Exploration of mentor and mentee perspectives of a mentored clinical practice programme to improve patient outcomes in musculoskeletal physiotherapy

Background A recent randomised controlled trial has demonstrated the impact on practice of an educational programme for clinicians. Mentored clinical practice in musculoskeletal physiotherapy resulted in clinically significant improvements in both physiotherapist performance and patient outcomes. The objectives of this study were to explore mentor and mentee perceptions of a mentored clinical practice programme, in order to identify key factors in the process to improve patient outcomes. Methods Employing a case study design of a mentoring programme that led to improved patient outcomes, mentored clinical practice was explored from multiple perspectives using a grounded theory strategy of enquiry to derive a theory of mentored clinical practice grounded in the views of the participants. Semi-structured interviews with a purposive sample of mentors and mentees were employed along with qualitative observations of mentored clinical practice. Data analysis and collection were concurrent, with analysis an iterative process deriving inductive analytical categories from the data through constant comparison. Findings Highly informative themes of how the complex interaction between mentor, mentee, patient and environment worked successfully were identified from the data. The mentors' knowledge, additional perspectives, critical analysis and facilitatory style were enabling factors, as were mentees' motivation, openness to criticism and commitment to reflect on practice. Themes around potential threats to the mentees' development were also identified. Overloading or contradictory feedback and lack of relationship with mentees were barriers that mentors could bring; fear, defensiveness, routine working, people-pleasing and lack of experience were potential mentee barriers. A model emerges from the data demonstrating how these themes interact, providing guidance to mentors and mentees to optimise the effectiveness of mentored clinical practice. Conclusion This study provides a sound basis for future mentored clinical practice, producing a model from key themes from a case study where impact on clinician performance and patient outcomes are established.

Automated summary

This study explores a mentoring program for clinicians in musculoskeletal physiotherapy and identifies key factors that contribute to improved patient outcomes. The study finds that the mentor's knowledge, additional perspectives, critical analysis, and facilitatory style, as well as the mentee's motivation, openness to criticism, and commitment to reflection, are enabling factors in mentored clinical practice. However, potential threats to mentee development, such as overloading or contradictory feedback, lack of relationship with mentors, fear, defensiveness, routine working, people-pleasing, and lack of experience, were also identified. Overall, the study provides a model that demonstrates how these themes interact and offers guidance to optimize the effectiveness of mentored clinical practice.