Twenty-five alumni who had graduated from a postgraduate Clinical Biomechanics award at Staffordshire University between 2002–2020 (Fig. 1) completed the 15-item questionnaire. Respondents’ current professions include Podiatrist (n = 20), Physiotherapists (n = 3), Osteopath (n = 1) and Teaching Sports Biomechanics (n = 1).
Respondents’ currently work in a range of settings including Private practice (n = 10), NHS (n = 10), Academia (n = 2), Industry (n = 2) and within the Army (n = 1). Of the alumni questioned, 14 had completed MSc Clinical Podiatric Biomechanics, 8 MSc Clinical Biomechanics, 1 PgCert Gait Analysis, 1 PgCert Musculoskeletal Diagnostic Process and 1 PgCert Clinical Biomechanics. There had been a variety of different modules studied to equate to the award achieved with the majority of alumni studying the module on Origins and Principles of Biomechanics (Fig. 2)
3.3 Thematic analysis
Competency development
The first theme discusses how students have developed their capabilities during and implemented them following the completion of a postgraduate course. This theme has three sub-themes which describe how students have acquired a greater depth of knowledge, which has promoted enhanced clinical skills and has improved their clinical reasoning.
Greater depth of knowledge
Students discuss that completing a postgraduate course has helped them acquire a greater depth of knowledge and understanding which can be adapted for use within their professional careers, and this has led to the revision of their working practices. Further, this underpinning knowledge is adaptable to support the treatment of a variety of conditions.
“It is the underpinning of my knowledge of lower limb biomechanics and gives me the foundation to understand all mechanical injuries that come through my clinic door, whether they are tendinopathies or stress bone responses” (Respondent 7).
Furthermore, the students express that being part of an interprofessional cohort has contributed to their learning process. Respondents converse that by exchanging knowledge with other professions allows for a greater level of understanding from a different perspective.
“It is also good to work with different Professions such as Physios and Orthotist to enhance shared knowledge.” (Respondent 25)
“Perhaps by listening and observing how other students on the course worked biomechanically.” (Respondent 4)
Moreover, this acquisition of knowledge has led to improved professional confidence.
“Support through learning helped with confidence as growing underpinning knowledge was learnt” (Respondent 17) and has “enhanced and given me more confidence in my clinical treatment” (Respondent 15).
Enhanced clinical skills
Students disseminated that this greater level of knowledge informed from course content has supported them to enhance their clinical skills. This has supported student innovation by helping them think differently about patient conditions, and be clearer about treatment options, which can impact the effectiveness of treatment.
“My understanding of biomechanics has allowed me to address overuse injuries with greater success, working backwards to target the causes of their problems not just treat the symptoms” (Respondent 13).
“I have a more clear understanding about what treatment will be most effective in specific situations.” (Respondent 21)
“I’m much more aware of the insufficiencies in day to day gait and can direct my treatment based on what I observe in an individual’s gait analysis”. (Respondent 24)
These skills are adaptable and have allowed students to treat a range of conditions by using enhanced strategies to evaluate complex conditions.
“It has given me the skills to research and formulate treatment pathways for a variety of conditions” (Respondent 11).
“I apply biomechanical principals[sic] and tissue stress to all foot pathology from diabetic wounds to tendinopathy not just Podiatric paradigm theories. This has given me a better understanding of how to treat the root cause and not just the symptoms.” (Respondent 25)
Improved clinical reasoning
The completion of a postgraduate course has facilitated students to advance their clinical reasoning. Students suggested that they have adopted a more critical and reflective methodology within their professional practice which has also enhanced their problem-solving abilities within a clinical setting. Students are using their renewed understanding to challenge their perspective of their professional ‘landscape’ [12] which has supported the modification of their professional thinking.
“I was able to move away from the dogmatic approach taught at undergraduate level to be more critical. It elevated my problem-solving skills when you realise that there are so many more factors to consider” (Respondent 8).
Students have become more analytical not just about their own practice, but the practices of others with the aim to improve practice. The postgraduate course has given students confidence to communicate in a professional setting.
“It has given me the foundations to challenge existing practice and try to improve patient care” (Respondent 11).
“To implement new changes in the NHS which are researched base [sic] and give me more confidence in questioning and arguing the case for improvements within the department.” (Respondent 5)
“The MSc made me analyse and critically think about everything I was doing (to a higher level than as an undergraduate) the depth in which we covered the course content also gave me the confidence to challenge current systems.” (Respondent 20)
Clinical impact of postgraduate study
The second theme discusses how, by students enhancing their clinical skills and capabilities through postgraduate study, it has made a positive clinical impact. This theme has two sub-themes which are clinical practice and professional development. These themes discuss how clinical practices have improved through evaluating problems in a broader sense, using a different perspective, which has helped improve assessment and treatment methods; this has also aided in better dialogue with patients. The acquired skills and knowledge have improved confidence which has supported professional development (external and internal).
Clinical practice
Students outlined that they have altered their approach in clinical practice by changing their perspective when treating patients.
“The influence has changed the way I observe manage and treat patients with Biomechanical dysfunction especially from a foot-driven perspective.” (Respondent 4)
“Changed the way I thought and managed patients, altered materials used, ways of managing conditions changed and read a lot more”. (Respondent 19)
This has also informed process changes within clinical practice.
“Assessment process focussing on identification of structure causing tissue stress”. (Respondent 17)
Students’ enhanced understanding has helped improve the dialogue with their patients by having the skills to better explain to patient’s information regarding their conditions, leading to improved patient outcomes.
“I also feel better equipped to explain biomechanical causes of injury to patients in a way that they understand - which helps with compliance.” (Respondent 13)
“It has developed my ability to gain patient understanding of the condition.” (Respondent 15)
The improved confidence in their own clinical practice and communication skills has allowed students to work as part of an interdisciplinary team, which contributes to the improvement of interprofessional communication and collaboration.
“My master’s module has enhanced my knowledge and allowed me to work integrated in a multidisciplinary team and given me the confidence to discuss concerns i have with paediatricians re my patients.” (Respondent 2)
“The course has given me confidence to pursue a leadership role across a multidisciplinary team.” (Respondent 16)
“Improved links with physiotherapy/joint clinics for adults and paediatric patients.” (Respondent 5)
Professional development
The impact of completing a postgraduate course has helped students evolve and acquire skills and knowledge that have supported professional development, including the establishing of new clinics.
“Opened a new clinic specialising only in MSK injuries, running gait analysis and Sports Podiatry”. (Respondent 7)
Further, being part of a postgraduate course with other professionals has helped to support the formation of new working relationships.
“I went on to set up and develop the 1st community orthopaedic post with another colleague on my cohort”. (Respondent 6)
The impact of the course is far-reaching: it has not only helped individuals to progress in their chosen profession, but it has allowed students to share their learning by educating their colleagues.
“My masters allowed me to undertake training to my colleagues and pass on my new knowledge on orthotics and pressure redistribution for ulcers.” (Respondent 2)
“The MSc allowed me to embed my understanding and be able to teach clinical and functional biomechanics to the junior staff”. (Respondent 16)
“Helped me manage patients better and as went through the course all my team benefited from my learning as we all grew with the experience.” (Respondent 19)