Master's level study: learning transitions towards clinical expertise in physiotherapy

Background Evidence suggests that practitioners who successfully complete a UK Master's level course, accredited by the Manipulation Association of Chartered Physiotherapists (MACP), enhance their clinical practice and demonstrate attributes of clinical expertise. What remains unclear is the process by which practitioners change and enhance their practice. Greater understanding of the learning process would help to inform programme design and delivery, and enhance the quality of the educational experience and impact for practitioners. Objective To explain the learning process experienced by physiotherapists on completion of an MACP-approved Master of Science (MSc) course. Design A naturalistic inquiry was conducted using a single theory-seeking case study. Dimensional analysis was used to develop a substantive theory of the learning transition. Participants Twenty-six semi-structured interviews were carried out with 11 alumni from one MACP-approved MSc programme. Results The learning transition was from uncritical practice knowledge with routine, therapist-centred clinical practice to critical understanding of practice knowledge that enabled patient-centred practice and the capability to learn in, and from, practice. This development towards clinical expertise was primarily facilitated by critical evaluation of practice knowledge, particularly through mentorship in clinical practice. This highly challenging experience was helped by high levels of support from the mentor. The learning transition varied between participants and depended on a host of moderating factors. Conclusion This is the first documented theoretical explanation of how physiotherapists enhance their clinical practice and develop attributes of clinical expertise within an MACP-approved MSc course. This explanatory theory may be of value for educational programmes that seek to facilitate practitioners' development towards clinical expertise. This study also offers a novel model of learning transition that may be applicable to other educational settings. (C) 2010 Chartered Society of Physiotherapy. Published by Elsevier Ltd. All rights reserved.