Document Type : Original Articles


1 Department of Occupational Therapy, School of Rehabilitation Sciences, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran

2 Musculoskeletal Rehabilitation Research Center, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran

3 Physical therapy, Musculoskeletal Rehabilitation Research Center, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran.

4 Department of physical therapy, School of rehabilitation Science, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran

5 Department of Physiotherapy, School of Rehabilitation Sciences, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran

6 Department of Health Education and Promotion, School of Health, Isfahan University of Medical Sciences, Isfahan, Iran

7 Menopause & Andropause Research Center, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran

8 Department of Health Education and Promotion, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran


Background: Clinical education is a core component of the curriculum of undergraduate rehabilitation students. Nevertheless, this field more than any other field of education has many shortcomings that should be addressed.
Methods: The aim of this study was to explore the challenges of clinical education from the perspective of rehabilitation educators with particular focus on the new challenges created bythe COVID-19 outbreak. This qualitative study was conducted through purposeful sampling. Semi-structured interviews were conducted with 12 rehabilitation clinical educators of Ahvaz Jundishapur University of Medical Sciences, Iran. Data analysis was accomplished according to conventional content analysis. To prove the trustworthiness of the data, credibility, dependability, confirmability, and transferability were assessed.
Results: Through data analysis, 240 initial codes were extracted in three main categories and nine sub-categories, indicating redundant challenges imposed by COVID-19 comprising restricted clinical resources (inadequate patient number and diversity, inadequate equipment, limited clinical space, inadequate manpower), an inefficient clinical education system (poor management of clinical education programs, insufficient clinical evaluation), and personal and professional characteristics of the students (lack of students’ practical knowledge, lack of motivation, fear).
Conclusion: The results of this study provide deeper insight into the perceptions and experiences of rehabilitation educators regarding clinical education challenges. At present, an accidental and unexpected problematic event (COVID-19 pandemic) has inflicted detrimental effects on various aspects of clinical rehabilitation sciences. It is necessary to implement changes in future plans which include adaptations for COVID-19.


