Clinical supervisors’ perceptions of podiatry students’ preparedness for clinical placement and graduates’ preparedness for podiatry practice in Australia: An exploratory study
DOI:
https://doi.org/10.11157/fohpe.v22i2.339Keywords:
competence, self-efficacy, practical clinical skills, communication skillsAbstract
Introduction: Little is known about Australian podiatry students’ preparedness for clinical placement and graduates’ preparedness for clinical practice. This qualitative study explored clinical supervisors’ perceptions of podiatry students’ and graduates’ preparedness-related challenges and their recommendations for improvement.
Methods: Eleven registered podiatrists who had supervised or were still supervising students were interviewed. Transcribed interviews were thematically analysed. Benner’s (1984) stages of clinical competence from novice to expert informed the study.
Results: Clinical supervisors were divided about students’ preparedness for clinical placements, with their perceptions ranging from generally prepared (n = 2) to unsure (n = 5) to unprepared (n = 4). They commented on junior versus senior students, institutional differences and specific clinical skill deficiencies, e.g., scalpel debridement and patient communication skills. Perceived challenges for students on placement included poorly developed clinical skills and low self-efficacy, both stemming primarily from insufficient hands-on experience. Participants suggested that for improved placement preparedness, students required better quality clinical experiences and communication skills training. Being work-ready, which most graduating Australian podiatrists were reported to be, involved being safe and self-efficacious. Participants also suggested that a supportive clinical environment, an internship and more advanced interpersonal skills would facilitate preparedness.
Conclusion: In terms of Benner’s (1984) framework, during training, podiatry students should be considered novices, and they should be considered advanced beginners on graduation. An entry-level graduate should not be expected to be competent across all areas of clinical practice. Hands-on clinical practice during placements was needed for moving successfully through Benner’s (1984) stages of clinical competence. While clinical supervisors believed that podiatry training generally prepared students for clinical practice immediately following graduation, they asserted that manual clinical and communication skills improvement is required for clinical placements.References
Abdal, M., Alavi, N. M., & Adib-Hajbaghery, M. (2015). Clinical self-efficacy in senior nursing students: A mixed-methods study. Nursing and Midwifery Studies, 4(3), 1–18. http://nmsjournal.kaums.ac.ir/article_65896_52cb466ed685028130b276197674ab2e.pdf
Adams, A., & Cox, A. L. (2008). Questionnaires, in-depth interviews and focus groups. In P. Cairns & A. L. Cox (Eds.), Research methods for human computer interaction (pp. 17–34). Cambridge University Press. https://doi.org/10.1017/cbo9780511814570.003
Al Sebaee, H. A., Aziz, E. M. A., & Mohamed, N. T. (2017). Relationship between nursing students’ clinical placement satisfaction, academic self-efficacy and achievement. IOSR Journal of Nursing and Health Science, 6(2), 101–112. https://doi.org/10.9790/1959-060203101112
Arndt, J., King, S., Suter, E., Mazonde, J., Taylor, E., & Arthur, N. (2009). Socialization in health education: Encouraging an integrated interprofessional socialization process. Journal of Allied Health, 38(1), 18–23. https://pubmed.ncbi.nlm.nih.gov/19361019/
Artino, A. R. (2012). Academic self-efficacy: From educational theory to instructional practice. Perspectives on Medical Education, 1(2), 76–85. https://doi.org/10.1007/s40037-012-0012-5
Attia, M., & Edge, J. (2017). Be(com)ing a reflexive researcher: A developmental approach to research methodology. Open Review of Educational Research, 4(1), 33–45. https://doi.org/10.1080/23265507.2017.1300068
Attrill, S., Lincoln, M., & McAllister, S. (2016). Supervising international students in clinical placements: Perceptions of experiences and factors influencing competency development. BMC Medical Education, 16(1), 1–11. https://doi.org/10.1186/s12909-016-0702-5
Australian and New Zealand Podiatry Accreditation Council (ANZPAC). (2009). Podiatry competency standards for Australian and New Zealand. https://pdf4pro.com/view/podiatry-competency-standards-for-australia-and-2bbbea.html
