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"Students as partners" is a movement which is gaining momentum in higher education, yet disciplinary perspectives are underexplored. Using a qualitative synthesis approach informed by Major and Savin-Baden (2010), we systematically investigated how health professional education has taken up the practice of working in partnership with students. Fifty-five publications were identified in our search from 2011 to -mid 2018. The majority of literature came from North America and medicine was the most frequently represented health profession. Our three stage analysis identified five key themes: (1) framing (i.e. ethos) of the partnership; (2) drivers for partnership; (3) sustainability; (4) inclusion of student voice; and (5) understanding of partnership and its benefits and challenges. Health professional educators are well equipped to enact partnership opportunities due to their clinical skills in person-centred care. However to gain the most from student-staff partnerships, health professional education would benefit from greater awareness of the field's theoretical understandings of partnership and its key principles of reciprocity, respect and responsibility.

Health professional education (HPE) has been affected significantly by the COVID-19 pandemic, due to a combination of disruption to healthcare systems, changes to workforce needs, the effects on tertiary education provision and a necessity to innovate. While a challenging time, these were also opportunities in disguise. There is evidence that HPE is historically slow to adapt at the best of times; COVID-19 was an unavoidable catalyst for change. As the world tries to adapt to 'COVID-19 normal' life, it is essential that those in HPE consider what a 'COVID-19 normal' response might be. The learnings noted in this paper draw on recent literature and aim to help health professional educators consider what we have learned from our experiences during the height of the pandemic and ways of advancing curricula, teaching and learning. While the learnings are drawn from the health professions, they likely have relevance to professional and higher education more broadly. [ABSTRACT FROM AUTHOR]

Touch is an integral part of human life. Consequently, touching and being touched are also fundamental to healthcare practice. Despite a significant literature on touch, it is rarely conceptualized or discussed in terms of the student journey from layperson to practitioner. We chose to explore professional touch using the threshold concepts framework (TCF), which provides a theoretical model for exploring the way in which learners encounter, engage with and understand fundamental concepts in a discipline. This qualitative research synthesis (QRS) describes the use of the TCF to identify key issues involved in developing and using professional touch. Through a cross-professional analysis and synthesis of recent international literature, we aimed to identify key characteristics of the transitional journey for professional touch. Three orders of analysis were applied, employing a methodology described by Major and Savin-Baden (An introduction to qualitative research synthesis: managing the information explosion in social science research, Routledge, London, 2010). Following identification of threshold characteristics in the overall sample of articles, second order analysis revealed the nuances of professional touch associated with the characteristics. The final synthesis led to identification of five themes: (1) touch as dialogue; (2) being changed by touch; (3) multiple boundaries of touch; (4) multiple meanings of touch; and (5) influences on touch. Whilst providing support for some assertions within the literature, this QRS also offers new insights into the complexity of professional touch. Given the paucity of explicit learning and reflection around professional touch in training programmes of health professionals, the TCF reveals ways in which professional preparation might be improved to promote understanding of the role and impact of touch in practice.

The threshold concepts framework provides educators with a useful way of thinking about the struggles students have in coming to know essential, hard to grasp knowledge. A threshold concept is often best understood through reference to eight characteristics that together describe what is critical to effective knowledge acquisition. This conceptual paper hones in on just one of these characteristics -- the bounded quality -- that we propose is the most overlooked, but important, of the characteristics. The bounded characteristic frames the unique knowledge of a discipline and reflects its particular world-view. In this critical review, we analyse examples from threshold concepts scholarship: first, to explore the limitations of overlooking what the bounded characteristic has to offer, and second, to show how attention to ways of thinking and practising (WTP), may help to bring the bounded characteristic into focus, and reveal it as another non-negotiable threshold concept characteristic.

