The Current State of Remote Physiotherapy in Finland : Cross-sectional Web-Based Questionnaire Study

Publisher Copyright: ©Thomas Hellstén, Jari Arokoski, Tuulikki Sjögren, Anna-Maija Jäppinen, Jyrki Kettunen.Background: The ongoing COVID-19 pandemic has required social, health, and rehabilitation organizations to implement remote physiotherapy (RP) as a part of physiotherapists’ daily practice. RP may improve access to physiotherapy as it delivers physiotherapy services to rehabilitees through information and communications technology. Even if RP has already been introduced in this century, physiotherapists’ opinion, amount of use, and form in daily practice have not been studied extensively. Objective: This study aims to investigate physiotherapists’ opinions of the current state of RP in Finland. Methods: A quantitative, cross-sectional, web-based questionnaire was sent to working-aged members of the Finnish Association of Physiotherapists (n=5905) in March 2021 and to physiotherapists in a private physiotherapy organization (n=620) in May 2021. The questionnaire included questions on the suitability of RP in different diseases and the current state and implementation of RP in work among physiotherapists. Results: Of the 6525 physiotherapists, a total of 9.9% (n=662; n=504, 76.1% female; mean age 46.1, SD 12 years) answered the questionnaire. The mean suitability “score” (0=not suitable at all to 10=fully suitable) of RP in different disease groups varied from 3.3 (neurological diseases) to 6.1 (lung diseases). Between early 2020 (ie, just before the COVID-19 pandemic) and spring 2021, the proportion of physiotherapists who used RP increased from 33.8% (21/62) to 75.4% (46/61; P20% of their practice time for RP in 2021. The real-time method was the most common RP method in both groups (public sector 46/66, 69.7% vs private sector 157/219, 71.7%; P=.47). The three most commonly used technical equipments were computers/tablets (229/290, 79%), smartphones (149/290, 51.4%), and phones (voice call 51/290, 17.6%). The proportion of physiotherapists who used computers/tablets in RP was higher in the private sector than in the public sector (183/221, 82.8% vs 46/68, 67.6%; P=.01). In contrast, a higher proportion of physiotherapists in the public sector than in the private sector used phones (18/68, 26.5% vs 33/221, 14.9%; P=.04). Conclusions: During the COVID-19 pandemic, physiotherapists increased their use of RP in their everyday practice, although practice time in RP was still low. When planning RP for rehabilitees, it should be considered that the suitability of RP in different diseases seems to vary in the opinion of physiotherapists. Furthermore, our results brought up important new information for developing social, health, and rehabilitation education for information and communications technologies.Peer reviewe

Effectiveness of Technology-Based Distance Physical Rehabilitation Interventions for Improving Physical Functioning in Stroke : A Systematic Review and Meta-analysis of Randomized Controlled Trials

Objective: To study the effectiveness of technology-based distance physical rehabilitation interventions on physical functioning in stroke. Data Sources: A systematic literature search was conducted in 6 databases from January 2000 to May 2018. Study Selection: Inclusion criteria applied the patient, intervention, comparison, outcome, study design framework as follows: (P) stroke; (I) technology-based distance physical rehabilitation interventions; (C) any comparison without the use of technology; (0) physical functioning; (S) randomized controlled trials (RCTs). The search identified in total 693 studies, and the screening of 162 full-text studies revealed 13 eligible studies. Data Extraction: The studies were screened using the Preferred Reporting Items for Systematic Reviews and Meta-analysis guidelines and assessed for methodological quality and quality of evidence. Meta-analysis was performed if applicable. Data Synthesis: A total of 13 studies were included, and online video monitoring was the most used technology. Seven outcomes of physical functioning were identified-activities of daily living (ADL), upper extremity functioning, lower extremity functioning, balance, walking, physical activity, and participation. A meta-analysis of 6 RCTs indicated that technology-based distance physical rehabilitation had a similar effect on ADL (standard mean difference 0.06; 95% confidence interval: -0.22 to 0.35, P=.67) compared to the combination of traditional treatments (usual care, similar and other treatment). Similar results were obtained for other outcomes, except inconsistent findings were noted for walking. Methodological quality of the studies and quality of evidence were considered low. Conclusions: The findings suggest that the effectiveness of technology-based distance physical rehabilitation interventions on physical functioning might be similar compared to traditional treatments in stroke. Further research should be performed to confirm the effectiveness of technology-based distance physical rehabilitation interventions for improving physical functioning of persons with stroke. (C) 2018 by the American Congress of Rehabilitation MedicinePeer reviewe

