Graduate reflections on Community Service: a view of roles in practice

In South Africa, newly qualified physiotherapists transition to the workplace during community service, often in diverse healthcare settings, attending to patients with complex ailments. The transition is complicated by the shortage of rehabilitation personnel, especially in rural and peri-urban areas. While higher education curricula should prepare students for the workplace, the roles and expectations of new therapists remain unclear. Assessing how well current curricula, built around the CanMEDS framework, equip students with the competencies needed for entry-level community service practice will help to improve physiotherapy training practices. This study investigated the experiences of community service physiotherapists to inform curriculum design and graduate outcomes.

A descriptive qualitative study was conducted. Graduates were purposefully sampled during their community service year via a class group contact, with a snowball approach to recruit diverse participants. Semi-structured interviews were conducted over MS Teams, recorded, and transcribed. Reflexive deductive coding was used to interpret the data, which was analysed around the CanMEDS roles and graduate outcomes, as well as curriculum constraints and enablers to the workplace transition.

Ten community service physiotherapists placed in five different provinces participated. Most identified strongly with their core role as clinicians and felt prepared in terms of clinical skills. However, aspects of roles linked to advocacy, leadership, and professionalism were more complex to navigate. The contexts of placements and the nuances of how the healthcare system operated in each province impacted their experience.

The study highlighted varied readiness levels among community service physiotherapists. While many felt competent in specific clinical tasks, there are significant gaps in their preparation for broader community practice challenges. Participants noted their undergraduate training adequately prepared them for the clinician role but not for roles integrating collaboration, communication, patient and professional advocacy. Quality clinical placements and the role of educators were crucial, yet the protective nature of these placements limited exposure to real-world scenarios. Insufficient mentorship and support contributed to feelings of isolation. To enhance preparedness, the curriculum should integrate more experiences addressing real-world challenges, which value multiple competencies and outcomes. Future research should examine the development of context-appropriate competency frameworks and long-term effects of community service on career development.