Australian and New Zealand Podiatry Accreditation Council (ANZPAC). (2015a). Australian and New Zealand podiatry accreditation standards. http://www.anzpac.org.au/files/Anzpac_Accreditation%20Standards_MAY_2015_V3.1.pdf
Australian and New Zealand Podiatry Accreditation Council (ANZPAC). (2015b). ANZPAC podiatry competency standards. https://www.google.com/url?sa=t&rct=j&q=&esrc=s&source=web&cd=&ved=2ahUKEwi2zsCV0JbxAhWy7HMBHfATD_oQFjAAegQIAxAD&url=https%3A%2F%2Fwww.podiatryboard.gov.au%2Fdocuments%2Fdefault.aspx%3Frecord%3DWD19%252F28845%26dbid%3DAP%26chksum%3Db9pNShP06LHSKEfKtzT9Bw%253D%253D&usg=AOvVaw2s-yYaQO3l0TzYd93qLOFT
Australian Nursing & Midwifery Council. (2009, February). Standards and criteria for the accreditation of nursing and midwifery courses leading to registration, enrolment, endorsement, and authorisation in Australia—with evidence guide. https://www.nursingmidwiferyboard.gov.au
Bandura, A. (1977). Self-efficacy: Toward a unifying theory of behavioral change. Psychological Review, 84(2), 191–215. https://doi.org/10.1037/0033-295X.84.2.191
Banneheke, H., Nadarajah, V. D., Ramamurthy, S., Sumera, A., Ravindranath, S., Jeevaratnam, K., Efendie, B., Chellamuthu, L., Krishnappa, P., & Peterson, R. (2017). Student preparedness characteristics important for clinical learning: Perspectives of supervisors from medicine, pharmacy and nursing. BMC Medical Education, 17, Article 133. https://doi.org/10.1186/s12909-017-0966-4
Benner, P. (1984). From novice to expert. Addison-Wesley. https://doi.org/10.1002/nur.4770080119
Benner, P. (2004). Using the Dreyfus model of skill acquisition to describe and interpret skill acquisition and clinical judgment in nursing practice and education. Bulletin of Science, Technology & Society, 24(3), 188–199. https://doi.org/10.1177/0270467604265061
Birks, M., Bagley, T., Park, T., Burkot, C., & Mills, J. (2017). The impact of clinical placement model on learning in nursing: A descriptive exploratory study. The Australian Journal of Advanced Nursing, 34(3), 16–23. https://www.ajan.com.au/archive/Vol34/Issue3/2Birks.pdf
Bisholt, B. K. (2012). The professional socialization of recently graduated nurses: Experiences of an introduction program. Nurse Education Today, 32(3), 278–282. https://doi.org/10.1016/j.nedt.2011.04.001
Braun, V., & Clarke, V. (2006). Using thematic analysis in psychology. Qualitative Research in Psychology, 3(2), 77–101. http://dx.doi.org/10.1191/1478088706qp063oa
Brown, R. A., & Crookes, P. A. (2016). What level of competency do experienced nurses expect from a newly graduated registered nurse? Results of an Australian modified Delphi study. BMC Nursing, 15(1), 1–8. https://doi.org/10.1186/s12912-016-0166-2
Brown, T., Williams, B., & Lynch, M. (2013). Relationship between clinical fieldwork educator performance and health professional students' perceptions of their practice education learning environments. Nursing & Health Sciences, 15(4), 510–517. https://doi.org/10.1111/nhs.12065
Burns, P., & Poster, E. C. (2008). Competency development in new registered nurse graduates: Closing the gap between education and practice. The Journal of Continuing Education in Nursing, 39(2), 67–73. https://doi.org/10.3928/00220124-20080201-03
Chipchase, L. S., Buttrum, P. J., Dunwoodie, R., Hill, A. E., Mandrusiak, A., & Moran, M. (2012). Characteristics of student preparedness for clinical learning: Clinical educator perspectives using the Delphi approach. BMC Medical Education, 12(1), 1–9. https://doi.org/10.1186/1472-6920-12-112
Clarke, V., & Braun, V. (2017). Commentary: Thematic analysis. Journal of Positive Psychology, 12(3), 297–298. https://doi.org/10.1080/17439760.2016.1262613
Corlett, S. (2013). Participant learning in and through research as reflexive dialogue: Being "struck" and the effects of recall. Management Learning, 44(5), 453–469. https://doi.org/10.1177/1350507612453429
Cox, J., & Simpson, M. D. (2016). Exploring the link between self-efficacy, workplace learning and clinical practice. Asia-Pacific Journal of Cooperative Education, 17(3), 215–225. https://www.semanticscholar.org/paper/Exploring-the-link-between-self-efficacy%2C-workplace-Cox-Simpson/98deb74b1c598810d925bf8e761e48d45691e38f
Creswell, J. W. (2013). Qualitative inquiry and research design: Choosing among five approaches: Sage.
