Implementing european programs: creating platforms for innovation of physiotherapy education

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Critical Reflections on the Physiotherapy Profession in Canada

A rethinking of scope of practice, patient access, accountability and payment is coming to bear on healthcare systems around the world . . . We must be ready to meet these changes and effect a positive outcome for our patients and our profession. —Michel Landry, President, Canadian Physiotherapy Association (2007–2009)1 Physiotherapists are faced with a number of unprecedented opportunities and challenges that require new ways of thinking about and practising physiotherapy. Significant among these is legislation recently tabled in Ontario that will enable physiotherapists to order tests such as x-rays and to diagnose patient conditions that are within the profession’s scope of practice. This expansion of scope follows closely on the heels of progressive changes to physiotherapy (PT) in Canada and other countries, including the move to entry-level master’s and doctoral training programmes, increasing privatization of PT services, licensure of alternative practitioners, and health workforce reform. Because of the current global economic crisis, federal budgets are being tightened; in Canada, this has implications for transfer payments to provinces and for alterations to the funding of PT services. Collectively, these changes signal profound shifts that are underway for PT as our profession continues to evolve in response to social, political, and economic influences. In order to respond, we argue, it is crucial for PT to engage in rigorous critical reflection on the theoretical basis of physiotherapy practice. As we outline below, critical reflection will assist us in further developing the foundations of PT, opening up new opportunities for growth and change in PT practice, research, and education.No abstract

The "Woundosome" Concept and Its Impact on Procedural Outcomes in Patients With Chronic Limb-Threatening Ischemia

This editorial assembles endovascular specialists from diverse clinical backgrounds and nationalities with a global call to address key challenges to enhance revascularization in chronic limb-threatening ischemia (CLTI) patients.- Dedicated below-the-ankle (BTA) angiography and revascularization is underutilized in ischemic foot treatment. Existing guidelines do not address comprehensive BTA vessel analysis. CLTI trials also often lack data on in-line arterial flow to the ischemic lesion and BTA vessel evaluation, hindering outcome assessment.- Dedicated multi-planar angiographic evaluation of the distal microcirculation is key: Direct arterial flow or good-quality collaterals are crucial in influencing wound healing and need to be assessed diligently to the level of the distal ischemic wound territory, termed “woundosome.”- An important primary emphasis of future trials should be on validating technologies and strategies for assessing tissue perfusion before, during, and after revascularization undertaken to heal tissue loss in CLTI patients. This will allow determination of a potentially significant delta in tissue perfusion prior to and following intervention at the “woundosome” level. Once changes in arterial perfusion have been identified as positively correlated to wound healing, these could serve as a much-needed novel primary technical outcome measure for patients with tissue loss undergoing surgical, hybrid, or endovascular revascularization

‘There’s so much to it’: the ways physiotherapy students and recent graduates experience practice

Health science courses aim to prepare students for the demands of their chosen profession by learning ways appropriate to that profession and the contexts they will work and live in. Expectations of what students should learn become re-contextualised and translated into entry-level curriculum, with students operating as a connection between what is intended and enacted in curriculum, and required in the real world. Drawing on phenomenology, this paper explores how students understand practice—the collective, purposeful knowing, doing and being of a community—in entry-level physiotherapy programs. Ways of thinking and practising (WTP)—a framework attentive to the distinctive nature of a discipline, its values, philosophies and world-view (McCune and Hounsell in High Educ 49(3):255–289, 2005)—provides the conceptual lens. Six themes describing how students see the WTP of physiotherapy practice emerged from the analysis: discovery of new knowledge; problem solving client related contexts; adopting a systems based approach to the body; contributing to a positive therapeutic alliance; developing a sense of self and the profession; and the organisation of the workforce. The study produces knowledge about practice by focusing on physiotherapy students’ experiences of disciplinary learning. Including students in educational research in this way is an approach that can help students realise their potential as part of a community of practice