Clinician's Commentary on Hall et al.1

It is well established that clinical education (CE) is a vital part of entry into practice training for physiotherapy students. This form of education depends on the willingness of clinicians to take on a supervisory or instructor role. Educational programmes are increasingly being challenged to find quality placements, and larger class sizes are putting further demands on these already scarce resources. The article by Hall and colleagues 1 provides a compelling argument for understanding the factors that influence therapists' decisions to supervise or not supervise students. The article identifies six factors that influence this decision: stress, workplace productivity, the evaluation instrument, student preparation, instructor preparation (related to evaluation), and physiotherapists' professional roles and responsibilities. The article also identifies challenges specific to loss of income and the ethics of charging for student services in private practice and clusters these challenges under the student preparation factor. The strongest influencer identified is therapist stress. Clini-cians are experiencing increasing pressure in the health care environment, with leaner staffing models in patient care environments (including outright short staffing), increased acuity and complexity of patients, and quicker turnover of patients through the health care system. Practices are also changing. For example, acute care environments are seeing a shift in the cardiorespiratory world from manual chest care (percussions, vibrations, etc.) to chest care interventions that are more focused on mobility. In some environments, therapists no longer believe that they are able to offer students a cardiorespiratory learning experience, voicing concerns about a disconnect between stu-dents' expectations and the type of learning that therapists are able to provide. The reluctance of these clinicians to supervise places an additional barrier on a system that is already under stress. It has been suggested that the stress associated with CE can be decreased by a work environment that supports student CE and by training courses aimed at preparing the clinician for the role of supervisor and evaluator. Hall and colleagues 1 point out that these types of courses are available—for example, through free web-based programmes such as the Preceptor Education Program for Health Professionals and Students 2 —and are also offered by university physiotherapy programmes. But are these programmes having the desired outcome of producing better prepared (and therefore less stressed) clinical educators? Does awareness of these programmes mean that people will use them? Are we preaching to the choir in that attending clinicians are the individuals who are already supervising …