Spotlight on pre-registration education

Arguably the biggest part of CSP’s role shaping physiotherapy education is ensuring that what’s experienced by physiotherapy students is high quality and appropriate. Doing this involves influencing everything from the educational design of programmes, the teaching, learning and assessment strategies being deployed, and the student experience.

The other factor we consider is whether those graduating from pre-registration programmes are ready for practice. Unsurprisingly it’s this bit that gets the most attention from you – our members, employers, patients applicants and students alike.

There’s always an inherent tension within pre-registration programmes that has to be balanced – graduates need to come out well-rounded and competent with the basics to practise autonomously as physiotherapists from the get-go. They also need to be an eye to the future.

Physiotherapy has always been at the forefront of change. Your history is forged in carving out a unique role crossing four different but equally important pillars of practice. The CSP’s quality assurance role looks to balance these elements as well, ensuring graduates as individuals are competent for any sector or setting and that graduates collectively are well placed, not just for practice now but for the direction that the profession needs to be travelling.

And that’s where the CSP comes in in terms of accreditation and carrying out our education remit – we help programmes navigate that fine line, giving a clear steer in terms of setting the direction for the profession based on current and future needs.

Practice itself is evolving in complexity, breadth and depth, and patient expectations similarly are changing so we see this direction setting role as crucial. The pandemic has shown us why this agility and flexibility is so necessary. It isn’t enough to come out technically proficient (although that’s essential), pre-registration education has to be focused on handling change, complexity and unambiguously so.

Universities are adept at handling the different voices and demands placed on them, and I’m happy to say they all welcome them. After all you have to lean into difference and embrace it if you’re going to evolve. And programme teams are always looking to evolve and improve. 

Just as a side note – if you want to add your voice to those who already give feedback to your local university, you might find this link useful.

Setting the direction

CSP takes a hand-on and constructive approach. While we know that the standard is high across all programmes, we actively work with providers as they design and redesign their programmes to enhance and keep lifting them higher. And, while it rarely happens, we do place conditions on a programme and – even rarer still – remove CSP accreditation from them should they fail to improve sufficiently even after being thoroughly supported to do so.

The process

Roughly every five years a programme undertakes a substantial review of what it delivers but, between these points in time, we encourage programmes to evolve iteratively based on feedback and evidence. 

Every year we formally carry on encouraging programmes to evolve through a process known as annual quality review (AQR). This review is part quantitative and part qualitative/reflective in nature. We include a different key area pertinent to the profession’s evolution, and we have a strong focus on highlighting best practice and innovation. 

By using the data collected through this we’re not only able to see trends but crucially see where programmes might need more help, support or encouragement. The AQR is essentially our diagnostic tool to check the health of each programme and the health of all the programmes across the four nations. 

We don’t look at this data in isolation, we also look back over a number of years, tracking the changes. 

By doing this we get a clear picture of how the programme and the profession is developing as well as who’s coming into the profession, what they’re being taught, and who is graduating from the programmes. 

CSP priorities

Because we set the reflective part of our annual quality review to cover a different topic/theme each year, we’re able to drill down into the detail of how it is taught/brought to life within the curriculum. In the last few years, we’ve covered everything from public health, mental health, person-centred care, leadership, digital health, cultural competence.

We have also focused on wider concerns such as how the profession continues to diversify

whether that’s students having opportunities to experience the full breadth of the profession through contemporary placements, or looking at student cohorts themselves – how diverse and reflective of the population’s demographics they are. Ultimately this review is a diagnostic tool but as an intentional by-product we do produce a highlight report for public consumption. 

The report features an overview of the more detailed theme I outlined earlier, and also draws out trends relating to all datasets that we think the universities, members and even the public will be interested in.

The reports can be found here, but to give you an idea – they cover everything from staffing levels, to how practice-based learning is diversifying and whether there is placement capacity locally, regionally and nationally. It also provides a snapshot of the student profile.

The data in the student profile box is headline only. There’s more detail in the full reports. They also provide more of the context with which to interrogate/interpret the data. By reading the full report, you’ll see for example that while the data shows that there are less men (41 per cent) in the profession than the national average (49 per cent), this figure has been increasing year on year, giving us confidence that for gender the student population is likely to mirror the national picture shortly. A real change to the perception of a female dominated profession! 

Our continuing priority: equality, diversity and inclusion

When I first started at the CSP (a very long time ago now) I regularly used to hear voiced the opinion from a vocal minority (and it was a minority I hasten to add), that part of their role was to act as gatekeepers to the profession or that the purpose of placements was to create mini versions of themselves. There was a much narrower view of how physiotherapists should look and behave. 

I’m pleased to say those days are long gone – as the data in the student profile box shows the student population is actually diverse, and has been becoming increasingly more diverse as each year has gone by. 

And that has been intentional. I mentioned earlier that we need graduates who are agile, flexible and able to transform – challenging themselves and the services and organisations that they work for. And I also spoke about leaning in to difference.

One of the ways the CSP has been able to help shape the evolution of the profession has been by challenging that notion of uniformity. Particularly by setting inclusive expectations about admissions, and also by creating spaces and encouraging HEIs to share good practice around interview best practice for example. We’re able to set clear expectations and challenge appropriately because we rely on the data gathered through our AQR review, and also the research coming out from different HEIs around diversity and inclusion. 

We can then use this informed picture to create spaces for programme teams to come together to share and challenge each other to be more inclusive and diverse. We’ve also built an expectation into our education expectations including the new common placement assessment form that we’re piloting at the moment.

That way we’re clear that programmes must be inclusive and anti-discriminatory, that applicants are welcomed from all demographics and supported to thrive on their programmes – on placements and in the university setting. 

We have been actively working with programme teams to change a number of different elements to help bring this about. Small changes in the way we (all of us not just CSP) promote the profession, the images and language that we use. Teams have changed the way they interview and have looked critically about how they minimise bias.

It’s great that we’re making strides but that doesn’t mean we’re there yet nor are we complacent. It would be tempting to look at the ethnicity profile of those entering the profession say, and pat ourselves collectively on the back because the students are more diverse than the UK’s profile but we know we have a way to go.

We have a responsibility to ensure that those students are able to achieve as much as their white colleagues do, that they don’t suffer discrimination while on placement, that they see themselves, their lives and their reality reflected within the curriculum, and that their career aspirations are just as ambitious as their white peers.  Which leads me back full circle. CSP’s approach to education is all about the iterative process – continual improvements, and not settling for good when we can achieve great. And once we’ve achieved great, pushing on to exceptional! 

We review our AQR process continually because of that commitment. This year we’re collecting data that should help us understand the demographic of those that leave the programmes and why. We’ve expanded the sections on gender identity.

We’re looking at sexual orientation and trying to find a way to capture information about socio-economic background. All so that the programmes can continue to evolve and improve!

In detail: how we do it

You’ll notice a couple of new pages on CSP website that give you and any interested party a more in depth understanding of how we carry out our role. Suffice to say that like the HCPC we (CSP) also focus on outcomes, giving programmes the flexibility to develop within a framework of expectations.