Curran, M., Campbell, J., & Rugg, G. (2006). An investigation into the clinical reasoning of both expert and novice podiatrists. The Foot, 16(1), 28–32. https://doi.org/10.1016/j.foot.2005.11.001
Darcy Associates Consulting Services. (2009). Best practice clinical learning environments within health services for undergraduate and early-graduate learners: Final report. https://tlap.ksu.edu.sa/sites/tlap.ksu.edu.sa/files/attach/ref20.pdf
Dearnley, C. (2005). A reflection on the use of semi-structured interviews. Nurse Researcher, 13(1), 19–28. https://doi.org/10.7748/nr2005.07.13.1.19.c5997
Donnelly, F. P. (2014). The influence of clinical placement and experiential learning on student nurse development: An exploratory case study [Doctoral dissertation, The University of Adelaide]. https://hekyll.services.adelaide.edu.au/dspace/bitstream/2440/91213/3/02whole.pdf
Doody, O., & Noonan, M. (2013). Preparing and conducting interviews to collect data. Nurse Researcher, 20(5), 28–32. https://doi.org/10.7748/nr2013.05.20.5.28.e327
Gilbert, J., & Brown, L. (2015). The clinical environment: Do student nurses belong? A review of Australian literature. The Australian Journal of Advanced Nursing, 33(1), 23–28.
https://www.ajan.com.au/archive/Vol33/Issue1/3Gilbert.pdf
Healey, M., & Jenkins, A. (2000). Kolb's experiential learning theory and its application in geography in higher education. Journal of Geography, 99(5), 185–195. https://doi.org/10.1080/00221340008978967
Higgs, J., & McAllister, L. (2007). Being a clinical educator. Advances in Health Sciences Education, 12(2), 187–200. https://doi.org/10.1007/s10459-005-5491-2
Hultquist, B. L. (2014). A mixed methods study of the sources of clinical self-efficacy beliefs in baccalaureate nursing students [Doctoral dissertation, Mercer University]. UMI Dissertation Publishing. https://ursa.mercer.edu/bitstream/handle/10898/11802/3662191_1.pdf?sequence=7&isAllowed=y
Illing, J., Morrow, G., Kergon, C., Burford, B., Spencer, J., Peile, E., Davies, C., Baldauf, B., Allen, M., Johnson, N., Morrison, J., Donaldson, M., Whitelaw, M., & Field, M. (2008). How prepared are medical graduates to begin practice? A comparison of three diverse UK medical schools. Final report to GMC Education Committee. https://dro.dur.ac.uk/10561/1/10561.pdf?DDD45+
Irwig, L. (2007). Smart health choices: Making sense of health advice. Hammersmith Press.
