Co-authored by Dr Peter Stubbs and Lucy Blakemore.
As an academic, looking at feedback from students can be a daunting and interesting experience. In Physiotherapy, practical subjects lend themselves to more positive feedback than non-practical subjects. I took over the (‘non-practical’) Physiotherapy research subjects in Spring 2022, excited for the opportunity but apprehensive as previous versions of the subject had received comments including:
I don’t think that the lectures were particularly easy to follow.
Occasionally during the lectures students would be lost and wouldn’t know why we’re covering the content, regardless of going through the lesson objectives at the start of the lecture.
Unfortunately this subject is very dry and boring.
In my first semester, I made what I felt were relevant changes to the subject. In my mind, these innovations would transform Research into a high-performing subject with positive student feedback. Unfortunately, the feedback after the semester was similar to previous years. My changes had fallen short in improving students’ perceptions of the value of the subject.
We’ve all had challenging feedback from students at some point in our teaching and learning careers. It may be related to content and curriculum design, teaching delivery or a lack of perceived relevance to future careers. In our case, students had something to say about all of these.
Why does research matter for clinical practitioners?
Teaching research as a subject in coursework degrees can present particular challenges, as we found with Masters subject Research Design in Physiotherapy (96086) and Research Project (96092). Students who are focussed on becoming practising clinicians often don’t see how research connects with their future work. When the subject is difficult, this only adds to frustration.
Student feedback provides an indication of what students ‘want’ but does not always capture what students ‘need’. It is important that students master the skills and knowledge to read, interpret and use clinical research findings as it impacts short- and long-term patient outcomes; it’s how we discovered massage doesn’t reduce long-term pain in physiotherapy, and has led us past age-old prescriptions of ‘bed rest’ for back pain.
Aside from impacting the quality of life of countless patients, being an evidence-informed clinician opens up long-term career development opportunities for physiotherapists who may seek variety and challenge after their first few years of clinical practice. This is especially true in Physiotherapy where there is high workforce dropout and attrition, with the average career-life of a Physiotherapist being about 7 years.
What’s so bad about research design?
Some lectures were extremely intense and relied on an understanding of content delivered early in undergraduate degrees.
[Student feedback, 2022]
As a balanced academic and researcher, it can be hard to understand why students find research so difficult. I know why I love research and why I’m passionate about it, but acknowledge that my interests may be very different to the students we teach.
In these research subjects, the content and curriculum were difficult, the delivery modes were not always engaging, and it didn’t feel connected to future clinical work. Some of the content, for example, involves statistics – and stats are hard! Even though students on this course have usually covered stats in a previous undergraduate subject, they can struggle to re-engage and apply the learning here.
On top of this, research design can be hard to understand; once you move past basic Randomised Controlled Trials (RCTs) to more complex topics such as prognosis and diagnosis, it’s a difficult balancing act to make sure the right content is covered to prepare students for future careers, without over-doing it.
Students often struggled to see the relevance to their future professional selves. How could we frame and prioritise research as something that impacts patients directly, not as an academic aside? How could we encourage students to ‘want’ what they ‘need’?
What we changed
To bridge this gap, we utilised formal and informal feedback opportunities, asking students about their interests, likes and dislikes. When received, we discussed the feedback with students and took action on appropriate suggestions, providing reasons why these were implemented or not. We then re-examined student perceptions of the newly introduced content.
There were changes across a number of areas, including:
- A focussed year-long research project component with limited research design options (systematic review, with or without meta analysis) so that workshops could be focussed rather than having time spread across multiple methodologies. Every class was made more relevant, and students felt the workshops were more focussed.
- Students had a larger range of topics to choose from, including their own topics, in some instances.
- Acknowledging students’ varied experience and knowledge gaps, even when the course has pre-requisites. In topics such as statistics and ethics, ensuring examples relevant to physiotherapy were always used.
- Re-thinking a research presentation part way through the subject to incorporate a real poster presentation of preliminary findings, delivered by students to other academics. By making it into an event, not just a workshop group, the work felt ‘bigger’ and more meaningful as an output.
What difference did it make?
These changes improved student perceptions of the subjects, leading to higher satisfaction and more positive feedback from students. Anecdotally, students feel more engaged in the research subjects; whilst they may not always enjoy research, they see it as being relevant.
Students who feel more engaged in research will continue to use it in their future careers. With the utilisation of good quality research in clinical practice, we can hopefully see better patient outcomes in the future.