Overcoming the Monster! Perceptions of physiotherapy students regarding the use of stroke master plots for building therapeutic relationships; a mixed methods survey.

Abstract

Background Research is needed that considers student health care professional (HCP) reactions to different stories of illness. Master plots identify illness stories which are recognisable within particular settings. One master plot for people with stroke that has not been well studied is called ‘overcoming the monster’. Students reactions to such a plot are important as a way to enhance therapeutic interactions. Objective To examine the responses of physiotherapy students to three variations of master plot called ‘overcoming the monster’ generated from patients who have had a stroke. Methods A qualitative narrative vignette study was undertaken. A university in the West Midlands was used to access physiotherapy students on the pre-registration programs. A purposive sample of students volunteered to complete a single vignette questionnaire at one time point. The vignette provided three unique examples of the master plot overcoming the monster as told by people with stroke. Students responded to each by asking specific questions that captured demographic information and questions that captured reactions to the different versions of the master plot. Categorical content-analysis was undertaken. Results Thirty-two first year (BSc) students, thirty-nine first year (pre-registration) MSc students and nineteen third year (BSc) students participated in this study. Neither first year groups had undertaken any clinical training. All third-year students had finished the required clinical placement hours for the physiotherapy course. Students consistently demonstrated empathy towards this master plot. Students often valued the variant of the story which illustrated how difficulties following stroke could be experienced as an ‘adventure’. Students also valued and were motivated by the story variant that considered a family member as a source of motivation and encouragement. The story variant which focused on the shortcomings of the health care system was more often related to by the final year BSc students and MSc students. However, first year students, particularly BSc students, reported being more emotionally affected by the vignette. Conclusion Overcoming the monster is a master plot which appears to generate more empathetic responses compared to other master plots. This is important because it highlights the value of students understanding the patients’ story and challenges or ‘monsters’ faced. Therapeutic relationships will benefit from training HCP students on the importance of listening, exploring and reflecting on the different master plots they may hear in practice.

Testing a Psychological Tool to Enhance Hope in People With Stroke; Qualitative Study

“…The MEAH appears to be a useful tool that can meet important psychological needs for people with stroke. This includes a need for enhanced patient centredness [32], a need to capture psychological constructs like acceptance early on in rehabilitation, something which has been called for [15] and a need to be able to listen to the individuals' stories which can enhance the empathetic response of physiotherapy students [33]. Finally, it may be useful as a tool that can prepare people with stroke for discharge which is often influenced by worry and apprehension [34].…”

Testing a Psychological Tool to Enhance Hope in People With Stroke; a Qualitative Study

“…The MEAH appears to be a useful tool that can meet important psychological needs for people with stroke. This includes a need for enhanced patient centredness [32], a need to capture psychological constructs like acceptance early on in rehabilitation, something which has been called for [15] and a need to be able to listen to the individuals' stories which can enhance the empathetic response of physiotherapy students [33]. Finally, it may be useful as a tool that can prepare people with stroke for discharge which is often influenced by worry and apprehension [34].…”