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

Reflect to interact - fostering medical students' communication through reflection-focused e-learning

BACKGROUND

Previous research indicates that reflection can foster medical communication competence. However, best practices for embedding reflection in online medical education are missing. This study examined how reflection processes can be promoted and embedded in an e-learning course on physician-patient communication to foster learning.

METHODS

We investigated three differently designed e-learning conditions featuring different proportions of reflection triggers and compared their effects on students' reflections. We had 114 medical students in their first clinical year complete one of the variants: video modelling (VM, n = 39), video reflection (VR, n = 39), or a variant merging both approaches (VMR, n = 36). Each student wrote a total of nine reflections based on the same guiding questions at three time points embedded in the course. The students' levels of reflection were measured using an adapted version of the REFLECT rubric (scale 0-18).

RESULTS

Students of all course variants achieved good levels of reflection beyond the descriptive level at all three time points, with no significant differences between the variants. The mean reflection scores at the end of the course were M = 14.22 for VM (SD = 2.23), M = 13.56 for VR (SD = 2.48), and M = 13.24 for VMR (SD = 2.21). Students who completed VM showed significantly improved levels of reflection over the course, whereas we found no statistically significant development for those in VR or VMR. The reflection scores correlated significantly positively with each other, as did the text lengths of the written reflections. Reflection scores also correlated significantly positively with text length.

CONCLUSIONS

Our study offers a teaching strategy that can foster good levels of reflection, as demonstrated in the three e-learning variants. The developed reflection prompts can be easily embedded in various e-learning environments and enable reflections of good quality, even in settings with limited available teaching time.

"I haven't got a clue what policies are in place for this!": physiotherapy students' preparedness to deal with self-harm

OBJECTIVES

The prevalence of self-harm and the potential link with suicidal ideation highlights the need to prepare future physiotherapists to deal with the potentially catastrophic outcomes to which a lack of understanding in this area can lead. The aim of this research was to investigate if final year physiotherapy students felt prepared to assess risk of suicide or self-harm following patient disclosure, or showing signs of intention to harm themselves.

DESIGN

An interpretive phenomenological methodology (IPA) was implemented to aid in the understanding and interpretation of participants' own experiences. In conjunction with the overarching design, semi-structured interviews, via two focus groups, were used to explore participants' views.

SETTING

Focus groups were conducted via an online platform.

PARTICIPANTS

Purposive sampling was employed as a sampling method to recruit final year physiotherapy students. The final sample consisted of ten participants.

RESULTS

Four main themes were identified: Experiences of disclosure; Encountering mental health; Lack of mental health education, and Lack of knowledge regarding policy and procedure.

CONCLUSIONS

The findings highlight a deficit with regards to the preparedness of final year students in dealing with disclosure to self-harm. A lack of both formal education regarding mental illness and of practice experience in the field of mental health contribute to this. Therefore, a more rigorous and directed approach to education regarding mental illness is essential. Furthermore, involvement in mental health practice placements would allow for a greater level of experiential learning and understanding of the issues faced by those living with mental illness.

CONTRIBUTION OF THE PAPER

Contribution to the evidence: Contribution to knowledge.

Beyond scientific and technical training: Assessing the relevance of empathy and assertiveness in future physiotherapists: A cross-sectional study

Background and Aims

Empathy and assertiveness are two essential social skills for a health professional such as a physiotherapist and are necessary for developing moral thinking. Previous studies show that the development of empathy and other social skills improves as students progress in their studies. However, other authors show deterioration of empathy as students progress in their studies and acquire clinical experience. Training in soft skills, such as assertiveness, among health science students will have an impact on the quality of patient care. Effective communication, conflict resolution and the ability to work as part of a team are competencies that have been put to one side as a result of the recent COVID-19 pandemic and it is important to resume training students in soft skills. The objective of this study is to investigate to determine the empathic and assertive state of physiotherapy university students.

Methods

A descriptive cross-sectional study of physiotherapy university students was conducted in the 2022/2023 academic year. The Interpersonal Reactivity Index (IRI) scales for empathy and the Rathus test for assertiveness (RAS) were used as study tools. Finally, 127 students participated in the study, 52.91% of the total population of physiotherapy students. The questionnaire was available for 4 weeks in November and December 2022.

Results

The empathetic and assertive development of the students was found to be acceptable. Significant differences were also observed according to the gender variable in the students, with female students presenting better results (p = 0.01). Students who are working or have clinical experience in other professions score lower on the empathy personal distress subscale (p < 0.001).

Conclusion

Future research should be considered to help improve clinical and professional expertise in physiotherapy students about empathic and assertive development. The findings provide new evidence on the levels of empathy and assertiveness in physiotherapy students.

A novel approach to improving colonoscopy learning efficiency through a colonoscope roaming system: randomized controlled trial

Background

Colonoscopy is indispensable in the diagnosis and treatment of lower digestive tract (LDT) diseases. Skilled colonoscopists are in great demand, but it takes considerable time for beginners to become experts. In addition, patients may refuse to permit primary learners to practise colonoscopy on them. Thus, improving the instructional programmes and models for primary learners is a key issue in endoscopy training. Convenience and a self-paced, learner-centred approach make e-learning an excellent instructional prospect. Therefore, we created the Colonoscope Roaming System (CRS) to assist in colonoscopy teaching procedures. We aimed to develop the e-learning software, test it with beginner colonoscopists and evaluate its effectiveness via subjective and objective methods.

