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

Exploring strategies used by physiotherapy private practices in hosting student clinical placements

_Introduction:_ Private practice clinical education experiences are important for workforce readiness of physiotherapy graduates, however there are limited opportunities to experience this setting during training. Furthermore, private practice is considered a valuable source of placements for education providers where shortages occur. Exploring the strategies used by physiotherapy private practice providers when hosting students may provide insight into how students can be integrated into practice whilst minimising disruption to staff, clients and service delivery. _Methods:_ A qualitative study with a general inductive thematic analytical approach was undertaken. Semi-structured interviews of ten physiotherapy private practice placement providers responsible for student placement provision were used to explore the strategies used to successfully integrate students into private practice settings. _Results:_ Four key themes emerged following data analysis; developing systems, student service provision, finding other ways to educate, and seeking support from the education provider. _Conclusion:_ This study is the first to explore the perspective of private practice placement providers regarding how students are successfully integrated into private practice settings where learning and service delivery can be maximised. Areas for further research are outlined

Local Partners’ Perspectives on Health Student Service-Learning Placements in Low- and Middle-Income Countries: A Pilot Qualitative Study with Partners from Vietnam and Timor-Leste

Service-learning programs can provide clinical assistance in low-resourced settings while providing students with intercultural learning opportunities in diverse health contexts; local partners’ perspectives on international service-learning (ISL) programs are integral to ethical, effective and sustainable university-community partnerships; yet the perspectives of local partners remain under-represented in research. Interpretive description methods guided data collection and thematic analysis of qualitative responses from written questionnaires. Four local partners from Vietnam and Timor-Leste responded to questionnaires in this pilot project. Three themes were identified regarding benefits, underpinning factors for program effectiveness, and a further three themes related to desired improvements. According to local partners, benefits of ISL include skill and knowledge exchange, enhanced assessment and intervention strategies, and increased service quality. Communication and relationships were seen as underpinning factors of effective partnerships. Areas for further improvement included drawing more strongly on local partner strengths and perspectives, further collaborative preparation for the placements, and more regular communication. These preliminary findings align with existing research regarding benefits to local partners. Modelling effective practices, formal training and meetings, and ongoing case discussions may be some useful methods for achieving knowledge and skill exchange in ISL

Association of the PHACTR1/EDN1 genetic locus with spontaneous coronary artery dissection

Background: Spontaneous coronary artery dissection (SCAD) is an increasingly recognized cause of acute coronary syndromes (ACS) afflicting predominantly younger to middle-aged women. Observational studies have reported a high prevalence of extracoronary vascular anomalies, especially fibromuscular dysplasia (FMD) and a low prevalence of coincidental cases of atherosclerosis. PHACTR1/EDN1 is a genetic risk locus for several vascular diseases, including FMD and coronary artery disease, with the putative causal noncoding variant at the rs9349379 locus acting as a potential enhancer for the endothelin-1 (EDN1) gene. Objectives: This study sought to test the association between the rs9349379 genotype and SCAD. Methods: Results from case control studies from France, United Kingdom, United States, and Australia were analyzed to test the association with SCAD risk, including age at first event, pregnancy-associated SCAD (P-SCAD), and recurrent SCAD. Results: The previously reported risk allele for FMD (rs9349379-A) was associated with a higher risk of SCAD in all studies. In a meta-analysis of 1,055 SCAD patients and 7,190 controls, the odds ratio (OR) was 1.67 (95% confidence interval [CI]: 1.50 to 1.86) per copy of rs9349379-A. In a subset of 491 SCAD patients, the OR estimate was found to be higher for the association with SCAD in patients without FMD (OR: 1.89; 95% CI: 1.53 to 2.33) than in SCAD cases with FMD (OR: 1.60; 95% CI: 1.28 to 1.99). There was no effect of genotype on age at first event, P-SCAD, or recurrence. Conclusions: The first genetic risk factor for SCAD was identified in the largest study conducted to date for this condition. This genetic link may contribute to the clinical overlap between SCAD and FMD

Weighing up the benefits and challenges of hosting physiotherapy student placements in private practice; a qualitative exploration

New graduate physiotherapists are entering private practice in increasing numbers despite limited opportunity to experience this setting during training. Exploring the perceived benefits and challenges of physiotherapy private practices in hosting students is important to help understand what motivates private practices to engage in clinical education and inform how practices can be best supported in student placement provision.The aim of this study was to explore the benefits and challenges of hosting physiotherapy students from the perspective of private practice providers.A qualitative study with an inductive thematic analytical approach was used. Semi-structured interviews of 10 physiotherapy private practice placement providers responsible for student placement provision were undertaken.Five themes emerged: 1) value to client care; 2) value to staff; 3) value to future planning; 4) contribution to students and the profession; and 5) stress associated with resources.Private practice placement providers perceive a range of benefits to their practice, staff and clients, including rich opportunities for future recruitment when hosting physiotherapy students. These benefits are carefully weighed up against the required resources of time, physical space and opportunities for students to participate in client care. This study has identified implications for education providers in supporting physiotherapy student placements within private practice and may enhance placement capacity within this sector

Responding to emerging needs:Development of adapted performance indicators for physiotherapy student assessment in telehealth

Clinical placements in 2020 have been significantly impacted by the COVID-19 global pandemic. Ensuring that effective clinical placement opportunities continue during this time remains the priority of the Clinical Education Managers Australia and New Zealand (CEMANZ). Supporting educators to assess student competency when service delivery models are altered to embrace telehealth services, has been integral to achieving this. Telehealth has been widely adopted to maintain services and contact with patients during the pandemic. Physiotherapy clinical educators voiced concern about the applicability of the Assessment of Physiotherapy Practice (APP) tool in this emerging learning environment and sought guidance from University Clinical Education Managers. This paper describes representative consensus across Universities regarding use of the Assessment of Physiotherapy Practice (APP) tool and the development of adapted APP performance indicators for use in telehealth. Clinical educators can use these adapted performance indicators to guide assessment of student competency for students completing placements in a telehealth setting