Training physiotherapy students to educate patients: A randomised controlled trial

Use of standardized patients in patient education practices of senior nursing students: A mixed-methods study

BACKGROUND

There is a need for innovative teaching practices in nursing education due to many factors, such as global changes, the rapid development of technology, the increasing number of students, and the recent pandemic.

OBJECTIVES

This research was conducted using standardized patients to evaluate the attitudes and skills of senior nursing students toward patient education practices following the implementation of a patient education training program.

DESIGN

Mixed-methods design.

SETTINGS

The study was conducted at a nursing faculty.

PARTICIPANTS

The sample of the study consisted of 47 senior nursing students.

INTERVENTION

The students participating in the study were given a four-hour patient education training that included the preparation of patient education, preparation of materials, and effective presentation.

METHODS

A descriptive information form prepared by the researchers, the Patient Education Implementation Scale (PEIS), the Turkish version of the Patient Education Materials Assessment Tool for Printable Materials (PEMATTR-P), and the presentation skill evaluation form (PSEF) were used to collect quantitative data. Semi-structured interview forms were utilized to collect qualitative data. SPSS for Windows v. 25.0 and MAXQDA20 were used for the data analyses. Results with a p value of <0.05 were considered statistically significant.

RESULTS

The post-test mean PEIS scores of the students increased in the total scale and in all subdimensions. A significant difference was found in the understandability and actionability of patient education materials evaluated with PEMATTR-P (p < 0.05). The mean PSEF score of the students was 85.14 ± 9.25 points. Within the scope of the research, two main themes, namely emotions and efficacy, were determined.

CONCLUSIONS

This study confirms that structured patient education training, including the use of standardized patients, is important for supporting and developing nursing senior students' attitudes and skills toward patient education.

Fostering collaborative practice through interprofessional simulation for occupational therapy, physiotherapy, dietetics, and nursing students

Literature regarding simulation for learning interprofessional collaborative practice (IPCP) indicates a need to include a range of health professions and to focus on students' development of team communication and conflict resolution skills in day-to-day healthcare delivery. This study evaluated the impact of interprofessional simulation for occupational therapy, physiotherapy, dietetics, and nursing students on interprofessional collaboration competencies, specifically collaborative communication and conflict resolution during day-to-day interactions, and their intention for IPCP during placement. A series of simulations featuring the potential for interprofessional conflict and involving explicit coaching on communication and conflict resolution were conducted. A single cohort pre-test post-test design included the Students' Perceptions of Interprofessional Clinical Education Revised (SPICE-R), the Interprofessional Collaborative Competencies Attainment Survey (ICCAS), and an open response survey question on future intended practice. A total of 237 students participated in the simulation experience. Overall scores and scores on all IPCP competencies in the ICASS (n = 193) and SPICE-R (n = 226) improved for all professions post-simulation. The mean score of the ICCAS increased for 98% of the respondents and similarly the mean score of the SPICE-R increased for 71% of the respondents. Open-ended responses indicated students' intentions to pursue self-leadership in IPCP. Students who participated in an interprofessional simulation reported perceived improvements in IPCP competencies and were encouraged to initiate IPCP when on placement in the practice setting.

Physiotherapy students' empathy towards Australians living in rural settings: A pre-test post-test evaluation of a stand-alone rural simulation activity

OBJECTIVE

To investigate how a rural simulation activity influenced physiotherapy students' rural empathy, and to explore students' perception of the activity.

SETTING

A metropolitan university in Queensland, Australia.

PARTICIPANTS

Second year undergraduate physiotherapy students.

DESIGN

A single cohort pre-test post-test evaluation was undertaken to evaluate a rural simulation activity. Participants received the rural simulation activity, featuring an immersive video and telehealth simulation with a standardised patient portrayed by an actor. Participants undertook a structured debrief and guided reflection following the simulation. Outcome measures included the Rural Comprehensive State Empathy Scale (R-CSES) and the Satisfaction with Simulation Experience Scale. Group interviews were undertaken regarding participant perceptions of the activity. Wilcoxon Rank-Sum tests were used to analyse survey data, and group interview data were subject to thematic analyses.

RESULTS

A total of 102 students undertook the activity, with an outcome measure response rate of 92.2% (94/102). Intra-personal rural empathy increased following the activity as demonstrated by the overall R-CSES score [pre-test: 101.5 (90-110.75) vs post-test 107 (100-120); p = <0.001; r = 0.39]. There was high satisfaction with the experience [mean SSES score = 18/21]. Two themes were generated from the group interview data: (1) effect on perceptions of rural practice and (2) feedback regarding the simulation.

