Clinical Education

Project U, a unique undergraduate research training initiative

Developed by: 
Associate Professors Marie Williams and Karen Grimmer
Institution: 
University of South Australia
Teaching and Learning Strategy: 

Our teaching approaches include lectures, small group learning and problem solving, ownership of outcomes, practical skill development and participation in assessment. We teach our students that research has many different approaches and that there is value in all of them. We also show students that statistics are tools to assist in summarising and understanding data, an approach that has particularly assisted in breaking down barriers to reading the research literature. We embed different methods of teaching into our research training model to ensure that students attain as many graduate qualities as possible.
Practical research activities include collecting data from children on school premises. Six measurement stations are used and the students then participate in data amalgamation at the end of data collection. The first station is the questionnaire station, which includes assigning appropriate (pre-set) ID numbers to participants, reconfirming their previously written informed consent on the day of testing, refamiliarising them with the study process and checking that questionnaires have been appropriate completed. The other stations collect data related to the child's assigned ID number, on anthropometric data, school backpack contents, weight and design, child's balance and coordination, child's muscle performance (strength and endurance), hypermobility and standing posture.
 
Data handling and analysis is also taught. Each student learns to record data appropriately on child identity, and to enter this data accurately using MS Excel. Validation techniques are taught, whereby students check their data entry for accuracy before presenting it to senior research staff for inclusion in the overall dataset.
 
Students work in small groups for all activities, which teaches them team management skills. They work together to set their research questions based on required data items, and with the assistance of senior research and teaching staff, identify the research design and statistical analysis required to answer the research question. They all have a responsibility to contribute to the final research report, in the manner expected of professional research groups (i.e. taking ownership of each step in producing the research report) (ref JAMA conditions for authorship)
 

Course Name: 
Research Project U is a 4th year course in the Bachelor of Physiotherapy where the emphasis is on providing students with knowledge about research methodology but also providing students with active involvement in data collection. The overall aims of the course is to provide students with the opportunity to be actively involved in a major research project. By doing so, students developed group skills in compiling, critically reviewing and analyzing information (both data and scientific concepts) and written and verbal, particularly scientific communication skills.
Year Level: 
Fourth Year
Expected Outcomes: 

This program gives undergraduate students a hands-on experience of research endeavors, as they join an existing research project with well developed structures and processes. Whilst they do not have responsibility for research design or overall organization, they are integrally responsible for the year-to-year running of the project. This gives them a sense of ownership over research activities and outcomes for their particular year group. Student outcomes are learning about measurement issues (including data recording, reliability and error), learning to work in small groups, setting research questions on a specified set of data, identifying the appropriate statistics to answer the research question, and writing up the findings in a research report which could be submitted to a peer reviewed journal .

Effective Aspects: 

This project collects data from primary school and high school students. It commenced as a cross-sectional study in 1998, in which data on approximately 1300 students was collected from 12 Adelaide high schools. Since 1999, it has been a longitudinal study, in which the same information is collected from the same students each year throughout their school life. The high school study finished in 2003, when the cohort of students completed their hight schooling. The primary school project is ongoing.
The project:

  • incorporates learning activities that assist each student to ask questions, plan methods of testing questions and locate, access and interpret information to assist in sustaining or refuting supporting arguments (logical, critical and creative thinking, acquisition and development of skills in information literacy for lifelong learning)
  • provides a professional and authentic work environment where both individual and group performance such as peer evaluation are necessary and valued (working both collaboratively and autonomously, communicating effectively)
  • offers assessment activities relevant to the graduate working environment-for example, scientific writing for professional publications, data management, participation in meetings-as well as highlighting key issues within research practice (effective communication, problem solving, logical and critical thinking, ethical practice)
Evaluation: 

Internal evaluation is by student feedback (using CEI and SET instruments), focus groups and individual written responses. Students evaluate the effectiveness of their small groups as part of the course evaluation process (worth 15% total marks), and employer feedback is sought by questionnaire.
 
External evaluation is made by consulting industry partners on their perceptions of the success of the project, for instance the Dept of Education and Children's Services (the overarching body) and each of the five schools in which data collection takes place. We invite parents of children to attend test days in the schools, and we receive feedback from them regarding their perceptions of the value of the project, and the interaction of our students with the school students.

