Electrophysical agents: Entry-level physiotherapy curricula and physiotherapy practice

The ability of the new graduate physiotherapist to perform safely and competently in a range of clinical settings is integral to the effective delivery of patient services. As such, entry level curriculum must match the competencies required of a practicing physiotherapist. Electrophysical agents (EPAs) are a core competence required of Australian new graduate physiotherapists. There is currently a paucity of published research on how physiotherapy entry level education is designed to ensure that new graduates are prepared in those EPAs considered essential for safe and competent practice. The broad goal of the research program was to ascertain if a discrepancy existed between entry level physiotherapy curricula and contemporary clinical practice. To achieve this, two separate prospective studies were conducted sequentially

Which learning activities enhance physical therapist practice? Part 2: Systematic review of qualitative studies and thematic synthesis

Objective. Post-professional physical therapy expertise requires career-long participation in learning activities. Understanding physical therapists’ lived experience of learning activities provides novel insight into how best to enhance physical therapist practice from the perspective of the learner. The purpose of this study was to explore qualified physical therapists’ experiences, beliefs, and perspectives with regard to learning activities and professional development. Methods. Eight databases were searched for studies published from inception through December 2018. Study selection included mixed-methods and qualitative studies exploring physical therapists’ experiences, perspectives, beliefs and attitudes. Thematic synthesis was performed, and the GRADE-Confidence in the Evidence from Reviews of Qualitative research (CERQual) was used to assess the level of confidence in the findings. Forty-one studies with 719 participants were included. Results. The key findings include physical therapists’ perceptions that worthwhile post professional learning requires more than attendance at professional development courses. Physical therapists perceived that worthwhile learning requires connection with others and being “taken out of ones’ comfort zone.” Sufficient time and accessible, trustworthy resources were also valued. Conclusions. Moderate- to low-level evidence suggests that the choice of professional development activities and education design for qualified physical therapists should consider the inclusion of connected activities, activities that take participants out of comfort zones, time to practice, and trustworthy resources that are easily accessible. Future research should evaluate the effectiveness of learning activities encompassing these factors, prioritizing those that minimize the barriers of time and distance. Impact. This study adds to the profession’s understanding of physical therapists’ lived experience of learning activities, providing novel insight into how best to enhance physical therapist practice from the perspective of the learner

Study abroad: Exploring the pre-departure preparation provided to students, staff and host communities

Student pre-departure preparation has been identified as essential if study abroad programs involving work integrated learning are to deliver the numerous benefits they intend, while mitigating the many risks they involve. However, little is known about what preparation is provided to the academic and professional staff who implement these programs, and the community members who host the students. Interviews with 16 academic and professional staff involved in preparing students, staff, and host communities for Australian study abroad programs reveal inconsistencies in the preparation provided to students, and very limited preparation to staff and host communities. The limited preparation that is offered, is designed and developed in an organic (not structured) and inconsistent manner. Our findings suggest that institutions should consider implementing a more structured, consistent and institutionally driven approach to preparation for students, staff, and host communities to reduce the substantial risks associated with these programs while maximizing the benefits

Evaluating Telesupervision as a Support for Clinical Learning: an Action Research Project

Telesupervision is a process whereby distant supervision is provided using electronic information and communication technologies. This study aimed to investigate whether telesupervision can be used as an effective method of supervision to complement traditional face-to-face clinical supervision in physiotherapy, speech pathology and occupational therapy education.Three action research cycles were undertaken between July 2010 and December 2012 in Queensland, Australia. A shared supervisory model was employed whereby telesupervision was used as an adjunct to face-to-face supervision in a variety of clinical contexts. Phase 1 was undertaken as a metropolitan pilot while Phase 2 was conducted in a regional city and Phase 3 in a geographically isolated rural town. Participants included 30 students from entry-level programmes in Physiotherapy, Occupational Therapy and Speech Pathology and five remote clinical educators (CE), and five on-site CEs. Evaluation consisted of clinical educator and researcher observations, a student satisfaction survey and a student learning survey. In later phases, data were collected from individual semi-structured interviews with students, remote and on-site CEs.Results demonstrate that student learning is not compromised when telesupervision is used to complement face-to-face supervision. Further, when used with small educator to student ratios (1:4), students were satisfied with the process. Many of the benefits of the telesupervision experience appeared to be due to the shared supervisory model. Limitations were low bandwidth and unreliable connectivity that interrupted learning; however, cyclical problem solving by educators and students improved the telesupervision learning experience

Development and validation of an assessment tool for higher education learning abroad programs:A qualitative Delphi study

Background: Higher education learning abroad programs provide many benefits to healthcare students. However, inadequate preparation prior to their international travel, and misdirected motivations for their participation, can jeopardise the benefits and increase the risks. While it is pivotal to objectively evaluate pre-departure student preparation and the impact the programs have on students, existing assessment questionnaires fail to inform these aspects. Objectives: To develop an assessment tool (two surveys) to holistically evaluate learning abroad programs for higher education healthcare students. Design: A qualitative Delphi technique. Participants: A total of 24 experts who had designed, managed, participated in, hosted, funded, and/or researched Australian learning abroad programs for higher education students. Methods: The study was conducted over a 4-month period. An initial set of pre-departure and post-program questions was developed through a review of the existing literature and from a post-program survey previously used at an Australian higher education institution. Subsequently, experts provided constructive and practical feedback on the questions to be included in the two surveys. Results: The experts reached consensus on the 26 questions to be included in the pre-departure survey and the 16 questions in the post-program survey after three Delphi rounds. Key areas of interest to the experts were mitigating student risk, improving effectiveness of pre-departure briefings, gaining a better insight into student motivations for participation, and understanding the impact the programs have on students. Conclusions: The development of this valid assessment tool (two surveys) will provide higher education institutions and program leaders with the ability to better evaluate the effectiveness of the pre-departure preparation they provide to students, understand the motivations of students who participate, as well as assessing the impact these programs have on students. The insights gathered can be used to improve future program offerings and maximise the benefits to healthcare students while reducing the risks.</p

