CONCLUSIONES Y RECOMENDACIONES

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Despite their comments regarding the M-level accelerated pre-registration course many of the participants admitted knowing little about its delivery and format ‘I mean I’m not entirely sure of the, how crammed in and the exact content of the course, … I haven’t really thought about it …, (Participant 11: lines 162-165). Another agreed:

how they might actually condense it into two years I, I’m not a hundred percent certain I must, must admit. Erm, … I’m trying to think what, I, I, nobody’s ever actually talked to me about it, where, erm, no I, I’m clutching at straws,

(Participant 14: lines 211-215).

The term ‘condensed’ was noteworthy and will be considered shortly. Many ‘hoped’ that students taking the course ‘would come out as having the same qualities and the same abilities’ as the traditional course (Participant 3: lines 458-460). This assumption is understandable as each and every UK physiotherapy training course has commonalities as dictated by the relevant statutory bodies which enforce the same standards of proficiency and curriculum frameworks (Health Professions Council, 2007; Chartered Society of Physiotherapy, 2002b). Re-validation events for such courses then ensure that the physiotherapy courses remain current, relevant and fit for purpose. Perhaps for this reason participants found the shortened timescales of such training to be confusing.

The perception of squeeze

The previous quote indicates that participants believed that the accelerated physiotherapy course was simply a shortened version of the traditional degree. Apparently it had a similar content but was simply compressed. Hence, to them, the accelerated physiotherapy course has ‘a year to make up’ (Participant 1: line 147). The following was a common point of view which illustrates the theme:

having sort of undertaken the three year course myself it was a squeeze to get everything into three years… er, so initial er, thoughts would be how do you do it in two? How do you get to the right standard in two, erm, without a good background already (Participant 2: line 74-80).

From such responses the theme of ‘squeezing a quart into a pint pot’ was created to reflect the perceptions of many participants. It was a question that was reproduced in the questionnaires in Stage Five. Of the 51 respondents 63% (n=32) agreed that ‘three years of

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training are required to develop the necessary skills to become a physiotherapist’. In contrast 37% (n=19) disagreed.

According to the Oxford English Dictionary (OED) ‘accelerated learning’ is taken to mean ‘an intensive method or course of study which enables material to be learnt in a shorter time than is usual’ (Oxford University Press, 2009, no page). The term ‘fast-track’ can mean ‘a route to rapid advancement or development’ (Oxford University Press, 2009, no page). These terms appear to be neutral or non-judgemental. However, several participants expressed their concern and/or confusion regarding such accelerated training:

- ‘it does seem quite a lot to do from, within a two-year sort of space …very intense’ (Participant 3: line 205-207),

- ‘there’s a lot more packed in’... ‘into a much tighter timescale’ (Participant 11, line 37; 43), - ‘It’s quite compact for them isn’t it, everything’s sort of thrown at them at one go’

(Participant 13: line 36-37),

Thus it appeared as though some participants interpreted the concept of accelerated learning meaning ‘hurried’ or ‘rushed’ as suggested by Swenson (2003). The OED defines ‘rushed’ as

to have much to do in a limited time, to be hard-pressed by shortage of time (also with the activity or the period of time as subject). Hence in colloq. phrases ‘to be rushed around, to be rushed off one’s feet

(Oxford University Press, 2009, no page).

The perception of absence

However, other participants showed greater concern. For them it was not an issue of compressing course content but one of reduction of course content:

I find it difficult to think you can get the same amount of knowledge in there within a two-year period compared to a three-year period,

(Participant 3: line 244-246).

For this reason Participant 3 ‘can’t imagine’ what elements of a physiotherapy training could be excluded from an accelerated training course and yet enable a student to qualify (Participant 3: line 145-146). They suggested from their own experiences that sufficient time was required to develop the intricacies of their vocational training. This was supported by Brookfield’s (2003) critical theory perspective on accelerated learning highlighting that:

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extended contact time and a teacher’s skilled help are also believed to be necessary so that learners are able to uncover dimensions and applications of ideas that would remain hidden in on-line or independent study environments, (Brookfield, 2003 p73).

Yet it contrasts with Scott’s (2003) findings that compared accelerated courses and traditional courses that were presented by the same instructor. Scott found that the uninterrupted delivery and ‘intensive’ format of the course enabled synthesis and understanding rather than detracting from it, (Scott, 2003).

The perception of lost depth

Lastly, the sense of reduction progressed to a sense of lost depth of knowledge, understanding and application. For one participant ‘there’s only so many hours in, in a year… how many hours are in a year? (laughs)’ (Participant 2: line 650; line 661). To another ‘I don’t think it’s [the basics are] covered in perhaps as much detail’ (Participant 14: line 172-173). These doubts are reflected in the literature of other disciplines suggesting that accelerated courses sacrifice breadth and depth as noted in the fast-food analogy of the ‘McDonalds of higher education’ (Wlodkowski, 2003; Traub 1997).

