What does an enquiry-based approach offer undergraduate physiotherapy students in their final year of study?

Background. Physiotherapy students in their final year at Stellenbosch University (SU) complete a module that follows an enquiry-based learning (EBL) approach. This module exposes them to higher-order problem solving and was developed to facilitate independent self-directed learning and improved higher-order thinking skills.Objective. To describe the perceptions of undergraduate physiotherapy students on the impact of this EBL approach on their learning.Methods. A cross-sectional descriptive study was conducted with three consecutive cohorts of final-year undergraduate physiotherapy students. A questionnaire was used to obtain information related to the students’ perception of this module. Coding and identification of themes were done independently using an inductive approach. Initial themes were compared and discussed to achieve consensus regarding the final themes reported.Results. Students reported the development of skills such as the ability to source relevant information and problem-solving abilities. Students attributed improvements in their clinical reasoning and performance during clinical work to the skills they developed during this module. The main themes identified as barriers to learning during this module were availability of learning materials, quality assurance and time constraints. Group work was identified as both a facilitator and a barrier to their learning.Conclusion. Physiotherapy students at SU perceived the introduction of a module following an EBL approach positively. They developed skills such as sourcing information and problem-solving, which they perceived improved their clinical work. The main barriers to learning were time constraints and concerns regarding quality assurance of learning material. Group work was regarded as both facilitatory and a barrier to learning. Programmes considering the implementation of EBL should ensure sufficient resource material and that quality assurance mechanisms are in place to address students’ anxiety regarding learning material. Guidance and support to students during the initial implementation phase of an EBL approach are necessary to allay fears and frustrations

The lived experience of health sciences students’ participation in an interprofessional community-based stroke class

Background. Collaborative approaches in healthcare contexts may provide better care for patients. Interprofessional circuit-based group therapy could counter profession-specific tribalism. There is no evidence on interprofessional education (IPE) community-based interventions on student learning in the health professions. Objective. To explore undergraduate health sciences students’ experience of being involved in community-based interprofessional circuit-based group therapy. Methods. Semi-structured interviews were inductively analysed exploring undergraduate health sciences students’ experience of involvement in an IPE community-based stroke intervention. Results. A total of 12 final-year students participated, with representation from physiotherapy, occupational therapy and speech therapy. This IPE opportunity beneficially impacted students’ collaborative competencies in knowledge, attitudes, skills and behaviours. This community-based rotation immersed students in a service-delivery environment where patient management was co-ordinated by a multiprofessional rehabilitation team. The integrated stroke circuit group activity aimed to enhance further interconnectedness between student participants. Students who were exposed to this clinical activity reported an understanding of (i) patients’ unique contexts; (ii) role development and complementary overlap between health professions; and (iii) the value of joint interventions to both patients and rehabilitation teams in resource-constrained settings. Conclusion. These students have been primed in their practice-readiness as healthcare professionals for the 21st century who will promote quality care, and embrace collaborative professional practice and person-centredness

Access to health care for people with stroke in South Africa: a qualitative study of community perspectives.

BACKGROUND: Incidence of stroke is increasing in sub-Saharan Africa. People who survive stroke experience disability and require long-term care. Health systems in South Africa (SA) are experiencing important challenges, and services in the public health system for people with stroke (PWS) are fragmented. We aimed to explore the perspectives and experiences of PWS related to stroke care services to inform health system strengthening measures. METHODS: In-depth interviews with 16 PWS in urban and rural areas in the Western and Eastern Cape Provinces of SA were conducted between August and October 2020. PWS were recruited through existing research networks, non-government organisations and organisations of persons with disabilities by snowball sampling. Interviews were transcribed, coded, and thematically analysed. We used the conceptual framework of access to health care as proposed by Levesque et al. to map and inform barriers to accessing health care from the user perspective. RESULTS: PWS recognised the need for health care when they experienced signs of acute stroke. Health literacy on determinants of stroke was low. Challenges to accessing stroke care include complex pathways to care, physical mobility related to stroke, long travel distances and limited transport options, waiting times and out of pocket expenses. The perceived quality of services was influenced by cultural beliefs, attitudinal barriers, and information challenges. Some PWS experienced excellent care and others particularly poor care. Positive staff attitude, perceived competence and trustworthiness went in hand with many technical and interpersonal deficits, such as long waiting times and poor staff attitude that resulted in poor satisfaction and reportedly poor outcomes for PWS. CONCLUSIONS: Strategic leadership, governance and better resources at multiple levels are required to address the unmet demands and needs for health care of PWS. Stroke care could be strengthened by service providers routinely providing information about prevention and symptoms of stroke, treatment, and services to patients and their social support network. The role of family members in continuity of care could be strengthened by raising awareness of existing resources and referral pathways, and facilitating connections within services

Post-TB health and wellbeing

TB affects around 10.6 million people each year and there are now around 155 million TB survivors. TB and its treatments can lead to permanently impaired health and wellbeing. In 2019, representatives of TB affected communities attending the ‘1st International Post-Tuberculosis Symposium´ called for the development of clinical guidance on these issues. This clinical statement on post-TB health and wellbeing responds to this call and builds on the work of the symposium, which brought together TB survivors, healthcare professionals and researchers. Our document offers expert opinion and, where possible, evidence-based guidance to aid clinicians in the diagnosis and management of post-TB conditions and research in this field. It covers all aspects of post-TB, including economic, social and psychological wellbeing, post TB lung disease (PTLD), cardiovascular and pericardial disease, neurological disability, effects in adolescents and children, and future research needs

A lesson in listening : is the student voice heard in the rush to incorporate technology into health professions education?

