Status: Article under review
Authors: Forbes R, Toloui-Wallace J
DOI: to be allocated
Date submitted: 25/02/2021
Background: Diagnostic uncertainty in musculoskeletal pain presents as a frequent and challenging dilemma encountered by physiotherapists. Current literature indicates that diagnostic uncertainty impacts the clinical decision making of experienced and new graduate physiotherapists, highlighting a need for training and support in this space. Aim: This paper outlines considerations for diagnostic uncertainty in physiotherapy practice. It outlines four key strategies to help student and novice physiotherapists experiencing and navigating diagnostic uncertainty when managing individuals with musculoskeletal pain. These strategies include applying a critical lens to diagnostic certainty; recognising and normalising uncertainty; utilising direct practice and authentic experiences, and Balint groups as a strategy for sharing. Conclusion: New graduate physiotherapists frequently experience diagnostic uncertainty within musculoskeletal practice and are commonly challenged by this dilemma. There is a need to focus on acknowledging and managing diagnostic uncertainty in physiotherapy education and workplace support to address the ethical and emotional reactions associated with uncertainty. Physiotherapy educators and professionals can lead by example, acknowledging and sharing uncertainty and exploring this with students to build their capacity and self-efficacy to manage the complex and multidimensional nature of pain.
Read: Diagnostic uncertainty in physiotherapy: Implications for physiotherapy education and educators
Status: Article under review
Authors: SD Perumal
DOI: To be allocated
Date submitted: 12/11/2020
In modern education, flipped-blended learning has gained popularity around the globe. However, pedagogical inquiry of what we teach, where we teach, how and how much we blend in face to face (F2F) and online teaching is focused on the account of instructors (lecturer) designing new models of flipped-blended learning at undergraduate physiotherapy courses. This article describes a case report that illustrates why TBL and how hybrid TBL can be used to help undergraduate physiotherapy students (year 2) to understand and improve their ‘4Cs’ - Critical thinking, Communication, Collaboration, and Creativity in a cardio-respiratory disease management topic. This case report intends to answer one big question “Is H-TBL a way forward for 21st-century learning?”
Read: A way forward: Teaching lens for embedding 4C’s in 21st century learning for future Physiotherapy Graduates Education
Status: Article accepted
Authors: Kim Buchholtz, Roberto Meroni, Bettina Karsten, Fraser Carson
DOI: 10.14426/art/1564
Date submitted: 29/07/2020
Date accepted: 17/11/2020
In this report we reflect on the decision-making process and actions taken by a young higher education institution to the COVID-19 pandemic to continue teaching both undergraduate and postgraduate physiotherapy degree programmes. LUNEX University is unique in that it is the only higher education institute in Luxembourg to provide education in physiotherapy. The response to the global pandemic is further complicated as the majority of students commute across international borders to attend campus. We have focused on three distinct challenges LUNEX staff faced to ensure continued and quality teaching was provided: 1) Response to the country-wide and global shutdown; 2) Return to campus; and 3) Provision of clinical placements. We describe the decisions and actions to rapidly move to a blended learning format, and the strategic approach to incorporating simulated practice after restrictions were eased and a return to campus was possible. Initial observation suggests improvement in student competency in practical skills as a result of the blended learning approach. Recommendations are provided to encourage the integration of blended learning for practical and clinical degree programmes, like physiotherapy, where an emphasis is placed on simulated practice in classroom settings, underpinned by prior theoretical knowledge delivered online.
Read: Responding to COVID-19: LUNEX University’s decisions and actions to continue physiotherapy education
Status: Article accepted
Authors: Joost van Wijchen, Roger Kerry, Maria Nordheim Alme
DOI: 10.14426/art/1552
Date submitted: 19/07/2020
Date accepted: 12/01/2021
The Covid-19 pandemic presented challenges for students and teachers to engage and create good learning environments. In this situation, new opportunities for learners and teachers to engage and learn have evolved. Historically, communities of practices have been developed and used to help solve complex and dynamic challenges in society. The idea is that people get an opportunity to work together to solve a specific challenge or task. Here we present a pedagogical community of practice (CoP), QuaranTrain, where students from different countries have developed a platform for co-creation and sharing material and strategies for better health during a period with social distancing. This student-led and self-organised CoP have created a framework for learning that our health care educations can be inspired by and use in their programs. We conclude that out of this challenging situation, new and creative ways of learning emerged, which can enrich and develop health care education.
