Department of Health

Innovative allied health primary care chronic disease management, health promotion and private practice placements

INNOVATE PROJECT

Educating allied health students for beyond the acute setting

Project summary

During the two-year period from 2012–13, the Innovate Project operated by the Department of Physiotherapy, University of Melbourne facilitated a new approach to educating entry-to-practice allied health students for workplaces beyond the acute setting. This placement was an opportunity for allied health students to gain skills and knowledge of chronic disease management, aged care, health promotion, interprofessional practice and private practice with an aim to better prepare the future allied health workforce in these areas.

Drivers and challenges

Given the definition of chronic disease (“diseases of long duration and generally slow progression”– WHO) is so broad, there are many individual conditions and diseases that fall under this umbrella term across the lifespan from infancy to aged care.Lifestyle choices, the aging population, and earlier detection and better treatment of previously life-threatening conditions has resulted in a high prevalence of chronic conditions amongst the Australian population and this prevalence is predicted to increase in future years.Chronic disease national guidelines based on the latest evidence-based practice state the greatest outcomes are achieved in the most cost-effective way when healthcare services are delivered for people with chronic health conditions (CHC) in community-based settings.Current registration data indicates that 60% of the current physiotherapy and allied health workforce are currently working within these community settings. Yet, traditionally physiotherapy students spent almost all of their clinical placement training in acute hospital settings.Whilst the knowledge and experience gained during these placements are inherently valuable and necessary to their training, nothing existed in terms of curriculum or clinical experience that specifically targeted CHC management. This is an area that has been identified as one of the most prevalent and challenging for future Australian healthcare.

Arriving at a solution and implementation

The Innovate Project aimed to better prepare the future allied health workforce for working with this complex patient population group in community settings across the Central CPN.An expert project team was recruited to provide the necessary skills and experience to ensure project deliverables remained on target and met regularly throughout the life of the project to review project activities and maintain a viable budget.In order to maintain a quality clinical learning environment within these new settings, the activities of Innovate Project included the development of new curriculum to support new CHC placement and the new private practice placement. This was considered essential in preparing the students for these new settings, as reflected in feedback obtained from both students and clinical supervisors.Stakeholders were actively engaged during the life of the project, and specifically at key intervals via clinical educator workshops.Resources were developed including short training videos and websites containing useful and practical information to support clinical educators. These resources also provided a forum to freely share the project processes and outcomes for any other institutions who may wish to implement a similar project.

Outcomes and evaluation

The success of the Innovate Project was reflected in the achievement of the target levels of student placements and the development of new clinical partnerships that exceeded the project target. During the Innovate Project, 120 students completed the CHC placement, 47 students completed the private practice placement and partnerships were established with 54 new healthcare providers across the Central CPN.The quality of the clinical placement was evaluated by means of self-completed online surveys distributed to students following completion of each placement and interviews conducted with a selection of the clinical supervisors.This quantitative and qualitative feedback data demonstrated that the clinical placement was positively regarded, with a number of key strengths.These included the positive student/supervisor relationships, positive interdisciplinary and multi-disciplinary experiences; recognition of appropriate student theoretical preparation for the clinical placement; successful integration of theory and clinical experience; adequate student resources and overall a good level of organisation of the unit.Areas that were identified for improvement included greater clarity of the clinic aims and objectives,guidance on the type and quantity of student activities during the placement, increasing the amount and type of specific supervisor feedback to students during the placement, and the development of additional resources for supervisors.The above issues were discussed and action plans were put in place at the second clinical educator workshop in July 2013.For theprivate practiceplacement, greater clarity was sought regarding the financial implications of studentsconductingassessments and treatments. The development of clinical educator skills in areas such as ‘giving effective feedback’, andhaving clinical educator resources readily available were important factors in the creation of the Innovate website, which has specific sections dedicated to clinical educators for both placements.

“A highly enjoyable clinic where I learnt so much about multidisciplinary team work and self-management.” – CHC student

“The supervisors were incredibly helpful and welcoming. Learning about other disciplines was incredibly useful and interesting.” –CHC student

“This was an excellent placement, if not the best of the course.” –Private practice placement student

“One of the real strengths of this style of placement for us is that it means we can host students we otherwise wouldn’t be able to.” – CHC clinical supervisor

“It’s valuable for us because a lot of people don’t really understand our role and what we do, so it’s good for us to have the next generation of people exposed.” – CHC clinical supervisor

“Increasing their (the student’s) understanding of how we can best manage this complex patient population with multiple chronic diseases and what is our role as a physio – I think this is a great topic and great placement, I wish I had this!” – CHC clinical supervisor

Future directions

Post completion, this project will continue to build on the relationships with the healthcare providers, continue to deepen and broaden the placement experience and continue to guide further developments of the supporting curriculum.A private practice working party has been formed to take forward and find solutions for ‘how to get student’s hands-on’ in this setting in preparation for the next private practice placement in 2014.All members of the project team have ongoing positions within the Department of Physiotherapy that will ensure thatthese initial project outcomes will be sustained and continually developed beyond the completion of Innovate Project.

Further information

For further information please contact:

Dr Louisa Remedios

Innovate Project Manager, Senior Lecturer, Deputy Head of Department of Physiotherapy

Email:

Page 1Department of Health