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L. Barnes1, J. Foster1,2, K. Adams1, C. Louwen1
1Logan Hospital, Physiotherapy Department, Meadowbrook, Australia, 2University of Queensland, Brisbane, Australia
Background: Vestibular Rehabilitation Therapy (VRT) is well established in over 25 different countries and continues to gain momentum globally. Despite this growth, the training opportunities afforded to pre-registration physiotherapy students are still quite sparse with disparity of teaching hours across university programs. In Queensland public hospitals, physiotherapists are the clinicians of choice for VRT and referrers have growing expectations of bedside vestibular skills for rotational ward-based physiotherapists. This presents a significant challenge for graduate physiotherapists who typically step into these roles, driving the need for increased clinical exposure within university programs to improve work-readiness and meet the demands of the evolving physiotherapy workforce. Until recently, pre-registration physiotherapy student placements in vestibular physiotherapy have remained unexplored during traditional student placement allocation processes. Logan Hospital now offers a novel pre-registration clinical placement which focuses on exposure to complex vestibular diagnoses and First Point of Contact (FPOC) vestibular physiotherapy roles.
Purpose: The purpose of this study is to identify and map student clinical exposure and learning opportunities within a specialised vestibular physiotherapy placement.
Methods: Retrospective data was collected from three pre-registration physiotherapy student placements in Logan Hospital’s Vestibular Physiotherapy Service. Timeframes of each chart audit reflects the duration of placement:
Audit 1) 18/2/19 – 29/3/19;
Audit 2) 24/2/20 – 3/4/20;
Audit 3) 11/5/20 – 12/6/20.
Data included patient diagnoses, student occasions of service (OOS), adverse events and exposure to FPOC clinics. Data from each audit was reviewed both independently and as an average across three placements.
Audit 1) 18/2/19 – 29/3/19;
Audit 2) 24/2/20 – 3/4/20;
Audit 3) 11/5/20 – 12/6/20.
Data included patient diagnoses, student occasions of service (OOS), adverse events and exposure to FPOC clinics. Data from each audit was reviewed both independently and as an average across three placements.
Results: 160 student OOS were included in the study, representing 95 patients. On average, each student reviewed 32 patients with vertigo/dizziness and there was an average of 53.33 OOS per placement. This equated to an average of 1.68 OOS per patient. Benign Paroxysmal Positional Vertigo (BPPV) was the most frequently encountered diagnosis, with 43% of patients (n = 41) presenting with BPPV across the three placement blocks. Each student treated an average of 14 patients with BPPV. Unilateral vestibular hypofunction (UVH) and vestibular migraine were also highly prevalent, with 38% (n = 36) and 19% (n =18) patients with these conditions. 11% (n = 10) of patients presented with more than one vestibular diagnosis. Rare conditions such as third window syndromes, Meniere’s Disease and bilateral vestibular loss were also encountered. On average students spent 86% of their outpatient clinic time in secondary contact clinics and 14% in specialist FPOC vestibular clinics where they contributed to specialised primary contact care. There were no recorded adverse events to patient care during the placements.
Conclusion(s): Student involvement in specialised vestibular physiotherapy placements provides a unique experience to pre-registration physiotherapy students in managing complex clinical conditions, understanding FPOC physiotherapy roles and application of learned skills through high OOS in this specialty area. We have demonstrated that pre-registration physiotherapy students can gain valuable exposure to common and complex vestibular conditions with nil adverse outcomes to patient care.
Implications: This research may assist other specialist vestibular clinics to offer similar clinical placement experiences and thus enhance the learning exposure available to pre-registration physiotherapy students.
Funding, acknowledgements: There was no funding acquired for this project.
Keywords: Clinical placement, Vestibular physiotherapy, Pre-registration students
Topic: Education: clinical
Did this work require ethics approval? No
Institution: N/A
Committee: N/A
Reason: Not required as this work addresses new and unique developments in physiotherapy student education of local quality improvement.
All authors, affiliations and abstracts have been published as submitted.