CONCLUSION

A rural simulation activity using an immersive video, standardised patient, and a structured debrief increased physiotherapy students' empathy towards Australians living in rural settings. Students were satisfied with the activity and felt that it improved their understanding of the challenges of rural healthcare.

The Impact on the Stress-Associated Autonomic Response of Physiotherapy Students Receiving Interferential Current in an Electrotherapy Training Session

Electrical currents are didactic contents widely applied in the training of physiotherapy students, but the treatment is considered a stressful situation for both the patient who receives it and the student who applies it. The aim of this study was to evaluate the stress-associated autonomic response of physiotherapy students receiving interferential current by measuring and analysing heart rate variability. An observational case-control study was conducted. Ninety healthy male volunteers, all physiotherapy degree students, were enrolled while attending laboratory practice during the 2020-2021 academic year. Participants were randomly allocated to a sham electrotherapy group (44 subjects), in which heart rate variability was recorded for 10 min, both at rest and during the application of sham technique on the lower back (10 min), and an electrotherapy group (46 subjects), applying the same procedure with the electrical current flowing. Outcome measures included baseline (seated position) and postintervention (prone position) time domain parameter, diameters of the Poincaré plot 1 and 2, stress score, and sympathetic/parasympathetic ratio. The sham electrotherapy group exhibited significant increases in time domain parameter (p = 0.027) and diameters of the Poincaré plot 1 (p = 0.032), with a small effect size (d ≤ 0.5). The electrotherapy group exhibited significant increases in time domain parameter and diameters of the Poincaré plot 1 and 2 (p < 0.001) and decreases in the stress score and sympathetic/parasympathetic ratio (p < 0.001), with a large effect size (d > 0.8) other than for the time domain parameter (d = 0.42), indicating increased parasympathetic and decreased sympathetic activity. After interventions, there were significant differences between groups in diameters of the Poincaré plot 2 (p < 0.001), stress score (p = 0.01) and sympathetic/parasympathetic ratio (p = 0.003), with moderate effect size (d > 0.5). The application of the interferential current technique produces stress-associated autonomic response characterized by greater parasympathetic activity and decreased sympathetic activity. Further studies are needed to determine possible adverse effects.

Effectiveness of patient education training on health professional student performance: A systematic review

BACKGROUND

Despite the fundamental role of patient education, concerns have been raised by health professionals, students, and professional bodies regarding student preparation for this area of practice.

OBJECTIVE

To evaluate the effectiveness of patient education training on health professional student performance.

METHOD

A systematic search was performed across PubMed, Cinahl, Embase, and Cochrane Library. Reference and forward citation searches of included articles were conducted. Inclusion criteria were published journal articles from 2010 to 2020 regarding patient education training for health professional students with measures relating to patient education performance. Quality appraisal of individual studies was conducted using Cochrane risk-of-bias v2 or ROBINS-I; overall appraisal was also determined. Sixteen articles met eligibility criteria. Independent data extraction was undertaken.

RESULTS

Fourteen studies reported improvements in student performance following patient education training; two studies reported no significant improvements. Of different modalities examined, simulation-based learning appeared to be most effective.

CONCLUSION

Patient education training enhances health professional students' performance of patient education. Future research is needed to evaluate effectiveness of pedagogically informed interventions across health professions using objective approaches to assess student performance in clinically relevant settings.

PRACTICAL VALUE

This review supports the use of specific training approaches to improve student performance of patient education.

E-learning communication skills training for physiotherapy students: A two phased sequential mixed methods study

OBJECTIVE

Test whether a single e-learning session can improve empathy and communication across pre-registration and postgraduate physiotherapy students.

METHODS

Design: Two-phase sequential mixed methods study. Phase 1: Pilot randomised control trial. Phase 2: Qualitative study using interpretive phenomenological analysis.

SAMPLING

A purposive sample for both phases.

OUTCOME MEASURES

Phase 1: At baseline, post and 6-week follow up. Demographics.

PRIMARY OUTCOME

Inter-personal Reactivity Index (IRI). Phase 2: Demographics and interview schedule.

INTERVENTION

An e-learning (E) narrative intervention group or active control condition.

ANALYSIS

Phase 1: Descriptive statistics and confidence intervals. Mann-Whitney U test to compare across group change. Phase 2: Thematic analysis.

