title: Barriers and facilitators to providing undergraduate physiotherapy clinical education in the primary care setting: a three-round Delphi study.
abstract: BACKGROUND
  With the global shift in health care from secondary to primary care, employment opportunities for newly qualified physiotherapists are likely to be in the primary care setting. However, to date, undergraduate physiotherapy clinical education has been centred around secondary care, focusing on acute services in large teaching hospitals. For contemporary physiotherapists to become effective first-contact primary care providers, they need to be exposed to the primary care environment during their undergraduate education.
  
  
  OBJECTIVE
  To explore the concept and identify perceived barriers and facilitators to providing physiotherapy undergraduate clinical placements in the primary healthcare setting
  
  
  METHODS
  A three-round Delphi survey was used. Participants were asked to answer open-ended questions with regard to: (i) student preparation for and (ii) provision of primary care placements (Round 1). Content analysis was employed to identify key themes. These themes generated statements for Round 2. In Round 2, participants were asked to rate their level of agreement/disagreement with the generated statements. In Round 3, a final rating process was conducted. Level of consensus was established as ≥70% agreement, with an interquartile range of ≤1.
  
  
  METHODS
  One hundred and ninety-eight primary care physiotherapy staff.
  
  
  RESULTS
  Barriers identified included shortage of resources (e.g. staff) and a lack of tradition; in other words, students are not traditionally educated in the primary care setting. Response rates were 60% (120/198), 70% (84/120) and 76% (64/84) for Rounds 1, 2 and 3, respectively. All seven key facilitators identified reached consensus. They included additional support for staff taking students and motivated students.
  
  
  CONCLUSIONS
  This study revealed that there is support for the provision of physiotherapy clinical education in the primary care setting. Through careful consideration with clear planning and collaboration with all stakeholders, it may be possible to convert the main barriers identified into facilitators to ensure that there will be an adequately prepared physiotherapy work force in the future.
authors: UCD School of Public Health Physiotherapy and Population Science, Health Sciences Building, Belfield, Dublin, Ireland. Electronic address: sinead.mcmahon@ucd.ie.
authors: S
authors: S
authors: McMahon
authors: UCD School of Public Health Physiotherapy and Population Science, Health Sciences Building, Belfield, Dublin, Ireland.
authors: T
authors: T
authors: Cusack
authors: School of Health and Human Performance, Dublin City University, Dublin, Ireland.
authors: G
authors: G
authors: O'Donoghue
mesh_terms: D001291:Attitude of Health Personnel; D002983:Clinical Competence; D003697:Delphi Technique; D005260:Female; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D008297:Male; D059825:Physical Therapists / Q000193:education*; D011320:Primary Health Care / Q000458:organization & administration*; D012959:Socioeconomic Factors
keywords: Physiotherapy, Physical Therapy, Clinical education, Education, Primary healthcare