Evaluation Outcomes: 

Based on feedback from employers of our graduates over the last few years, we are pleased that our research training efforts appear to be producing young health professionals who are comfortable undertaking research activities within a department/practice, and who can lead by example. Over the past five years the general common responses include:

  • About 90% of students agreed or strongly agreed that "The subject, to date, has clarified and broadened my understanding of research processes"
  • 74% of students agreed or strongly agreed that "I feel I have a strong grasp of the need for reliability testing procedures"
  • 84% agreed or strongly agreed that "I have a good understanding of how much work is required in designing accurate and effective research protocols"
  • 78% agreed or strongly agreed that "Prior to this subject I did not know how to use computer spreadsheets such as EXCEL".

Common written comments submitted by students undertaking this course over the past five years include: " a good introduction to research...working in a group with other groups...enjoyable...insight into research...lots of practical skills... can actually see research in action-will make reading research articles a little less dreary...learning team work...dedication of staff members ...learning how to manage a project."

Plans for Changes/Developments in Future: 

This project has been running since 1998. Each year small refinements are made to the way the project is introduced to students, and in the ways that they are trained in the requisite research techniques, based on student and peer feedback, and on project director and course coordinator's increasing skills in presenting the research training material, and organising the data collection processes. Changes include presenting the commercial and academic outputs of the project to each year group of student researchers to give them a bigger picture of the research outputs, giving them more time to practice computer skills, providing mentoring to small groups whilst setting their research question and determining the statistical tests that underpin it.
 
After 7 year, with completion of the high school data and a potential of 4 further years of data collection in the primary school, it was considered the ideal time to consider the future the course conducted in this way. Decisions need to be made about whether the same study could be conducted in other schools or whether specific aspects could be further investigated or whether a further large study along similar lines but addressing entirely different questions could be sought. The question was also raised about whether students could achieve the same objectives using an on-line format of delivery.

We will continue to refine the teaching and mentoring aspects of this project, in line with best practice teaching and learning activities, and based on student feedback. .
In 2004 Semester 1 the students collected data at Magill Primary School in accordance with the outline presented here. In 2004 Semester 2 there will a trial of delivering the course online in its entirety. The aims, objectives and assessment of the course will remain the same with emphasis on the group experience, accessing information, data entry and analysis skills and the writing of a scientific report. Student will form themselves into groups and separate online discussion areas will be made available for each group.
Data previously collected will be made available for completing the scientific report. Course co-ordinator and other support will also be incorporated. An evaluation form has been designed and will be completed by all students and the responses to the Semester 1 and 2 formats of delivery will be compared. Where responses between students in the two semesters differ markedly or seem contentious or ambiguous, further discussion, is planned in a focus group format to explore these issues further.

For Further Details
Contact Name: 
Maureen McEvoy and Associate Professor Karen Grimmer
Contact Faculty/School: 
School of Health Sciences
Contact Institution: 
University of South Australia
Contact Link: 
http://www.unisa.edu.au/hls/

Clinical school model to facilitate clinical education for all students

Developed by: 
Joan McMeeken, Gillian Webb, Cathy Nall collaboratively with many academics and clinicians
Institution: 
The University of Melbourne
Teaching and Learning Strategy: 

