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In Australia, physiotherapists are registered healthcare practitioners who possess the knowledge and skills to care for clients with poor physical health as a result of musculoskeletal, neurological, and respiratory conditions. Although physiotherapists are not considered a primary profession in the Australian mental health workforce, the association between suicide and poor physical health suggests that they may encounter clients with suicidal thoughts and behaviours. We used a qualitative approach inspired by phenomenology to explore the experiences of nine physiotherapists who encountered clients with suicidal thoughts and behaviours. We used a combination of focus groups and in-depth interviews to collect this data. The data were analysed inductively using framework analysis. The main themes identified in the data were: i) the importance of trust, ii) the mechanism of conversation, and iii) the 'middle space'. The middle space refers to the experience of working with clients at risk of low or medium risk of suicide. A trusting practitioner-client relationship was reported to be essential in facilitating the disclosure of suicidal thoughts and behaviours. Physiotherapists also reported that less structured subjective assessments encourage clients to talk more openly, which in turn facilitates the disclosure of suicidal thoughts and behaviours. Once the disclosure of suicidal thoughts and behaviours occurred, physiotherapists reported a lack of confidence regarding role clarity and issues associated with this. Difficulties were most evident during encounters with clients with low to medium suicide risk due to a lack of confidence in the accuracy of assessment of these clients. The findings suggest that physiotherapists are well placed to detect and/or receive disclosure of suicidal thoughts and behaviours, as well as the need for physiotherapists to be trained in how to support clients who disclose suicidal thoughts and behaviours.

This paper synthesises the results of three participatory action research (PAR) studies undertaken to improve the integration of evidence-based practice (EBP) education in three undergraduate health courses at one Australian university: Bachelor of Nursing, Bachelor of Occupational Therapy, and Bachelor of Physiotherapy. The PAR process with interested academics uncovered a range of EBP education strengths and weaknesses in the three courses. Common themes were evident, which are likely to be applicable in other similar courses. Identified weaknesses included a lack of explicit teaching about the meaning, principles, steps, and importance of EBP, partly stemming from a lack of shared understanding. A relative lack of emphasis on certain EBP steps was also noted, particularly the first step of ‘asking’ questions. A lack of communication with workplace learning (WPL) supervisors about how to facilitate EBP was also noted, raising concerns about variable EBP-education quality across WPL settings.  Opportunities for improvement were identified by academics in each course, across multiple subjects and year levels. In our experience, PAR has been a highly constructive approach to EBP curriculum improvement. We encourage consideration of a PAR approach for addressing similarly complex curriculum challenges.

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