PhD physiotherapy research

Results of my Delphi first round

I’ve recently finished the analysis of the first round of the Delphi study that I’m conducting as part of my PhD. The aim of the study is to determine the personal and professional attributes that determine patient outcomes, as well as the challenges faced in clinical education. These results will serve to inform the development of the next round, in which clinical educators will suggest teaching strategies that could be used to develop these attributes, and overcome the challenges.

Participants from the first round had a wide range of clinical, supervision and teaching experience, as well as varied domain expertise. Several themes were identified, which are summarised below.

In terms of the knowledge and skills required of competent and capable therapists, respondents highlighted the following:

  • They must have a wide range of technical and interpersonal skills, as well as a good knowledge base, and be prepared to continually develop in this area.
  • Professionalism, clinical reasoning, critical analysis and understanding were all identified as being important, but responses contained little else to further explain what these concepts mean to them.

In terms of the personal and professional attributes and attitudes that impact on patient care and outcomes, respondents reported:

  • A diverse range of personal values that they believe have relevance in terms of patient care
  • These values were often expressed in terms of a relationship, either between teachers and students, or between students and patients
  • Emotional awareness (of self and others) was highlighted

In terms of the challenges that students face throughout their training:

  • Fear and anxiety, possibly as a result of poor confidence and a lack of knowledge and skills, leading to insecurity, confusion and uncertainty
  • Lack of self-awareness as it relates to their capacity to make effective clinical decisions and reason their way through problems
  • A disconnect between merely “providing a service” and “serving”
  • They lack positive and supportive clinical learning environments, have poor role models and often aren’t given the time necessary to reflect on their experiences
  • The clinical setting is complex and dynamic, a fact that students struggle with, especially when it comes to dealing with complexity and uncertainty inherent in clinical practice
  • Students often “silo” knowledge and skills, and struggle to transfer between different contexts
  • Students struggle with the “hidden culture” of the professional i.e. the language, values and norms that clinicians take for granted

These results are not significantly different from the literature in terms of the professional and personal attributes that healthcare professionals deem to be important for patient outcomes.

The second round of the Delphi is currently underway and will focus on the teaching  strategies that could potentially be used to develop the attitudes and attributes highlighted in the first round.

research students

4th year research presentations

Just got back from watching 6 groups of 4th year physiology students present the results or their research projects at a competition.

There were a few things that struck me:

  • The “examiners” were all clinicians with few research credentials
  • Many of the the students who presented had little understanding of the results they presented, especially those who made use of statistics (the examiners were just as clueless)
  • Most of the studies were methodologically flawed, a point that was lost on the examiners
  • Our students really struggle with confidence and presentation skills, which comes across clearly when pitted against students from other universities (there seems to be an inferiority complex that they inherit when they arrive…many complex socio-economic factors involved)

All in all I think our students did well and am proud of their achievements.

social media

Blogging as a reflective tool

As part of their clinical placements (short term working placements in either hospitals or health clinics), the students in our department must write reflective pieces on their time at the placement where they look at things like their strengths, weaknesses, learning opportunities and clinical situations that raised issues for them.

This reflection is usually a typed page or two inserted into a file and submitted at the end of the placement.  Recently I’ve been wondering about the possibility of using blogging as a tool for our students to write their reflective journals, and encouraging other students on the same placements to to comment on each other’s work.

On one level I’m hoping that this will encourage further reflection based on feedback and discourse on both personal and clinical learning situations.  On another level, I’d like to use it to get students (and staff) to think about other concepts, such as the peer review process, the changing nature of academic publication and how knowledge is constructed through discourse.  I’m sure there’ll be plenty of other issues that are raised.

I also have anecdotal evidence that our students find it difficult to express themselves in clinical settings, for a variety of reasons, including not having English as a first language, which brings a subsequent lack of confidence when speaking in a group, as well as what seems to be an inferiority complex when confronted with students from other universities.  I’ve love for our students to be able to use this as an opportunity to find their own voices and tell their own stories in a semi-public space, which will still be a safe environment.

Here’s the article linked to in the post:
Academic blogging opens new world