Meanwhile, other participants spoke of particular elements of the training course to highlight their concerns. Some participants recognised the timetabling issues for students to gain the required 1,000 hours of clinically-based experience that is needed to successfully complete any validated physiotherapy course (Chartered Society of Physiotherapy, 2002b). They calculated that students must ‘spend more or less a year out on placement’ out of total of 2 years, (Participant 13: line 32-35). To this individual this had ramifications upon the remaining theory-based instruction sensing that consolidation of knowledge and skill could be affected. Perhaps for this reason Participant 7 appeared equally concerned:

I would say my own personal opinion would’ve been, I would’ve been very wary about somebody who would’ve come on the back of an accelerated programme because how can you suddenly in two years acquire some of the actual skills erm, particularly some of the practical skills in a shorter time and take on board all the information from a theoretical point of view and sort of synthesise that into your like clinical reasoning process?

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The choice of the word ‘suddenly’ in the context of a two-year course indicated Participant 7’s unease. She questioned whether there would be ‘elements or bits missing from the curriculum’ (line 885). Another participant spoke of a dilemma that the accelerated route lessened the abilities of such graduates but sensed, logically, that this could not, or should not, be the case. The following quotes summarise a lengthy conversation that needed some teasing out. Despite having already supervised accelerated graduates there was:

still just at the back of my head… erm, that, that they might have missed something maybe in …

[J: What might they have missed?]

I: … some, something they might have not learned that they needed to learn which is kind of ridiculous because if they had they wouldn’t have got through their exams and their clinical placements.

(Participant 1: line 761-770).

[J: What’s niggling at the back of your mind?]

…I wonder if it’s like … a little bit like, took me three years to learn this stuff, what makes them think they can do it in two?

(Participant 1: line 806-812).

The last statement ‘what makes them think they can do it in two?’ signified unease and even suspicion giving a negative position to this ‘squeezing’ theme. It suggested that she believed the accelerated student to be arrogant or unaware. However, it is an interesting contrast to the interview participants’ beliefs that the accelerated graduates were super-human. The distrust has some comparisons with the findings of Halkett and McLafferty’s (2006) study of traditional nursing students who showed animosity towards accelerated students. In that study they were perceived as ‘cheating’ or ‘getting an easy ride’; and questioned ‘who do you think you are?’ (Halkett and McLafferty’s (2006, p164).

Participant 5 offers concerns from a practical perspective:

I think if you’re trying to learn in two years what other people are learning in three then there are things that you’ve probably done that you haven’t absorbed in depth that there are probably written in your notes somewhere but you perhaps haven’t had time to consolidate that knowledge erm so I think sometimes yes there is that possibility or that the course just didn’t have time to explore some of the treatments or conditions perhaps as much as we used to,

(Participant 5).

For these reasons the content of a first degree proved to be an important issue to be able to ‘cope with the accelerated learning’ (Participant 10; line 525). It was considered that

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accelerated students needed ‘relevant knowledge to be able to cope with the amount of work to get done in two years rather than three’ (Participant 10: line 613-615). This suggests relevant prior knowledge. Whilst some participants did not consider the graduates’ first degree others did recognise the accelerated graduates’ benefit of two combined courses. This gave them five years’ worth of study of ‘quite similar kind of things’ (Participant 11: line 683). Such accelerated graduates would therefore have a ‘broader knowledge’ and ‘a bit more of an overview’ (Participant 4: lines 421-426) giving them a ‘head-start’ (Participant 12: line 434). Another went further stating that it ‘had almost shaped the kind of people that they were’ (Participant 8: line 285). Accordingly it would be:

it’ll be much more ‘oh yeah I’ve done that and now I’ve, just let me sort of re-look at it in this sort of term from a physiotherapy angle’,

(Participant 7: line 833-836).

Such comments are reflected in the literature as Pepa et al. (1997, p48) suggested that the accelerated students’ prior learning enabled them to ‘grasp the concepts relating to nursing more quickly and to matriculate through the program at a faster rate’ than traditional students. This offers one explanation for the perceived success of these courses.

Hence there was a divide amongst participants. A few suggested that the accelerated graduates were at a disadvantage by not having studied a three-year physiotherapy course. Others offered less concern for the accelerated students by believing that they had more in their armoury, not less, by virtue of five years worth of study. Nonetheless it transpired that the nature of the previous degree was of concern to some participants as discussed in the next section.

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