A national survey exploring the influence of UK-based post-graduate education on the past, present and future of musculoskeletal physiotherapy practice.

Purpose: To describe current musculoskeletal (MSK) therapy masters-level graduates career pathways and explore clinical academic development needs to future-proof the profession and ensure UK Higher Education Institutes (HEI) and current workforce employers are responsive to the rapidly changing needs of practitioners, service delivery models and patients. Comparisons to a similar, 2008, survey, are discussed.

Methods: A mixed method survey design was utilised employing the Bristol online Survey platform to describe participants’ MSK career pathways, respondents’ experiences with MSK learning at masters’ level and explore the participants clinical academic development needs in a rapidly changing work-place. Descriptive statistics and thematic analyses were employed to develop understanding. Contrasts and similarities to data from a previous, 2008 survey, were undertaken to reveal the shifting needs and current drivers in the profession.

Results: In total, 272 participants, representing 11 UK HEIs, responded to the survey of which 63% graduated from their M-level studies since the 2008 survey. Comparisons from 2008 to the 2018 survey indicated a reduction in respondents undertaking clinical roles (83% in 2008 to 61% in 2018) with more grandaunts in academic careers (14% to 26%), a marked increase in private practitioners (8% to 31%) and the number of physiotherapy researchers tripling (n=21). Similar to the 2008 survey, Consultant therapist numbers were unchanged (6% to 7%). Most notably, there were marked drops in the numbers of respondents in extended scope (14% to 7%) and clinical specialist roles (17% to 5%). Respondents revealed that key positive factors from their studies were accelerated career progression (83%) and, personally, the enhancement of confidence and self-esteem (25%). Consistently, respondents found the most valuable learning elements that influenced clinical practice, included enhancement and application of clinical reasoning, evidence-informed research, critical appraisal and teaching skills. Respondents in both surveys were most disillusioned by their organisations lack of vision regarding opportunities for role development beyond M-level, with figures rising from 8% to 26%. Overwhelmingly, respondents requested further developmental opportunities at doctoral level (64%) with 17% wanting teaching qualifications and 9% seeking post-graduate business administration courses.

Conclusion(s): HEIs in the UK have consistently responded to the needs of employers and individual professionals by providing valued career development opportunities and an emergence of roles such as therapy consultants, clinical specialists, extended scope and, more recently, first contact and advanced practitioner physiotherapists. Nevertheless, respondents reported a paucity of development opportunities for senior/specialist staff beyond M-level with trends suggesting graduates are taking their higher-order skills from the NHS into alternate employment providers as reflected by the current acceleration in the uptake of roles in teaching/academia, research and private practice. The desire, of these respondents, to undertake clinical academic roles can be met by the partnership of HEIs and healthcare employers in the development of clinical professional doctorate pathways.