclusion criteria were studies focussing on extended care paramedics or community paramedics caring for elderly patients. Case studies were excluded. All papers were screened by at least two authors and underwent a quality assessment, using the Joanna Briggs Institute appraisal checklists for cross sectional, qualitative, cohort, and randomised controlled trial studies to assess the methodological quality of the articles. A process of narrative synthesis was used to summarise the data. Results Ten studies, across 13 articles, provided clear evidence that Community Paramedic programs had a positive impact on the health of patients and on the wider healthcare system. The role of a Community Paramedic was often a combination of four aspects: assessment, referral, education and communication. Limited evidence was available on the involvement of Community Paramedics in palliative and end-of-life care and in care delivery in residential aged care facilities. Observed challenges were a lack of additional training, and the need for proper integration and understanding of their role in the healthcare system. Conclusions The use of community paramedics in care delivery could be beneficial to both patients’ health and the wider healthcare system. They already play a promising role in improving the care of our elderly population. With consistent adherence to the training curriculum and effective integration within the wider healthcare system, community paramedics have the potential to take on specialised roles in residential aged care facilities and palliative and end-of-life care. Supplementary Information The online version contains supplementary material available at 10.1186/s12913-020-06037-0.
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Affiliation(s)
- Julia van Vuuren
- Department of Community Health, Rural Health School, La Trobe University, Melbourne, Australia.
| | - Brodie Thomas
- Department of Community Health, Rural Health School, La Trobe University, Melbourne, Australia
| | - Gina Agarwal
- Department of Family Medicine, McMaster University, Hamilton, Canada.,Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, Canada
| | - Sean MacDermott
- Department of Community Health, Rural Health School, La Trobe University, Melbourne, Australia
| | - Leigh Kinsman
- University of Newcastle and Mid-North Coast Local Health District, Port Macquarie Base Hospital, Port Macquarie, Australia
| | - Peter O'Meara
- Department of Paramedicine, Monash University, Peninsula Campus, Melbourne, Australia
| | - Evelien Spelten
- Department of Community Health, Rural Health School, La Trobe University, Melbourne, Australia
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15
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Forbes R, Lao A, Wilesmith S, Martin R. An exploration of workplace mentoring preferences of new‐graduate physiotherapists within Australian practice. PHYSIOTHERAPY RESEARCH INTERNATIONAL 2020; 26:e1872. [DOI: 10.1002/pri.1872] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2020] [Revised: 07/05/2020] [Accepted: 07/24/2020] [Indexed: 11/07/2022]
Affiliation(s)
- Roma Forbes
- School of Health and Rehabilitation Sciences The University of Queensland Brisbane Queensland Australia
| | - Andrew Lao
- School of Health and Rehabilitation Sciences The University of Queensland Brisbane Queensland Australia
| | - Sarah Wilesmith
- School of Health and Rehabilitation Sciences The University of Queensland Brisbane Queensland Australia
| | - Romany Martin
- School of Health and Rehabilitation Sciences The University of Queensland Brisbane Queensland Australia
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16
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Seaton JA, Jones AL, Johnston CL, Francis KL. The characteristics of Queensland private physiotherapy practitioners' interprofessional interactions: a cross-sectional survey study. Aust J Prim Health 2020; 26:500-506. [PMID: 33239149 DOI: 10.1071/py20148] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2020] [Accepted: 10/09/2020] [Indexed: 11/23/2022]
Abstract
Effective interprofessional collaboration (IPC) contributes to superior patient outcomes, facilitates cost-efficient health care, and increases patient and practitioner satisfaction. However, there is concern that IPC may be difficult to implement in clinical settings that do not conform to formal team-based processes, such as mono-professional physiotherapy private practice facilities. The aim of this study was to describe the characteristics of private physiotherapy practitioners' interprofessional interactions, including their experiences and perceptions regarding IPC. A custom developed cross-sectional online survey instrument was used to collect data from physiotherapists employed in private practice facilities in Queensland, Australia. In all, 49 (20% response rate) physiotherapists completed the survey. Only a small proportion (14%) indicated that their interprofessional interactions were a daily occurrence, and less than one-third of all respondents (31%) participated in formal, multi-professional face-to-face planned meetings. Most participants (76%) reported a moderate-to-high level of satisfaction regarding their interprofessional interactions. Despite low self-reported levels of interprofessional activity and other data indicating that IPC is necessary for holistic patient care, this study shows that physiotherapists were predominately satisfied when interacting with health practitioners from various professional backgrounds. Further research is required to inform the implementation of robust strategies that will support sustainable models of IPC in physiotherapy private practice.
