Good Practice in Australian Physiotherapy Education

At the University of Newcastle, Occupational Therapy students participate in a largely Problem Based Learning program Physiotherapy students study under a program that includes foundation study of relevant scientific and behavioural disciplines and the study of specific physiotherapeutic management of conditions. In each area eg neurological, musculoskeletal, study includes many selected case-based discussions which develop clinical reasoning skills through use of true cases backed up by video resources.
Preparation for this joint tutorial session involved development of a scenario for a patient undergoing rehabilitation following stroke. Both groups of students worked with common derived learning goals that included exploration of pathology, impairments, assessment, goal setting and appropriate interventions related to the patient.
 
OT and PT students addressed the learning goals from their own professional perspective. Students in pairs groups developed information related to one of the learning goal areas. The lecturers ensured that all aspects of the learning goals were covered.
In the joint two hour session, 12 OT students joined with 13 PT students .They presented their topic using illustrative OHP sheets and a one page handout for five minutes and answered questions. The presentation included demonstration of assessment tools/ methods and intervention techniques where appropriate.
 
Discussion was facilitated by the lecturers, one from each discipline, to consider the decision making, the specific roles of the therapists and any differing philosophies of management. Students then considered how these roles might overlap and how best they could collaborate to manage this patient.
Later feedback from physiotherapy students suggested that they found that the session was valuable in gaining insight into the role and philosophy of the occupational therapist in the neurological area and further knowledge about stroke patient management.
 
It is planned to continue to run this tutorial and attempt to develop other joint sessions with other health professionals where appropriate. Student learning and valuing of other health professionals only occurs through first hand experience. These shared learning experiences, followed up by shared clinical experiences in later years are vital to develop co-operative graduate practice among health professionals.

In the 2nd year of the course students complete separate subjects in the core physiotherapy areas of musculoskeletal and cardiopulmonary physiotherapy. An example of the cross specialty teaching is in a practical/tutorial class scheduled towards the end of the session; classes in the two areas are combined and facilitated by teaching staff from both areas. Students are presented with two case studies and are then guided in the process of clinical reasoning about these cases. The client problems used in the case studies involve chest wall and thoracic spine pain, and thus reflect the overlap between these two areas of practice. The cardiopulmonary lecturer deliberately facilitates the case study in which the client's problems are primarily musculoskeletal in origin and the musculoskeletal lecturer facilitates reasoning in the case where the problems are primarily cardiopulmonary in origin.
The aim of the strategy is to encourage students to access and integrate knowledge from both clinical areas. The case studies are deliberately chosen to elicit students' assumptions about the different areas of physiotherapy practice. This process of shared facilitation challenges them to recognize how they may have segregated their knowledge and then challenges them to develop strategies that take a more holistic approach to patient care.
 
We feel that introducing this strategy at a 2nd year level influences students' learning as they develop further knowledge in core areas and prepares students for latter subjects that require more advanced integration of knowledge and reasoning, such as Complex case management.