Display options
Share it on

Physiother Res Int. 2022 Jan;27(1):e1929. doi: 10.1002/pri.1929. Epub 2021 Oct 31.

Physiotherapy student clinical placements in Australian private practice: Patient-reported outcomes with supervised student care.

Physiotherapy research international : the journal for researchers and clinicians in physical therapy

Ruo Xin Chia, Sjaan R Gomersall, Jonas Fooken, Stephen Birch, Alana Dinsdale, Ruth Dunwoodie, Roma Forbes

Affiliations

  1. School of Health and Rehabilitation Sciences, The University of Queensland, Brisbane, Queensland, Australia.
  2. Centre for the Business and Economics of Health, The University of Queensland, Brisbane, Queensland, Australia.

PMID: 34719081 DOI: 10.1002/pri.1929

Abstract

BACKGROUND AND PURPOSE: The sustainability of physiotherapy clinical placements is an ongoing challenge, yet there is potential to increase placement capacity within the private practice sector. Barriers to hosting students, including perceived impacts on patient care, reportedly limit the uptake of hosting students within this setting. This study aimed to evaluate the effect of physiotherapy student involvement on patient-reported Global Rating of Change (GRoC) in Australian physiotherapy private practice care.

METHODS: A cross-sectional, patient survey study was conducted in three private physiotherapy practices over two 5-week periods. At their completion of care, participants completed the survey seeking demographic information, GRoC and aspects of care including number of consultations involving students, proportion of physiotherapy time involving students and frequency of student involvement in treatment delivery. After accounting for clinic-level differences, ordinal logistic regression analyses were performed to explore the impact of supervised student care on GRoC.

RESULTS: 119 participants across three practices completed the survey. There were no significant associations between patient-reported GRoC and: (1) student involvement in patient care; (2) number of consultations involving students; (3) proportion of physiotherapy time involving students; or (4) frequency of student involvement in treatment delivery (p > 0.05).

CONCLUSIONS: Supervised student care in private physiotherapy practice does not appear to have a detrimental impact on patient-reported outcomes. These findings may address concerns relating to student involvement in patient care within this setting. Future research should address economic and service delivery impacts of supervised student care on private practices.

© 2021 John Wiley & Sons Ltd.

Keywords: health occupations; patient outcome assessment; patient reported outcome measures; private practice; students

