Employing a coaching model of supervision during physiotherapy placements: charting the learner experience in England

Objectives: The UK government has moved to increase pre-qualification training places across all Allied Health Professions by 50%, without any reduction in quality of education. Universities and healthcare teams are therefore being asked to change their ways of working and consider alternative practice supervision models during placements. This study explores the experiences of pre-qualifying physiotherapy learners involved in a trial of one such model, a coaching and peer-learning approach. The work described assesses its facility as an augmentation to the traditional one-to-one clinical supervision model. Design: A qualitative-thematic approach using semi-structured interviews was employed. Detailed, open-ended interviews were conducted in order to ascertain the nuanced experiences of participants involved in the trial. Setting: An intervention in multiple sites (both hospital inpatient and community care) within a single NHS trust, administered by a single UK university. Participants: N=17 pre-qualifying participants involved in the trial consented to be interviewed. Of these, n=11 were final year undergraduate learners, and n=6 were final year postgraduates, of which n=12 identified as female and n=5 identified as male. Results: Analysis revealed four interconnected major themes: 1. Teamwork, Camaraderie and Hierarchical Tensions in Peer-Support; 2. Adapting to Leadership and Being Led; 3. Safety Nets versus Supervisors; 4. Fast Starts and Variable Endings in Learning and Experience. Conclusion and Implications: The model was broadly well-received by participants, and ultimately gave rise to greater workplace confidence, with potential impact for capacity, though the nuanced outcomes of the research indicated contingencies around gradual assimilation and group dynamics that should be considered in future development. Contribution of the paper: • The coaching model of placement supervision was broadly well-received among learners, and has facility as a part of the expansion process in physiotherapy workforce development. • Freedom from the need for persistent clinical scrutiny can reduce the pressure on learners and also on practice educators. • Social dynamics in teams are not an arbitrary contingency but need to be a core feature of the design in any given case.