Learning to be a physiotherapist

Few studies have explored student experience of learning in physiotherapy and none has explored student experience throughout an education programme from a student perspective. The traditional role of physiotherapists as responsible for evaluation, diagnosis and treatment of the individual patient has changed and is expected to develop and expand due to radical changes in aim and focus of health care. Knowledge of students' experience of learning may help to ensure curriculum development to meet these needs. The aim of the work reported in this thesis was to explore students' experience of learning to be a physiotherapist in a threeyear programme.

A longitudinal study followed physiotherapy students over a three- year period. A qualitative phenomenographic approach was used. A cohort of twenty-one students from Sweden and the UK was purposefully selected by sex, age, earlier work experience and educational background to ensure diversity. Semi-structured interviews were carried out with the students at the beginning of the programme and then after each term. One hundred and eleven interviews from four component studies were analysed. This was followed by a metasynthesis of the findings of the four studies to capture the longitudinal character of variation in learning experience throughout the education programme.

New students' expectations of the professional role ranged from a concern to learn how to behave as a physiotherapist, to be able to work with physical problems of movement, to be able to focus on the needs of the patient in illness and health and to communicate to find ways to help patients with mental and physical problems (Study I). Valued learning experience from the first year was described as learning from support and feedback, others and self, from observing and from participating (Study II). Discrete development pathways identified through the first five terms were searching for evidence, employing skills, communicating with others and reflecting on practice (Study III). On the threshold of working life professional identities were revealed as the 'treater', the 'educator' and the 'empowerer' (Study IV). Through a metasynthesis study from the findings of the four original studies three patterns of learning, ranging from a cognitive to a cultural view of learning, were described as ,performing treatment', 'solving problems' and 'managing health'. They indicate differences in learning to be a physiotherapist in the focus of learning, the ways in which the learning occurred, and together with whom and in what context learning took place.

Patterns of learning identified over a physiotherapy education programme show a variety in learning focus and in ways of learning. Differences in patterns of learning can be related to different views of knowledge and learning. Experience of learning is influenced by the context in which learning occurs. Experience of learning is influenced by learning partners participating in the physiotherapy activity. The work offers to staff in physiotherapy education insights into students' learning experience that may help students and staff to achieve desired educational outcomes.

List of scientific papers

I. Richardson B, Lindquist I, Engardt M, Aitman C (2002). Professional socialization: students expectations of being a physiotherapist. Med Teach. 24(6): 622-7.
https://doi.org/10.1080/0142159021000063943

II. Lindquist I, Engardt M, Richardson B (2004). Early learning experiences valued by physiotherapy students. Learning in Health and Social Care. 3: 17-25.
https://pubmed.ncbi.nlm.nih.gov/10416575

III. Lindquist I, Engardt M, Poland F, Garnham L, Richardson B (2006). Development pathways in learning to be a physiotherapist. Physiotherapy Research International. [Accepted]
https://pubmed.ncbi.nlm.nih.gov/17019942

IV. Lindquist I, Engardt M, Poland F, Garnham L, Richardson B (2006). Physiotherapy students professional identity on the edge of working life. Medical Teacher. E-pub ahead of print.
https://doi.org/10.1080/01421590600605272