Community-Based Primary Healthcare Training for Physiotherapy Undergraduates: Perceptions of Physiotherapy Academics

Abstract

Community-based primary healthcare training for health science students is based on the tenets of primary healthcare. The approach seeks to provide clinical education and training for health science students in previously disenfranchised communities. Some South African universities train their physiotherapy students through a community-based primary healthcare approach to undergraduate training. However, there is currently a lack of an integrated model guiding clinical education for physiotherapy clinical education in the country. The aim of this paper was to explore the perceptions of physiotherapy academics about a novel, community-based primary healthcare approach to clinical education for students at a university in South Africa. This study sought to inform the roll-out of an evidence-based model for physiotherapy education. A qualitative explorative approach, using semi-structured interviews with physiotherapy academics at the institution, was used to explore their perceptions of the community-based primary healthcare training platform. Data was analysed using conventional content analysis and was classified into themes and sub-themes. Four overarching themes emerged, namely: curriculum review, constraints to decentralised learning, benefits of community-based clinical education and recommendations for the learning platform. Participating academics believed that community-based primary healthcare training is an approach that influences students to be socially responsive, while providing access to healthcare services, such as rehabilitation, in resource-poor communities in South Africa.

Impactful educational transitions: Crossroads for physiotherapy education in South Africa?

“…This could have a negative effect on the skills mix of the workforce and could limit the positive outcomes foreseen for the NHI. Some strategies to temporarily alleviate human resource constraints in the public healthcare sector have included the introduction of compulsory community service in professions such as physiotherapy (Nadasan & Chetty 2020 ), as well as extended or decentralised clinical training implemented by universities such as the University of Kwazulu-Natal (Govender et al 2018 ).…”

Clinical educator’s experiences of the decentralised training platform for Occupational Therapy students in KwaZulu-Natal, South Africa

“…Decentralised training plays a role in addressing the inequality in service delivery to public sector facilities, including rural health facilities. 3 , 4 , 5 , 6 , 7 It aims to provide future healthcare professionals (HCPs) with an opportunity to utilise and practice essential competencies required for community engagement and to ensure quality healthcare services, 10 , 12 , 13 , 17 which is operationalised more autonomously for the first time during community service.…”

“…Community service practitioner's difficulties with adjusting to the reality of service delivery, and the diversity of their placements, has been acknowledged in the literature. 2 , 4 , 8 , 9 , 10 In a study by Beyers, community service practitioners who were deployed at rural health facilities, were primarily embedded in the process of adapting to a new environment and professional expectations, rather than focussing on service delivery. 11 Challenges such as feeling isolated due to a lack of support and being away from home, as well as being unequipped for professional practice whilst assuming increased professional accountability were also noted in other studies.…”

“… 11 Challenges such as feeling isolated due to a lack of support and being away from home, as well as being unequipped for professional practice whilst assuming increased professional accountability were also noted in other studies. 2 , 9 , 10 , 13 Similarly, Naidoo and colleagues 14 found that final year occupational therapy (OT) students were only partially prepared for their community service year of practice. This, was attributed to their lack of confidence in applying newly developed professional skills and perceived inability to apply the OT process adequately.…”