When Thao Nguyen arrived at the Royal Melbourne Hospital (RMH) as a newly appointed physiotherapy clinical educator at the end of 2021, Melbourne was still grappling with the lingering effects of the pandemic. 

Physiotherapy placements had been cancelled, shortened or modified, leaving many emerging clinicians without the depth of exposure typically required for a confident transition to hospital practice.

Speaking at APASC25 in Adelaide last October, Thao recalled that those disruptions had left the junior workforce pipeline severely impacted, sparking conversations across the sector on how to better support new graduates entering an increasingly complex clinical environment.

As the RMH prepared to onboard six new graduate physiotherapists in 2024—more than 20 per cent of its Grade 1 cohort—Thao recognised the need for a structured, accessible model of early support. 

This group, he says, had experienced fragmented clinical learning and would soon be stepping into high-demand rotations without the preparation typical of recent years.

Thao worked alongside Laura Sparkes (deputy manager of physiotherapy at the RMH) and together they began to address the gap, creating the Workforce Integration Support Program (WISP), which is designed to ease what many have described as the shaky early stage of practice. 

‘The transition from healthcare students to practitioners in a professional setting is known as the flaky bridge,’ Thao says. 

‘And new graduates have reported experiencing transition shock when they enter the workforce.’ 

Thao cited research by Stoikov and colleagues in 2022, which found that many students were protected from actual clinical practice during their placements and were often not exposed to the essential tasks required in real hospital work. 

‘They were sheltered from complex patients and from dealing with all the other bits of being a physiotherapist, such as reviewing and prioritising case loads, delegating to allied health assistants, interacting with the multidisciplinary team and managing complex patients.’

Thao further highlighted the challenges faced by new graduates as they transition into the workforce, since students were commonly shielded from prioritising ward lists, managing complex or deteriorating patients and coordinating with multidisciplinary teams. 

Thao says the research showed that new graduates were arriving in their first roles ‘unaccustomed to receiving minimal supervision and feedback’ and reported wanting ongoing reassurance. 

They also tended to set extremely high expectations for themselves, expecting to achieve outcomes comparable with senior clinicians—a pressure that led to excessive stress.

Thao understood the weight of this transition. While physiotherapy students might graduate with a strong theoretical grounding and solid patient-handling fundamentals, their early exposure to the realities of hospital practice is varied.

Thao and Laura’s response was to build something practical, sustainable and grounded in real workforce needs. They created WISP as a learner-led system designed to complement existing supervision. 

Prior to WISP, new graduates received support from a buddy and a dedicated supervisor but this tended to focus on social integration or high-level clinical oversight. 

There was no structured mechanism for consistent, rotation-specific support delivered by someone closer in experience. 

WISP filled this gap by inserting a trained Grade 1 physiotherapist, known as a WISPeer, into the new graduate’s first weeks on the wards.

Thao described the program’s aim as being ‘to optimise the transition to practice for new graduate physiotherapists through targeted learner-led near-peer-supported activities’. 

The idea was not to replace supervision or formal professional development but rather to build a bridge between training and independent practice—a bridge built by someone who had only recently walked it themselves.

WISP’s aims were multifaceted, Thao says. 

It aimed to provide new graduates with timely access to resources, processes and systems relevant to their rotation; help guide wellbeing and self-care; reduce the onboarding workload for senior clinicians; and build capability in Grade 1s, who were often restricted from supervising students due to enterprise bargaining changes. 

‘We wanted to also target them with WISP, giving these clinicians the chance to develop skills in guidance, reflection, communication and teaching.’

In its first year of operation, WISP supported six new graduates across the two main campuses of the RMH. 

The graduates were matched with three WISPeers, who provided four hours of structured support a week for four weeks, with optional tapering. 

The program was refined in its second year, supporting five new graduates across two intakes. Evaluation was embedded from the beginning. 

Thao asked the new graduates and WISPeers to complete weekly diary entries documenting their experiences, emotional responses, activities and skills developed. 