Evaluating allied health students’ readiness for placement learning

Background: Experiential learning opportunities, such as work integrated learning placements, are often challenging for health professional students. It is therefore imperative that students are adequately prepared before engaging in placement learning. Operationalising ‘readiness for learning on placement’ as a construct, is necessary for providing quality student feedback and assessment. Methods: An integrative mixed methods approach was adopted for this study, utilising a survey to canvass the perspectives of academics, students, and placement educators around the construct of readiness to inform potential assessment items. An assessment tool measuring student readiness for placement was then developed. Data from occupational therapy, physiotherapy and speech pathology programs were evaluated using Rasch analysis to explore the unidimensionality of this construct. Results: The online survey was completed by 64 participants, confirming the importance and measurability of foundational skills integral to readiness for placement learning. These foundational skills were then reflected in a pilot 20-item tool covering domains of professional and learner behaviour, communication, information gathering skills and reasoning. The Rasch analysis of 359 pre-registration student assessments confirmed unidimensionality, suggesting that the skills and attributes (operationalised as assessment items) that are considered part of ‘readiness for placement’ are components of this construct. Together, these findings provide support that the items on this tool are relevant and representative of the skills and behaviours that indicate readiness for placement learning. Two items regarding documentation and appropriate professional dress demonstrated some lower importance scores and interpretation variance warranting further investigation. Conclusion: Through the exploration of the construct of readiness for placement learning, we have created and subsequently revised, an innovative assessment tool that measures novice students’ pre-placement capabilities. Further research is now needed to explore the psychometric properties of the tool

Development and psychometric testing of an instrument to evaluate cognitive skills of evidence based practice in student health professionals

<p>Abstract</p> <p>Background</p> <p>Health educators need rigorously developed instruments to evaluate cognitive skills relating to evidence based practice (EBP). Previous EBP evaluation instruments have focused on the acquisition and appraisal of the evidence and are largely based in the medical profession. The aim of this study was to develop and validate an EBP evaluation instrument to assess EBP cognitive skills for entry-level health professional disciplines.</p> <p>Methods</p> <p>The Fresno test of competence in evidence based medicine was considered in the development of the 'Knowledge of Research Evidence Competencies' instrument (K-REC). The K-REC was reviewed for content validity. Two cohorts of entry-level students were recruited for the pilot study, those who had been exposed to EBP training (physiotherapy students, n = 24), and who had not been exposed to EBP training (human movement students, n = 76). The K-REC was administered to one cohort of students (n = 24) on two testing occasions to evaluate test-retest reliability. Two raters independently scored the first test occasion (n = 24) to evaluate the inter-rater reliability of the marking guidelines. Construct validity was assessed by comparison of the two groups, 'exposed' and 'non-exposed', and the percentage of students achieving a 'pass' score in each of these groups. Item difficulty was established.</p> <p>Results</p> <p>Among the 100 participants (24 EBP 'exposed', and 76 EBP 'non-exposed' students), there was a statistically significant (<it>p </it>< 0.0001) difference in the total K-REC scores. The test-retest and inter-rater reliability of the individual items and total scores ranged from moderate to excellent (measured by Cohen's Kappa and ICC, range: 0.62 to perfect agreement).</p> <p>Conclusions</p> <p>The K-REC instrument is a valid and reliable evaluation instrument of cognitive skills of EBP in entry-level student health professionals. The instrument is quick to disseminate and easy to score, making it a suitable instrument for health educators to employ to evaluate students' knowledge of EBP or in the evaluation of entry-level EBP training.</p

Therapeutic ultrasound:Clinician usage and perception of efficacy

AbstractA mailed questionnaire, employing both open- and closed-ended questions, was distributed to all members of the Australian Physiotherapy Association (South Australian branch) registering an interest in the musculoskeletal field. Questions were asked regarding the usage and perception of the effectiveness of therapeutic ultrasound. A response rate of 55% was achieved, with a total of 210 questionnaires available for statistical analysis. The results demonstrated that ultrasound is frequently used as an electrotherapy modality by South Australian musculoskeletal physiotherapists. Most physiotherapists perceived ultrasound to be effective in treating localized, superficial conditions, especially when used in conjunction with other treatment techniques and at suitable dosages. However, ultrasound was thought to be most effective in producing a placebo effect. These findings suggest that ultrasound is perceived as an effective treatment tool when applied appropriately. Its placebo quality may contribute to its effectiveness. Further scientific research is warranted to confirm the results. Randomized controlled trials investigating ultrasound's usefulness for muscle strains, scar tissue, bursitis and tendinitis are indicated. The results of this study will be useful for educators and researchers, and suggest that more research into ultrasound applied as part of a treatment package is needed