NEW GRADUATE PHYSIOTHERAPISTS RECOGNISE THAT UNIVERSITIES CANNOT FULLY PREPARE THEM FOR PRIVATE PRACTICE – AND THAT’S OK

K. Evans¹, A. Papinniemi², V. Vuvan³, L. Chipchase⁴

¹University of Sydney, Faculty of Medicine and Health, Brisbane, Australia, ²Healthia Limited, Brisbane, Australia, ³University of Queensland, School of Health and Rehabilitation Sciences, St Lucia, Australia, ⁴Flinders University, College of Nursing and Health Sciences, Adelaide, Australia

Background: Graduate preparedness for private practice has been explored in several studies with suggestions that universities do not prepare physiotherapy students adequately for working in fee-for-service settings. However, there is increasing recognition that the transition from university student to autonomous healthcare professional is a distributed responsibility between universities, employers, and new graduates themselves. Given the increasing number of new graduates electing to work in private practice rather than government-funded health services, a greater understanding of their views on their preparedness may identify strategies to facilitate a successful transition.

Purpose: To evaluate new graduates’ perceptions of their preparedness to practice in an Australian fee-for- setting.

Methods: A qualitative longitudinal descriptive approach was employed. Semi-structured interviews of 20 new graduates occurred immediately prior to their commencement of work, then at three, nine and 12-months. The interview guide included questions relating to participants’ perceptions of the most important attributes/skills learnt at university that supported work as a new graduate physiotherapist and their hopes, expectations, concerns about starting their first job. Interviews were recorded and transcribed verbatim and a conventional content analysis was conducted.

Results: A total of 72 interviews were conducted over the 12-month period. Themes related to the perception that university provided a good theoretical foundation and basic technical skills, but participants described accepting that their education would never prepare them completely for the workload, type of administrative tasks (e.g., third party paperwork) or the lifestyle associated with working in private practice (e.g., “..not sure how they would prepare you for the lifestyle”), all of which was unexpected for the new graduates. Participants reflected that some skills, such as communication, complex clinical reasoning and “seeing the whole picture” take time to develop and are best learnt “on-the-job”. Overall, participants reflected that they felt as prepared as they could be and expected the first year to be a steep learning curve. However, participants also expected to be supported in their first year of practice in an environment that was non-judgemental and fostered learning.

Conclusions: New graduate physiotherapists believed that their university education had prepared them well for working in fee-for-service-setting despite gaps related to administrative tasks and complex clinical reasoning. Participants were cognisant that acquiring clinical skills and fostering effective patient-therapist interactions (through effective communication and a holistic approach to care) takes time and that these skills were nascent when they graduated. Despite initial concerns, participants at 12 months reflected that they had sufficient knowledge and skills to navigate the first year of practice and that they needed to “back themselves” and their education.

Implications: New graduates need reassurance that whilst the transition to private practice is challenging, their undergraduate degree provides a strong foundation albeit with some gaps that are likely to be best filled with on-the-job training. Nevertheless, universities could make small changes to their curriculum to prepare graduates for some of the administrative tasks associated with private practice. Finally, employers must have realistic expectations of graduate preparedness and new graduates themselves take responsibility for fine tuning and developing their skills.

Funding acknowledgements: No funding was received to conduct the study.

Keywords:
Transition to practice
Graduate preparedness
Work-ready

Topics:
Education: continuing professional development
Education
Education: clinical

Did this work require ethics approval? Yes

Institution: The University of Sydney

Committee: Human Research Ethics Committee

Ethics number: #1028