EXSC637 - Clinical Experience 1

Year

Credit points

Campus offering

Prerequisites

EXSC634 Clinical Assessment and Exercise for Musculoskeletal Conditions of the Lower Limb AND EXSC636 Responsible Clinical Practice AND EXSC639 Clinical Assessment and Exercise for Musculoskeletal Conditions of the Trunk and Upper Limb AND EXSC679 Clinical Assessment and Exercise for Chronic and Complex Conditions

Teaching organisation

Unit rationale, description and aim

Accredited exercise physiologists (AEPs) must be able to deliver services competently, diligently and ethically and adapt their application of enhanced knowledge, skills and attributes to practice effectively across different clinical domains and within distinct models of consumer healthcare. EXSC637 is the first of three clinical experience units that place students in clinical domains specific to contemporary professional practice in exercise physiology. Supported by the sponsorship of a clinical educator, students will assimilate and apply old and new knowledge, skills and attributes through legitimate peripheral practice within models of consumer healthcare specific to public and or private hospitals, community health centres, private practice, the occupational health and rehabilitation sector, and/or relevant sport and educational settings. To foster critical thought, clinical reasoning and the ability to evaluate current practice, students will engage in purposefully designed experiential learning activities including deliberate practice, reflective observation, abstract conceptualisation of their practice and that of others, and active experimentation of clinical skills specific to a range of contemporary exercise physiology service provisions.  

The aim of EXSC637 and the clinical experience units is to develop essential clinical competencies as they relate to performance and provision of ethical, culturally safe, person centred and effective exercise physiology services for target pathologies within the exercise physiology scope of practice, consistent with the professional standards for AEPs.

Learning outcomes

To successfully complete this unit you will be able to demonstrate you have achieved the learning outcomes (LO) detailed in the below table.

Each outcome is informed by a number of graduate capabilities (GC) to ensure your work in this, and every unit, is part of a larger goal of graduating from ACU with the attributes of insight, empathy, imagination and impact.

Explore the graduate capabilities.

On successful completion of this unit, students should be able to:

LO1 - Demonstrate the development of essential clinical competencies as they relate to performance and provision of ethical, culturally safe, person centred and effective exercise physiology services for target pathologies within the exercise physiology scope of practice (GA1, GA2, GA3, GA5, GA6, GA7)

LO2 - Reflect on the application of enhanced knowledge, clinical skills, attributes and experiential learning in the clinical workplace setting, and analyse the implications for future clinical assessments and person centred exercise interventions implemented as part of holistic therapeutic management for consumers with target pathologies (GA3, GA4, GA5, GA8)

LO3 - Use effective communication to demonstrate reflection, critical thinking and evaluation of applied knowledge, skills and attributes in contemporary professional practice in clinical exercise physiology and relate to personal and professional growth as an exercise physiology practitioner (GA2, GA4, GA5, GA8, GA9, GA10)

Graduate attributes

GA1 - demonstrate respect for the dignity of each individual and for human diversity 

GA2 - recognise their responsibility to the common good, the environment and society 

GA3 - apply ethical perspectives in informed decision making 

GA4 - think critically and reflectively 

GA5 - demonstrate values, knowledge, skills and attitudes appropriate to the discipline and/or profession 

GA6 - solve problems in a variety of settings taking local and international perspectives into account

GA7 - work both autonomously and collaboratively 

GA8 - locate, organise, analyse, synthesise and evaluate information 

GA9 - demonstrate effective communication in oral and written English language and visual media

GA10 - utilise information and communication and other relevant technologies effectively.

Content

Students’ clinical experience will involve placement in a variety of clinical domains (public and or private hospitals, community health centres, private practice, occupational health and rehabilitation organisations, and/or relevant sport and educational settings), with different funding and service models (Medicare, WorkCover, DVA, TAC, NDIS, private health insurers), locations (metropolitan, regional, rural, international), and serving a variety of populations with different target pathologies, people of different socio-economic status and cultural backgrounds including Aboriginal and Torres Strait Islander Peoples and vulnerable people from marginalised groups.

To satisfy the practicum requirements mandated by Exercise and Sport Science Australia (ESSA) for accreditation as an exercise physiologist, students must complete a minimum of 360 hours of clinical placement across the three clinical placement units (EXSC637, EXSC684, EXSC680).

• Minimum of 200 hours clinical experience with Category 1 target pathologies which includes musculoskeletal, cardiovascular and metabolic conditions.  
• Minimum of 100 hours clinical experience with Category 2 target pathologies which includes other includes but is not limited to neurological, mental health, respiratory, and autoimmune conditions and cancer.
• An additional 60 hours of clinical experience with either Category 1 or Category 2 target pathologies OR clinical experience in any other professional activities relevant to the AEP Professional Standards.

Supplementary learning activities will centre on topics relevant to professional practice in different clinical domains. Topics include:

• Comparison of clinical domains and review of models of consumer healthcare 
• Models to structure personal reflections of current practice 
• Interprofessional practice and stakeholder relations 
• Strategies to enhance graduate employability 
• Cultural competence: Review of workplace frameworks and practices to develop cross-cultural capabilities 
• Identifying the gap between science and practice: Review of the application of clinical guidelines in practice 
• Review of clinical reasoning and frameworks to advance clinical decision making 
• Review of complex case studies 

Learning and teaching strategy and rationale

This unit is offered through multi-mode delivery and aims to facilitate learner centred, online and face-to-face learning. Learning and teaching strategies within this Masters level unit are based on a blend of constructivism, social constructivism, and experiential learning. These strategies focus on active participation within a community of inquiry. Purposefully designed online and face-to-face workshop activities, focus on inquiry-based learning principles aimed at encouraging critical thinking, application of knowledge and skills, evidence for practice, collaborative peer learning and self-reflection. 

