Please provide a review in the form of a summary that addresses the following main themes. Note that the purpose of the review process at OpenPhysio is not to act as a gatekeeper to knowledge but to help the author present the best possible version of their ideas. Your comments below may not necessarily be used to accept or reject the article but should rather aim to identify areas where the author/s can improve their work.
1. Complete, coherent, and well-organized presentation: The article is presented well for the most part, although there are some minor grammatical errors remaining. I have made suggestions below that may help with clarifying some of the issues with presentation.
2. Sufficient explanation of the significance of the problem: There isn’t a clear link between the problem that the study purports to address (i.e. improving learning outcomes) and the findings of the study. The authors can do more to create a stronger link between student perceptions’ of clinical learning placements and clinical teachers, and improvements to the curriculum (and therefore, to learning outcomes).
3. Clear demonstration of the relevance to the field (beyond the case presented): If the authors can strengthen the link between student perceptions and improved curricula with practical suggestions, this article will have relevance for other physiotherapy educators.
4. Original contribution to the topic of physiotherapy education: While this is a local study in two Nigerian institutions, the lessons learned could be useful to other contexts.
5. Compelling presentation of the problem within a theoretical framework (where appropriate): There is room for improvement in the introduction, especially with respect to connecting the findings of the study to the practical issue of curriculum reform. The authors might consider looking for a curriculum development framework that includes ‘student perception’ as a relevant variable to consider, and then integrate it into this article.
6. Establishment of a relationship between the problem and other relevant literature: The authors can do more to link this study to the wider literature on curriculum development. Even though this isn’t made explicit in the article, the premise is that student perceptions of various parts of the programme are important for further developing the curriculum, with the aim of enhancing student learning outcomes. This connection between the existing literature and what this study sets out to achieve, can be strengthened. In addition, the use of citations to support claims made in the discussion is poor. The authors could do more to use existing research to justify some of the explanations provided for the findings of this study.
7. Appropriate research design and method: The study design is appropriate, although the analysis of data (and the meaning of the analysis outputs) could be explained more clearly.
8. Accurate and useful interpretation: For me, this was the least effective part of the article. I had difficulty connecting the findings of the study to it’s relevance to a broader community of physiotherapy educators. What is the value of reading this article, if you’re not an educator based at either of these institutions in Nigeria? The authors can do more to demonstrate the utility of these findings for a wider audience.
9. Sound argument and analysis: See my comments below for guidance on how the argument and analysis could be improved.
10. Effective conclusion about the implications for physiotherapy education, research, and/or practice: The conclusion in its current form is more like a list of recommendations. However, these recommendations don’t flow clearly from the study findings. I had little confidence in the reasons provided for the findings (because of the limited connection to existing research) and so couldn’t take the recommendations seriously. The conclusion section should be primarily a summary of the findings of this study, and recommendations could certainly be included, but only after having been thoroughly discussed in the previous section.
If, in addition to the points above, you could provide more detailed comments and feedback below, that would also be appreciated.
> assessed regularly
I wonder if ‘evaluated’ would be more accurate since you’re not assessing the quality of students’ feedback but rather evaluating it. Later in the article you talk about ‘evaluation’ and not ‘assessment’.
It’s not clear what you mean by ‘it’ here. Is ‘it’ the students’ feedback, or is ‘it’ the clinical learning environment and instructors? This sentence should be rephrased to make it clear how ‘it’ affects the outcomes of learning.
This is different to saying that you’re ‘assessing’ (or evaluating) student feedback. I suggest changing to “To evaluate physiotherapy students’…”
> based on clinical instructors’ gender
This is very specific and should be justified earlier in the abstract. Why do you think it’s important to determine differences in student perceptions of clinical instructors’ teaching attributes based on their (the instructors’) gender?
> Perception of the students’ learning environment resulted in more positive compared to negative features.
This sentence isn’t clear.
> perception of learning
You should try to differentiate the names of your categories from the rest of the sentence. You could do this by using italics for the category names, or capitalising them, or placing them in single quotes.
> ‘Clinical interest in helping students to learn’
Here you’ve used capitalisation and single quotes to name the category. I suggest using only one of these options, and ensuring that you’re consistent in how you do this throughout the article.
Use UK/English spelling throughout the article. In this case, you should use “Emphasises” i.e. “s”, not “z”.