1. Sevenhuysen SL, Haines T. The slave of duty: Why clinical educators across the continuum of care provide clinical education in physiotherapy. HKPJ. 2011;29(2):64-70.
2. Mohseni R., Sandoughdar N., Bradaran H.R., Kouhpayezadeh J.. Educational Environment of Rasoul-e-Akram Hospital;Viewpoints of Speech-Therapy Learners. Educ Strategy Med Sci. 2016;8(6):43-8
3. Hirneth M, Mackenzie L. The practice education of occupational therapy students with disabilities: practice educators’ perspectives.BJOT. 2004;67(9):396-403.
4. Alsiö Å, Wennström B, Landström B, Silén C. Implementing clinical education of medical students in hospital communities:experiences of healthcare professionals. IJME.2019;10:54.
5. Hamid B, Faroukh A, Mohammadhosein B. Nursing students’perceptions of their educational environment based on DREEM model in an Iranian university. MJMS.2013;20(4):56.
6. Ajani K, Moez S. Gap between knowledge and practice in nursing.Procedia Soc Behav Sci. 2011;15:3927-31.
7. Pazokian M, Rassouli M. Challenges of nursing clinical education in world. MEJ. 2012;5(8):18-26.
8. Pashmdarfard M, Shafarood N. Factors affecting the clinical education of rehabilitation students in Iran: A systematic review.MJIRI. 2018;32:114.
9. Baraz S, Memarian R, Vanaki Z. Learning challenges of nursing students in clinical environments: A qualitative study in Iran. J.Educ. Health Promot. 2015;4.
10. Tabatabai S. Simulations and virtual learning supporting clinical education during the COVID 19 pandemic. Adv Med Educ Pract.2020;11:513.
11. Kamali M, Dadgoo M, Ghanaatian S. Physiotherapy students’ experiences from clinical education processes: A qualitative study. J. Rehabil. Sci. 2013;9(5):818-32.
12. Rezaee M, Rassafiani M, Khankeh H, Hosseini MA. Experiences of occupational therapy students in the first fieldwork education:a qualitative study. Med J Islam Repub Iran. 2014;28:110.
13. Shafaroodi N, Kamali M, Parvizi S, Hassani Mehraban A.Occupational Therapists’ Clinical Reasoning: A Qualitative Study.Iran. Rehabil. J.. 2017;15(3):277-86.
14. Beidokhti MH, Moradi N. Assessment of Satisfaction of Rehabilitation Students With Clinical Education Quality in Ahvaz University of Medical Sciences. J. Mod. Rehabil..2017;11(4):251-7.
15. Cole B, Wessel J. How clinical instructors can enhance the learning experience of physical therapy students in an introductory clinical placement. Adv Health Sci Educ.2008;13(2):163-79.
16. Hashemian M, Solhi M, Gharmaroudi G, Mehri A, Joveini H, Shahrabadi R. Married Men’s Experiences of Domestic Violence on their Wives: A Qualitative Study. Qual. Health Res.2020;7(2):214-26.
17. Guba EG. Criteria for assessing the trustworthiness of naturalistic inquiries. Ectj. 1981;29(2):75-91.
18. Dastgheibi SMR, Kamali M, Dadgoo M, Chabok A. Internal elements and external factors affecting physiotherapy clinical education from physiotherapy student’s perspectives: Qualitative study. J. Rehabil. Sci. 2014;10(3):393-407.
19. Zareiyan Jahromi A, Ahmadi F. Learning needs assessment in bachelor of nursing: a qualitative research. IJME. 2005;5(2):81-92.
20. A’bdi K, Maddah S S B, Rahgozar M, Dalvandi A. Evaluation of Educational Situation of Rehabilitation Branches in Welfare and Rehabilitation University from the Student’s Viewpoint in Educational Year 2003-2004. jrehab. 2007; 7 (4) :57-64
21. Alavi M, Abedi H. Nursing students experiences from effective clinical education. 2006.
22. Larin H, Wessel J, Al-Shamlan A. Reflections of physiotherapy students in the United Arab Emirates during their clinical placements: a qualitative study. BMC Med. Educ. 2005;5(1):1-9.
23. Nodehi Moghadam A, Abdi K, Kashfi Ardehjan P. Exploring the challenges of physiotherapy clinical education: A qualitative study. Iran. Rehabil. J.. 2017;15(3):207-14. 24. Farzi S, Shahriari M, Farzi S. Exploring the challenges of clinical education in nursing and strategies to improve it: A qualitative study. J. Educ. Health Promot. 2018;7.
25. Lovrić R, Farčić N, Mikšić Š, Včev A. Studying during the COVID-19 pandemic: A qualitative inductive content analysis of nursing students’ perceptions and experiences. Educ. Sci..2020;10(7):188.
26. Namdar P, Dehghankar L, Shafaei M, Panahi R, Yekefallah L. Challenges in the Clinical Education Environment during the COVID-19 Outbreak: The Experiences of Medical Students. Int.J. Body Mind Cult. 2021.
27. Hashemiparast M, Negarandeh R, Theofanidis D. Exploring the barriers of utilizing theoretical knowledge in clinical settings: aqualitative study. Int. J. Nurs. Sci..2019;6(4):399-405.
28. Bazrafkan L, Najafi Kalyani M. Nursing Students’ Experiences of Clinical Education: A Qualitative Study. Investigacion y educacion en enfermeria. 2018;36(3).
29. Grantcharov TP, Reznick RK. Teaching procedural skills. Bmj.2008;336(7653):1129-31.
30. Kouhpayezadeh J, Dargahi H, Soltani Arabshahi K. Clinical assessment methods in medical sciences universities of Tehran–Clinical instructors’ viewpoint. HMJ.2012;16(5):395-402.
31. Reid WA, Duvall E, Evans P. Relationship between assessment results and approaches to learning and studying in year two medical students. Med. Educ. 2007;41(8):754-62.
32. Aliakbarzadeh Arani Z, Salmani S, Farghadanai Z. The Relationship between Clinical Education Status and Academic Motivation in Students of Qom University of Medical Sciences.Educ Res Med Sci. 2019;11(4):3-12.
33. Orsini C, Evans P, Binnie V, Ledezma P, Fuentes F. Encouraging intrinsic motivation in the clinical setting: teachers’ perspectives from the self‐determination theory. Eur JDent Educ .2016;20(2):102-11.