Jamshed, S. (2014). Qualitative research method-interviewing and observation. Journal of Basic and Clinical Pharmacy, 5(4), 87–88. https://www.jbclinpharm.org/articles/qualitative-research-methodinterviewing-and-observation.pdf
Jones, D., McAllister, L., & Lyle, D. (2015). Stepping out of the shadows: Allied health student and academic perceptions of the impact of a service-learning experience on student's work-readiness and employability. Journal of Teaching and Learning for Graduate Employability, 6(1), 66–87. https://doi.org/10.21153/jtlge2015vol6no1art574
Kiernan, L. C. (2018). Evaluating competence and confidence using simulation technology. Nursing, 48(10), 45–52. https://doi.org/10.1097/01.NURSE.0000545022.36908.f3
Lewallen, L. P., & DeBrew, J. K. (2012). Successful and unsuccessful clinical nursing students. Journal of Nursing Education, 51(7), 389–395. https://doi.org/10.3928/01484834-20120427-01
Lima, S., Newall, F., Kinney, S., Jordan, H. L., & Hamilton, B. (2014). How competent are they? Graduate nurses self-assessment of competence at the start of their careers. Collegian, 21(4), 353–358. https://doi.org/10.1016/j.colegn.2013.09.001
Liou, S.-R., & Cheng, C.-Y. (2013). Developing and validating the clinical competence questionnaire: A self-assessment instrument for upcoming baccalaureate nursing graduates. Journal of Nursing Education and Practice, 4(2), 56–66. https://doi.org/10.5430/jnep.v4n2p56
Maginnis, C., Croxon, L., & Croxon, C. (2010). Transfer of learning to the nursing clinical practice setting. Rural and Remote Health, 10(2), 1313–1320. https://doi.org/10.22605/RRH1313
McAllister, L., & Nagarajan, S. (2015). Accreditation requirements in allied health education: Strengths, weaknesses and missed opportunities. Journal of Teaching and Learning for Graduate Employability, 6(1), 2–24. https://doi.org/10.21153/jtlge2015vol6no1art570
McHugh, M. D., & Lake, E. T. (2010). Understanding clinical expertise: Nurse education, experience, and the hospital context. Research in Nursing & Health, 33(4), 276–287. https://doi.org/10.1002/nur.20388
Monrouxe, L. V., Grundy, L., Mann, M., John, Z., Panagoulas, E., Bullock, A., & Mattick, K. (2017). How prepared are UK medical graduates for practice? A rapid review of the literature 2009–2014. BMJ Open, 7(1), 1–18. https://doi.org/10.1136/bmjopen-2016-013656
Morris, M., O'Neill, A., Gillis, A., Charania, S., Fitzpatrick, J., Redmond, A., Rosli, S. & Ridgway, P. F. (2016). Prepared for practice? Interns’ experiences of undergraduate clinical skills training in Ireland. Journal of Medical Education and Curricular Development, 3, 85–90. https://doi.org/10.4137/JMECD.S39381
Nicol, M. J., Fox-Hiley, A., Bavin, C. J., & Sheng, R. (1996). Assessment of clinical and communication skills: Operationalizing Benner's model. Nurse Education Today, 16(3), 175–179. https://doi.org/10.1016/S0260-6917(96)80020-7
Norwood, A. W. (2010). The lived experience of nurse mentors: Mentoring nurses in the profession [Doctoral dissertation, University of Missouri-Columbia]. ProQuest Dissertations Publishing. https://www.semanticscholar.org/paper/The-lived-experience-of-nurse-mentors%3A-Mentoring-in-Norwood/3ac10db60ab5c7aa440cdb9d241a5388504a1ee5
Pfitzner-Eden, F. (2016). Why do I feel more confident? Bandura's sources predict preservice teachers' latent changes in teacher self-efficacy. Frontiers in Psychology, 7, Article 1486. https://doi.org/10.3389/fpsyg.2016.01486
Sewell, A., & St George, A. (2009). Developing efficacy beliefs in the classroom. The Journal of Educational Enquiry, 1(2), 58–71. https://ojs.unisa.edu.au/index.php/EDEQ/article/view/576
Taylor, D. C., & Hamdy, H. (2013). Adult learning theories: Implications for learning and teaching in medical education: AMEE Guide No. 83. Medical Teacher, 35(11), e1561–e1572. https://doi.org/10.3109/0142159X.2013.828153
Taylor-Powell, E., & Renner, M. (2003). Analyzing qualitative data. http://thesummerinstitute.ca/wp-content/uploads/Qualitative-Methods.pdf
Thomas, C. M., & Kellgren, M. (2017). Benner’s novice to expert model: An application for simulation facilitators. Nursing Science Quarterly, 30(3), 227–234. https://doi.org/10.1177/0894318417708410
Woods, C., West, C., Mills, J., Park, T., Southern, J., & Usher, K. (2015). Undergraduate student nurses’ self-reported preparedness for practice. Collegian, 22(4), 359–368. https://doi.org/10.1016/j.colegn.2014.05.003
Yeong, M. L., Ismail, R., Ismail, N. H., & Hamzah, M. I. (2018). Interview protocol refinement: Fine-tuning qualitative research interview questions for multi-racial populations in Malaysia. The Qualitative Report, 23(11), 2700–2713. https://doi.org/10.46743/2160-3715/2018.3412
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