Policy in undergraduate physiotherapy clinical education: Lessons from the implementation of the framework and strategy for disability and rehabilitation

Abstract

Background: Physiotherapy clinical education in South Africa faces persistent challenges related to equity, relevance and sustainability, compounded by resource constraints and workforce pressures. Policy, as a tool for shaping undergraduate clinical training, remains underutilised despite its potential to drive transformative educational practices. Objectives: This study explores how policy can inform and strengthen undergraduate physiotherapy clinical education, drawing on findings from a doctoral evaluation of the Framework and Strategy for Disability and Rehabilitation (FSDR) in South Africa. Method: An explanatory mixed-methods design was employed, guided by implementation science frameworks, to evaluate barriers, enablers and outcomes of FSDR implementation. Data were analysed to identify implications for clinical education, including curriculum design, clinical placements and supervisory practices. Results: Key barriers identified included limited funding, insufficient resources, weak intersectoral collaboration and workforce shortages. Enablers included active disability advocacy, alignment with international rights-based frameworks and community-based rehabilitation initiatives. Applying these findings to clinical education highlighted strategies for optimising clinical placement resources, building supervisor capacity, integrating disability-inclusive and community-based approaches and developing robust monitoring and evaluation systems to ensure training is relevant and socially accountable. Conclusion: Policy-driven transformation of physiotherapy clinical education is essential to equip graduates with the competencies required to meet societal and health system needs. Clinical implication: Embedding policy into clinical training fosters socially accountable graduates who can advance disability rights, contribute to equitable rehabilitation services and translate national health priorities into practical clinical practice.