Developing clinical expertise in musculoskeletal physiotherapy; Using observed practice to create a valued
Matthew Carr1, Jane Morris2, Paula Kersten2
1School of Health Sciences, University of Brighton, 49 Darley Road, Eastbourne BN20 7UR, UK; Sussex MSK Partnership East, Ivy House, PO Box 3196, Eastbourne, BN21 9QH, UK.
Background:
Observed clinical practice is a commonly used approach to develop clinical expertise in the musculoskeletal (MSK) physiotherapy workforce. The value of this approach is not known.
Objectives:
To understand how regular observed clinical practice is considered to support the development of MSK physiotherapy clinical expertise in one UK organisation who adopts this approach to practice-based education.
Design:
A qualitative, constructivist grounded theory study.
Method:
Eight initial individual interviews were undertaken with MSK physiotherapists engaged in this approach to practice-based education. Secondary interviews were completed with two participants. A focus group concluded data generation. Data were analysed using a three-stage constant comparative process.
Findings:
Regular observed clinical practice was found to facilitate the development of clinical expertise by enabling a valued practice-based collaborative learning cycle. Three essential elements were identified: PRECURSORY REQUIREMENTS: Mentors are required to reflect on their own successful experiences of clinical development and consider their professional moral responsibility to develop the future workforce.
Learning Activity:
Observed clinical practice situated in the workplace can successfully facilitate clinical expertise development. Whole-team involvement adds further value.
Subsequent Requirements:
Successful learning outcomes are achieved when mentor and learner engage in collaborative reflection and analysis soon after the observed practice. Developing an 'educational alliance', sharing fallibilities, adopting a developmental approach and placing the learner as the 'judge' of the learning experience are important considerations to achieve successful learning outcomes.
Conclusion:
These findings offer a framework to consider when using observed clinical practice to develop the clinical expertise of a MSK physiotherapy workforce.
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