RESULTS

Thirty-nine participants took part in the mixed methods study (Phase 1 n = 25; Phase 2 n = 14). Phase 1: No significant differences between groups were identified. Potentially importance changes across time were found for the intervention group and control group. Phase 2 results identified 5 themes and 12 sub-themes.

CONCLUSION

The e-learning groups identified an increase in the perceived ability to handle distressing communication. Other important findings from the e-learning are discussed. Further research is warranted. Practical Implications Novel e-learning intervention may have an important role in curriculum development and clinical practice to promote therapeutic communication.

PRACTICAL IMPLICATIONS

Novel e-learning intervention may have an important role in curriculum development and clinical practice to promote therapeutic communication.

Navigating diagnostic uncertainty in musculoskeletal practice: The perspectives and experiences of new graduate physiotherapists

BACKGROUND

Diagnostic uncertainty in musculoskeletal pain presents as a frequent and challenging dilemma encountered by health professionals. Current literature indicates that diagnostic uncertainty impacts the clinical decision making of experienced physiotherapists. Despite this, the experiences and navigational strategies of new graduate physiotherapists, pertaining to this dilemma, are widely unknown.

OBJECTIVES

The aim of this study was to explore how new graduate physiotherapists experience and navigate diagnostic uncertainty when managing individuals with musculoskeletal pain.

METHODS

A qualitative study using a thematic analytical research approach was undertaken. A randomized sample of new graduate physiotherapists, working in musculoskeletal settings (n = 17), participated in semi-structured telephone interviews. Interview data was subsequently subject to thematic analysis.

RESULTS

Four key themes emerged from the data: 1) diagnostic uncertainty is fraught with challenges; 2) diagnosis is not the end game; 3) intrinsic strategies and extrinsic actions and 4) the imperative role of clinical practice.

CONCLUSION

New graduate physiotherapists frequently experience diagnostic uncertainty within musculoskeletal practice and are commonly challenged by this dilemma. Despite this, new graduates utilize several strategies to mitigate challenges including focusing on patient-centered care, maintaining transparency and relying on senior colleagues. Most strategies are directly attributed to clinical experiences. This study further outlines implications for physiotherapy curricula and workplace support.

Physiotherapy new graduate self-efficacy and readiness for interprofessional collaboration: a mixed methods study

Effective interprofessional collaboration is a required competency for all health professionals including physiotherapists. Little is known about new graduate physiotherapists' self-efficacy and readiness for interprofessional collaboration. A sequential mixed-methods design was used to examine and explore (a) new graduate self-efficacy and (b) new graduate perception of the role and influence of curricular activities on their readiness for interprofessional collaboration. New graduate physiotherapists completed a self-efficacy measure based on the Interprofessional Care Core Competencies Global Rating Scales, and semi-structured interviews were undertaken and subjected to framework analysis. 150 surveys were completed (response rate 91%). Less than one quarter of all participants agreed or strongly agreed that they were confident in relation to all interprofessional competencies. New graduates attributed their self-efficacy to being directly exposed to interprofessional collaboration in a clinical setting during their placement year. The results demonstrate that new graduate physiotherapists have high self-efficacy communicating with other professionals and understanding their roles, however they have low self-efficacy with interprofessional conflict resolution and providing feedback to others. This study has implications for supporting new graduates in practice, and for preparing physiotherapy students for interprofessional collaboration.

The investigation of the educational needs on the job competence for physical therapist assistant in the students of Quang Tri medical college in Vietnam

[Purpose] The purpose of this study was to investigate the educational needs on the job competence for physical therapist assistant in the students of Quang Tri medical college in Vietnam. [Participants and Methods] Participants consisted of 17 individuals in the educational program for physical therapist assistant in Quang Tri medical college. The importance recognition ranking and current levels were measured by self-assessment for job competence of physical therapist assistant using a questionnaire. The educational needs were calculated by importance recognition ranking and current level by a self-assessment of job competence. [Results] The importance recognition ranking of job competence appeared to show a ‘system checkup’ as the top ranked category. The rank of current levels of competencies was determined by self-assessment of job competence and results showed that ‘cooperation, communication, and documentation’ was the highest category of the current levels. The highest rank of the educational needs was ‘counseling and education’. [Conclusion] The educational needs rank of job competence appeared to be ‘counseling and education’ foremost. Counseling and education with the patient is a fundamental component of effective healthcare. Therefore, it should be considered a priority for the educational curriculum of physical therapist assistant.