The use of critical reflection to foster reflective practice in student osteopaths

Reflection and reflective practice, have gained increasing importance in health practitioner education. This has led to the inclusion of reflection in the documentation of capabilities for health practitioners. Despite a growing literature and interest in reflective practice, it remains unclear how reflection facilitates the development of reflective health practitioners. Using a longitudinal qualitative case-study design, this research investigated the impact of embedding a pedagogical intervention of reflective learning across four years of the five-year osteopathic course at an Australian university. The aim was to understand how a cohort of student osteopaths used reflection to develop reflective practice and why reflection was important to these students during their preregistration education. Multiple qualitative data sets of student written reflections and focus group and interview transcripts were analysed using a validated level-of-reflection measurement scale and a thematic analysis approach. The key findings which also have implications for other health practitioner courses, are threefold: (1) sustained and repeated use of reflection enhances the development of critical reflective practice more effectively than brief, single course exposure; (2) students engaging with reflection require dedicated support, including access to professional counselling; and (3) an early introduction to and positive reinforcement of the benefits of reflective learning engenders an enculturation of the legitimacy of reflective practice as essential learning for health professionals. This research is the first to examine reflective practice in osteopathy and proposes a model of reflective practice in osteopathy. The use of reflection to facilitate the development of reflective practice in health practitioner education is supported with recommendations for future research in academic and workplace settings

Work-related musculoskeletal injuries among Australian osteopaths: A preliminary investigation

Background:Work-related musculoskeletal injury (WRMI) is a significant risk factor for registered manual therapists, including physiotherapists, occupational therapists and chiropractors. The physically demanding nature of manual therapy has been identified as the common factor in WRMIs among these professions. There is currently no available literature on the prevalence of WRMIs among osteopaths.Objective:This research sought to collect preliminary data to establish the prevalence and characteristics of WRMIs among Australian osteopaths; including body area injured, risk factors and strategies used to manage injury.Method:Registered osteopaths, who were members of the professional association Osteopathy Australia,were invited to participate via an online survey.Results:A total of 160 surveys were completed. The incidence of WRMI was high, with 58% of re-respondents having sustained one or more injuries. Results indicated that the wrist and the fingers are the most frequently injured areas (41%), while the least injured body part was the knee (1.1%). Performing repetitive tasks accounted for 52% of injuries, followed by performing manipulative techniques (23%).Working too many hours per week (43%) and fatigue (38%) were the main factors contributing to Background:Work-related musculoskeletal injury (WRMI) is a significant risk factor for registered manual therapists, including physiotherapists, occupational therapists and chiropractors. The physically demanding nature of manual therapy has been identified as the common factor in WRMIs among these professions. There is currently no available literature on the prevalence of WRMIs among osteopaths.Objective:This research sought to collect preliminary data to establish the prevalence and characteristics of WRMIs among Australian osteopaths; including body area injured, risk factors and strategies used to manage injury.Method:Registered osteopaths, who were members of the professional association Osteopathy Australia,were invited to participate via an online survey.Results:A total of 160 surveys were completed. The incidence of WRMI was high, with 58% of respondents having sustained one or more injuries. Results indicated that the wrist and the fingers are the most frequently injured areas (41%), while the least injured body part was the knee (1.1%). Performing repetitive tasks accounted for 52% of injuries, followed by performing manipulative techniques (23%).Working too many hours per week (43%) and fatigue (38%) were the main factors contributing to injury. Conclusions: highlight the risk to osteopaths of sustaining musculoskeletal injuries while working in clinical practice highlight the risk to osteopaths of sustaining musculoskeletal injuries while working in clinical practice

2023 HRS/APHRS/LAHRS guideline on cardiac physiologic pacing for the avoidance and mitigation of heart failure

Abstract Cardiac physiologic pacing (CPP), encompassing cardiac resynchronization therapy (CRT) and conduction system pacing (CSP), has emerged as a pacing therapy strategy that may mitigate or prevent the development of heart failure (HF) in patients with ventricular dyssynchrony or pacing‐induced cardiomyopathy. This clinical practice guideline is intended to provide guidance on indications for CRT for HF therapy and CPP in patients with pacemaker indications or HF, patient selection, pre‐procedure evaluation and preparation, implant procedure management, follow‐up evaluation and optimization of CPP response, and use in pediatric populations. Gaps in knowledge, pointing to new directions for future research, are also identified