> regular evaluation of the clinical instructors’ attributes
Your study didn’t evaluate the actual attributes; you evaluated student perceptions of the attributes. Please make sure that you are clear in terms of what you actually did and what you say you did.
> in order to monitor students’ learning outcomes and to ensure readiness for professional practice
I think it’s a stretch to say that this is something that your study can say anything about. You didn’t formally establish a link from student perceptions of various concepts to the monitoring of outcomes and readiness for practice.
UK spelling should be used throughout the article.
I’m not sure that this first paragraph adds much value to the article. The second paragraph could also serve as a suitable opening for the article.
> Clinical education is a core component of physiotherapy professional training
You don’t have to argue for why clinical training is important; everyone reading this article already accepts the value of clinical placement and education in that environment. I suggest that this introduction should try to focus on the core concepts of the study i.e. student perceptions, clinical learning environments, and clinical teachers. What is the minimum amount of information you need to provide to ensure that the reader is comfortable with the concepts you’re going to explore in the article?
> Benner et al,
Please review the APA guidelines for citation formatting and ensure that your usage is consistent throughout the article.
It feels like this paragraph is a distraction and doesn’t add much to the overall article. I get that it’s providing a basic overview of different approaches to clinical training but the reader doesn’t need to know the other systems in order to understand this article. Maybe a single sentence describing how Nigerian clinical supervision takes place would be enough?
> with medical dysfunctions
Unnecessary to include.
> Clinical learning is therefore an important part of physiotherapy education as it is a key determinant of curriculum and a silent index of both students’ and teachers’ behaviour (Demiroren et al., 2008)
You’ve made this point several times in the article already. I’m not sure you need to keep repeating it.
> Medical Students’ Perception of the Clinical Learning Environment
Shouldn’t be capitalised.
> Different Phases of Medical Education
Would it be worthwhile summarising the key findings of these studies? Without knowing what the authors found, there’s little value in including this list of papers. Perhaps you could summarise the main outcome of the studies collectively, rather than simply listing the authors and titles.
> Nigerian Universities
Is this the name of an institution? It’s not clear. If not, consider rephrasing.
> Oyeyemi et al
Review APA for correct formatting of in-text citations.
> have been reported to have an enormous impact on the outcome of learning
Who made this claim and what is the nature of this impact? Considering the pivotal role that the claim plays in the article, it should be clearly cited and explained in some detail earlier in the introduction.
> In addition, students’ opinion on their clinicians’ teaching attributes and the clinical learning environment needs to be constantly evaluated to ensure it’s in line with the recent innovations in patient care.
I don’t recall seeing any evidence for this claim earlier in the introduction. Please justify it with some form of evidence because it’s a strong claim to make and is central to your main argument.
I think that the introduction section is too long and could be shortened to 2-3 paragraphs that describe only what is essential for the reader to understand this study.
> cross-sectional research design
It’s often useful to explain briefly what this is and why you chose this design.
> Section A and B
Of what? A self-designed questionnaire? It’s not clear what these sections are referring to.
> self-structured questions
What is a ‘self-structured question’?
“…was used to collect sociodemographic characteristics…”
“…included…” may be more suitable.
> physical therapy
Be consistent in how you name the profession. You can use either “physical therapy” or “physiotherapy” but not both.
> is rated on
“…uses a 5 point…”
> It consists of five sub-domains with a total of 48 questions. Students’ perception of learning contains 11 questions, students’ academic self-perception contains 8 questions, students’ perception of teachers contains 10 questions, students’ perception of the atmosphere contains 12 questions and students’ self-perception contains 7 questions. The DREEM is rated on a 5-point scale as follows: Strongly agree = 4, Agree = 3, Unsure= 2, Disagree=1, Very Strongly Disagree= 0. Environmental perception of students as determined by DREEM is classified as “very poor” for scores between 0 and 50, “plenty of problems” for scores between 51 and 100, “more positive than negative” for scores between 101 and 150, and “excellent” for scores between 151 and 200 (Askari et al., 2018).
It’s reasonable to direct the reader to the relevant source for more detailed information, especially for a commonly used tool like the DREEM. It’s not a problem for this detail to be included here but it does take up more space than necessary, and the reader can easily find this information on their own.
> The students were asked to complete all the questions honestly.
We can safely assume that students were expected to answer honestly. This sentence could be removed.
