Review (Karen McCreesh) – An overnight shift towards remote teaching and learning of musculoskeletal physiotherapy in Karelia University of Applied Sciences in Finland

Thank you for a very interesting article describing your experiences in moving physiotherapy teaching online in response to the pandemic. I very much appreciate the opportunity to read your paper, as an academic facing the same challenges. There is a wealth of learning to be gained from the paper in terms of how you have described the approaches taken to meet the challenges of practical MSK teaching and in particular reading the student perspectives. You have opened up the idea of how we teach and assess practical skills in a way that is relevant beyond the current crisis.

My comments and queries below are aimed at making the paper more practically useful and directly applicable to the reader. The questions below are the ones I had while reading the paper, and so it would be great if some of them could be addressed to make the piece more informative.

I suggest including an abstract would help orientate the reader to the paper.

I feel what I’m missing in the paper is a sense of the context.

Consider adding detail on:

University (size and scale), numbers of students, level of degree, year/stage of students (had they undertaken placement yet? Have they had previous MSK teaching?), staff-student ratios. Did any students have additional learning needs and if so how were these accommodated?

Is this a single MSK module being described? How many ECTS? What were the usual assessments (formative and summative) and how were these changed?

I think the learning activities could be more tangible and accessible for the reader if you could provide more concrete examples (just like the case-based approach you describe using with your students). For example, I’d like to see a worked example of how you used flipped classroom methods in traditional teaching versus online, using a table or diagram, and the information from the “pedagogical manuscript”.

“Flipped classroom and learning approach enabled students to deepen their learning together by discussions and teamwork during online lectures”. How was the teamwork managed during online lessons? Were online ‘breakout rooms’ used? Did students work in the same groups throughout? Did they engage in the same groups outside of contact lessons?

“Students were engaged in providing teaching materials and learning from each other. For assessing practical skills and getting feedback students provided video-recordings demonstrating their manual therapy and mobilization techniques. Especially videos as learning materials supported remote learning process and most students were able to practice skills with classmates in their own environment.” MSK skills: Did the students source and post videos on a discussion forum? In what way did the shared learning occur? How did they practice with classmates?

“Video-recording and reviewing their own work helped students self-evaluate their practical skills and note the successful and correctable details, which are normally more difficult during the lessons. The teacher also reviewed the videos and gave written feedback to each student.” Describe more about how the students produced and submitted their own videos- was there clear guidance for what had to be submitted and how often? How was the self-evaluation conducted – was there a reflective submission involved? How often was feedback provided? How burdensome was this for teachers?

How were the practical skills assessed? Were the videos used to provide a summative assessment for clinical competence?
I think it would also be useful to present your views and perspectives on whether the summative assessment used are ‘fit for purpose” and likely to be acceptable for assessing competencies for professional accreditation purposes.

Regarding the case-based learning was there any patient involvement in presenting this material, or any use of the ‘patient voice’?

Thank you again for the sharing of your experiences – the paper has the potential to springboard some really valuable conversations about the “new normal” we find ourselves in for MSK physiotherapy.

One thought on “Review (Karen McCreesh) – An overnight shift towards remote teaching and learning of musculoskeletal physiotherapy in Karelia University of Applied Sciences in Finland

  1. Thank you for very valuable advice and collegial discussion of issues brought up in this paper.

    We have made changes as we feel is appropriate and possible based on this work. We clarified the context of the paper by adding details to the requested questions. For example, we described more about the Karelia-University of Applied Sciences, number of students, MSK module etc. We also wrote more detailed description of the teaching methods and assessment we used during the remote teaching period. We made a more detailed explanation of how and where the used video material was downloaded and how the self-evaluation conducted.

    The purpose of this paper was to describe the change, and we are unable at this point to elaborate some of the issues brought up for the following reasons: the invitation to submit the paper, in our understanding, focused on a description of what has changed, hence we took the opportunity in a very short time and at the very busy time to write the paper as a discussion starter. Secondly, we have not interviewed or explored in depth students’ or teaching faculty’s feelings, experiences or opinions on the remote flipped learning approach, and therefore would not want to speculate on those. We are however encouraged by the students’ spontaneous responses, and also your interest and valuable comments, and are hoping to continue the development of this teaching mode and research into its impact on learning as well as teaching.

    We are very grateful for your time and advice and look forward to further discussion and further work on this important and continuing change and challenge of educational provision for all of us.
    The authors.

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