Co-creating learning: A qualitative exploration of physiotherapy clinical education

Background: A large part of physiotherapy clinical training is situated in the workplace. Learning in an authentic environment is supported by facilitators.
Objectives: This study focussed on the perceptions and understanding of physiotherapy students and facilitators while learning on the clinical platform.
Method: A qualitative methodology within an interpretivist paradigm was followed using convenience sampling.
Results: Physiotherapy students (n = 45) in their fourth and final year of study and clinical facilitators of this student group (n = 13) were invited to participate in a focus group discussion (FGD) for the students (n = 7) and semi-structured interviews for the facilitators (n = 7). An inductive data analysis approach was followed. Three themes were generated: Learning as a Shared, Active Process; Relationships, Role Modelling and Power Dynamics in Clinical Learning; and the Clinical Environment as Both Constraint and Catalyst.
Conclusion: Across themes, learning was shaped by how students and facilitators understood and enacted their roles, the degree to which student agency was recognised and supported, and how relational safety and environmental constraints mediated engagement. Implicit and sometimes misaligned expectations between students and facilitators influenced whether learning opportunities were taken up or constrained. Clinical learning emerged as a co-constructed, relational process rather than a unidirectional transfer of knowledge.
Clinical Implications: Supporting meaningful learning in the clinical environment requires greater attention to implicit expectations, relational dynamics and the conditions under which student agency can be enacted.