Response to Letter to the Editor re ‘Exploring the experiences and implementing strategies for physiotherapy students who perceive they have been bullied or harassed on clinical placements: participatory action research’

It was with great interest that I read the commentary in response to our paper “Exploring the experiences and implementing strategies for physical therapy students who perceive they have been bullied or harassed on clinical placements: participatory action research” by Thomson et al. [1]. The author comments that the students may have seen their educator as an ‘outgroup member’ in the sense of student and educator not fitting into the same social group in their particular transitory setting of a practice placement. I am not sure that this is so as in my research, students saw themselves as belonging to the same group (i.e. the same profession) but as ‘novice’ members of this group. Metaphorically they saw themselves at the bottom of a steep hill with their educators near the top BUT still on the same hill. If this relationship goes well they aspire to be like their educators and often model themselves on them after qualifying and cite them as having the greatest influence on their education, rather than their university lecturers. The major issue is a ‘power differential’ as educators have to assess them and so inevitably it is not an equal relationship. Additionally this assessor’s role may be seen differently by different educators for example benign, enabling, critical or authoritative depending on their own experiences as well as the style of communication of that particular practice area. Another problem is that although educators complete an agreed assessment form (which arguably may give some consistency) an accredited ‘clinical education process’ does not exist in the UK and clinical educators see this activity as part of the seniority of their position rather than an expertise. A student’s positive experience may therefore be due to a ‘clinicians’ intuition and natural abilities as an educator’ (Strohschein et al., 2002, p. 171). Another factor is that a university environment is very different to that of a clinical placement. Currently universities are judged by their NSS (National Student Survey) results and similar to Ofsted results for schools this could make a difference to recruitment and selection for their courses. Hence the environment in a university is very student-centred (with students anonymously evaluating every taught module) whereas on clinical placement their learning experience is often secondary to the service needs and demands of the practice settings. Your writer further wondered if students should focus more on using criticism positively I agree that this is a very important point with any feedback and I believe our article did suggest that students developed coping strategies such as ‘playing the game’, ‘taking a considered view’ and ‘assertiveness’. The statutory need to keep a reflective portfolio begins with challenging the students’ assumptions whilst on placement and feeds into the development of their professional skills.

I would like to thank the author for their thoughtful comments on our study. Ethical approval: Ethical approval given by the Faculty Research Committee (FREC 2014/03/008).Conflict of interest: None declared.