Good Practice in Australian Physiotherapy Education

Assessment is known to drive learning, so for learning objectives to be met, assessment must reflect those objectives to allow students to demonstrate the nature of their learning. (Gibbs 1995). Where integration of various aspects of learning is important, a challenge exists to find ways of teaching and assessing which provide opportunity for that integration to occur and its importance and relevance to be appreciated. A further challenge is to find a way of assessing students, which is in itself a continuation of learning and an enjoyable experience. A possible solution can be found in the concept of "performance" in the form of role-play.
Students in year one undertake a course with major themes in 'communication', 'understanding disability' and 'developing professionalism'. It is anticipated that by the end of the course students will have acquired both knowledge and skills. To test the integration of knowledge and skill and the ability to actually apply them in a real world situation, students are organized into self -selected groups of six students and required to develop a role -play response to a given scenario. In the role play, the dialogue and actions are to be used to illustrate the group's awareness and acknowledgement of human / patient rights, their understanding of communication skills and their ability to make caring attitudes explicit to a patient. A short summary report is prepared and presented to clarify which elements of the play represent fulfillment of these objectives. The play and the verbal presentation are part of the assessed exercise, which includes a two- minute question time. Total time for the presentation is 12 minutes. Students receive this information by handout, which also includes information on the assessment criteria. A copy is posted to the Web CT.
 
Groups are given their scenario once all students are allocated. The scenarios are developed by the teaching staff and raise a range of issues that require attention to patient rights, good communication skills, professional conduct and sensitivity and compassion in patient or client management. Individual mark sheets for each scenario are prepared, reflecting the expectation of the issues to be raised.
Students allocate the workload and responsibilities within their group and are required to sign an acceptance of the shared mark based on equity of load carried. The group scenario presentation has an assessment weight of 15%.
 
Question time allows both the students and the examiners, who have taught in the course, an opportunity to clarify issues or to extend the learning of the group around issues that arise from the handling of the scenario.
There has been strong group cooperation and commitment to the exercise. There is strong evidence of integration of the learning and skill development as well as strong indication by the use of humor (and cross dressing !), that student learning has been an enjoyable experience in modules of a course that are heavily focused in small group discussion and peer supported learning.
 

This conference takes place as the assessment for part of the subject Physiotherapy Practice 1. The student conference introduces the students to an aspect of professional life that they will participate in as graduates. It demonstrates to them the nature of a professional conference. The students are both the participants and the presenters. The students gain information on many aspects of professional issues and related topics from their peers. Time is allowed for questioning and discussion. Keynote speakers are invited to speak on topics of interest to the students and a trade fair is arranged. The conference is organized for the students by fourth year students undertaking a teaching elective. The fourth year students are responsible for the gaining of sponsorship, the trade display, the organisation of the timetable and the production of the conference proceedings. Third year students must individually submit an electronic abstract, which is then compiled into the proceedings. The students are divided into small groups for the presentations and the poster production. Students must reference their talks and posters appropriately.
Prizes are given to the best podium presentation and the best poster. Detailed feedback is given to each group following the conference.
 

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Clinical Conference is a 10CP capstone course undertaken by students in the last/final semester of studies prior to the final 8 weeks of clinical placements. The course aims to fully integrate the student's prior learning in exercise science with evidence-based physiotherapy knowledge and skills using complex clinical cases. These cases are complicated by 'real-life' moral, ethical and medico-legal issues. The students study four separate cases in detail and in a holistic manner, examining the progress of patients through a continuum of care (eg, early diagnosis, acute care, sub-acute needs, rehabilitation and through to re-integration back in to the community). Sessions are led by various members of different disciplines from the healthcare team that might be involved with such cases. The cases are updated and modified each year depending on medical advances or social change.

A new subject, HLT101 Foundation Skills for Allied Health Professionals was offered for the first time in Autumn 2004 to the first year students in physiotherapy, occupational therapy, podiatry and speech pathology. This subject was designed, presented and assessed by an interdisciplinary team of academics.
The School of Community Health is in an optimal position in that four allied health courses (occupational therapy, physiotherapy, podiatry and speech pathology) are offered at the same time on one campus. When students from these courses graduate they need to be able to work effectively in a range of mixed discipline health care teams.
Essentially graduates from these four disciplines need to be able to learn to work together so that on graduation their different contributions will complement the care of their clients (Leathard 1994). CSU has captured an ideal opportunity to enable these four health disciplines to learn together in the same learning environment, and to evaluate the effects of this learning model.
HLT101 includes content that all allied health disciplines require as a foundation. In the past the subject content was taught to each discipline in isolation. HLT101 not only draws students together, but is constructed so that students work cooperatively and collaboratively in interdisciplinary learning groups. Students learn about the process of reflection and how this will enhance their learning. As well, involvement in the project has encouraged lecturers to reflect on their own scholarship in teaching and the learning experiences of their students.
 
Studies have found that if team conflict and failure are to be reduced, allied health professionals need greater understanding of individual roles, skills and expectations, in order to avoid stereotyping that may at times be negative (Hilton 1995; Pietroni 1991). As well, this understanding needs to be developed early in their education if it is to prove effective (Clark 1997). Prior to 2004 students from these courses were enrolled in the same subjects to learn anatomy, physiology and psychology. However, informal observation revealed that students tended to sit in their discipline groups within the lecture theatre. In HLT101 first year students specifically learnt about teams and teamwork, professional roles, and communication skills, all of which have been reported to be vital to the ability of a health professional to work effectively in teams (Pietroni 1991; Clark 1997; Hilton 1995). Interdisciplinary group work formed the foundation of this subject.

This subject covers three aspects of working as a health professional again in a multidisciplinary team. These incude medico-legal and ethical requirements, working within a multidisciplinary team, and quality and safety in health care.
Ethical practice is taught separately and integrates within other topics.
 
Medico-legal issues include:

• Law and health care
• Requirements
• Professional code of conduct
• Insurance issues
   

The multidisciplinary team introduces the student to:

• A range of allied health and medical disciplines. Their role in the health system will be explored in seminar format. Interaction between the health professionals will be encouraged to maximise client outcomes.
• Community resources and access to these
• Quality and Safety of Health Care is considered in private practice, accreditation processes, and physiotherapists role in prescribing medications. The Quality and Safety of Health Care unit will be integrated into a category of the ACT Health Quality and Safety Best Practise Awards within which a "student category" is to be developed.