The Use of Self-Study in Health Professional Higher Education and Medical Education - A Mixed-Method Systematic Review

Purpose: Health profession education and medical education should implement primarily active learning units in the curriculum. Self-study/guided self-study is such a tool that promotes active learning, a method that involves students in their learning process. The implementation of active learning is intended to develop or consolidate practical skills (hands-on). This mixed-method systematic review evaluated the of self-study/guided self-study in the university landscape for health professions education and medical education. Another goal was to foster awareness of the method self-study/guided self-study. Method: A systematic literature search in CINAHL, Embase, ERIC, PubMed and Web of Science was performed. Additionally, a manual search was conducted. This article included qualitative, quantitative, or mixed-method study designs. Included articles were appraised using the JBI Critical Appraisal Tool for qualitative and quantitative research. Abductive thematic analysis was used to synthesize evidence. Random-effects meta-analysis was performed to determine the effects of self-study that develop or consolidate practical skills (hands-on) in health professional or medical students compared to traditional teaching. Results: Fifteen articles were included totaling 3949 students volunteering in the studies. Critical appraisal of the studies ranged from average to good. Seven studies reported the use of individual self-study. The overall weighted effect favored self-study compared to traditional teaching (SDM 0.30, 95%CI: 0.13-0.48, p = 0.003). Discussion: The synthesized findings suggested that self-study/guided self-study was used as individual self-study. Self-study/guided self-study could develop or consolidate practical skill (hands-on) in health professional and medical students. The self-study/guided self-study should be structured in such a way that individual learning, dyad and group learning are possible

Associations between different types of physical activity and teachers' perceived mental, physical, and work-related health

Background: The teaching profession is characterized by high levels of stress and physical complaints, which might be improved through regular participation in physical activity (PA). However, the effect of PA on mental and physical health is not always consistent and depends on the type of PA performed. The aim of this study was to examine the mental, physical, and work-related health of Flemish secondary school teachers and identify the impact on those health variables by demographic and teaching-related factors and various types of PA. Methods: This study included an online survey conducted across a representative sample of secondary school teachers (n = 1066, average age 40 years; 68 percent female). Level of PA and sitting time were estimated using the International Physical Activity Questionnaire, and perceived mental health and physical health were estimated using the Short Form 36. Work-related factors such as job satisfaction, occupational stress, and absenteeism were also collected. T-tests, ANOVAs, and linear regression analyses were performed. Results: Flemish secondary school teachers have poorer perceived mental and physical health than a general healthy population. This difference is particularly evident among female teachers, who reported lower perceived health, more occupational stress, and more absent days compared to their male colleagues. Higher participation in leisure-time PA was associated with a more positive perceived health. In contrast, higher levels of occupational PA and sitting time had a negative impact on perceived health. Total amount of PA, total amount of moderate-to-vigorous PA, transportation-related PA, and PA at home were not associated to teachers' perceived health. Conclusion: Because secondary school teachers' levels of perceived health are low, they are an important target group for interventions aiming to improve health. Only leisure-time PA was associated with more positive perceived health. This finding may indicate that teachers performing more exercise during leisure time, or in a more autonomous way, may be more resistant to physical and mental health problems. Future research should verify whether promoting leisure-time PA among teachers has the potential to improve their mental and physical health, and counteract the negative associations between teachers' health and their occupational PA

Planning and Implementation of Guided Self-study in an Undergraduate Physiotherapy Curriculum in Switzerland: A Feasibility Study

Background: Self-directed learning (andragogy) or self-determined learning (heutagogy) can be implemented in guided self-study (GSS) with the aim to foster changes in the knowledge and skills of physiotherapy students in a higher education setting. To date, there is a lack of evidence for the use of GSS in higher education for physiotherapy. Aim: This study aimed to evaluate the feasibility of developing and implementing GSS in an undergraduate physiotherapy educational program in Switzerland. In addition, the effectiveness of GSS in bringing changes in knowledge and skills was assessed. Method: Full-time undergraduate physiotherapy students (n = 49) from the third semester volunteered in this feasibility study. Students were randomly allocated into a GSS group or a control group (CG) in the period from October to November 2019. The GSS group prepared a total of 3 clinical cases. Each case was processed in an 8-day cycle. On day 1, the clinical case (ie, description of a patient and symptoms) and learning goals were provided to the students electronically. The students prepared the cases in groups from days 2 to 7. They were guided 2 times by the tutor (physical meeting and via Skype) during this preparation phase. The results of group work were presented and reflected on during a moderated plenum session (90 minutes) on day 8. The feasibility of this higher education study was operationalized as follows: exposure (“dose,” ie, the number of GSS sessions performed over 90 minutes, as well as the content of the cases and the learning objectives); students’ responsiveness, with an a priori set 100% willingness to participate on day 8; program differentiation, to illustrate differences between the content of GSS cases and the curriculum; and degree of acceptability. In addition, an assessment was made of the total scores in the objective structured clinical examination (OSCE) and written examinations, as well as the amount of GSS. Statistical analyses were conducted using an intention-to-treat approach. Results: All 3 GSS sessions on day 8 lasted the scheduled 90 minutes. The content of the presented cases was aligned with the learning objectives. The responsiveness of students willing to participate on day 8 was 42%. In program differentiation, no differences in content were found between the GSS presentation content and the usual curriculum content when compared with the learning aims. Objective structured clinical examination grades and written examination grades were similar for the GSS and CG. The analysis of the focus group interview showed a low degree of acceptability indicating that the students’ workload was high during the GSS period. Conclusions: This study showed that this GSS program for undergraduate physiotherapy students in its current form is “feasible with modification.” Modification of the study protocol (eg, better time planning in the academic calendar) is needed to improve the students’ responsiveness. Alternatively, classroom hours may be reduced to favor self-study time. Such adjustments to the timetable should allow the physiotherapy students to better prepare the clinical cases. The effectiveness of the GSS and normal curriculum on OSCE and written examination scores was similar, probably due to the observed low students’ acceptability Keywords education graduate, learning curve, physical therapist

