Students commencing clinical placements often have difficulty applying their knowledge to produce meaningful clinical interactions. Patient-centred simulation can provide a bridge to clinical practice but can be expensive. This chapter describes the development and evaluation of a simulated environment integrating patient-centred simulation with an online adaptive learning platform to assist students to transition from classroom to placement. Student confidence increased significantly from pre- to post-simulation in all 12 areas that were surveyed from 3.4/6 (2.9–4.2) to 3.9/6 (3.7-4.5). Ninety-one percent of students felt better prepared for placement. The activity was not assessable and students rated this aspect highly for engagement and efficacy of learning. Student marks on their subsequent clinical placement were significantly higher for professional behavior, communication, and evidence-based practice compared with previous cohorts of students who had not undertaken a similar program.
TopBackground: The Role Of Clinical Placements
In Australia, physiotherapy is a registered profession under the Australian Health Practitioner Regulation Agency (AHPRA). To become qualified and registrable, an individual must undertake physiotherapy studies within a university-based program of physiotherapy studies accredited by the Australian Physiotherapy Council (APC). The APC undertakes the task of accrediting entry-level physiotherapy programs on behalf of the Physiotherapy Board of Australia which is supported by AHPRA.
The enormous growth in Physiotherapy programs in Australia is illustrated by an increase from six entry-level physiotherapy programs in 1998 to 29 in 2017. Each physiotherapy program has at its core, a curriculum reflective of contemporary Western physiotherapy. Integral to the curricula are clinical placements wherein physiotherapy students, apply their knowledge and skills in clinical settings under the supervision of registered physiotherapists. Typically such placements are of five weeks duration (or in multiples of five weeks) across a range of areas of practice either incorporated into the program structure such that a placement immediately follows a period of theoretical and practical learning (integrated model); or follow directly after each other once the bulk of theoretical and practical learning has been completed (immersive model). Each model has its benefits and challenges but these placements are required to include exposure to people of all ages in a range of specified areas of practice (Australian Health Practitioner Regulation Agency, 2015).
In order to assure public safety, the APC accreditation standard requires students:
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“Achieve the relevant competencies before providing supervised patient care as part of the (university) program” of studies, and
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“Are supervised by suitably qualified and registered physiotherapy and health practitioners during clinical education”. (Australian Physiotherapy Council, 2015).
The APC accreditation standards are designed to link to the physiotherapy binational practice thresholds (Australian Physiotherapy Council, 2015). The threshold statements are a reference point of threshold competence in the context of physiotherapy practice in Australia and New Zealand. The threshold statements are used to assess “student’s performance in the context of a clinical placement or simulated setting for education purposes.”
A range of key competencies are listed within the binational threshold statements. Of relevance to this chapter, is the role domain of ‘physiotherapy practitioner’, and specifically the key competencies that registered physiotherapists in Australia and New Zealand are able to:
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Plan and implement an efficient, effective, culturally responsive and client-centred physiotherapy assessment; and
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Involve the client and relevant others in the planning and implementation of safe and effective physiotherapy using evidence-based practice to inform decision-making.