Background and Purpose: The impact of the COVID-19 pandemic on physiotherapy education meant that innovative responses were needed quickly. This paper describes a scholarly approach to changes within an entry-level physiotherapy program where one of its clinical placements was replaced with a fully online unit during 2020, as well as exploring the experiences of students who completed this newly developed online unit. Methods: A mixed methods approach was used. Sixteen of a possible 31 students responded to an online survey comprising quantitative and open-ended questions. Results: The majority of participants were satisfied with the unit and reported that: the unit helped them to learn valuable skills; feedback from educators was helpful; and that they were able to apply to future contexts. Small numbers of students were more ambivalent about the use of online media and tools including discussion boards, the workload and being part of a learning community. Conclusion: The online unit described in this research is evidence that non-traditional forms of clinical education might also address clinically important learning outcomes, provide sustainable options and alleviate some of the stresses that both tertiary providers and healthcare settings endure. However, these types of placement experiences require a paradigm shift from educators, the profession, accrediting bodies and even future students. [ABSTRACT FROM AUTHOR]

BackgroundPurposeResultsConclusionsIt has been two decades since the World Health Organization’s endorsement of the International Classification of Functioning, Disability and Health (ICF). It is timely to undertake a rigorous search that analyzes the discourses around the ICF’s conceptual framework within physiotherapy, the kinds of enquiry to date and the professional areas where this is happening and how.The aim of this research is to synthesize the literature related to how the physiotherapy profession (practice, research and education) thinks about and puts to use the WHO ICF.A final sample of 37 papers was agreed. Five overarching third-order interpretations were derived: (i) A way of thinking and practicing, (ii) Endorsed but not embedded, (iii) Striking a balance, (iv) Power of participation and (v) Moving forward. Together, these themes illustrate the evolving role of the ICF in physiotherapy over the previous two decades. They highlight the ICF’s potential for shaping the future of physiotherapy practice, education and research.Work is needed to connect existing literature about the ICF and related models and embed the ICF, its language and philosophy across physiotherapy education and practice. Re-representation of the model might help address misinterpretation of the ICF, but fundamentally, embedding the ICF in entry-level curriculum is likely to be the most significant driver of change in practice. [ABSTRACT FROM AUTHOR]

In this paper, we draw on an example of heuristic inquiry – (Re)imagining becoming a physiotherapist: a phenomenological approach – to illustrate the role that reflexivity and representation can play in physiotherapy research outcomes and the meaning they might have for moving the profession forward. Qualitative research in physiotherapy tends to acknowledge reflexivity as a route to objectivity by making researcher biases overt, yet the debate about data representation (a researcher’s decision-making about how data are represented in a text) barely feature. This contrasts with qualitative research in other fields, including other health professions, where matters of representation (i.e., how knowledge is conveyed) are routinely debated and contested. Reflexivity, in fact, is much more than being transparent. Together with representation, reflexivity helps to position both the voices of participants and researchers within the research. The heuristic inquiry described in this paper offers new insights about learning to be a physiotherapist; it challenged assumptions about care in physiotherapy practice and it changed the first researcher’s identity and practice. These insights were generated through the synergies between reflexivity and representation, and we argue that physiotherapy research has an opportunity to be more expansive by taking a commitment to reflexivity and representation more seriously. [ABSTRACT FROM AUTHOR]

There is often little opportunity to think deeply about educational practice, and curriculum in particular in universities today, yet this is a much-needed conversation as graduates encounter an increasingly complex world. We propose ways of thinking and practising (WTP) as an idea to help frame these complex conversations. In this conceptual paper, we suggest that WTP provides an opportunity to think about curriculum in four key ways. The first is WTP help foster an "integrated" and "holistic" view of curriculum. The second is WTP help to focus learning on "multiple" knowledge forms, as well as "production," "circulation" and "application." Third, WTP signal the importance of "simultaneously" developing student "agency" whilst inducting students into disciplinary communities. Finally, WTP help focus learning on "real-world needs." The complexity of WTP transects the epistemological, ontological and axiological concerns facing today's universities, providing academics with a framework to engage with curriculum from multiple perspectives.

