The theory-practice gap and physiotherapy in the UK: Insights from the nursing experience

Evidence based practice in clinical physiotherapy education: a qualitative interpretive description

BACKGROUND

Health care undergraduate students are expected to practice evidence-based after they graduate. Previous research indicates that students face several problems with transferring evidence-based practice to real patient situations. Few studies have explored reasons for this. The aim of this study was to explore beliefs, experiences and attitudes related to third year students' use of evidence-based practice in clinical physiotherapy education among students, clinical instructors and visiting teachers.

METHODS

In total, six focus group interviews were conducted: three with 16 students, two with nine clinical instructors and one with four visiting teachers. In addition, one individual interview and one interview in a pair were conducted with clinical instructors. Interviewing three different participant-categories ensured comparative analysis and enabled us to exploit differences in perspectives and interactions. Interpretive description guided this process.

RESULTS

Four integrative themes emerged from the analysis: "attempt to apply evidence-based practice", "novices in clinical practice", "prioritize practice experience over evidence-based practice" and "lack role models in evidence-based practice". Students tried to search for research evidence and to apply this knowledge during clinical placements; a behaviour that indicated a positive attitude towards evidence-based practice. At the same time, students were novices and required basic background information more than research information. As novices they tended to lean on their clinical instructors, and were more eager to gain practical experience than practicing evidence-based; a behaviour that clinical instructors and visiting teachers often supported. Students noticed a lack of an EBP culture. Both students and clinical instructors perceived a need for role models in evidence-based practice.

CONCLUSIONS

Clinical instructors are in a position to influence students during clinical education, and thus, important potential role models in evidence-based practice. Actions from academic and clinical settings are needed to improve competence in evidence-based practice among clinical instructors, and future research is needed to investigate the effect of such efforts on students' behaviour.

Pragmatism in practice: mixed methods research for physiotherapy

The purpose of this paper is to provide an argument for the place of mixed methods research across practice settings as an effective means of supporting evidence-based practice in physiotherapy. Physiotherapy practitioners use both qualitative and quantitative methods throughout the process of patient care-from history taking, assessment, and intervention to evaluation of outcomes. Research on practice paradigms demonstrates the importance of mixing qualitative and quantitative methods to achieve 'expert practice' that is concerned with optimizing outcomes and incorporating patient beliefs and values. Research paradigms that relate to this model of practice would integrate qualitative and quantitative types of knowledge and inquiry, while maintaining a prioritized focus on patient outcomes. Pragmatism is an emerging research paradigm where practical consequences and the effects of concepts and behaviors are vital components of meaning and truth. This research paradigm supports the simultaneous use of qualitative and quantitative methods of inquiry to generate evidence to support best practice. This paper demonstrates that mixed methods research with a pragmatist view provides evidence that embraces and addresses the multiple practice concerns of practitioners better than either qualitative or quantitative research approaches in isolation.

Perceptions and Attitudes toward Conducting Research: A Nuclear Medicine Student Perspective

One of the well-established hallmarks of a profession is its ability to generate research to expand its unique professional knowledge base. Health care professionals in today's rapidly evolving, highly technological work environment also need the skills to use research findings in their practice. Practitioners, therefore, need to have the knowledge and skills to competently engage in research activities. There have been a number of studies investigating how health care professionals perceive their role in regards to research. However, little is known about how nuclear medicine (NM) students perceive research and if they see themselves playing a role in the future research in their field.

OBJECTIVES

To determine the attitudes and perceptions of NM students toward conducting research and to explore factors that influence NM students' perceptions of conducting research.

METHODS

Seventy surveys were sent out via e-mail to NM students studying at the University of Toronto and Michener Institute joint degree-diploma program in Medical Radiation Sciences; 21 completed surveys were collected.

RESULTS

The majority of students reported having no intention of engaging in research in the future. General disinterest in research was the most common reason stated for not engaging in research.

DISCUSSION

Though the results of this preliminary study cannot be generalized to all NM students, it does reveal a negative attitude toward conducting research among the NM students surveyed. It has also been shown that general disinterest in research seems to be one of the most important barriers for students. Further studies with more in-depth analysis and a larger sample size are necessary to determine whether students feel they have a role to play in the future research in the NM field and to further explore barriers to research participation.

Clinical supervision as an interaction between the clinical educator and the student

The interaction between clinical educators and students is regarded as the strongest element in developing expertise and in forming students' professional identity in clinical education. Although clinical education has been studied in physiotherapy, the natural interaction between clinical educators and students has remained unanalyzed. The aim of this study was to examine how supervised learning sessions during patient treatment were constructed. The focus was on the forms of interaction between clinical educators and students in natural contexts. By videotaping 12 natural patient treatment sessions, which simultaneously comprised part of the clinical education of physiotherapy students, and by using qualitative discourse analysis, three supervision discourses emerged from the data: "directing the interaction," "making limited room for the student," and "encouraging the student's participation." This study revealed that clinical educators have a dominant role in constructing supervised learning sessions during patient treatment. Depending on how the interaction is constructed, it is possible to support or prevent student participation in decision making as well as to promote or reject the rehearsal of critical thinking or self-directed learning among students. This study highlighted the importance of interactional skills in supervision practices. More research into constructing learning sessions in clinical education is needed.

Do occupational therapy and physiotherapy students care about research? A survey of perceptions and attitudes to research

Do occupational therapy and physiotherapy students care about research? A survey of perceptions and attitudes to research. In this cross-sectional study, we have used a questionnaire to study perceptions and attitudes to research-related activities of Swedish occupational therapy and physiotherapy first (T1) and final term (T6) students. Two hundred and eleven students from programmes employing either problem-based learning (PBL) or traditional education methods participated. The results showed that students had a positive attitude towards research, particularly for the activity 'read research literature to update knowledge' and 'apply research findings to improve practice'. When T1 were compared with T6 students, the ability to perform research-related activities was rated significantly higher by T6 students regardless of educational methods. A comparison of PBL and the traditional educational method resulted in moderate but significant differences. The PBL students had a more positive attitude towards research and to a greater extent intended to engage in research activities in the future. The results give hope for a positive future development of the occupational therapy and physiotherapy professions and a PBL education method may be more conducive to the shaping of a research consumer than a traditional method, although more research is needed to substantiate these claims.

What do Swedish physiotherapists feel about research? A survey of perceptions, attitudes, intentions and engagement

BACKGROUND AND PURPOSE

Although the past decades have witnessed an increase in physiotherapy research, there remains a concern about the translation of research into clinical practice, a problem that to date has attracted relatively limited interest. The aim of the present study was to investigate perceptions and attitudes toward research, intentions to perform as well as actual engagement in research-related activities in a sample of Swedish physiotherapists.

METHOD

A cross-sectional design was used, and 343 Swedish physiotherapists responded to a postal questionnaire (representing a response rate of 61.7%). Questions about research-related activities were measured on a Likert-type scale, whereas questions referring to attitudes toward research used a semantic differential scale.

RESULTS

The physiotherapists considered research as an important part of their professional role. Reading research literature was perceived as the most important research activity, and all mean attitude ratings were on the positive side of the scale. High workload and lack of time were the most commonly mentioned barriers to participation in research-related activities. Although Swedish physiotherapists read a large variety of journals, they most frequently read in their own language.

CONCLUSIONS

The physiotherapists in this study were generally positive about research, which offers hope for an increased use of evidence-based practice in the future. In order to facilitate this development, easily accessible summaries could be provided. A cultural change within the profession, allowing more time for reading and discussing research reports should be encouraged.