> was also used to determine the difference in the student’s perception of their clinician’s teaching attributes based on clinical instructors’ gender.
Why do you emphasise this component? There is nothing in your introduction to indicate that this variable (i.e. gender) is relevant for your study question. I think it would be useful for you to explain why this particular variable is important to investigate.
> Table 1 shows the socio-demographic characteristics of the students while Table 2 presents the profile of the clinical instructors.
At this point I’m wondering where you’re presenting cross-tabulated data e.g. participants with variable X were more likely to respond in this way to question Y.
> plenty of problems
Do you have any sense of what these problems might be? Simply knowing that almost 20% of the students perceive there to be “plenty of problems” isn’t very useful, without knowing what they are.
> domains of DREEM
I see some of them listed below but it may be difficult for the reader to understand what you mean when you say that the highest mean on a certain domain is X.
> to have more positive than negative features
Is it relevant that there are “more” or “less” positive/negative features? What we really need to know are how important the relative value of each feature is. For example, a negative feature might be that there isn’t enough space to properly learn. While a positive feature might be that there is parking space for students. These are not equivalent and one is way more important for learning than the other. A simple tally of “how many” doesn’t tell the reader the important part of the story. Is it possible to add any of this detail?
> This is not surprising given that students in their third and fourth years of study have a greater desire to learn and explore new ground as they transition from the preclinical to the clinical phase of training.
This would benefit from a citation in support of the claim.
> may be unfamiliar with the system
> They reported that the ‘clinicians interest in helping students learn’ had the highest mean score amongst physiotherapy students in Nigeria
Your discussion would benefit from some description of what this all means for the reader or interested physiotherapy educator. How can the reader use the results of your study to make changes in their own programme?
> This may have been noted in NAU students because of a wide range of contact with different clinicians who have different specialties during their SIWES programme.
It would really strengthen your article if you provided citations in support of the rationales you provide for your findings. Yes, it may be because of what you suggest. But it also may not. A citation in support would give the reader more confidence that your explanation is valid.
> This may be attributed to their increased number of contact with their clinical instructors
Same here. It may be because of what you describe but it may also be something else entirely. Without a citation to support your claim, the reader can’t have much confidence in your explanation.
> This could be attributed to the style of teaching adopted in these clinical posting units which involve majorly practical teaching sessions
Again, a citation would be great here.
> These hospitals had more male instructors compared to female instructors.
How does this explain the fact that participants rated male teachers more positively?
> The majority of these clinical instructors head clinical posting units and may not always be available to students.
> so as to improve student learning outcomes and ensure readiness for professional practice after training
What you’ve presented in the results and discussion doesn’t actually provide any guidance around how knowing this information can improve learning outcomes. If you want to make this claim in your conclusion, you really should discuss how your findings can be used in this way. What, in practical terms, can the reader do with your findings in order to improve learning outcomes?
> There should be a revised harmonised curriculum for the clinical posting experience of students outlining the minimum standards of clinical exposure a student should have during clinical education.
Again, it’s not clear to me how your findings lead you to this conclusion. And, what do you mean when you say “harmonised curriculum”?
> Seminars and workshops on clinical skill acquisition should be regularly organised for clinical instructors in the health sector to improve their teaching abilities.
Your conclusion doesn’t actually discuss the findings of this study. You seem to be making recommendations in the conclusion that don’t clearly stem from your results and discussion. This paragraph should only present the conclusions from this study. And recommendations should be supported in the discussion through appropriate citation.
> Poor compliance on the part of some students.
This isn’t a limitation. If students chose not to complete your survey, there are many other reasons for why that might be true. For example, the survey may have been confusing, or distributed at a busy time of year, or the rationale for completing it may not have been explained. My point is, you can’t blame your participants when things don’t work out as you had hoped.
Table layout and presentation
Write these out in full.
Remove the decimal place when the first number after the point is 0.
> Marital status
Why present this information if you’re not going to link responses to these variables. For example, It might be interesting to know if married participants perceptions of feedback based on the gender of the clinical teacher is different to the perceptions of unmarried participants. The same question can be asked of the gender of participants. There’s little value in including sociodemographic information that isn’t tied to some other variable.
> Key: N= Number of participants, UNN= University of Nigeria, NAU= Nnamdi Azikiwe University.
Not necessary to include. All readers will know what the “N” stands for. And there’s enough space in the table to write the institution names in full.[jetpack-related-posts]