Impact of guided self-study on learning success in undergraduate physiotherapy students in Switzerland – a feasibility study of a higher education intervention

Background Guided self-study (G-SS) can be used as a self-directed learning method or self-determined learning that fosters changes in knowledge and skills in a higher physiotherapy education setting. Until now, there has been no empirical evidence for the use of G-SS in higher physiotherapy education. This study aimed to investigate the feasibility to establish a G-SS program in a fulltime undergraduate physiotherapy degree course. In addition, the effectiveness of the G-SS was assessed on changes in knowledge and skills. Method Fifty-one first-semester physiotherapy students were randomly divided into a G-SS group or control group (CG). The G-SS group received six clinical cases. Each case was processed in an eight-day cycle. One week in advance, the clinical case were provided to the students electronically (day 1). The students prepared the cases in groups and were guided by the tutor during this preparation time (day 2 to 7). Group work results were presented and reflected on during a moderated plenum session at day 8. A priori criteria of success were defined based on empirical experience for the primary outcome parameters i) exposure, ii) responsiveness of students and iii) program differentiation. The secondary outcome was the total score in the objective structured clinical examination (OSCE) and written exams. Statistical analyses were conducted using SPSS. Results The responsiveness of students as willing to participate in the G-SS program was 23%, clearly below the a priori set 83%. No differences in program differentiation were found. G-SS as compared to the CG scored significantly better on OSCE (p = 0.003) and on the written exam (p = 0.004). Conclusion The results showed that this higher education G-SS program in its current form was not feasible. Slight modification of the study protocol (e.g. better time planning in the academic calendar) is needed to improve the student’s responsiveness. The adjustments to the timetable must allow the physiotherapy students to prepare the clinical cases under conditions of lower workload. G-SS has the potential to promote change in knowledge and skills in undergraduate physiotherapy students when students prepare and present the clinical case solutions and reflect upon their actions

Biolocomotion, kinésiologie, électrologie, électromyographie

Clarys Jan Pieter, Zinzen Evert. Biolocomotion, kinésiologie, électrologie, électromyographie. In: Les Cahiers de l'INSEP, hors-série, 2003. L’Empreinte de Joinville, 150 ans de sport. pp. 487-493

ENERGY EXPENDITURE AND HABITUAL PHYSICAL ACTIVITIES IN ADOLESCENT SPRINT ATHLETES

This study aimed to assess total energy expenditure (TEE) and specific habitual physical activities in adolescent sprint athletes. Two methods used to estimate TEE, an activity diary (AD) and SenseWear armband (SWA), were compared. Sixteen athletes (6 girls, 10 boys, mean age 16.5 ± 1.6 yr) simultaneously wore a SWA and completed an AD and food diary during one week. Basal energy expenditure as given by the SWA when taken off was corrected for the appropriate MET value using the AD. TEE as estimated by the AD and SWA was comparable (3196 ± 590 kcal and 3012 ± 518 kcal, p = 0.113) without day-to-day variations in TEE and energy expended in activities of high intensity. Daily energy intake (2569 ± 508 kcal) did not match TEE according to both the AD and SWA (respectively p < 0.001 and p = 0.007). Athletes were in a supine position for a longer time on weekend days than on week days and slept longer on Sundays. Athletes reported a longer time of high-intensive physical activities in the AD than registered by the SWA on 4 out of 7 days. In addition to specific sprint activities on 3 to 7 days per week, 11 out of 16 athletes actively commuted to school where they participated in sports once or twice per week. The AD and the SWA are comparable in the estimation of TEE, which appears realistic and sustainable. The SWA offers an appropriate and objective method in the assessment of TEE, sleeping and resting in adolescent athletes on the condition that detailed information is given for the times the armband is not worn. The AD offers activity specific information but relies on the motivation, compliance and subjectivity of the individual, especially considering high-intensive intermittent trainin

Impact of guided self study on learning success in undergraduate physiotherapy students - a study protocol for a randomized controlled feasibility trial

