Teaching person-centered practice to pre-registration physiotherapy students: a qualitative study

Figures & data

Table 1. Pedagogic approach to teaching person-centered practice.

Overarching program aims being addressed via this pedagogic strategy:	Competent and autonomous practitioners with the clinical skills and knowledge to assess, evaluate, formulate, and implement treatment programs in a diverse range of settings using a person-centered approach. Compassionate, inclusive, ethical physiotherapists with excellent communication skills who focus on person-centered care.
Theoretical approach:	Social constructivist
First-year	As part of the Foundations of Professional Practice module in Trimester 1 (September – January) of year 1 students spend time learning about person-centered practice. Due to the impact of Covid-19, this module content was delivered online for the 2020 cohort. As the COVID-19 restrictions eased the module content was delivered face-to-face for the 2021 cohort. This involves the following learning activities: Pre-session work: Pre-reading lecturer sourced materials on person-centered practice. Post on a discussion board their thoughts on what they believe to be the most important aspect of person-centered practice and why, and who they believe is the expert in physiotherapy consultations (the patient or the therapist). Face-to-face session: Students hear first-hand from a service user and carer who has experienced physiotherapy at multiple time points. Students work in groups where they read a blog written by a service user. They are asked to discuss what represents good versus poor person-centered practice and then find a picture online which best represents what is happening in the story. Each group then reports back to the whole cohort on their learning using the picture as a focal point of discussion. Students work on their own to write their philosophy of practice, i.e. what kind of physiotherapist they want to be. They aim to develop 5–8 principles and include 1–2 which are reflective of their learning on person-centered practice. Further indicative module content: Reflective practice, communication skills, health coaching, emotional intelligence, self-care, mental health first aid, and self-leadership. Following a one-week introductory physiotherapy placement, students attend a placement de-brief session. A service user is involved in this placement de-brief to offer the patient perspective on their experiences. Part of the debrief session involves them reviewing their personal philosophy of practice. They are asked to reflect on a time on placement where they were faithful to their philosophy (or an aspect of their philosophy) and a time when they found it difficult to be faithful to their philosophy. They will consider reflective questions such as: What made it easy or difficult to be faithful to your philosophy? How did these situations make you feel? What could you have done differently? Were any of your expectations unrealistic given the context? Students consider their philosophy of practice and various person-centered frameworks as part of their module assessment
Module assessment	Early in the module, students are tasked with having a health-coaching conversation with a peer. The conversation is used as a tool for reflection over the course of the module. They are expected to reflect on how person-centered their conversation was (using a person-centered framework and person-centered literature to support their learning), their philosophy of practice, their communication skills, and professionalism (as related to Health and Care Professions and Chartered Society of Physiotherapy standards) to identify strengths, weaknesses, and an action plan to inform future practice. The summative assessment was built using the principles of constructive alignment and is a 15-minute prerecorded voice over PowerPoint where students present the learning achieved on the above areas in a reflective manner.

Table 2. Semi-structured interview guide.

Questions Use prompts such as “tell me more about this” or “how did that make you feel?” as necessary. Would you like to start by telling me about why you decided to become a physiotherapist? [Opener question] What do you understand by the phrase “person-centered practice”? Could you explain it in your own words? Could you explain what you have written as your philosophy of practice from your Foundations of Physiotherapy Practice Module? What was your experience of learning about person-centered practice and developing your philosophy through the Foundations module? [Prompt: tell me more about that]. Were you able to apply any of those principles when you were on placement in November? Did you notice anything in practice which could have been a barrier to working in such a way [based on your philosophy of practice]? You spoke about [link to what they shared in their philosophy] being important in person-centered practice. Did you see that happening in practice on your placement? What are your thoughts on whether person-centered practice is realistic in the National Health Service and what is more about aiming for an ideal? Is there anything about you as a person which will help you practice in a person-centered way? Thinking back to your placement again. Was there anything about the environment that makes person-centered practice easy? Thinking back to your placement again. Was there anything about the environment that makes person-centered practice difficult? Is there anything that you have learned about the collaborative role you will have with patients that will help person-centered practice taking place? Is there anything that you have learned about the collaborative role you will have with patients that will hinder person-centered practice taking place? What do you think might be important about person-centered practice from the perspective of the patient you are working with?