Social, health and rehabilitation sector educators’ competence in evidence-based practice: A cross-sectional study

Aim The purpose of the study was to identify and describe the characteristic profiles of evidence-based practice competence of educators in the social, health and rehabilitation sectors and to establish relevant background factors. Design This study was carried out as a descriptive cross-sectional study. Methods Data were collected from social, health and rehabilitation sector educators working in the 21 Finnish universities of applied sciences and seven vocational colleges (n = 422; N = 2,330). A self-assessment instrument measuring evidence-based practice competence was used. Competence profiles were formed using a K-cluster grouping analysis. Results Three distinct competence profiles were identified and delineated. Most educators feel that they can guide students' critical thinking and are able to seek and produce scientific knowledge. Evidence-based practice competence was explained by background factors such as year of graduation (for higher degree), level of education, job title, current employer and current field of work.publishedVersio

Enhancing social and health care educators’ competence in digital pedagogy: A pilot study of educational intervention

The purpose of this pilot study was to explore connection of an educational intervention on the competence of health care educators and educator candidates (n=11) in digital pedagogy as a part of national TerOpe project. An educational intervention, Basics of Digital Pedagogy was developed by the TerOpe project’s experts. The participating educators and educator candidates of the educational intervention were recruited from the universities and university of applied sciences, which were involved in TerOpe project. All the participants of the educational interventions were invited to take part in this study. The educational intervention was conducted during spring 2019. Pre- and post-tests were implemented digitally by using an Educators’ and Educator Candidates’ Competence in Digital Pedagogy self-assessment instrument (OODI), which was developed for this study. The OODI includes 32 items divided in six digital competence areas professional engagement, digital resources, teaching and learning, assessment, empowering learners and facilitating learners’ digital competence. The data was analysed statistically. The self-assessed level of overall competence in digital pedagogy and competence in all competence areas of digital pedagogy increased statistically significantly during the intervention. The educational intervention used in this study seems to increase educators’ self-assessed competence in digital pedagogy. We recommend that all educators be encouraged to conduct continuous education on the basics of digital pedagogy.</p

Health sciences educators’ and educator candidates’ digipedagogical competence: assessment after an online course

The purpose of this paper is to describe the implementation of an online course, as well its development after implementation, and to focus on the health sciences educators’ and educator candidates’ assessments of their digipedagogical competence after the course. Semi-structured interviews to learners (n = 11) were used to collect data that were then analysed using inductive content analysis. The learners perceived that their ability to exploit digital applications increased and that they critically reflected upon their use of digital technology in teaching. The feedback from and presence of the tutors, as well as the collaborative activities with peer learners in the course, were generally regarded positively. Suggestions for improving the course were to limit the course content and to increase communality and other factors that support learners’ learning and work. The lessons learned from this study can be applied in basic and continuing professional development of health sciences educators.</p

Health and social care educators' ethical competence

Background and purpose: Educators' ethical competence is of crucial importance for developing students' ethical thinking. Previous studies describe educators' ethical codes and principles. This article aims to widen the understanding of health- and social care educators' ethical competence in relation to core values and ethos. Methods: Data material was collected from nine educational units for healthcare and social service in Finland. In total 16 semi-structured focus group interviews with 48 participants were conducted. The interviews were analysed with a thematic analysis according to Braun and Clarke. Ethical considerations: The study is approved by the Declaration of Helsinki, the legislation regarding personal data and the General Data Protection Regulation. The study received ethical permission from the University of Jyvaskyla. Informed consent was obtained from all the educational units and participants in the study. Findings: The findings are presented based on three general patterns, an ethical basic motive, an ethical bearing and ethical actions. Subthemes are Humane view of students as unique individuals with individual learning, Bearing of tactfulness and firmness, Bearing of perceptiveness and accessibility, Bearing of satisfaction and joy over student learning, Valuing bearing towards each oneself and colleagues, Ability to interact and flexibility, Collegiality and a supportive work community and Educators as role models and inspirators. Conclusion: Educators' personal and professional ethos is crucial to student learning, personal growth and ethical reasoning. Therefore, it is important to further develop educators' training regarding ethical competence.</p

