CHAPTER TWO How to prepare for placement
Clinical placements are one of the most exciting and enjoyable parts of your training as a physiotherapist. Placements provide the opportunity to develop and enhance your patient handling, problem solving, communication and team working skills, and to apply all of your theoretical knowledge as well as gain lots of new knowledge.
The Chartered Society of Physiotherapy (CSP) states that to qualify as a physiotherapist you need a minimum of 1000 hours of practise- based learning to prepare you for professional practise (Chartered Society of Physiotherapy 2005). To some this may be adequate in order to build enough confidence in your own ability, get out there on your own and go for it. For the majority of others it just doesn’t seem like enough time. Therefore, it is really important to make the most of every one of those 1000 hours and one way to achieve this is to do some placement preparation. Investing some time into getting ready for your placement will prevent you playing catch up on theoretical knowledge when you’re working full time as a student physiotherapist, trying to process all the new clinical knowledge that you will be gathering daily.
Where to get information on your placement
Placement profiles
Some universities have a profile for each placement. This should give details of type of placement you are going on, the address of where the placement is and how to get there, the name and contact details of who your clinical educator(s) will be, hours of work, accommodation if applicable, educational facilities, local information (Chartered Society of Physiotherapy 2003), possibly some recommended reading, and the types of conditions you will be seeing.
Your clinical educator
If he or she is happy to be contacted, call your clinical educator and make the most of the opportunity by writing down some specific questions before you phone. This is especially useful if the person you get on the other end of the phone is not volunteering much information. Examples of the things to ask about include: what types of patients or common injuries/conditions you will be dealing with; how many physiotherapists there are in the team; whether you will be seeing a patient on the first day or not; if there is anything they suggest you look over beforehand or any recommended textbooks or journal articles; what texts and other resources are available at the placement site; where and what time do you report on your first day; if there are any specific uniform requirements; what changing facilities are available and whether to bring a padlock. For infection control reasons you must change into uniform on site.
What do you need to know before placement?
Housekeeping information, for example: address of hospital; how you are going to get there; if there is somewhere to get lunch or do you need to take it; what you are expected to wear as uniform.
You are on placement to learn so remember you aren’t expected to know everything for your first day. No matter what, you will learn things as you go along.
Some departments will expect you to know more than others but know the basics and you can’t go wrong – make notes in a notebook to keep in your pocket.
Knowing too much will likely confuse you – know the basics to get a broad overview, then you will have a good knowledge base to build on when you start learning more on placement.
How much time you allocate to revision prior to placement will depend on what placements you have already been on, what knowledge you already have, your development of transferable skills and how much confidence you have.
Practising some practical skills, for example goniometry or carrying out other outcome measures, with a few friends will help you get used to handling patients when assessing them.Surgical respiratory
Pre- and post-operative respiratory assessment, including chest X-ray interpretation and arterial blood gas normal values and interpretation.
Find out common types of surgery you will encounter in your placement and be aware of what is involved and where the surgical incision is made as this can impact on physiotherapy input.
Normal values for SpO2 (blood oxygen levels), blood pressure, heart rate, respiratory rate, arterial blood gases.
Treatment options to clear secretions, decrease work of breathing and increase lung volume, e.g. mobilisation, positioning, ACBT (active cycle of breathing technique), manual techniques, incentive spirometry, suction (different types including via tracheostomy), IPPB (intermittent positive pressure breathing), oxygen therapy. Consider how you could assess for their effectiveness and how they may be modified and progressed.Harden B. Emergency Physiotherapy. Edinburgh: Churchill Livingstone, 2004.
Hough A. Physiotherapy in Respiratory Care – An Evidence Based Approach to Respiratory and Cardiac Management, 3rd edn. Cheltenham: Nelson Thornes, 2001.
Pryor J.A., Prasad S.A. Physiotherapy for Respiratory and Cardiac Problems, 3rd edn. Edinburgh: Churchill Livingstone, 2002.
Kenyon J., Kenyon J. The Physiotherapist’s Pocket Book. Edinburgh: Churchill Livingstone, 2004.