Read: QuaranTrain: An international community of practice for learning
Status: Article accepted
Authors: Christopher Tack
DOI: 10.14426/art/1434
Date submitted: 06/07/2020
Date accepted: 08/12/2020
Background: Healthcare digital transformation should focus on the use of innovative technologies to enhance quality, safety, efficiency of care services, and patient experience. Subsequently, the roles and skills of healthcare staff will change, requiring evaluation and elevation of digital literacy across the physiotherapy profession. Aim: To evaluate the confidence, motivation and competence of digital technologies in a cohort of UK physiotherapists (juxtaposed with a wider group of allied health professionals). Methods: A quantitative, cross-sectional online questionnaire of physiotherapists and other allied health professionals (AHPs) in the UK. Results: 282 responses from AHPs were received with 279 complete responses for further analysis (including 126 physiotherapists). Physiotherapists report moderate-high levels of confidence in the use of digital devices (7.6 ±1.77), and high levels of motivation in learning about digital technology (8.7 ±1.6). Physiotherapists self-rate their knowledge regarding the benefits of digital transformation as high (72%). Physiotherapists show a strong preference for daily communication via telephone (82%) and email (97%). Conclusion: Physiotherapists demonstrate moderate-high levels of confidence and motivation to use digital technologies (in line with those seen in other AHPs). Higher degrees of competence are reported regarding understanding the benefits of digital technology, and lower competence is reported regarding topic areas such as artificial intelligence and data analytics.
Read: Digital confidence, experience and motivation in physiotherapists: A UK-wide survey
Status: Article accepted
Authors: Shaun Cleaver, Sidhiprada Mohapatra, Mathieu Simard,
DOI: 10.14426/opj/20210303
Date submitted: 01/07/2020
Date accepted: 03/03/2021
Background: The COVID-19 global pandemic, and the policies created to respond to it, has had profound and widespread impacts. We – three early career physiotherapist academics focused on equity and human rights – noticed both common and divergent experiences amid the impacts of the initial pandemic response. Aim: To explore the professional contexts in which we operate as physiotherapist academics through an analysis of our COVID-19 pandemic-related experiences. Methods: We used a professional practice analytic framework to conduct a collective biographical analysis of our individual and collective experiences. The analytic framework consists of three lenses (accountability, ethics, and professional-as-worker), each of which is considered through three questions. Results: The analysis revealed the instability of our working conditions. Among us, there were experiences of the pandemic inducing unmanageable workloads and also experiences of the pandemic providing reprieve. We found that our accountability to departments and funders competed for our professional resources with our ethics of providing quality services. The combination of accountability obligations and ethics commitments often overwhelmed our capacities to sustainably maintain well-being. Caregiver status was an important characteristic determining whether the professional context improved or deteriorated in the early pandemic phase. Conclusion: This analysis can help inform essential changes to professional and academic institutions during and after the COVID-19 pandemic.
Read: Contagious precarity: A collective biographical analysis of early-career physiotherapist academics’ experiences of the COVID-19 pandemic
Status: Article accepted
Authors: Maiju Issakainen, Sini Puustinen, Raija Kuisma
DOI: 10.14426/art/1355
Date submitted: 04/06/2020
Date accepted: 27/10/2020
Background: Musculoskeletal physiotherapy (MSK) is learned and practiced in a classroom with the guidance of a physiotherapy teacher. In Karelia University of Applied Sciences, a flipped classroom approach has been implemented and developed actively since 2017 in MSK courses in physiotherapy education. However, the COVID-19 pandemic changed everyday life very fast all over the world. Karelia, like all other schools, moved all activities into remote mode very quickly and "normal" teaching methods had to change. Aim: This article describes how the change from contact to remote teaching was implemented in MSK courses in the physiotherapy programme at Karelia in Finland, using a flipped classroom approach. The article also highlights students’ experiences of remote teaching in these courses, although theoretical analysis and discussion on the impact on students' learning is not considered in this Research Note. We are planning to continue exploring the impact and practice of this remote teaching approach, which is becoming the new normal. Conclusion: Well-planned pedagogical manuscript implemented with a flipped classroom approach seems to work well in teaching physiotherapy theory and skills remotely. Carefully planned learning tasks and individual feedback are particularly important for learning during remote teaching. Video and text material in theoretical and practical MSK topics seemed to support students’ learning during the remote teaching and video feedback especially, could be used more in the future.
