Status: Article accepted
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.
QuaranTrain: An international community of practice for learning
Status: Article accepted
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.
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Digital confidence, experience and motivation in physiotherapists: A UK-wide survey
Status: Article accepted
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.
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Contagious precarity: A collective biographical analysis of early-career physiotherapist academics’ experiences of the COVID-19 pandemic
Status: Article accepted
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.
An overnight shift towards remote teaching and learning of musculoskeletal physiotherapy in Karelia University of Applied Sciences in Finland
Status: Article accepted
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.
Project-based learning for physiotherapy clinical education quality and capacity
Status: Article accepted
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.
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Ten guiding principles for movement training in neurorehabilitation
Status: Article accepted
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.
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Exploring barriers, advantages and potentials in realising clinical education in private physiotherapy practice settings in Germany
Status: Article accepted
Background: Traditionally, the clinical education of physiotherapy students in Germany takes place in inpatient settings. Against the background that the majority of graduated physiotherapists work in private 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. Aim: The aim of this study is to describe advantages, barriers and options of collaboration between physiotherapy educational institutions and private practices. Methods: A qualitative interview study was conducted, in which two practice owners of a physiotherapy practice and two programme directors were interviewed using a problem-centred interview approach. All participants were contacted via email or telephone. Textual data was analysed using thematic analysis, to inductively discover and describe relevant themes. Results: The economic conditions of private practices in Germany, legal requirements and training regulations are identified as the main barriers preventing forms of collaboration. One of the advantages of offering students practical placements is their probable future employment. Successful collaboration may depend on remunerating clinical instruction time, relaxing legal requirements or increasing the participation of schools in practical training. Conclusion: Private practice needs financial and content-related support to engage in clinical education. Health insurance companies or the government could act as financial sponsors.
The fundamental violence of physiotherapy: Emmanuel Levinas’s critique of ontology and its implications for physiotherapy theory and practice
Status: Article accepted
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 problem. 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.
Infusing Rehabilitation with Critical Research and Scholarship: A Call to Action
Status: Article accepted
In this editorial, we argue that ‘critical’ thinking, research and scholarship are essential to understanding and practising 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.
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