| Popis: |
BACKGROUND AND PURPOSEClinical education is a critical component of physical therapist (PT) training; it allows students to develop and apply the necessary knowledge, skills, and behaviors learned in the classroom in a clinical setting, under the supervision of a clinical instructor (Cl).1'5 Common across health science disciplines, clinical education permits the acquisition of skills and the professional socialization of students as they prepare to enter the workforce as competent entry-level health care practitioners.5"7 Essential to the success of clinical education is the willingness of CIs to provide quality placement experiences characterized by the Cl having the time available and skill set necessary to observe, evaluate, and provide feedback on student performance.8,9 However, a pressing dilemma facing physical therapy, and many other health science programs in Canada and beyond, is a shortage of quality clinical placement experiences.1,8,10'13Among the key issues faced by physical therapy clinical education identified in the literature are: competing caseload and clinical teaching demands,1,8,14 increasing patient acuity, staff workloads, staff burnout,11,15,16 and a dissatisfaction with the instrument used to evaluate students on placement-the Clinical Performance Instrument (CPI).7 Literature regarding Canadian PTs' attitudes and opinions of clinical education in general is limited. Published studies have been smallscale and qualitative in nature, not necessarily generalizable to the PT population as a whole or representative of the Canadian context.14 The overall goal of this study was to provide a national, cross-sectional perspective of the issues affecting both public and private practice PTs with respect to clinical education, and to begin to address the knowledge gaps on this important topic.Research Questions1. What are the factors that contribute to Canadian CIs' decisions to supervise PT students?2. To what extent do personal and professional, workplace/contextual, student, and evaluation factors contribute to Canadian CIs' decisions to supervise a PT student?Review of the LiteratureClinical education comprises a significant portion of curriculum time (roughly one third) in Canadian entry-level PT education programs and, similar to many countries, is a requirement for program accreditation.17'19 Under the supervision of a Cl, clinical education provides PT students with experiences necessary for their professional socialisation and growth20 that are difficult to reproduce in classroom or laboratory environments.1 Moreover, these clinical experiences are essential for the acquisition of knowledge, skills, and behaviors needed to join the workforce as competent, independent physical therapist practitioners.2,7,20'21Canadian academic coordinators of clinical education (ACCEs) anecdotally report continued difficulties with obtaining sufficient appropriate placement numbers to meet student needs-a challenge that has been reported in physical therapy and other health science programs both domestically and abroad.1,8,11'13 Staff shortages, an increased acuity and complexity of the health care environment, reorganization of health care delivery models, and a lack of funding are all cited as reasons for decreasing clinical placement opportunities.11 Researchers highlight the growing concerns expressed by clinicians related to the challenges of student supervision that include personal factors such as the stress associated with the clinical placement, workplace and contextual factors related to clinical caseload management and employer support, as well as student preparation, and evaluation-related factors.1,6,7,14Qualitative studies from the United Kingdom and Australia highlight that many PTs believe that clinical education is a core responsibility of the profession and that most PTs should be involved in student training.1,22 But a lack of time to supervise students and complete caseload requirements led to stress and reduced job satisfaction, which was seen as the primary barrier to student placements. … |
