The research aim of this paper was to assess clinical placements in a B.Sc. Physiotherapy Program. The research was carried out by Jose M Frantz, PhD an Associate Professor, University of the Western Cape, South Africa and Anthea J. Rhoda, MSc, a lecturer at the same University. It was printed in The Internet Journal of Allied Health Sciences and Practice. July 2007, Volume 5 Number 3. The researchers’ objective was to evaluate existing clinical venues for physiotherapy students at the University of Western Cape, South Africa. They used both quantitative and qualitative methods, using a validated seventeen-item questionnaire using a Likert scale which ranged from 1-5, (1 representing strongly disagree to 5 representing strongly agree) for the quantitative information. Five open ended questions were used for qualitative research and themes were identified. Clinicians’ attitudes along with student positive and negative responses were recorded and the data analysed. Points on areas to improve were also highlighted.

This report will look at Literature reviewed by the researchers, Methodology used, Findings and Analyses, Ethical Considerations and finally a Conclusion with a reflective insight on the paper.

Literature Review

(Ridley 2008 p16) states the function of a literature review is to show how related work in the field shapes and influences your research. Ridley states that there are multiple purposes of a Literature Review including:

• looking at historical background of the area to be studied.
• finding out the place in which the study will fit in with current research.
• relevant theories and concepts.
• definitions and terminology relevant to the research.
• related research in the field and shows how the study extends or challenges this, or addresses a gap in work in the field.

It also provides supporting evidence for the issue which the research is addressing, thereby underlining its significance.

In all areas of research, literature reviews are used to inform researchers of the background to research projects and to provide context and ideas for the design of new studies. (Wynn Harlen & Ursula Schlapp, SCRE 18/11/99 The Scottish Council of Research in Education).

Literature review is carried out by the researchers by implementing an in-depth search into the subject they are looking at. They will read widely around the subject, comprehensively searching work done by others so that they are aware of where their own work stands in relation to these studies.

Frantz and Rhoda reviewed the question set by Dunn S and Hanford B, in the Journal of Advanced Nursing, 1997, which was, Undergraduate nursing students’ perceptions of their clinical learning environment. Dunn and Hanford identified that ‘interpersonal relationships play an enormous role in the students perceptions of the clinical learning environment’ and that staff and patients can have major influence in development. Frantz and Rhoda have used these findings to support their research and state that clinical experiences encountered by student in their undergraduate program can influence the quality of education and the ability for physiotherapists to adapt to clinical roles upon graduation. Frantz and Rhoda have also taken the point made by Dunn and Hanford that collaboration is essential for optimum student learning.

Methodology

The Philosophical Approach to the study can be described as Phenomenological. It concentrates on the direct experiences of the students on placement and their thoughts.

The overall approach used for the study was a mixed one. The researchers have used quantitative and qualitative methods.

Definition of quantitative. (Oxford Dictionary of English 2005)

Concerned with or measured by quantity

Definition of qualitative. (Oxford Dictionary of English 2005)

Concerned with or measured by quality 2. Describing the quality of something in size, appearance, etc

For quantitative research Frantz and Rhoda have used a questionnaire format with 17 items assessed by a Likert scale.

Quantitative research therefore is concerned with the collection of measurable data so that it can be analysed effectively. It is the use of facts and figures, and does not concern itself with emotion and feelings.

For qualitative responses, five open ended questions were added for the students to have further input explaining their experiences.

Qualitative research therefore looks at responses that deal with attitudes, beliefs and motivations of the study group.

Hammel & Carpenter 2004, state that scientific evidence such as found through quantitative research is the best source of evidence based practice in the Health services and Qualitative research is not seen as part of the evidence based process.

However, Frantz and Rhoda have identified that using both quantitative and qualitative methods will achieve the best results for the purpose of their study. This is a balanced approach to research.

Design

The research design is the overall plan for the study. There are two basic categories of research design, Experimental and Non Experimental. This paper is non-experimental, which can also be called Descriptive. It is cross sectional in design.

The study does not try to change behaviour or conditions and things are measured as they are, therefore it takes the form of a non-experimental or descriptive format of study. The design of this particular study is cross-sectional as defined on the website http://www.sportsci.org/jour/0001/wghdesign.html

In cross-sectional studies variables of interest in a sample of subjects are assayed once and the relationships between them are determined.

The researchers have decided to use the questionnaire in a quantitative and qualitative manner and use the results without intervention or alteration to the sample study group.

Method

The method used by Frantz and Rhoda was a questionnaire. Their questionnaire had been used in another study but was sent for peer review to determine its appropriateness in this particular research.

A questionnaire is a set of printed or written questions with a choice of answers, devised for the purposes of survey or statistical study (Oxford Dictionary of English 2005)

In this case the questionnaire is a seventeen item instrument, using a Likert scale. Answers range from strongly agree to strongly disagree. This part of the questionnaire deals with quantitative data as described above. Frantz and Rhoda also added five open ended questions which allow further input from the students which gives them a chance to explain their answers in more depth. This forms the qualitative approach to the study.

(Gillham 2002) points out that the answers in a structured questionnaire have already been determined by the researchers. This can be seen in the 17 item instrument of the first part of Frantz & Rhoda’s questionnaire. Semi structured questionnaires have open questions. We can see that the researchers have used a mixture of both to determine their answers.

A mixed approach is appropriate to gain more from the students’ responses than the answers that the researchers have already pre-determined, albeit on a sliding scale from 1-5 (1 = strongly disagree to 5 = strongly agree).

The target population for the study were all physiotherapy students registered for clinical practice in their third and fourth year. The total sample should have consisted of 332 responses. The sample was in fact only 61% of this figure as many students decided not to participate in the study by not filling out the questionnaires.

Results & Data

The students rotated through various placements, the number of placements depending on which year they were in. The most students rotated through primary settings which were community health centres and district hospitals, followed by tertiary hospitals, special schools, secondary hospitals, community settings (service centres for the elderly and NGO’s) and specialized areas.

Each student had the opportunity to fill in a questionnaire relating to their placements. Out of a total response of 61%, 44% had been at a fourth year placement, 40% at a third year placement and 16% at a placement that accommodated both years.

The research found that overall the students were satisfied with the clinical placements they are expected to attend as part of the BSc physiotherapy program.

However when these results were broken down the researchers’ findings was different. The level of satisfaction, with clinical placements according to setting, was not as high and areas were highlighted where students were more dissatisfied than satisfied. Areas identified where there was least satisfaction, were community settings. There were a lower percentage of students rotating through this particular setting than all but specialized settings.

The results gained from the qualitative part of the questionnaire i.e; the open ended questions helped back the findings from the initial quantitative results. The students expressed their dissatisfaction when they were able to say how they felt emotionally about their individual placements. Frantz and Rhoda identified quotes from students that helped to qualify their findings from the quantitative part of the study. The qualitative answers also identified that 33% of students were of the opinion that the clinicians were unwilling to help and students had a negative opinion of them.