Effective communication between a physiotherapist and a patient is considered essential for physiotherapy practice. Students are required to demonstrate ‘effective communication’ to become registered, yet it is not clear what actually constitutes effective communication. This study aimed to explore how clinical educators conceptualise effective communication in final year physiotherapy students in musculo-skeletal clinical settings in Aotearoa New Zealand.

Interpretive description informed by social constructionism was utilised as a methodology for this study. Seven physiotherapy clinical educators participated in the study. Data were gathered from two sources: written reflections from watching a student-patient interaction and semi-structured interviews. Reflexive thematic analysis was used to analyse the data.

Two themes were constructed from the data. Theme one is ‘Communication is complex’. The findings conclude that communication is by nature complex because it is subjective and deeply personal, and requires students to adapt and respond to a diverse range of patients and clinical situations ‘in the moment’. This suggests the task of making communication expectations visible to students, both in a practice setting and in assessment, is difficult. Theme two is named ‘Competing priorities wrestle for a place’. This study demonstrates that communication practices are shaped and perpetuated by broader understandings of physiotherapy practice which currently appear to be held in tension with each another rather than integrated. These are positioned as competing priorities at play.

Going forward, a broader understanding of the construct of person-centred communication is needed with particular attention to practical strategies for understanding the holistic needs of patients and more focus on doing care with patients rather than for them. Further training of both students and educators is needed so they have the tools to enact these in practice. Educators need support to make visible expectations of adaptive and responsive communication to students both in practice and in assessment so education is transparent and students know what the expectations are.