On clinical placement, students will engage in purposefully designed experiential learning activities including deliberate practice, reflective observation, abstract conceptualisation of practice, and active experimentation of clinical skills specific to a range of contemporary service provisions. These activities will foster the ability to think critically and evaluate current practice to facilitate transition of learning into future practice.  

In addition, students participate in individual and small group activities based on analysis of current practice, to assimilate application of enhanced knowledge and supplement the translation of learning into practice. Engagement in extended dialogue is encouraged to guide changes in practice to be more collaborative, holistic, and person-centred. Unit activities include, but are not limited to: case based and problem-based learning activities, synchronous and asynchronous online tutorials, clinical work-based activities with reflection, use of a reflective journal during experiential learning, skill development, and mentoring to enhance practice. Together, both modes of learning aim of develop higher order thinking and reasoning including: consideration, interpretation, appraisal and critical analysis of data, information and ideas for guiding students towards competent practice and provision of ethical, culturally safe, person centred and effective exercise physiology services. 

Assessment strategy and rationale

Assessment tasks in this unit have been purposefully designed to prepare for and replicate authentic clinical practice, with an “assessment for learning” approach to provide evidence for judgement of learning and to reinforce, facilitate and support learning and its application. The assessment tasks have been designed to provide a broad range of tasks aligned to andragogic principles of adult learning, facilitating choice and self-direction for the post graduate student. The design enables timely judgement to ensure students have appropriate knowledge and skills prior to application in subsequent workplaces. 

To satisfy the practicum requirements mandated by ESSA for accreditation as exercise physiologists, students’ will produce a Professional Practice Portfolio for each clinical experience unit. This portfolio is multifaceted and comprises two distinct features.  

The first feature of the Professional Practice Portfolio relates to assessment of student performance on clinical placement using the Clinical Performance Assessment Tool (CPAT). The CPAT is an important assessment tool developed for the Master of Clinical Exercise Physiology that assists with the identification and evaluation of student competencies and professional clinical performance. Specifically, assessment of performance will enable students an opportunity to demonstrate the development of essential clinical competencies as they relate to performance and provision of ethical, culturally safe, person centred and effective exercise physiology services. The CPAT is a hurdle task in each clinical experience unit. Clinical educator ratings and constructive feedback documented in the CPAT are used to determine whether overall performance was adequate to constitute a pass for the clinical experience unit. Feedback from clinical educators will also be used to inform the facilitation of subsequent clinical education and specific experiential learning activities as student practitioners transition toward entry-level exercise physiologists. 

The second feature of the Professional Practice Portfolio is the Placement Summary Report (PSR). The PSR enables students to reflect on the application of enhanced knowledge, clinical skills, attributes and experiential learning in the clinical workplace. Students will document the critical elements of placement that contribute to their continuing development of essential clinical competencies within the AEP Scope of Practice. The PSR seeks to 1) identify the range of placement activities performed by students within the AEP scope of practice, and 2) deduct explicit examples from placement where student practitioners demonstrated the minimum professional requirements of clinical exercise physiology relative to performance of AEPs. The PSR must be reviewed and signed by the placement supervisor/clinical educator within five (5) days following placement completion. A signed copy must be to submitted to LEO for review by an ACU professional practice coordinator.

The third assessment task enables students an opportunity to use effective communication (including written, verbal and non-verbal communication skills) to demonstrate reflection, critical thinking and evaluation of applied knowledge, skills and attributes in contemporary professional practice in clinical exercise physiology and relate to personal and professional growth as an exercise physiology practitioner. Students will apply for a hypothetical exercise physiology job and participate in a face to face interview become familiar with the recruitment process. Students will receive formative feedback on the quality of their application and interview to inform preparations for future practice and assessment tasks in subsequent clinical experience units.  

Overview of assessments

Representative texts and references

American College of Sports Medicine (2016). ACSM’s exercise management for persons with chronic diseases and disabilities (4th ed.). Champaign, IL: Human Kinetics

American College of Sports Medicine (2016). ACSM’s guidelines for exercise testing and prescription (4th ed.) Philadelphia, PA: Lippincott, Williams and Wilkins

Cameron, M, Selig, S, & Hemphill, D. (2011). Clinical exercise: A case based approach. Churchill Livingstone.  

Deloitte Access Economics. (2015). Summary Report: Value of Accredited Exercise Physiologists in Australia. Exercise & Sports Science Australia. 

Ehrman, JK, Gordon PM, Visich, PS & Keteyian SJ (2018). Clinical Exercise Physiology (4th ed.). Champaign, IL: Human Kinetics. 

Exercise & Sports Science Australia (2021). Code of professional conduct and ethical practice. Retrieved on 26 April 2021 from https://www.essa.org.au/Public/Professional_Standards/ESSA_Code_of_Professional_Conduct___Ethical_Practice.aspx.

Hayes, SC, Spence, RR, Galvao, DA, & Newton, RU (2009). Australian Association for Exercise and Sport Science position stand: Optimising cancer outcomes through exercise. Journal of Science and Medicine in Sport, 12, 428-434.   http://www.essa.org.au/aaess/files/image/AAESS%20Cancer%20position%20statement.pdf 

Lederman, O., Grainger, K., Stanton, R., et al. Consensus statement on the role of accredited exercise physiologists within the treatment of mental health disorders: a guide for mental health professionals. Exercise & Sports Science Australia. 

Marlow, N, Hastings, K, & Hansson, J. (2013). Exercise & Sports Science Australia’s Outcome Measures for Exercise Physiologists: Ensuring Evidence Based Practice. Queensland: Exercise and Sports Science Australia.