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Objectives: This paper explores the decision-making processes involved in giving physiotherapy students responsibility on clinical placement and the impact on their developing professional autonomy., Methods: The qualitative study, using semi-structured interviews, involved physiotherapy students and clinical educators (CEs) from two higher education institutions, one in Australia, and the other in the United Kingdom (UK)., Findings: Findings led to the development of a heuristic framework of 'graduated supervision,' a process of progressively less direct observation and monitoring of students as clinical proficiency improved. By focusing on the measured exposure of students to increasing complexity and inverse levels of supervision, the framework captures tacit practices, and consistent, yet varied facilitation strategies adopted across specialties, and evident in clinical education settings in both countries. The framework formalizes, for the first time, assumptions and expectations previously unacknowledged. Factors identified as affecting students' progress toward autonomy include the student/CE relationship, the development of mutual trust through ongoing dialogue, and the importance of formal discussions at the commencement of a clinical placement to establish learning goals, preferred supervision styles and learner responsibilities., Conclusion: Insights have significance for the CE community, and students who at times have to second-guess what is required of them and how they might excel on clinical placement.

Background:Knowledge of the effects on students of clinical educators’ giving or withholding responsibility on placement is limited. The associated empowering, or disempowering impact indicates the need for research on what grounds such decisions are made.Aim of Study:The study aimed to explore clinical educators’ perspectives on the importance of giving student physiotherapists increasing levels of responsibility on clinical placement, and the factors considered when giving or withholding responsibility.Methods:A grounded theory methodology underpins this United Kingdom (UK) based study. The phase of the study reported in this article involved 26, semi-structured interviews with clinical educators, each followed by the completion of a diamond ranking exercise.Findings:Three themes emerged: 1) the ubiquity of risk; 2) the relationship between trust and trustworthiness; and 3) graduated supervision. The first theme, acknowledged that risk is ever-present and that clinical educators are used to managing it, balancing risk and responsibility given to students. The second theme highlighted the importance of developing trust/trustworthiness as a foundation for a sound working relationship between student and clinical educator. The third theme focusing on graduated supervision as a means of empowering students to take on increasingly demanding responsibilities on placement.Conclusions:The study illustrates the complex relationship between risk, trust, responsibility, and developing student autonomy. A strategy is proposed to provide an empowering alternative to the tendency to increase surveillance and/or limit the responsibility for students who lack confidence or capability in taking responsibility on clinical placement. Future research could aim to test the strategy more widely. [ABSTRACT FROM PUBLISHER]

Given that all of us are potential users of health and social care services, the rigorous assessment of student health professionals in practice should be of common interest. However, rigorous assessment of practice-based learning is notoriously challenging. One would expect assessment in the context of the workplace to be an indicator of fitness for purpose and for practice. However, some indication that health professional students, including physiotherapists, are less fit for practice on qualification than might be desirable suggests a need to rethink assessment practices. Drawing on insights from students, clinical educators, and university visiting tutors in the United Kingdom, this article offers a rationale for combining assessment by observation of performance with a formal oral assessment. We argue that complementarity between the two types of assessment when combined means they allow us to gain a holistic impression of the student's overall performance. We illustrate how the oral component of assessment influences how students go about learning and highlight its perceived 'added value' in terms of helping students prepare for employment. Our findings are theorised in terms of the extent to which assessment aligns with learning activities and learning outcomes, which we believe is vital in health professional programmes. The purpose of this qualitative study was to explore the views of students, clinical educators, and university visiting tutors on assessment strategies used in clinical practice. Our objectives were to develop our understanding of the contribution made by each element of assessment to our overall view of student capability. On this basis we would determine whether both assessment components were deemed necessary by all of the stakeholders. [ABSTRACT FROM AUTHOR]

This paper explores the ways in which student health professionals undergo a transformation in their sense of identity as they engage with caring discourses that underpin healthcare. I argue that caring is a ‘threshold concept’ by virtue of the ‘troublesome knowledge’ with which students are confronted on meeting patients in practice. When superimposed on commonsense understandings of caring, medical connotations of care and moral and ethical dilemmas challenge students to develop their own personal framework within which to operate. I suggest a number of ways in which students can be helped to move forward towards or through the threshold to a more cogent understanding of caring. Subsequent positioning in terms of caring discourses forms a facet of the students’ developing identities as healthcare professionals and therefore is a fundamental aspect of professional socialization. [ABSTRACT FROM AUTHOR]