Background: Self-directed learning or self-determined learning can be used in guided self-study (GSS) as an educational method with the goal to promote changes in the knowledge and skills of undergraduate physiotherapy students in higher education. Until now, there has been a lack of empirical evidence for the usage of GSS in physiotherapy higher education. At the Faculty of Physiotherapy in the Department of Health Professions (Bern University of Applied Sciences (BFH), Switzerland) the module ‘basic examination’ – in the form of an objective structured examination (OSCE) and written exam – is scheduled in the first semester of the educational program. Objective: The primary aim of this study is to examine the feasibility of establishing GSS in an undergraduate physiotherapy degree program at the BFH. Secondary aim is to assess the effectiveness of GSS on the examination skills of first-semester undergraduate physiotherapy students will. Method: This paper describes the protocol of a randomized group-controlled educational feasibility study. 51 physiotherapy students from the first semester will be allocated into a guided self-study group (GSSG) or control group. The GSS takes place during the first semester, and consists of an eight-day cycle, with a presentation on the last day. Duration of this presentation is 90 minutes with supervision from a university lecturer. One week in advance of the presentation, the case and the learning goals are provided to the students electronically. The students prepare the cases in groups of five to six. The students are guided by the tutor during this preparation time. During a moderated plenum session, students present the results of group work and reflect upon the preparation phase and learning steps. Feasibility outcomes include the fidelity of implementation through exposure dosage, students’ responsiveness, program differentiation, and the degree of acceptability. Success criteria of feasibility are: 1) exposure dosage as the number of 90-minute presentations that are conducted, and the content of cases and competences, 2) students’ responsiveness, with the aim of 100% willingness to participate, and 3) program differentiation, which will illustrate the alignment between GSS case content and the curriculum. Acceptability of intervention from the students’ perspective will be evaluated by a semi-structured interview. Secondary outcomes will be the achieved grades in the OSCE exams and written exams that demonstrate learning success. Conclusion: This feasibility study assesses the fidelity of implementation, the degree of acceptability and the effectiveness of GSS sessions on examination skills in undergraduate physiotherapy students at the BFH. Furthermore, this study will demonstrate whether guided self-study is feasible and can be implemented with fidelity in the BFH physiotherapy higher education curriculum

Feasibility and effectiveness of guided self-study on examination and treatment competencies of undergraduate physiotherapy students: a protocol for a pilot randomized controlled trial

Background: To date, in-depth knowledge about how to structure guided self-study for the enhancement of the competencies of examination and treatment techniques in physiotherapy undergraduate students in the field of geriatrics, internal medicine and orthopedics is still lacking. For undergraduate physiotherapy students at Bern University of Applied Sciences—Health of Department a module on internal medicine and geriatrics as well as a module on orthopedics are scheduled in the third semester of the educational program. Objective: This pilot study will evaluate the feasibility and effectiveness of a guide self-study on examination and treatment competencies of undergraduate physiotherapy students in their third semester. Method: This study protocol describes a randomized-group controlled pilot educational study that will assess the feasibility and effectiveness of guided self-study units on the learning success of undergraduate physiotherapy students. Fifty physiotherapy students will be allocated into a guided self-study group (SG) or control group (CG). During the third semester, SG will receive three tutor supervised guided self-study sessions of 90 min each. One week prior to the guided self-study session, the case and the learning goals will be provided to the students via the institutional electronic learning system. Students will prepare the cases in groups of five to six peers. The students will be guided by a tutor during this preparation time. The results of the group works will be presented and reflected during a moderated plenum session. The primary outcome will be the feasibility of implementing the guided self-study in the existing educational program including assessment of protocol adherence and evaluation of the quality of the proposed cases. The secondary outcomes will be the total score in the objective structured clinical examination (OSCE) exams and written exams that demonstrate the learning success of the undergraduate physiotherapy students. Conclusion: This pilot study evaluates the feasibility and preliminary effects of implementing guided self-study units on active learning in bachelor’s degree physiotherapy students

The physically active lifestyle of Flemish secondary school teachers: a mixed-methods approach towards developing a physical activity intervention

Objective: The primary aim of this study was to describe and analyse the physical activity and sedentary levels of secondary school teachers in Flanders. A secondary aim was to collect information regarding a possible worksite intervention of special relevance to secondary school teachers. Design: Mixed-methods quantitative and qualitative enquiry. Setting: Secondary school teachers in Flanders. Method: An online survey was conducted consisting of the International Physical Activity Questionnaire, demographic information and teaching aspects. Additionally, four focus groups (n = 27) took place. Results: Respondents reported an average of 137.2 96.8 minutes/day of physical activity and an average sitting time of 4.6 +/- 4.2 hours/day. Overall, 66% of Flemish teachers met the physical activity guidelines of at least 150 minutes of moderate to vigorous activity a week. Lower levels of activity were more prevalent among female teachers, teachers working in technical and general education and those teaching theoretical courses. In focus group discussions, two types of barriers were identified influencing teachers' physical activity at school: organisational barriers such as planning and lack of accommodation, and individual barriers such as having other responsibilities. Conclusions: Interventions can be developed to target less active teachers. However, a classic worksite physical activity intervention during working hours is not suitable for most teachers. Promoting leisure-time activity and active commuting are more fitting components of an intervention for this target group. Actions at school should be achievable and unforced, supporting teachers' development of physical literacy