Read: An overnight shift towards remote teaching and learning of musculoskeletal physiotherapy in Karelia University of Applied Sciences in Finland
Status: Article accepted
Authors: Roma Forbes, Romany Martin
DOI: 10.14426/art/1310
Date submitted: 27/05/2020
Date accepted: 07/07/2020
Background: Increasing, supporting and sustaining the capacity for physiotherapy student placements is a priority for universities and the physiotherapy workforce. The interruption, and in some cases, cancellation of placements as a result of Covid-19 has provided an added impetus to consider the use of flexible and adaptive models to meet student learning needs and support new and existing placement host organisations. Project-based learning provides an opportunity to supplement clinical placements through student-led activities that are mutually beneficial for student learning and service delivery needs of the host organisation. Aim: This paper outlines the pedagogical underpinnings of project-based learning and provides tangible examples of activities that have been adopted within physiotherapy host organisations to support clinical placement quality and capacity. Discussion: Clinical placement host organisations require flexible, student-centred approaches to supporting clinical placement efforts during 2020 and beyond. Project-based learning has the potential to be adapted across settings to support student learning and host organisation services and their stakeholders. Universities should aim to encourage and support partnerships between host organisations and their students to adopt, evaluate and sustain project-based learning across physiotherapy settings.
Read: Project-based learning for physiotherapy clinical education quality and capacity
Status: Article accepted
Authors: James McLoughlin
DOI: 10.14426/art/1260
Date submitted: 17/05/2020
Date accepted: 17/11/2020
Clinicians and researchers in neurorehabilitation continue to have difficulties with reporting and describing the many active components used within physical therapy interventions. People with neurological conditions can present with cognitive, perceptual, behavioural and physical impairments that require individual consideration within their training program. Current knowledge from the areas from motor control theories, neuroscience and clinical evidence from neurological and musculoskeletal rehabilitation all inform the design of movement training programs. Such a diverse field of theoretical, scientific and clinical knowledge makes it difficult to agree upon a consistent way to label the many components relevant to training. This article proposes the use of ten guiding principles of movement training that can provide terminology for use in neurorehabilitation clinical practice that could be used by both professionals and individuals with neurological conditions. The ten Movement Training Principles could potentially improve interdisciplinary collaboration, enhance teaching of the clinical reasoning process and drive innovation for future therapies.
Read: Ten guiding principles for movement training in neurorehabilitation
Status: Article accepted
Authors: Jerin Mathew, Muhammed Rashid, Priyanka Shirsath, Kavitha Raja
DOI: 10.14426/art/1126
Date submitted: 04/02/2020
Date accepted: 03/12/2020
Background and purpose: It is necessary to bring the current understanding of pain to undergraduate, postgraduate, and academic faculty of physiotherapy in all the universities and independent institutions in India. Approximately 15,000 students graduate every year from various physiotherapy institutions in India. More than 20,000 physiotherapists teach or practice in various institutions, hospitals, and universities. The current pain curriculum for physiotherapy education is outdated and scanty. Physiotherapists are first-line managers of pain and it is important to understand the current advances in pain management to effect competent practice. Methods: An action research methodological concept (three phases) has been adapted to identify the missing areas of pain science from the physiotherapy curricula of universities of India (n=30). Instructional Digital Versatile Discs (DVD) was developed in these areas by experts through consensus methods. The reach of the study was evaluated through Google forms and email responses received from the participating institutions. Results: Pain lectures (22 hours) were recorded and four DVDs were commercially produced and duplicated. The DVDs were sent to all the universities and individual institutions (n=469) by post and recommended that they incorporate the information into the undergraduate and postgraduate curricula. The lecture series was also made available online via the institutional library depository system. Conclusion: This project has created a snowball effect by imparting current understanding and knowledge in young therapists and teaching faculty as the lectures are available on the website of the participating institution. Cultural and other characteristics are similar across the countries of South Asia (India, Pakistan, Sri Lanka, Nepal, Bhutan, Bangladesh, Maldives, and Myanmar) and all of these countries use English as the medium of higher education. Hence a regional impact is also anticipated.
Read: Development of learning material to complement pain education of physiotherapists in Indian universities: A synthesis of an action research study