History has practically vanished from allied health professional education. We ask, what kind of problem does a "history of the professions" pose for health sciences curriculum? What are the implications of graduates being unschooled in the history of their profession? Literature on knowledge in the curriculum, is used to interrogate how historical knowledge has come to be constituted in professional education fields. We develop a sketch of two particular health professions--occupational therapy and physiotherapy--and ask why it might be difficult to include a history of the profession in these curricula. Our view is that by helping students to cultivate an historical imagination, they can see how their experiences are framed by a fascinating collision of ideas, politics and practices. Furthermore, attention to history can help students better situate their own uncertainties about transitioning to practice enabling them to tackle professional quandaries with hindsight, foresight and insight.

The idea of threshold concepts (TC) has been well received across the higher education community. However the concept's framework is still evolving and the literature uses the framework in different ways. Just over a decade since the idea first captured interest, it is opportune to explore the nature of that discourse, and the kinds of enquiry undertaken to date. This article reports on a qualitative synthesis that analyses published research on TC in health sciences. It provides a fresh perspective on the literature to identify key themes. "Inducting students into complex practices"; "beyond concepts" and "developing students' agency," are the three themes to arise from our findings. These themes offer insights on the ways TC have been used to develop scholarly curriculum, teaching and learning practices. They not only reflect the concerns of the community, but represent a set of empirically based principles for curriculum and course design.

The original work on threshold concepts arose from a project designed to improve students' learning experiences by taking seriously the features of disciplinary knowledge as its starting point. The conceptual and empirical work on threshold concepts has since developed and matured. While many disciplines have engaged enthusiastically with the identification of threshold concepts, healthcare has not been well represented. Drawing on Cousin's (2007, 2009) notion of transactional curriculum inquiry, the study explores the identification of threshold concepts in a physiotherapy subject, with a sample of physiotherapy clinical educators, using nominal group technique (NGT). While the article presents a set of concepts from the pilot study, this is not its key contribution. Instead, three novel insights are offered for future threshold concepts research. First, there is a need to extend the stakeholders involved in curriculum reform and renewal beyond the university (particularly, for professions). Second, there must be ongoing opportunities for these external stakeholders to engage with and reflect on the distinct features of threshold concepts if the context and authenticity of practice is to be taken seriously for enhancing student learning. Third, the problem of identification is beset with conceptual challenges that remain unresolved for researchers.

This paper focuses on the experiences of four facilitators of a group mentoring programme for doctoral students aspiring to become academics. The methodology utilised collective sensemaking in a collaborative autoethnography. Aided by agreed reflective prompts, we initially analysed our own and each other's written accounts. This illuminated the motivations and hopes accompanying us into the project, as well as our individual experience of being a mentor within it. We digitally recorded the discussion of our initial analyses, sharing and debating what we felt our own and each other's reflections revealed. We subsequently discussed and collaboratively analysed the meeting transcript. This final meta-analytic phase exposed tension-laden emotions and experiences. We theorise that we were operating as wounded academics, seeking to recreate a nurturing academic space where it is simultaneously possible to express, contain and transform contradictory emotions associated with being in the academy. Drawing on Foucault's notion of heterotopia, we propose that such spaces may also unleash a sense of hope and possibility for contemporary academic life. [ABSTRACT FROM AUTHOR]

The work practices of a health professional involve a complex weaving together of knowing what, knowing how, and knowing why. To help students engage with what is required for practice, educators need to have an expansive view of what it means to be a health professional in the rapidly changing real-world contexts that people inhabit today. Threshold concepts, and the complementary framework Ways of Thinking and Practising (WTP), are educational ideas that can help educators to think in those broad ways about health's knowledge base, behaviours, and values, and how these appear in the curriculum. This article offers a case example from a pre-clinical entry-level physiotherapy subject to illustrate how threshold concepts and WTP informed what students came to understand about health professional practice. A curriculum that considers threshold concepts and WTP in combination helps both educators and students to engage with learning from multiple perspectives and to develop a connected understanding of their chosen profession. Helping students to articulate the connections between knowledge (e.g. threshold concepts) and how this knowledge is put to use (e.g. through the WTP of the profession) enables them to reconsider practice-related contexts in meaningful ways. [ABSTRACT FROM AUTHOR]