Sosiaali-, terveys- ja kuntoutusalan opettajien digitaalinen osaaminen

Tutkimuksen tarkoituksena oli kuvata sosiaali-, terveys- ja kuntoutusalan (soteku) opettajien (n=388) digitaalista osaamista osana TerOpe-hanketta. Aineisto kerättiin DigCompEdu CheckIn Self-reflection Tool -itsearviointityökaluun perustuvalla mittarilla, joka sisälsi 21 (strukturoitua) väittämää ja yhden avoimen kysymyksen. DigCompEdu-viitekehyksen kuutta osa-aluetta (ammatillinen sitoutuminen, digitaaliset resurssit, opettaminen ja oppiminen, arviointi, oppijoiden voimaannuttaminen ja oppijoiden digitaalisen osaamisen tukeminen) käytettiin sekä määrällisen aineiston keskiarvomuuttujien muodostamisessa että laadullisen aineiston deduktiivis-induktiivisen analyysin runkona. Opettajat olivat motivoituneita kehittämään digitaalista osaamistaan ja kokivat sen kehittämisen tarpeelliseksi. He laativat ja hallinnoivat digitaalista opetusmateriaalia ja käyttivät digitaalista teknologiaa säännöllisesti opetuksessa. Vähäiset resurssit, kuten riittämätön aika, tuki ja koulutus, vähensivät opettajien mahdollisuuksia kehittää digitaalista osaamistaan ja digitaalisen teknologian hyödyntämistä opetuksessa ja oppimisessa. Tuloksia voidaan hyödyntää soteku-alan opettajien jatko- ja täydennyskoulutuksen sekä terveystieteiden opettajakoulutuksen kehittämisessä. Opettajat tarvitsevat aikaa, tukea, koulutusta ja käyttäjäystävällisiä järjestelmiä digitaalisen teknologian hyödyntämiseen opetuksessa ja oppimisessa.</p

A Systematic Review and Metasyntesis of Qualitative Studies on the Competence of Health and rehabilitation Science Educators

publishedVersionPeer reviewe

Competence areas of health science teachers – A systematic review of quantitative studies

BackgroundIn the face of rapid digitalisation and ever-higher educational requirements for healthcare professionals, it is important that health science teachers possess the relevant core competences. The education of health science teachers varies internationally and there is no consensus about the minimum qualifications and experience they require.ObjectiveThe aim of this systematic review was to describe the health science teachers' competences and the factors related to it.DesignSystematic review of original quantitative studies.Data sourcesFour databases were selected from which to retrieve original studies: Cinahl (Ebsco), PubMed, Medic, Eri (ProQuest).Review MethodsThe systematic review used PICOS inclusion criteria. Original peer-reviewed quantitative studies published between 1/2007 and 1/2018 were identified. Screening was conducted by two researchers separately reading the 1885 titles, 600 abstracts, and 63 full-texts that were identified, and then agreed between them. Critical appraisal was performed using the JBI MAStARI evaluation tool. The data was extracted and then analysed narratively.ResultsThe core competences of health science teachers include areas of knowledge, skills and attitudes. Health science teachers evaluate their own competence as high. Only in relation to entrepreneurship and leadership knowledge was evaluated to be average. The most common factors influencing competence were teachers' title/position, healthcare experience, research activities, age, academic degree and for which type of organisation they work.ConclusionIt is important to identify the core competencies required by health science teachers in order to train highly competent healthcare professionals. Based on the findings of this systematic review we suggest that teachers should be encouraged to gain university education and actively participate in research, and that younger teachers should have opportunities to practice the relevant teaching skills to build competence.<br /

Social, health care and rehabilitation educators' competence in professional education-Empirical testing of a model

The social and health care educator's role in educating future professionals need to be stronger emphasised and deserves international recognition. The purpose of this study was to develop and test an empirical model of social and health care educators' competence in higher and professional education. The presented research employed a cross-sectional study design. Data were collected using HeSoEduCo-instrument from 28 educational institutions in Finland. The model was empirically tested with confirmatory factor analysis through Structural Equation Modelling that applied the Full Imputation Maximum Likelihood estimator. A total of 422 social and health care educators participated in the study. The empirical model of social and health care educators including eight competence areas: leadership and management, collaboration and societal, evidence-based practice, subject and curriculum, mentoring students in professional competence development, student-centred pedagogy, digital collaborative learning, and cultural and linguistic diversity. All of the connections between concepts of the empirical model were found to be statistically significant. There were strong connections between most of the identified competence concepts; however, two weak connections were found, namely, the link between competence in evidence-based practice and competence in subject and curriculum, along with the link between competence in digital collaborative learning and competence in student-centred pedagogy. The presented empirical model can help stakeholders identify which areas of social and health care educators' curricula should be further developed. The model is also relevant for improving continuous education, allowing educators to assess their competence levels and evaluating educators' performance at the organisational level