Physiotherapy students are allocated to one of the three general Clinical Schools of the Faculty on entry into year one of the physiotherapy course. Each Clinical School has an Associate Clinical Dean of Physiotherapy who is responsible for approximately 120 or one third of the undergraduate students. With the exception of 12 weeks of elective units and eight weeks in paediatric and gerontological physiotherapy all students spend their clinical education periods in their own Clinical Schools. This provides students with a university clinical base. Here they are well known by clinical and administrative staff, are supported by the infrastructure of the Clinical School and are familiar with the site environments and their requirements. In the Clinical School each student spends the equivalent of a week in each of the first two years, 18 weeks in year three and 12 weeks in year four.
An overview of the content and management of the clinical education components of the course is the responsibility of the Clinical Education Committee. The whole course is developed in conjunction with the clinicians who participate in discipline specific working groups. Course outcome, assessment, content and supporting teaching materials such as problem based learning triggers, manuals and multimedia are planned, developed and completed in these groups. The academic program is integrated within the clinical education program with appropriate teaching sessions occurring at the clinical sites. The clinicians have responsibility for continuous clinical assessment and the discipline specific and final clinical exams. Assessment reliability is established within the working groups.
The Associate Clinical Deans, with the support of their staff, the School of Physiotherapy's Clinical Coordinator and the undergraduate administrative team manage the clinical program. Junior clinical staff have management and content responsibility for the clinical education program in years one and two. They also act as mentors for students in years three and four. Senior clinicians oversee the clinical education program in these latter years.
An Associate Clinical Dean of Physiotherapy is a member of the School's Planning and Resources Committee and participates in senior academic staff selection. The Head of School participates in selection of Associate Clinical Deans. Clinical staff with significant educational responsibility are Fellows of the School of Physiotherapy and have full access to all University resources. In addition the University School of Physiotherapy runs general and site-specific inservice programs related to clinical education and in the specialist discipline areas. Clinical staff from the Clinical School teach elements of the academic program within the University.
The contained nature of the distribution of the students within the Clinical Schools enables the program's support by the International Student Support Program of the Faculty. As well as dedicated computers, telephone, fax and email the clinical education program is supported by 'Plexus' - an electronic data source for student timetables, assessment forms, information on clinical sites and clinical staff. It also includes notes on supervision and experiential learning for the clinicians.

Course Name: 
Throughout the four years of the undergraduate BPhysio and BPhysio (Hons) courses
Year Level: 
First Year
Expected Outcomes: 

Year Level : (First to Fourth)
 
The key learning outcome is that BPhysio and BPhysio (Hons) graduates fulfill all the expectations of their employers as new graduates and demonstrate the attributes of University of Melbourne graduates and all the ACOPRA competencies of physiotherapy graduates.
 

Effective Aspects: 

There are advantages in the integrated academic and clinical education program from the perspective of academic staff, clinicians and students.
Academic staff

  • Respect for clinical physiotherapists and strong sense of collegiality with clinicians
  • Development of strong linkages with Clinical School staff, knowledge of their expertise and co development of assessment and teaching materials
  • Co development of research activities and recruitment of graduate students and co supervision of graduate students
  • Assuredness of student placements in a strongly supportive and academically and clinically strong environment

Clinicians

  • Respect for academic physiotherapists and strong sense of collegiality with academics
  • Development of strong linkages with academic staff, knowledge of their expertise and access for inservice and collaborative activities
  • Co development of research activities and co supervision of graduate students, support for research activities
  • Established pattern of clinical placements
  • Development of strong professional relationships with students
  • Potential to recruit future employees for the Clinical School

Students

  • Development of professional identity and collegial support within own Clinical School
  • Secure clinical environment where the individual students learning needs are known
  • Limited number of geographic sites and familiarity with the various requirements of these sites
  • Potential for future employment with the Clinical School
Evaluation: 

The Clinical Education Committee and the discipline specific working parties are part of the dynamic continuous curriculum review. An example of changes that are introduced quickly as a result of legislative requirement was the integration of the "no lift" policy formally into the clinical curriculum.
Members of the Clinical Schools participate in all School strategic and operational planning processes
Students provide feedback on all clinical subjects and this information is provided to the clinicians involved. This process was originally paper based, but now occurs electronically through 'Plexus".
There is an annual anonymous questionnaire evaluation of employers' perception of the graduates and detailed discussion of graduates' outcomes with members of the physiotherapy profession who employ graduates.
Evaluation of graduates through the National Course Experience Questionnaire, through university surveys and through the annual School survey and informal feedback is integrated into the School's review processes.

Evaluation Outcomes: 

All questionnaire and survey results and discussions with graduates and members of the physiotherapy profession indicate strong support for the integrated academic and clinical program through the Clinical School Model. The close collaborative relationship continues to enable academics and clinicians to respond in a timely and considered fashion to issues arising in either environment.

Plans for Changes/Developments in Future: 

This is a dynamic program such that annual cycles of evaluation result in changes to the processes and curriculum as appropriate.

For Further Details
Contact Name: 
Joan McMeeken
Contact Faculty/School: 
School of Physiotherapy
Contact Institution: 
The University of Melbourne
Contact Link: 
http://www.physioth.unimelb.edu.au/