Investigating strategies to enhance clinical education in an undergraduate physiotherapy programme: An action research study
The traditional approach to physiotherapy education is that of an applied science, in which scientific theory and therapeutic skills are taught in a classroom, and then implemented in a clinical setting. Many difficulties were demonstrated by students during the clinical practice component of the undergraduate course at the University of the Western Cape (UWC). This raised the question of whether current strategies of clinical education were effective in facilitating the development of the clinical skills deemed necessary for professional practice. Furthermore, it appeared to me that the teaching strategies which I employed did little to integrate classroom teaching with clinical practice. During 1993 and 1994 I initiated two cycles of workshops as an action research project, in collaboration with students and colleagues at UWC. The purpose of the workshops was for me to investigate my practice as a clinical educator, whereby I hoped to understand more fully, and therefore enhance, my teaching practice. The study revealed that clinical education is a complex and dynamic process strongly influenced by many factors. Personal perceptions of the educator's role in clinical teaching and learning, as well as the interaction with, and expections of those participating in clinical education, shape teaching practice. The concept of a positive learning environment was explored, and it was found that collaboration_with students and classroom democracy has a significant impact on student motivation. The effect of a variety of reading and writing tasks, co-operative learning and structured group discussion are some of the teaching strategies that were implemented, and positively evaluated by students and colleagues. Ethical considerations relating to the role of the patient during clinical practice and clinical education developed as an important aspect of the workshops. The conflict which can arise between the related roles of clinical educator and clinician, evolved as a professional dilemma. It is suggested that the process of clinical education requires further investigation. Educational change and innovation proved to be a difficult personal, and co-operative, process. Unique responses by different groups of individuals to similar situations or strategies make this issue more complex. In order to practice more competently, it would be appropriate that the clinical education process be thoroughly investigated in order to be more fully understood by physiotherapy educators, rather than be taken for granted. Action research proved to be an effective and flexible vehicle for investigating, and responding to, the dynamic teaching process. The action research study documented in this thesis, being similar in effect to the therapeutic process, would serve the physiotherapy clinician as effectively as it would the physiotherapy lecturer.