Co-creating learning: A qualitative exploration of physiotherapy clinical education.
Alison Lupton-Smith, Anna M Schmutz
Students described clinical learning as something they drove themselves, through relationships and curiosity rather than through being told what to do.
Facilitators more often saw their role as central to directing that learning. The gap between those two stances shaped how much learning actually happened.
Key findings
1Students consistently described themselves as active learners, but their expectations of facilitation diverged: some wanted facilitators to respond to learning bids, others expected facilitators to initiate and drive encounters. Most facilitators said they guided students, yet this assumed student agency was seldom made explicit.
2Relational safety was central to students' willingness to ask questions, make mistakes and take learning risks. In its absence, students turned to peer learning for that safety. Students also emphasised being recognised as whole persons rather than merely as students.
3The clinical environment was experienced as both constraint and catalyst. Limited resources and competing service delivery demands challenged learning, but the same conditions fostered creativity, adaptability and the use of human resources (peers, patients, other professionals) as learning opportunities.
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What it does not show
Convenience sampling at a single university; the authors note data saturation may not have been achieved and the findings are theoretically informative rather than statistically generalisable. All student participants were female, so the study does not capture how gender may shape experiences of learning, agency, confidence and power in the clinical environment. The facilitators were employed primarily for student education rather than for service delivery, so perspectives from clinicians juggling patient care and teaching may be missing. Academic performance data were not collected, so it is unclear how variations in academic standing influenced engagement. The study was conducted in the South African public health context; the authors note that similar studies in different settings may add further layers.
Declared interests
Funded by the Fund for Innovation and Research into Learning and Teaching (Finlo) at Stellenbosch University. No industry funding or other conflicts of interest were declared.
The easy way to misread this
Do not read the students' positive descriptions of their own agency as proof that the current facilitation model is working well. The same data show that facilitators seldom made student agency explicit, that divergent expectations about who drives learning created tension in the clinical relationship, and that the study involved a small, single-site, all-female student group at one South African university.
Summarised by AI from the full paper, without a clinician reviewing it. Check it against the source before it changes what you do. Read it on PubMed →