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Affiliation(s)
- Jack A Seaton
- College of Healthcare Sciences, James Cook University, 1 James Cook Drive, Townsville, Qld 4811, Australia; and College of Public Health, Medical and Veterinary Sciences, James Cook University, 1 James Cook Drive, Townsville, Qld 4811, Australia; and Corresponding author.
| | - Anne L Jones
- College of Healthcare Sciences, James Cook University, 1 James Cook Drive, Townsville, Qld 4811, Australia
| | - Catherine L Johnston
- College of Public Health, Medical and Veterinary Sciences, James Cook University, 1 James Cook Drive, Townsville, Qld 4811, Australia
| | - Karen L Francis
- School of Health Sciences, The University of Newcastle, University Drive, Callaghan, NSW 2308, Australia
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17
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O'Meara P. The ageing farming workforce and the health and sustainability of agricultural communities: A narrative review. Aust J Rural Health 2019; 27:281-289. [DOI: 10.1111/ajr.12543] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2019] [Revised: 05/27/2019] [Accepted: 05/29/2019] [Indexed: 11/27/2022] Open
Affiliation(s)
- Peter O'Meara
- Department of Emergency Health and Paramedic Practice Monash University Frankston Victoria Australia
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18
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Noblet TD, Marriott JF, Jones T, Dean C, Rushton AB. Perceptions of Australian physiotherapy students about the potential implementation of physiotherapist prescribing in Australia: a national survey. BMJ Open 2019; 9:e026327. [PMID: 31110095 PMCID: PMC6530448 DOI: 10.1136/bmjopen-2018-026327] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
Abstract
OBJECTIVES To explore the perceptions of Australian physiotherapy students about (1) the potential implementation and use of non-medical prescribing by physiotherapists in Australia and (2) how physiotherapist prescribing might impact the care that the physiotherapy profession can provide in the future. DESIGN A cross-sectional descriptive survey of physiotherapy students across Australia was completed using an online questionnaire developed by subject-experts and pretested (n=10) for internal consistency. A hyperlink to the questionnaire was emailed to all students enrolled in any accredited, entry-level Australian university physiotherapy programme. A reminder email was sent 4 weeks later. SETTING Participants completed an online questionnaire. PARTICIPANTS 526 physiotherapy students from universities across all states with entry-level programmes. OUTCOME MEASURES Quantitative data underwent primary descriptive analysis. Thematic analysis was used to synthesise qualitative data. RESULTS 87% of participants supported the introduction of physiotherapist prescribing in Australia. 91% of participants stated that they would train to prescribe following introduction. Participants identified improvements in clinical and cost effectiveness, timely access to appropriate prescription medicines and optimisation of quality healthcare as key drivers for the introduction. CONCLUSIONS Student physiotherapists support the introduction of physiotherapist prescribing in Australia, reporting potential benefits for patients, health services and the physiotherapy profession. Stakeholders should use the results of this study in conjunction with supporting literature to inform future decisions regarding physiotherapist prescribing in Australia.
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Affiliation(s)
- Timothy David Noblet
- Centre of Precision Rehabilitation for Spinal Pain (CPR Spine), School of Sport, Exercise and Rehabilitation Sciences, University of Birmingham, Birmingham, UK
- Faculty of Medicine and Health Sciences, Department of Health Professions, Macquarie University, Sydney, New South Wales, Australia
| | - John F Marriott
- Institute of Clinical Sciences, College of Medical and Dental Sciences, University of Birmingham, Birmingham, UK
| | - Taryn Jones
- Faculty of Medicine and Health Sciences, Department of Health Professions, Macquarie University, Sydney, New South Wales, Australia
| | - Catherine Dean
- Faculty of Medicine and Health Sciences, Department of Health Professions, Macquarie University, Sydney, New South Wales, Australia
| | - Alison B Rushton
- Centre of Precision Rehabilitation for Spinal Pain (CPR Spine), School of Sport, Exercise and Rehabilitation Sciences, University of Birmingham, Birmingham, UK
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