Authors: Maiju Issakainen, Sini Puustinen & Raija Kuisma / Submitted: 04 June 2020. This article is undergoing peer review. Introduction Physiotherapy in musculoskeletal (MSK) disorders requires skills in examination, clinical reasoning, pain management, therapeutic exercise, manual therapy, and other physiotherapy modalities e.g. electrophysical therapies. Traditionally in physiotherapy education, these skills have been learned and practised […]
Background: Increasing, supporting and sustaining the capacity for physiotherapy student placements is a priority for education providers 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 goals 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: Physiotherapy educators and 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 stakeholders. Education providers should aim to partner with students and host organisations to support the adoption and evaluation of project-based learning across physiotherapy settings.
Abstract: 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.
Background and purpose: It is necessary to bring the current understanding of pain to undergraduate, postgraduate, and staff of physiotherapy in all the universities and institutions in India. Approximately 15,000 (minimum) students are graduated every year from different institutions in India. More than 20,000 physiotherapists teach or practice in various institutions, hospitals, and universities. The current pain curriculum of the universities is outdated and scanty. Physiotherapists are first-line managers of pain and it is important for them to understand the current advances in pain management to effect competent practice. Methods: With this objective in mind, missing areas of pain science have been identified from the curricula of universities of India and instructional Digital Versatile Discs (DVD) were developed in these areas by experts. The DVDs were sent to all the universities and institutions by post and recommended to incorporate the information in the undergraduate and postgraduate curricula. Results and discussion: The impact and reachability of the study were evaluated through Google forms and email responses received from the participating institutions. This project is expected to have a snowball effect by imparting current understanding and knowledge in young therapists and teaching faculty as the lectures are available perpetually 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.
Historically, clinical education of physiotherapy students in Germany takes place in inpatient settings. Against the background that the majority of graduated physiotherapists work in outpatient settings like private practices, this education structure is no longer viable. Therefore, there is a need to develop models of cooperation between private practice and schools of physiotherapy. The aim of this study is to describe options of cooperation between educational institutions and private practices. A qualitative interview study was conducted, in which 2 practice owners of a physiotherapy practice and 2 heads of physiotherapy schools were interviewed using a problem-centered interview approach. Textual data was analysed using thematic analysis, to inductively discover and describe relevant themes. Heads of schools and practice owners share many ideas about learning location cooperation, such as a restriction on the number of students for each practice, the timing of clinical education in private practice at the end of the study program, the need for close cooperation between schools and practices. To undertake clinical education in private practices, students can offer treatments in addition to what is covered by the health insurance companies. The clinical education should be supervised by private practice physiotherapists who need to be reimbursed. Therefore, a modification of external framework conditions is necessary. Private practices need financial and content-related support to engage in clinical education. Health insurance companies or the state could act as financial sponsors.
The fundamental role of ontology, epistemology, and ethics is widely recognised across the healthcare professions. Yet what is less known in physiotherapy is how ontology and epistemology potentially undermine the ethical intentions of our theories and practices. In this article, we draw on the work of 20th-century philosopher Emmanuel Levinas to highlight this problematic. Particularly Levinas’s ethical critique of ontology and the associated notion of thematisation enable us to highlight a violence that takes place in the philosophical foundations of physiotherapy. Using the overarching aims of physiotherapy, the theory and practice of diagnosis, and the notion and enforcing of professional identities as examples, we additionally show how this violence consequently pervades physiotherapy theory and practice. By exploring a range of critical and practical implications, we finally show how an application of Levinas’s critique of ontology additionally opens toward an otherwise physiotherapy grounded in a renewed understanding of self, other, and their relation. With this, we hope to highlight the core value and critical need for a deeper engagement with the work of Levinas in relation to all aspects of physiotherapy, and particularly its understanding and implementation of ethics that is so fundamental to its practice and a cornerstone of physiotherapy education.
In this editorial we argue that ‘critical’ thinking, research and scholarship are essential to understanding and practicing rehabilitation, and yet are under-represented in the existing rehabilitation literature. By using the term critical, we are referring to research and scholarship that draw from social theory to examine pervasive taken-for-granted practices, assumptions, and principles in any field, including health care. Thus, critical work offers opportunities to enact more ethical and socially just rehabilitation practices. In what follows we call for rehabilitation journals to recognise, welcome, seek out and publish submissions in this exciting area of research, and thereby lead the field in promoting a new understanding of rehabilitation’s purpose, goals, practices, and outcomes.
About 200 years ago the invention of the steam engine triggered a wave of unprecedented development and growth in human social and economic systems, whereby human labour was supplanted by machines. The recent emergence of artificially intelligent machines has seen human cognitive capacity augmented by computational agents that are able to recognise previously hidden patterns within massive data sets. The characteristics of this technological advance are already influencing all aspects of society, creating the conditions for disruption to our social, economic, education, health, legal and moral systems, and which will likely to have a more significant impact on human progress than the steam engine. As AI-based technology becomes increasingly embedded within devices, people and systems, the fundamental nature of clinical practice will evolve, resulting in a healthcare system requiring profound changes to physiotherapy education. Clinicians in the near future will find themselves working with information networks on a scale well beyond the capacity of human beings to grasp, thereby necessitating the use of artificial intelligence to analyse and interpret the complex interactions of data, patients and the newly-constituted care teams that will emerge. This paper describes some of the possible influences of AI-based technologies on physiotherapy practice, and the subsequent ways in which physiotherapy education will need to change in order to graduate professionals who are fit for practice in a 21st-century health system.
Hong Kong is at the cross-road between Eastern and Western cultures. Increasing globalisation allows students to gather experiences from various educational contexts. While internationalisation has been promoted in higher education worldwide, the focus was often put on students from Chinese cultures integrating into Westernised education systems. Not much is known about how students from Chinese background with exposures to Western cultures, reintegrate into a Hong Kong university, characterised by a highly competitive system that potentially affects students’ well-being. To identify learning preferences by Hong Kong physiotherapy students who have been exposed to educational contexts in the USA, Australia or Canada, and to explore their subjective experiences regarding different educational approaches during their studies. Ten students participated in this phenomenological study. Semi-structured interviews were conducted in English, transcribed ‘ad verbatim’ and analysed using qualitative content analysis. Three themes emerged from the data: (1) Interaction between students and teachers, (2) past experiences that help with future dreams, and (3) obstacles and opportunities in learning. Physiotherapy students with globalised experience rely on their past educational exposure to give meaning to their future. They believe that a student-centred approach is crucial for learning. Their experiences shed light on consideration factors for optimally internationalising the physiotherapy curriculum.
Communication is fundamental in collaborative physiotherapy practice. Students develop understandings of what constitutes ‘good’ communication through the formal, informal and hidden curricula. Understanding how students understand communication and how this is influenced by the curricula can help educators consider how best to enhance communication knowledge and skills. This study explored how physiotherapy students conceptualised clinical communication. This study was underpinned by a social constructionist epistemology. Data consisted of fifteen assignments, completed by students as part of their coursework. Assignments were analysed using the Listening Guide which prompted attention to how the different ways students understood communication and how these understandings were constructed. Communication was understood as uni-dimensional. It was presented as an act done to the patient by the physiotherapist, with little attention to the patient’s communication and involvement in the interaction. Through communication, physiotherapists demonstrated and reinforced their expertise while simultaneously positioning the patient as the recipient of care and knowledge. Understandings of communication reflect broader constructions of physiotherapy and the role of the physiotherapist. These also reflect tensions in the curricula. Enhancing communication in student education requires all parties to understand, value and critically reflect on how communication is constructed and enacted.