Threshold concepts, student learning and curriculum are constructs within a learning and teaching discourse foregrounded by Meyer and Land. In this paper, we introduce a conceptual model that integrates these three constructs and identifies desired outcomes at the intersects: namely the processes of (1) ways of thinking and practising, (2) liminality, (3) meaningful learning and (4) metalearning. The model is holistic and scholars participating in the threshold concept discourse may find it helpful as a way to bring together various ideas; these ideas when understood as part of a "whole" provide a more systematic way of thinking about how to advance educational practice. By way of examples from our own personal experiences in health professional education, we highlight ways we have used aspects of the model to strengthen preparation of practice-ready graduates.

While the study of threshold concepts is a growing area of research, their identification has not proven to be an easy process. However, identification matters because of the potential impact of threshold concepts on the learning experiences of students. A dialogue amongst lecturers and/or students is common to the literature on identification of threshold concepts. This dialogue, with the inclusion of educational developers, has been called "transactional curriculum inquiry" (Cousin in "Researching learning in higher education," Routledge, New York, 2009). Diverse methods across a variety of disciplines have explored the identification of threshold concepts, including semi-structured interviews, analysis of exam responses and observation of classroom behaviour. A selection of these methods and disciplines is discussed in order to highlight two main challenges inherent in the identification process: first, the involvement of the wider professional and/or public community, and second, a lack of agreement amongst research participants about the threshold concepts within disciplines. This paper proposes that the transactional curriculum inquiry process should be extended to involve parties beyond the educational realm (e.g. the professional community) and that the use of consensus methodology offers the potential to facilitate agreement across the transactional process.

Issue: Preparing health professional students for practice matters and is an important objective of health professional education. But although health professional courses grow in number and continue to graduate entry-level practitioners annually, there are signs that health professional education is not quite hitting the "purpose" mark. Preparedness is a term encountered often in health professional education, but it is besieged with challenges. Those challenges relate to whether graduates are prepared for their future careers and how preparedness for practice is understood; understandings of preparedness influence what curriculum, teaching, and learning prepares graduates about and for. Evidence: There is a wealth of the literature that suggests that graduates are not prepared for practice or believe they are not. This literature tends to grow rather than diminish, with arguments about preparedness materializing time and again. Preparedness means different things to students, academics, and practitioners and this creates misunderstanding as well as lessening the construct's value to research, education, and practice. What it means to be prepared is in fact not a static construct but changes in response to the needs of individuals and communities and broader societal context. When preparedness is defined as competence in skills or knowledge, graduates will be ill equipped to operate in the chaotic, ambiguous times we now face as competencies tend to oversimplify and reduce the demands of practice. Implications: Preparedness is only one purpose that could be attached to the educational formation of university graduates. It is time we expand our thinking about what is valuable and necessary to learn in order to become health professionals equipped to address the health and social care problems now and to come. Furthermore, continuing to address the challenges of preparedness for practice in the same ways as we have done for decades will not result in change; new and different educational approaches are required to meaningfully reimagine health professional education. We need to value education as a scholarly field in its own right, as much as we do evidence-based healthcare. A concept that prompts us to think and act in these reinvigorated ways is stewardship, which I offer as an expansive way to think about the purposes and desired outcomes of health professional education. Stewardship is an idea that sustains and cares for the professions, and therefore is highly relevant to the preparation of healthcare practitioners. [ABSTRACT FROM AUTHOR]

