Exploration of mentor and mentee perspectives of a mentored clinical practice programme to improve patient outcomes in musculoskeletal physiotherapy

Background

A recent randomised controlled trial has demonstrated the impact on practice of an educational programme for clinicians. Mentored clinical practice in musculoskeletal physiotherapy resulted in clinically significant improvements in both physiotherapist performance and patient outcomes. The objectives of this study were to explore mentor and mentee perceptions of a mentored clinical practice programme, in order to identify key factors in the process to improve patient outcomes.

Methods

Employing a case study design of a mentoring programme that led to improved patient outcomes, mentored clinical practice was explored from multiple perspectives using a grounded theory strategy of enquiry to derive a theory of mentored clinical practice grounded in the views of the participants. Semi-structured interviews with a purposive sample of mentors and mentees were employed along with qualitative observations of mentored clinical practice. Data analysis and collection were concurrent, with analysis an iterative process deriving inductive analytical categories from the data through constant comparison.

Findings

Highly informative themes of how the complex interaction between mentor, mentee, patient and environment worked successfully were identified from the data. The mentors’ knowledge, additional perspectives, critical analysis and facilitatory style were enabling factors, as were mentees’ motivation, openness to criticism and commitment to reflect on practice. Themes around potential threats to the mentees’ development were also identified. Overloading or contradictory feedback and lack of relationship with mentees were barriers that mentors could bring; fear, defensiveness, routine working, people-pleasing and lack of experience were potential mentee barriers. A model emerges from the data demonstrating how these themes interact, providing guidance to mentors and mentees to optimise the effectiveness of mentored clinical practice.

Conclusion

This study provides a sound basis for future mentored clinical practice, producing a model from key themes from a case study where impact on clinician performance and patient outcomes are established.

Impact and feasibility of a tailor-made patient communication quality improvement programme for hospital-based physiotherapists: a mixed-methods study

Background

In tailoring a quality improvement programme for hospital-based physiotherapy, the original use of video recordings was replaced by using the tracer methodology.

Objective

To examine the impact of a tailor-made quality improvement programme addressing patient communication on the professional development of hospital-based physiotherapists, and to evaluate barriers and facilitators as determinants of feasibility of the programme.

Methods

A mixed-methods study was conducted. Participants were clustered in groups per hospital and linked with an equally sized group in a nearby hospital. Within the groups, fixed couples carried out a 2-hour tracer by directly observing each other’s daily work routine. This procedure was repeated 6 months later. Data from feedback forms were analysed quantitatively, and a thematic analysis of transcripts from group interviews was conducted.

Results

Fifty hospital-based physiotherapists from 16 hospitals participated. They rated the impact of the programme on professional development, on a scale from 1 (much improvement needed) to 5 (no improvement needed), as 3.99 (SD 0.64) after the first tracer and 4.32 (SD 0.63) 6 months later; a mean improvement of 0.33 (95% CI 0.16 to 0.50). Participants scored, on a scale ranging from 1 to 5 on barriers and facilitators (feasibility), a mean of 3.45 (SD 0.95) on determinants of innovation, 3.47 (SD 0.86) on probability to use and 2.63 (SD 1.07) on the user feedback list. All participants emphasised the added value of the tracer methodology and mentioned effects on self-reflection and awareness most.

Conclusions

The tailor-made quality improvement programme, based on principles of the tracer methodology, was associated with a significant impact on professional development. Barriers and facilitators as determinants of feasibility of the programme showed the programme being feasible.

Facilities management in the NHS: overlapping authority and demarcation disputes

Purpose

This research aims to investigate the implementation of the new ward housekeeper role in a hospital setting. The purpose is to propose a model to demonstrate how facilities management (FM) departments and clinical ward teams work together effectively to deliver catering and cleaning services.

Design/methodology/approach

The context of the implementation of the role was deemed a necessary feature, particularly to understand the organisational structures. In this case, the context was a hospital, and the underlying mechanisms that were in place included local recruitment and retention issues. Therefore, an interpretive approach was taken, and a series of semi-structured interviews was the primary method to collect data, supplemented by some non-participant observation and document analysis.

Findings

The findings from the two themes enable the development of a model to illustrate the working relationships between FM departments and clinical ward teams.

Practical implications

The findings from the study are of significance for hospital facilities and estates departments and clinical stakeholders who have the responsibility of ward catering, cleaning and the environment.

Originality/value

The significance of this study emerges through the advancement of methodology within the context of facilities in health care and through the contribution to knowledge and practice as a result of the proposed mode. This was the first type of study to look in detail at ward housekeeping models, using an interpretive approach over a relatively long period of time.

An Occupational Therapy Practice Initiative Using the Bobath Concept: A Collaborative Partnership with Higher Education

This practice analysis presents a critical investigation of a collaborative partnership between a National Health Service provider and a higher education institution. The practice initiative collaborative partnership provided an opportunity for mentorship, to develop further clinical reasoning skills and confidence in the application of the Bobath Concept for children with cerebral palsy within a community setting. It also provided opportunities for service development based on the Bobath Concept. Issues for future consideration and recommendations for service development are included.

Advancing Reflective Practice: An Evaluation of an Observed Practice Workshop for Occupational Therapists and Physiotherapists

Introduction:

An action research study resulted in an observed practice programme to advance the reflective skills of occupational therapists and physiotherapists. Action research offered a way of drawing on practitioners' knowledge and experience.

Method:

The programme was introduced through a one-day workshop to occupational therapists and physiotherapists of varying levels of experience within a mental health organisation. A purpose-designed questionnaire was used to evaluate learning outcomes and to capture participants' response to the workshops.

Results and conclusion:

The evaluation confirmed that the workshop design did support participants in developing the skills and confidence to implement the observed practice programme.