Supervisors and team leaders were also surveyed at the program’s end to capture service-level impacts.

The early data reflects what Thao had hoped to achieve. New graduates submitted 56 diary entries, most expressing overwhelmingly positive sentiments. 

Thao Nguyen from the Royal Melbourne Hospital discusses the WISP program at APASC25 in Adelaide. Picture: Michael Blyde

They frequently described feeling welcomed, supported, confident and settled and many noted steady improvements in their clinical performance. 

While there were occasional mentions of feeling overwhelmed or tired, Thao noted, ‘I feel that that is kind of natural when you’re entering the workforce for the first time.’

The activities undertaken in WISP mirrored the needs highlighted in the literature.

Co-treating was the most common activity, allowing new graduates to observe and practise alongside a near peer while receiving real-time feedback. 

Debriefing sessions followed, giving the pair space to discuss treatment decisions, patient responses and workflow priorities. 

WISP also helped new graduates to navigate electronic medical records, manage case loads and referrals, and work with complex patients—areas where placements had left gaps. 

Week by week, the diary entries showed a steady decline in the amount of hands-on support required, which Thao says is evidence of increased confidence and competence.

One of the most compelling aspects of WISP, Thao says, was the effect on the WISPeers. 

In total, 29 diary entries were submitted by the Grade 1s providing support, revealing substantial gains in their professional, clinical and educational capabilities.

Communication skills, self-reflection and time management were commonly cited areas of growth. 

In education-focused skills, WISPeers reported improvements in guiding reflections, making thinking visible, debriefing, tailoring learning and offering feedback. 

Even clinical skills benefited, as supporting new graduates encouraged WISPeers to examine their own clinical reasoning more deeply. 

One noted that observing the new graduates’ assessments ‘prompted me to reflect on my own growth and how my clinical reasoning skills have evolved’, Thao told conference delegates.

Thao says the insights mattered, not only for the development of the WISPeers but for the broader workforce pipeline. 

With fewer opportunities to supervise, WISP became a crucial mechanism for maintaining and growing instructional capability among the Grade 1 cohort, strengthening the department’s educational culture in a sustainable way.

Supervisors and team leaders also experienced clear benefits, Thao says. 

Many felt the program reduced their workload and pressure, freeing them from the expectation of providing all onboarding support. 

Thao says team leaders noted that WISP complemented the existing orientation process, offering a good balance between providing support and encouraging autonomy—a balance difficult to achieve when new graduates are overwhelmed.

The program was not without its challenges. Thao emphasised that ‘the allocation of the new grad and near-peer support is actually a crucial part’ of the program because interpersonal rapport strongly shaped outcomes. 

'Timing mattered too; WISP worked best when implemented as soon as graduates started.'

Communication across a large and partly part-time workforce was difficult, particularly because WISPeers were part of a leave reliever rotation and moved frequently between areas. 

Some senior leaders questioned whether WISP’s purpose and objectives had been clearly articulated across the department, highlighting the need for ongoing communication and refinement. 

Thao acknowledged that measuring onboarding impacts more formally, such as quantifying time saved, would strengthen the program’s evidence base.

Despite these complexities, WISP achievements were encouraging, Thao says. 

During his presentation, Thao noted that ‘the transition to practice for new graduate physiotherapists can be eased with a short period of support provided by a near peer, with benefits for the individual as well as for the health service’. 

He concluded that similar initiatives could benefit physiotherapists at other transition points in their career, suggesting that the principles behind WISP—learner-led support, near-peer connection and timely guidance—are relevant across the professional life span.

In just two years, the RMH’s WISP has become a model of strengthening early clinical transitions into physiotherapy, Thao says. 

It has enriched the confidence and capabilities of new graduates, supported the growth of emerging educators, eased the workload of supervisors and contributed positively to team culture. 

Most importantly, the program has created a bridge between education and practice, built through meaningful, compassionate peer-to-peer support, he says.