Tuttle N1, Horan S1, Bissett L1
1Griffith University, School of Allied Health Sciences, Gold Coast, Australia
Background: Many physiotherapy programs are structured with a delay between when students learn content for a particular area of practice, and when they undertake a related clinical placement. Learning theory would suggest that recency of learning would be expected to be associated with improved performance when the skills are applied practically.
Purpose: To determine whether a delay of five weeks or more between on campus teaching of content related to working with patients 1) in an orthopaedic surgical setting or 2) in an outpatient musculoskeletal setting negatively impacts clinical placement performance.
Methods: A retrospective cohort study. Participants: 273 students in three cohorts of a graduate entry two-year Masters program. The program has an integrated clinical placement model where all students undertake a clinical placement in an inpatient orthopaedic surgical setting after one semester of on-campus content. Students undertake this placement either immediately after their on-campus content or after a delay or five or ten weeks. Similarly, at the end of their second semester, students undertake a clinical placement in a musculoskeltal outpatient setting either immediately or ten weeks after relevant on-campus content. The timing of placements were not influenced by students' prior performance. Performance on clinical placements was assessed at mid-placement and end of placement using the Assessment of Physiotherapy Practice (APP) tool, a reliable and valid measure for assessing all physiotherapy clinical placements within Australia. Submission of mid-placement marks was optional, resulting in only 227 being submitted and available for analysis.
Results: For mid-placement scores there was a main effect of delay, which on post-hoc analysis demonstrated that, of the seven aspects of performance for the APP, students performed worse on three: Professional Behaviour, Evidence Based Practice and Risk Management. Average mid-placement marks being (SE): 2.70/4 (0.062) vs 2.49/4 (0.094), 2.49/4 (0.66) vs 2.14/4 (0.10), and 2.48/4 (0.66) vs 2.14/4 (0.10), respectively. For end of placement marks, no differences were found for students who experienced a delay.
Conclusion(s): A time gap of five weeks or more appears to have a detrimental effect on student performance in the first half of their placement, but not on their final marks. Students starting at a lower level can potentially place a greater burden on clinical educators. The lack of impact on end of placement marks may be due to a ceiling effect. Further work is being undertaken to determine if the inclusion of a 'just in time' targeted simulated learning environment immediately prior to a delayed placement will counteract the effect of the delay.
Implications: It would seem reasonable to either minimise the occurrence of delays between on campus content and clinical placements or develop and implement strategies to counteract the effect of delay.
Keywords: Clinical education, curriculum design
Funding acknowledgements: No funding was received for this project
Purpose: To determine whether a delay of five weeks or more between on campus teaching of content related to working with patients 1) in an orthopaedic surgical setting or 2) in an outpatient musculoskeletal setting negatively impacts clinical placement performance.
Methods: A retrospective cohort study. Participants: 273 students in three cohorts of a graduate entry two-year Masters program. The program has an integrated clinical placement model where all students undertake a clinical placement in an inpatient orthopaedic surgical setting after one semester of on-campus content. Students undertake this placement either immediately after their on-campus content or after a delay or five or ten weeks. Similarly, at the end of their second semester, students undertake a clinical placement in a musculoskeltal outpatient setting either immediately or ten weeks after relevant on-campus content. The timing of placements were not influenced by students' prior performance. Performance on clinical placements was assessed at mid-placement and end of placement using the Assessment of Physiotherapy Practice (APP) tool, a reliable and valid measure for assessing all physiotherapy clinical placements within Australia. Submission of mid-placement marks was optional, resulting in only 227 being submitted and available for analysis.
Results: For mid-placement scores there was a main effect of delay, which on post-hoc analysis demonstrated that, of the seven aspects of performance for the APP, students performed worse on three: Professional Behaviour, Evidence Based Practice and Risk Management. Average mid-placement marks being (SE): 2.70/4 (0.062) vs 2.49/4 (0.094), 2.49/4 (0.66) vs 2.14/4 (0.10), and 2.48/4 (0.66) vs 2.14/4 (0.10), respectively. For end of placement marks, no differences were found for students who experienced a delay.
Conclusion(s): A time gap of five weeks or more appears to have a detrimental effect on student performance in the first half of their placement, but not on their final marks. Students starting at a lower level can potentially place a greater burden on clinical educators. The lack of impact on end of placement marks may be due to a ceiling effect. Further work is being undertaken to determine if the inclusion of a 'just in time' targeted simulated learning environment immediately prior to a delayed placement will counteract the effect of the delay.
Implications: It would seem reasonable to either minimise the occurrence of delays between on campus content and clinical placements or develop and implement strategies to counteract the effect of delay.
Keywords: Clinical education, curriculum design
Funding acknowledgements: No funding was received for this project
Topic: Education: clinical; Education: methods of teaching & learning; Education
Ethics approval required: Yes
Institution: Griffith University
Ethics committee: Human Research Ethics Committee
Ethics number: PES/40/12/HREC
All authors, affiliations and abstracts have been published as submitted.