Background and Purpose: Understanding the experiences of learners—and future graduates—is integral to their professional development and to the development of the profession. This paper adds to understanding of physiotherapy student experiences by exploring the ways students and recent graduates approach, learn about, connect with and form a relationship with their chosen profession of physiotherapy. Methods: Heuristic inquiry, a form of phenomenology, was used. Thirteen participants (11 students and 2 new graduates) were interviewed. Results: The findings are presented as four portraits: passenger, tourist, resident and citizen. These represent four particular and prominent ways that the participants connected with specific situations and/or to the profession as a whole, the sense they made of those situations (or the broader profession) and the identity formed. Discussion: The portraits help educators to think about how students are navigating the process of becoming a physiotherapist and might act as a tool to help foster students' professional development. Educators who understand students' motivations and struggles are better prepared to help students to see themselves and the profession in sophisticated ways. [ABSTRACT FROM AUTHOR]

Care is central to many health professions, including physiotherapy. Different forms of care are enacted as part of being a caring professional. For example, a practitioner who provides good service to others and upholds standards while doing so is in-grained in education for professional formation. However, there are other topics and aspects of care that are not as well attended to, and that is care for the future of the profession. This too is an aspect of care, and it is an urgent objective in an era where societies and healthcare are changing at rapid rates. In this paper, I argue that Golde and Walker's (2006) idea of stewardship can help health professionals think about this often overlooked aspect of care. Stewardship adds a perspective that is centered on a deep authentic care for and responsibility towards the ongoing relevance of the profession. Stewardship keeps the question of what the profession is, and what a professional does, alive as part of its present and future practice. [ABSTRACT FROM AUTHOR]

This article reflects on the integration of threshold concepts and ways of thinking and practicing (WTP) in the field of physiotherapy education. The authors discuss their analysis of the relationship between these concepts and highlight the complexity and potential limitations of threshold concepts. They also note that there is a lack of literature on WTP compared to threshold concepts. However, they argue that WTP offers a holistic view of practice and supports student learning in health professional education. The authors suggest that further exploration of the integration of these concepts can enrich research conversations in the field. [Extracted from the article]

Introduction and Aim: A broader definition of health, and an increase in lifestyle-related health conditions, have necessitated a change in physiotherapy practice. As a result, what entry-level students learn about health and wellbeing for 21st century needs is receiving more attention. The aim of this study was to explore what entry-level physiotherapy students learned experientially about health promotion and behavior change by working with a peer to reciprocally prescribe and receive a six-week health promotion program. Method: Thematic analysis of an assessment task that students submitted as part of their enrolment in a second-year physiotherapy subject. Results: Analysis revealed three themes: 1) physiotherapist's contribution to the health and wellbeing of others; 2) needing to understand determinants of health to collaboratively facilitate behavior change; and 3) benefits of experiential activities to learn about professional/personal roles. Discussion: Students demonstrated understanding of the complexity and challenges associated with being a practitioner. The assessment task gave students an authentic learning experience to navigate factors such as establishing personal interests, negotiating goals, and addressing motivation. Furthermore, it highlighted that opportunities may exist for students to participate in, and learn from, practice-relevant situations outside of clinical placements. [ABSTRACT FROM AUTHOR]

The World Health Organization International Classification of Functioning, Disability and Health has the power to shape professional behaviour and positively influence all aspects of health and social care practice. The visual depiction of the ICF framework belies the complexity of this multifaceted classification and coding system which students and practitioners can find challenging to grasp. This guide offers twelve integrated practical tips to help health and social care educators embed the ICF throughout the curriculum with a view to supporting student learning and ultimately interprofessional and inclusive practice. [ABSTRACT FROM AUTHOR]

Aim: To explore how students, recent graduates, and qualified physiotherapists experience physiotherapy practice. Design: Two-part phenomenologically oriented study. Thirteen physiotherapy students/recent graduates and 32 qualified physiotherapists were interviewed. The transcripts were analyzed to identify the ways of thinking and practicing (WTP) of physiotherapy. Results: Seven themes representing particular WTP in physiotherapy emerged from the interview data. Six were shared by all participants but understood in different ways. These related to the discovery of new knowledge; problem-solving client-related contexts; adopting a systems-based approach to the body; contributing to a positive therapeutic alliance; developing a sense of self and the profession; and the organization of the workforce. A final theme, professional citizenship, was only described by the qualified practitioners. Conclusion: The results of this study indicate that physiotherapy practice can be characterized in six distinct ways, with a separate integrating idea that represents the relationship the individual practitioner has with the profession. The insights gained from this research suggest that new ways of thinking might benefit the profession, not least of all in relation to entry-level curriculum, contemporary practice and positioning of the profession for current health-care needs. [ABSTRACT FROM AUTHOR]