References

  1. Atkinson, R., & McElroy, T. (2016). Preparedness for physiotherapy in private practice: Novices identify key factors in an interpretive description study. Manual Therapy, 22, 116-121. https://doi.org/10.1016/j.math.2015.10.016 - PubMed
  2. Australian Health Practitioner Regulation Agency. (2013). Approved programs of study. https://www.ahpra.gov.au/Education/Approved-Programs-of-Study.aspx?ref=Physiotherapist - PubMed
  3. Australian Physiotherapy Association. (2018). National Physiotherapy Service Descriptors. https://australian.physio/sites/default/files/tools/APA_Service%20Descriptors_v5_FA.PDF - PubMed
  4. Australian Physiotherapy Council. (2017). Guidelines for accreditation of entry-level physiotherapy practitioner programs of study V1.2. https://physiocouncil.com.au/wp-content/uploads/2018/11/GUIDELINES-FOR-ACCREDITATION-V1.2-18052018.pdf - PubMed
  5. Bobos, P., Macdermid, J., Nazari, G., & Furtado, R. (2019). Psychometric properties of the global rating of change scales in patients with neck disorders: A systematic review with meta-analysis and meta-regression. BMJ Open, 9(11), e033909. https://doi.org/10.1136/bmjopen-2019-033909 - PubMed
  6. Costa, O. P. L., Maher, G. C., Latimer, H. J., Ferreira, L. P., Ferreira, C. M., Pozzi, M. A. G., & Freitas, M. A. L. (2008). Clinimetric testing of three self-report outcome measures for low back pain patients in Brazil: Which one is the best? Spine, 33(22), 2459-2463. https://doi.org/10.1097/BRS.0b013e3181849dbe - PubMed
  7. Daher, A., Carel, R. S., Tzipi, K., Esther, H., & Dar, G. (2020). The effectiveness of an aerobic exercise training on patients with neck pain during a short- and long-term follow-up: A prospective double-blind randomized controlled trial. Clinical Rehabilitation, 34(5), 617-629. https://doi.org/10.1177/0269215520912000 - PubMed
  8. Dalton, M., Davidson, M., & Keating, J. (2011). The assessment of physiotherapy practice (APP) is a valid measure of professional competence of physiotherapy students: A cross-sectional study with Rasch analysis. Journal of Physiotherapy, 57(4), 239-246. https://doi.org/10.1016/s1836-9553(11)70054-6 - PubMed
  9. Doubt, L., Paterson, M., & O'Riordan, A. (2004). Clinical education in private practice: An interdisciplinary project. Journal of Allied Health, 33(1), 47-50. https://search.proquest.com/docview/211061754?accountid=14723 - PubMed
  10. Ehlers, A. P., Khor, S., Cizik, A. M., Leveque, J.-C. A., Shonnard, N. S., Oskouian, R. J., Jr, Flum, D. R., & Lavallee, D. C. (2017). Use of patient-reported outcomes and satisfaction for quality assessments. The American Journal of Managed Care, 23(10), 618-622. https://pubmed.ncbi.nlm.nih.gov/29087633 - PubMed
  11. Forbes, R., Dinsdale, A., Brauer, S., Dunwoodie, R., Fooken, J., Khanna, D., & Birch, S. (2021). Hosting pre-registration physiotherapy students in Australian private practices does not change service and economic outcomes; an economic analysis. Musculoskeletal Science and Practice, 52, 102318. https://doi.org/10.1016/j.msksp.2021.102318 - PubMed
  12. Forbes, R., & Nolan, D. (2018). Factors associated with patient-satisfaction in student-led physiotherapy clinics: A qualitative study. Physiotherapy Theory and Practice, 34(9), 705-713. https://doi.org/10.1080/09593985.2018.1423592 - PubMed
  13. Gorrindo, P., Peltz, A., Ladner, T. R., Reddy, I., Miller, B. M., Miller, R. F., & Fowler, M. J. (2014). Medical students as health educators at a student-run free clinic: Improving the clinical outcomes of diabetic patients. Academic Medicine: Journal of the Association of American Medical Colleges, 89(4), 625-631. https://doi.org/10.1097/ACM.0000000000000164 - PubMed
  14. Hall, M., Poth, C., Manns, P., & Beaupre, L. (2016). An exploration of Canadian physiotherapists' decisions about whether to supervise physiotherapy students: Results from a national survey. Physiotherapy Canada, 68(2), 141-148. https://doi.org/10.3138/ptc.2014-88E - PubMed
  15. Health Workforce Australia. (2014a). Australia's health workforce series-Physiotherapists in focus. http://iaha.com.au/wp-content/uploads/2014/03/HWA_Australia-Health-Workforce-Series_Physiotherapists-in-focus_vF_LR.pdf - PubMed
  16. Health Workforce Australia. (2014b). Clinical training profile: Physiotherapy. https://acdhs.edu.au/wp-content/uploads/2018/05/Clinical-Training-Profiles-Project-Physiotherapy.pdf - PubMed
  17. Jaeschke, R., Singer, J., & Guyatt, G. H. (1989). Measurement of health status. Ascertaining the minimal clinically important difference. Controlled Clinical Trials, 10(4), 407-415. https://doi.org/10.1016/0197-2456(89)90005-6 - PubMed
  18. Kamper, S. J., Maher, C. G., & Mackay, G. (2009). Global rating of change scales: A review of strengths and weaknesses and considerations for design. Journal of Manual & Manipulative Therapy, 17(3), 163-170. https://doi.org/10.1179/jmt.2009.17.3.163 - PubMed
