Empowerment of physiotherapy students on placement: The interplay between autonomy, risk, and responsibility

Abstract

Background: Knowledge of the effects on students of clinical educators’ giving or withholding responsibility on placement is limited. The associated empowering, or disempowering impact indicates the need for research on what grounds such decisions are made. Aim of Study: The study aimed to explore clinical educators’ perspectives on the importance of giving student physiotherapists increasing levels of responsibility on clinical placement, and the factors considered when giving or withholding responsibility. Methods: A grounded theory methodology underpins this United Kingdom (UK) based study. The phase of the study reported in this article involved 26, semi-structured interviews with clinical educators, each followed by the completion of a diamond ranking exercise. Findings: Three themes emerged: 1) the ubiquity of risk; 2) the relationship between trust and trustworthiness; and 3) graduated supervision. The first theme, acknowledged that risk is ever-present and that clinical educators are used to managing it, balancing risk and responsibility given to students. The second theme highlighted the importance of developing trust/trustworthiness as a foundation for a sound working relationship between student and clinical educator. The third theme focusing on graduated supervision as a means of empowering students to take on increasingly demanding responsibilities on placement. Conclusions: The study illustrates the complex relationship between risk, trust, responsibility, and developing student autonomy. A strategy is proposed to provide an empowering alternative to the tendency to increase surveillance and/or limit the responsibility for students who lack confidence or capability in taking responsibility on clinical placement. Future research could aim to test the strategy more widely.