Search

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.

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.Heuristic inquiry, a form of phenomenology, was used. Thirteen participants (11 students and 2 new graduates) were interviewed.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.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.

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 ofte...

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.

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 stu...

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.

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.

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.

Health science courses aim to prepare students for the demands of their chosen profession by learning ways appropriate to that profession and the contexts they will work and live in. Expectations of what students should learn become re-contextualised and translated into entry-level curriculum, with students operating as a connection between what is intended and enacted in curriculum, and required in the real world. Drawing on phenomenology, this paper explores how students understand practice-the collective, purposeful knowing, doing and being of a community-in entry-level physiotherapy programs. Ways of thinking and practising (WTP)-a framework attentive to the distinctive nature of a discipline, its values, philosophies and world-view (McCune and Hounsell in High Educ 49(3):255-289, 2005)-provides the conceptual lens. Six themes describing how students see the WTP of physiotherapy practice emerged from the analysis: 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 organisation of the workforce. The study produces knowledge about practice by focusing on physiotherapy students' experiences of disciplinary learning. Including students in educational research in this way is an approach that can help students realise their potential as part of a community of practice.

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 in...

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.

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.

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.

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: touch as dialogue; being changed by touch; multiple boundaries of touch; multiple meanings of touch and 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.

Contemporary and future physiotherapists are, and will be, presented with challenges different to their forebears. Yet, physiotherapy tends to remain tied to historical ways of seeing the world: these are passed down to generations of physiotherapy graduates. These historical perspectives privilege particular knowledge and skills so that students gain competency for graduation. However, contemporary practice is inherently more complex than the focus on knowledge and skills would have us believe. Professional life requires students to develop the capability to deal with uncertain and diverse futures. This paper argues that physiotherapy needs to think differently about entry-level education; the focus on knowledge and competencies that has been the mainstay in physiotherapy education must now be understood in the context of an education that embraces knowing, doing, being. Two educational frameworks are offered in support of this argument - threshold concepts and ways of thinking and practicing (WTP). Taken together, these ideas can assist physiotherapy to think in fresh ways about disciplinary learning. Threshold concepts and WTP help to understand the nature of a discipline: its behaviors, culture, discourses, and methods. By interrogating the discursive aspects of the discipline, physiotherapy educators will be better placed to provide more relevant preparation for practice.

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, ther...

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.