Project-based learning for physiotherapy clinical education quality and capacity

Article accepted

This article has been accepted for publication. Peer reviews and author responses are available at the end of the article.


Background: Increasing, supporting and sustaining the capacity for physiotherapy student placements is a priority for universities and the physiotherapy workforce.  The interruption, and in some cases, cancellation of placements as a result of Covid-19 has provided an added impetus to consider the use of flexible and adaptive models to meet student learning needs and support new and existing placement host organisations. Project-based learning provides an opportunity to supplement clinical placements through student-led activities that are mutually beneficial for student learning and service delivery needs of the host organisation. Aim: This paper outlines the pedagogical underpinnings of project-based learning and provides tangible examples of activities that have been adopted within physiotherapy host organisations to support clinical placement quality and capacity. Discussion: Clinical placement host organisations require flexible, student-centred approaches to supporting clinical placement efforts during 2020 and beyond. Project-based learning has the potential to be adapted across settings to support student learning and host organisation services and their stakeholders. Universities should aim to encourage and support partnerships between host organisations and their students to adopt, evaluate and sustain project-based learning across physiotherapy settings.


Author: Shamila Gamiet
Review date: 23 June 2020
DOI: 10.14426/opj/20200623
Permalink: Review - Project-based learning for physiotherapy clinical education quality and capacity

General comments

  • The article is relevant. Due to the Covid-19 pandemic, physiotherapy education providers globally are identifying alternative and innovative ways to ensure students’ clinical learning outcomes are met for the 2020 academic year. The article also highlights other realistic challenges such as the increase in student numbers, lack of clinical placements and staff shortage which impacts on clinical education. The article adds value to the conservation of reshaping clinical education and contributes to the body of knowledge in physiotherapy. PjBL is clearly explained and the use of examples of PjBL activities enhances understanding of how this pedagogy facilitates students’ critical thinking and problem-solving skills. This is in line with what clinical education aims to achieve globally.
  • The aim of the paper is clearly described.
  • Authors should, however, define and clarify terms such as clinical education managers, clinical placement providers, education providers, physiotherapy training providers and host organisations. It is explained that placement provider is the host organisation but it is difficult at times to keep up with the different terms used throughout the paper. A suggestion would be for the authors to consistently use the same word or term throughout the paper instead of interchanging words. One example: in the abstract, under the heading Implications for practice the terms “host organisation” and “physiotherapy clinical placements” is used in the same sentence. Therefore it would be beneficial to explain the difference.
  • Clarify: Is this pedagogical approach a partnership/collaboration between the education provider, the student and the host organisation? Throughout the paper there are inconsistencies. For example: in the abstract, in the last sentence under the Discussion heading, the authors say that the education provider should partner with the student and the host organisation. However, in the background section, paragraph 4 the authors talk about “.. a partnership between The University of Queensland (UQ) academics, clinical education managers and host organisations.”
  • Paragraph 6 talks about “.. a partnership between student and host organisation” and paragraph 7 talks about “..helps students co-design projects either with their education provider or host organisation..” I suggest that the authors clarify who the stakeholders are in this partnership.
    It is not clear if students work alone, in pairs or in groups in PjBL.
  • PjBL is a student-led activity and the student works autonomously while collaborating with various stakeholders. Does the student receive any guidance/input or feedback? If so, then who provides this guidance?
  • The first sentence in the background speaks about integrating knowledge, skills and professional behaviours and developing clinical performance. It may be valuable to show or to identify how PjBL achieves this by reinforcing it in the discussion section.
  • Some sentences are long and therefore not easy to read or follow the concepts. Please review the article carefully with this in mind.

Specific Comments


Background, paragraph 1, the last sentence: “..mutually beneficial for student learning and the goals of the host organisation” I am not sure what meant by the “goals if the host organisation.” Can this be explained by simply adding a few words?


Paragraph 1: “Physiotherapy training providers rely on supervised clinical placements…..” it is not clear who provides supervision. Is it a staff member employed at the clinical placement or a staff member employed at the university? The issue of staff shortage is also raised so it would be good to know if clinical staff are responsible for student supervision. This will impact on clinical placements’ capacity to host students.

Paragraph 6, 1st sentence: remove the apostrophe after the word students’ co-design….

Paragraph 6, 2nd sentence: remove the comma after the word discovery.

Author: San Schmutz
Review date: 9 June 2020
DOI: 10.14426/opj/20200609
Permalink: Review - Project-based learning for physiotherapy clinical education quality and capacity

This article is most relevant in the current COVID-19 pandemic and the resultant effect of the pandemic on clinical placements for physiotherapy students globally. The approach of project-based learning to supplement clinical placements is based on sound pedagogy and is student-centred. The core idea of partnering with the host organisation in a flexible and responsive way to benefit both parties involved is a strength in the partnership that contributes to the host organisation’s capacity as well as learning for the student. However, it would add significance and value to the article if you could elaborate on a specific project or approach, applied during COVID-19, which you normally would not follow. Also, include what specific safety measures you need to follow for students and community members according to COVID-19 regulations.

Perhaps you can consider including a novel case study specifically during COVID-19 that is completely new for your context? It would further add value if you could elaborate on which student year group would participate, how many students per group, assessment and perhaps if the project is also community centred although student-driven?

The value of strengthening relationships in significant ways for mutual benefit when placing physiotherapy students is a matter of importance and should be mentioned. The project-based learning curricula model described, seems closely related to the service-learning model? How do these models relate and compare to each other? Do they complement each other so you could combine them to enhance effectiveness? Students are immersed in an environment where they have to think constructively toward learning and service and these projects lend themselves to the development of graduate attributes not necessarily only clinical competencies.

The consideration to the possible long-term effect of COVID-19 on clinical placement is important as we consider the preparation of physiotherapy students to prepare them for the future workforce and enable them to be responsive to health needs of the communities they will serve. How would you specifically evaluate your project for effectiveness and sustainability?

In both of these learning strategies, the mutual benefit for the health service as well as students’ learning is key and therefore worthwhile in exploring as a supplement to clinical exposure and practice. For relevance, during this COVID-19 time, I would suggest you include more recent references as well.

Conflict of interest statement

The authors report no conflicts of interest.

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