CITATION: Keiller, L. & Inglis-Jassiem, G. 2015. A lesson in listening : is the student voice heard in the rush to incorporate technology into health professions education?. African Journal of Health Professions Education, 7(1):47-50, doi:10.7196/AJHPE.371.The original publication is available at http://www.ajhpe.org.zaBackground. Early indications are that blended learning in health professions education has a positive influence on student satisfaction and learning. This is encouraging, as the call to incorporate technology in teaching and learning in higher education is increasing. The student voice in the planning and implementation of blended learning strategies is, however, not adequately addressed in many of the studies to date. Objective. To utilise videos and blogging in a problem-based learning physiotherapy module to enhance student engagement with content of problembased cases. Methods. Students completed a needs-analysis and engagement questionnaire. Videos made by students were uploaded to the learning management system and subsequent use of these videos was recorded. Two focus group discussions were held to evaluate students’ perceptions of the blended learning strategies. Results. Students perceived the level of engagement during case presentation periods to be satisfactory, but unsatisfactory outside of such periods. Focus group discussions identified the technology used in this study as being inappropriate for this population. Students had specific expectations of the roles of staff and students. There was a perceived lack of skill with regard to the use of the technology chosen. Conclusion. There is a need for the student voice to be heard with regard to both the rationale for implementation and the type of technology used in blended learning strategy innovations. This study recommends that student-generated videos of clinical skills could be implemented successfully with adequate support from staff.http://www.ajhpe.org.za/index.php/ajhpe/article/view/371Publisher's versio

A lesson in listening: Is the student voice heard in the rush to incorporate technology into health professions education?

Background. Early indications are that blended learning in health professions education has a positive influence on student satisfaction and learning. This is encouraging, as the call to incorporate technology in teaching and learning in higher education is increasing. The student voice in the planning and  implementation of blended learning strategies is, however, not adequately addressed in many of the  studies to date.Objective. To utilise videos and blogging in a problem-based learning physiotherapy module to enhance student engagement with content of problembased cases.Methods. Students completed a needs-analysis and engagement questionnaire. Videos made by students were uploaded to the learning management system and subsequent use of these videos was recorded. Two focus group discussions were held to evaluate students’ perceptions of the blended learning strategies.Results. Students perceived the level of engagement during case presentation periods to be satisfactory, but unsatisfactory outside of such periods. Focus group discussions identified the technology used in this  study as being inappropriate for this population. Students had specific expectations of the roles of staff and students. There was a perceived lack of skill with regard to the use of the technology chosen.Conclusion. There is a need for the student voice to be heard with regard to both the rationale for implementation and the type of technology used in blended learning strategy innovations. This study recommends that student-generated videos of clinical skills could be implemented successfully withadequate support from staff

Does a problem-based learning approach benefit students as they enter their clinical training years? Lecturers’ and students’ perceptions

Background. This paper presents the findings of a study completed to establish the differences between the lecturers’ and students’ perceptions of a hybrid problem-based learning (PBL) approach in successfully completing a PBL module in the third year of physiotherapy training at Stellenbosch University.Objectives. To assess the perception of the achievement of the PBL benefits, the module outcomes, the barriers to learning and positive aspects of the module.Methods. A theory-based evaluation approach using both qualitative and quantitative methods was used. All students and lecturers involved with the new module were invited to participate in the study. The participants consisted of 37 students and 11 lecturers. The data were collected using questionnaires and focus group discussions for both groups. The different components of the theory (PBL methods) were used as the guiding themes for the analysis of the qualitative data. The quantitative (ordinal) data are presented using descriptive statistics.Results. The results indicated that the module was enjoyed by both groups. The achievement of the generic outcomes for the module produced mixed results. Areas of agreement and areas of differences in perceptions relating to the achievement of the expected PBL benefits are discussed.Conclusion. PBL as a new methodology presents challenges for both groups; however, many of the benefits of PBL, in particular self-directed learning, were achieved. Some areas of shortfall are discussed

Teaching my peers: Perceptions of tutors in physiotherapy practical skills training

Background. A near-peer tutorial system was introduced and implemented as part of a second-year module to assist physiotherapy students with the practising of manual techniques. Although not the primary drive for initiating this system, there are potential added benefits for the tutor reported in the literature.Objective. To determine the effect of near-peer teaching on the perceptions undergraduate physiotherapy students have of their own learning.Methods. A descriptive study utilising mixed methods was used. A pre-tutorial focus group discussion (FGD) format explored the expectations and perceptions of tutors’ own abilities and the proposed tutorial system. The researchers conducted a post-tutorial FGD to explore the experiences and perceptions of the tutors’ learning experiences. The responses were transcribed and analysed using deductive thematic analysis. A questionnaire was used to quantify which competencies or skills student tutors thought they had obtained through the facilitation of the tutorial sessions. The results were explored using a competency framework.Results. All ten tutors in the 2012 programme participated in the study. Students moved from unconscious incompetence to conscious incompetence, and seemed to have reached the phase of conscious competence by the end of the programme. Unconscious competence was not observed. More than half of the tutors agreed that the programme had a positive impact on their communication, ability to transfer skills and their own understanding of techniques and underlying theory, while two tutors felt that the programme did not improve their own theoretical basis of techniques.Conclusion. Participating and functioning as near-peer tutors had a positive influence on physiotherapy students’ perceptions of their own learning both in terms of own clinical technique competency, but also as teachers and facilitators of learning. It is hypothesised that these students will transition effectively between clinician and health advocator/teacher

Additional file 1 of Access to health care for people with stroke in South Africa: a qualitative study of community perspectives

Additional file 1. Interview Guide - People with Stroke