Education of the future healthcare workforce has long been a partnership between university and healthcare sectors, with students learning under the shared guidance of academics and clinicians. Traditionally, academics have taught in the classroom and clinicians have engaged students at the patient bedside. Using a phenomenologically-oriented approach, this pilot project explored the experiences of clinicians who team-taught a theoretical subject in a classroom environment. Purposeful sampling of physiotherapy staff within a metropolitan healthcare organisation was used. Six clinicians were recruited and, prior to teaching, completed a blended educational program about higher education teaching and learning. The clinicians taught classes of twenty students within new classroom spaces co-located at the healthcare organisation, with curricula provided by the university. Two semi-structured interviews were conducted with each clinician at the beginning and end of the allocated teaching period. Transcripts from the semi-structured interviews were analysed and four themes emerged. First, physiotherapists initially identified as clinicians not teachers, but their perceptions later broadened. Second, the intention of teaching was patient-focused. Third, the balancing of multiple roles resulted in challenges for the clinicians; and fourth, the experience involved new immersion in digital media. This work explores a different form of educator role -- likened to a pracademic -- and supports the need for considered approaches to teaching and links between theory/education and practice to meet the demands of modern healthcare and university learning. [ABSTRACT FROM AUTHOR]

The work practices of a health professional involve a complex weaving together of knowing what, knowing how, and knowing why. To help students engage with what is required for practice, educators need to have an expansive view of what it means to be a health professional in the rapidly changing real-world contexts that people inhabit today. Threshold concepts, and the complementary framework Ways of Thinking and Practising (WTP), are educational ideas that can help educators to think in those broad ways about health’s knowledge base, behaviours, and values, and how these appear in the curriculum. This article offers a case example from a pre-clinical entry-level physiotherapy subject to illustrate how threshold concepts and WTP informed what students came to understand about health professional practice. A curriculum that considers threshold concepts and WTP in combination helps both educators and students to engage with learning from multiple perspectives and to develop a connected understanding of their chosen profession. Helping students to articulate the connections between knowledge (e.g. threshold concepts) and how this knowledge is put to use (e.g. through the WTP of the profession) enables them to reconsider practice-related contexts in meaningful ways. [ABSTRACT FROM AUTHOR]

In this article, we aim to add to the existing literature on practice-based education. First, we will present a form of situated learning, which involved piloting a new teaching and learning relationship between the university and healthcare setting. Second, we will examine how students made sense of this perspective of practice. Using a phenomenologically oriented approach, this pilot study explored the experiences of entry-level physiotherapy students learning in a classroom environment, facilitated by clinicians, and located on a healthcare partner’s site. Twenty students completed two concurrent, theoretically oriented subjects that did not involve traditional clinical practicum experience. Two individual semi-structured interviews were conducted with students. Data was thematically analysed using an inductive approach. Three inter-related themes emerged. First, meaning-making is enhanced by the relevance and authenticity afforded by immersion in a practice-oriented classroom environment where clinicians facilitate learning. Second, learning from those ‘in practice’ challenges students’ professional and academic accountability. Finally, new educational infrastructures influenced students’ agency in unanticipated ways. This work highlights that students valued contextual learning. While meaning-making was enhanced by the development of key new relationships with others and the environment, these relationships also influenced student agency. Recommendations for health professional curricula are discussed, and include: capitalising on learning with peers, bringing the hidden curriculum into view, and creating opportunities for students to navigate uncertainty and change. [ABSTRACT FROM AUTHOR]