An integrative collaborative clinical education model for physical therapy Joan McMeeken 100 years of experience 1
The Context University of Melbourne 1855 School of Medicine 1862 Physiotherapy education 1890 s - School of Physiotherapy 1991 - http://www.medfac.unimelb.edu.au/med/ School of Physiotherapy Framework to maintain the highest international standards of ethics & quality in research, teaching & administration in which... students are encouraged & assisted to realise their full potential The University of Melbourne 2004 2
School of Physiotherapy Enabling features Integration of basic & clinical sciences Emphasis on principles & concepts Vertical & horizontal integration of subjects Organisation of learning around body systems Application of research evidence Problem-based based self-directed learning Formative & summative assessment Transitions facilitation Process evaluation Clinical education an education program undertaken in the health setting where students enhance therapeutic abilities, develop the skills of reflection, narrow the gap between theory & practice & achieve a deeper understanding of what it means to be an accountable professional 3
The development process Consultation Senior experienced academic & clinical physiotherapists Registration Boards Recent graduates Current students Knowledge & experience of programs Clinical Working Party 1990 Clinical Schools at Melbourne Flexnerian model - teaching & research are integral to clinical practice & education Students become members of a specific clinical school which has responsibility for all core clinical education Ryan 1992 4
Development of policies, procedures & program Success depends on Resources Recognition Collaboration The Melbourne model Students allocated to one Clinic School University appointments for clinical educators Clinicians as program developers & educators Clinical educator development programs Rural placements as core components Clinical School research positions Research experience in clinical environment Clinical education over the lifespan Electives & International experience 5
Structures supporting clinical education Committee Discipline Working Groups Administration The program Resources Expert Advisory Committee Clinical Education Committee Responsibilities Clinical education policy Contribute to student selection Clinical education Assessment Exam setting Examination Board of Examiners 6
Discipline Working Groups Responsibilities Academic & clinical education content & delivery Educational materials Assessment materials Administration Clinical Coordinator Clinical Deans in Additional web-based based Communication Physiotherapy Clinical Schools Clinical administrators Discipline coordinators 7
Program Implementation Considerable autonomy in each Clinical School s s program delivery Students attached to one Clinical School Educational experience at more than one clinical site tertiary rural community private hospitals Profile of a Clinical School Year Student numbers Clinical Education Curriculum Year 1 38 2 hours per week of supervised clinical practice in semesters 1 & 2 Year 2 37 1 full time week - tutorials at end of each day Year 3 36 6 weeks, cardiothoracic, musculoskeletal & neurological supervised clinical practice Year 4 36 4 weeks, cardiothoracic, musculoskeletal & neurological physiotherapy. Paediatrics & Gerontology in Specialist Clinical Schools 8
Clinical Assessment Continuous clinical evaluation Final written & clinical exams Objective Structured Clinical Exams Patient management exams Funding & costing of Clinical Education No consideration of costs of clinical education in Government funding model for Physiotherapy in Australia Melbourne educational funds support clinical education Students bear costs of rural & overseas placement 9
Benefits Stability of program Shared responsibility Consistent patient care Interdisciplinary links Students follow patient progress Professional identity & affiliations developed Participation in research methods training Best outcome in Australia Evaluation The University The graduates Graduate employers 10
The University Demand for program Entry scores UMAHT, English, Chemistry, Maths or Physics, top 4% Internal semester evaluation of every subject Overall student satisfaction consistently high Graduate perspective Obtained annually Externally - National Course Experience Questionnaire results Internally - School of Physiotherapy evaluation 11
National Course Experience Questionnaire DETYA website comparisons 120 100 University of Melbourne mean others 80 60 40 20 0 Good Teaching Good Generic Skills Good Overall Satisfaction Full time job (of those available for full or P/T work) Full time study Employer survey Graduate performance after 9 months: 1. Attributes of the Graduates of the University of Melbourne - 12 items VAS Examples: Profound respect for truth and intellectual integrity, and for the ethics of scholarship - 79±17 Ability and confidence to participate effectively in collaborative learning as a team-member, member, while respecting individual differences - 82±12 12
Employer survey 2. Accreditation criteria 2. 1. Assessment 2. Interpretation & diagnosis 3. Planning 4. Implementation 5. Evaluation 6. Professional Behaviour 7. Health Care 8. Management 9. Ability to access and effectively use information technology Criteria of ACOPRA 1994, 2002 Performance Criteria 1 below acceptable level performance 2 acceptable level performance 3 good performance 4 excellent performance Enables trend tracking for program review Examples Communication abilities Health systems knowledge 13
Ultimately the test of a school's proficiency is expressed by the clinical competence of its graduates: no Physiotherapy School can function adequately if this area is not properly recognised & funded Twomey 1986 The Future? How will we manage clinical education? Internship before Registration Generalist & Specialist Physiotherapists Domiciliary physiotherapy International experience 14