  19. Kamper, S. J., Ostelo, R. W. J. G., Knol, D. L., Maher, C. G., de Vet, H. C. W., & Hancock, M. J. (2010). Global Perceived Effect scales provided reliable assessments of health transition in people with musculoskeletal disorders, but ratings are strongly influenced by current status. Journal of Clinical Epidemiology, 63(7), 760-766.e1. https://doi.org/10.1016/j.jclinepi.2009.09.009 - PubMed
  20. Kent, F., Richards, K., Haines, T., Morgan, P., Maloney, S., & Keating, J. L. (2015). Patient and practitioner perceptions of student participation in private practice consultations: A mixed-methods study. Focus on Health Professional Education, 16(2), 42-54. https://doi.org/10.11157/fohpe.v16i2.72 - PubMed
  21. Koontz, A. M., Mallory, J. L., Burns, J. A., & Chapman, S. (2010). Staff nurses and students: The good, the bad, and the ugly. Medsurg Nursing, 19(4), 240-244, 246. - PubMed
  22. Litwin, M. S. (1995). How to measure survey reliability and validity. https://doi.org/10.4135/9781483348957 - PubMed
  23. Maloney, P., Stagnitti, K., & Schoo, A. (2013). Barriers and enablers to clinical fieldwork education in rural public and private allied health practice. Higher Education Research and Development, 32(3), 420-435. https://doi.org/10.1080/07294360.2012.682255 - PubMed
  24. McBride, L.-J., Fitzgerald, C., Costello, C., & Perkins, K. (2018). Allied health pre-entry student clinical placement capacity: Can it be sustained? Australian Health Review, 44(1), 39-46. https://doi.org/10.1071/AH18088 - PubMed
  25. Mintken, P. E., Glynn, P., & Cleland, J. A. (2009). Psychometric properties of the shortened disabilities of the arm, shoulder, and hand questionnaire (QuickDASH) and numeric pain rating scale in patients with shoulder pain. Journal of Shoulder and Elbow Surgery, 18(6), 920-926. https://doi.org/10.1016/j.jse.2008.12.015 - PubMed
  26. Mulcahy, A. J., Jones, S., Strauss, G., & Cooper, I. (2010). The impact of recent physiotherapy graduates in the workforce: A study of Curtin University entry-level physiotherapists 2000-2004. Australian Health Review, 34(2), 252-259. https://doi.org/10.1071/ah08700 - PubMed
  27. Newstead, C., Johnston, C. L., Nisbet, G., & McAllister, L. (2018). Physiotherapy clinical education in Australia: An exploration of clinical educator characteristics, confidence and training requirements. Australian Health Review, 43(6), 696-705. https://doi.org/10.1071/AH18094 - PubMed
  28. Ngo, T., Stupar, M., Côté, P., Boyle, E., & Shearer, H. (2010). A study of the test-retest reliability of the self-perceived general recovery and self-perceived change in neck pain questions in patients with recent whiplash-associated disorders. European Spine Journal, 19(6), 957-962. https://doi.org/10.1007/s00586-010-1289-x - PubMed
  29. Peiris, C., Wells, C., Reubenson, A., Lawton, V., Francis-Cracknell, A., & Dunwoodie, R. (2019). Moving forward-Private practice placement capacity and quality. In Paper presented at the APA momentum 2019 physiotherapy vonference; 2019 Oct 17-19; Adelaide, Australia. - PubMed
  30. Physiotherapy Business Australia (PBA). (2010). Submission to council of physiotherapy deans of Australia and New Zealand: Students in private practice. Australian Physiotherapy Association. - PubMed
  31. Pivko, S., Abbruzzese, L., Duttaroy, P., Hansen, R., & Ryans, K. (2016). Effect of physical therapy students’ clinical experiences on clinician productivity. Journal of Allied Health, 45(1), 33-40. - PubMed
  32. Recker-Hughes, C., Wetherbee, E., Buccieri, K., Fitzpatricktimmerberg, J., & Stolfi, A. (2014). Essential characteristics of quality clinical education experiences: Standards to facilitate student learning. Journal of Physical Therapy Education, 28, 48-55. https://doi.org/10.1097/00001416-201400001-00009 - PubMed
  33. Stiller, K., Sorich, M., & Roberts, K. (2013). Evaluating patients' attitudes towards being assessed and treated by undergraduate physiotherapy students in a rehabilitation centre. The Internet Journal of Allied Health Sciences and Practice, 11(1). - PubMed
  34. Stuhlmiller, C. M., & Tolchard, B. (2015). Developing a student-led health and wellbeing clinic in an underserved community: Collaborative learning, health outcomes and cost savings. BMC Nursing, 14, 32. https://doi.org/10.1186/s12912-015-0083-9 - PubMed
  35. Wells, C., Olson, R., Bialocerkowski, A., Carroll, S., Chipchase, L., Reubenson, A., Scarvell, J., & Kent, F. (2021). Work readiness of new graduate physical therapists for private practice in Australia: Academic faculty, employer, and graduate perspectives. Physical Therapy, 101(6), 1-12. https://doi.org/10.1093/ptj/pzab078 - PubMed
  36. Wells, C., Olson, R., Kent, F., Bialocerkowski, A., Chipchase, L., Scarvell, J., Carroll, S., & Reubenson, A. (2017). Are new graduate physiotherapists ready for private practice? In Paper presented at: The APA momentum 2017 physiotherapy conference; 2017 Oct 19-21; Sydney, Australia. - PubMed

Publication Types

Grant support