Methods

Through a randomized controlled trial, participants were randomly allocated to an e-learning group (EG) or a control group (CG) after a pretest evaluation. The CG learned through the traditional colonoscopy teaching mode, while the EG used CRS in addition to the traditional teaching mode. Subsequent to the training, the participants completed a posttest and colonoscopy examination. The EG also completed a satisfaction questionnaire.

Results

Of the 84 participants, 81 (96%) finished the colonoscopy learning and evaluation modules of the CRS. No conspicuous differences in the pretest scores were found between the EG and CG (p > 0.05). Two months later, the posttest scores for the EG were higher than those of the CG (p < 0.001), and the EG had better performance on the colonoscopy examination (p < 0.01). Overall, 86.25% of questions raised in Q1-Q20 were satisfied with the CRS and considered it successful.

Conclusions

The use of CRS may be an effective approach to educate beginner colonoscopists to attain skills.

Simulation-based holistic education in physiotherapy interns to increase empathy toward older adults and individuals with disabilities

Background

The proportion of older adults and individuals with disabilities in the general population increases each year. Thus, clinical clerkships designed for physiotherapy interns should provide more than simply knowledge and skills. For such interns to be able to handle the requirements of their future jobs, clerkships must enable them to develop empathy and positive attitudes toward patients. This study investigated the effect of simulation-based, holistic health-care education on physiotherapy interns’ empathy, attitudes, and knowledge. 

Methods

A parallel-group design. Thirty physiotherapy interns from a medical institution were enrolled as participants, with experimental and control groups each comprising 15 participants. Both groups received standard clinical training. However, the experimental group received an additional 3.5 h of simulation-based holistic health-care education. The Jefferson Scale of Empathy, Kogan’s Attitudes Toward Old People Scale, the Attitudes Towards the Elderly Scale, the Knowledge About Aging Scale, Knowledge of the Situation of Older People Scale, Perceptions of Working with Older People Scale, and Care Willingness Scale were used in a pretest and posttest.

Results

After the intervention period, we observed substantial between-group differences of 6.4 points on the Jefferson Scale of Empathy (p = 0.001), 7.7 points on Kogan’s Attitudes Toward Old People Scale (p = 0.002), 3.5 points on the Attitudes Toward the Elderly Scale (p = 0.002), 2.5 points on Knowledge About Aging (p = 0.055), 4.5 points on the Knowledge of the Situation of Older People Scale (p < 0.001), and 2.1 points on Perceptions of Working with Older People Scale (p = 0.046).

Conclusion

Simulation-based, holistic health-care education can significantly improve the empathy, knowledge, and attitudes of physiotherapy interns.

A qualitative study of illness narratives: ‘overcoming the monster’ master plot for patients with stroke

Background/Aims

Research that considers illness narrative ‘master plots’ (common and recognisable story plots related to the experience of illness), as expressed by individuals who have had a stroke, is needed Thus far, the literature has focused on identifying pre-established illness narrative master plots: the restitution, the chaos and the quest narrative. However, these narrative plots represent extreme psychological responses to the experience of illness; other narratives need to be understood in order to most effectively support individuals with stroke. Further research must identify if other master plots exist, and consider the implication of such plots.

Methods

A narrative methodology was undertaken, contextualised within a social constructivist worldview. A purposive sample of individuals with stroke undertook a single online semi-structured interview. A categorical-form narrative analysis was undertaken in five stages.

Results

A total of eight individuals were interviewed. Following analysis, six individuals were identified as illustrating experiences related to a master plot termed ‘overcoming the monster’. The ‘monster’ was represented in several ways, which included: a mental health problem or an expression relating to internal feelings; a sense of being isolated from others; a threat to the individual's independence; and a negative interaction or experience related to health care. Individuals identified clear strategies for ‘overcoming the monster’. These included: adopting a different way of viewing life; identifying and attaining both big and small goals; persistence and determination in the face of adversity; and giving support to others through activities and receiving support.

Conclusions

Allied health professionals need to understand the importance of this narrativisation of stroke because research has shown that allied health professionals can stereotype interactions by plots and seek to correct them. Implications of these findings ilustate the importance of understanding the individuals experience, not immediately reacting to a narrative type that may seem to fit, understanding the plot of overcoming the monster varies and may need time to be observed.

Do online workshops using active teaching methods improve self-rated communication skills of physiotherapy students?

Study aim: In the education of physiotherapists, communication skills should be developed: this can be done by conducting special workshops. In the context of the COVID-19 pandemic, the need arose for replacing conventional forms of education with remote classes. Therefore, it was decided to test the effectiveness of a social skills workshop conducted using active online methods for second-year physiotherapy students.

Material and methods: The experimental factor was the contents of workshop classes taught online as part of the mandatory course included in the curriculum. The platforms Teams, Zoom, and the Messenger were used to carry out the experiment. The workshops used active learning methods: simulation of work situation, drama, peer feedback and interaction-based communication.

Results: The results obtained from 78 participants (pre-test and post-test, including 45 women) were analyzed. The age of the participants ranged from 20 to 22 years, with a mean of 20.7 years. A self-reported social skills questionnaire consisting of 17 statements was used. participation in the course resulted in a significant increase in the index of general communication skills of the students (Z = 5.11, p < 0.001, R = 0.582).

Conclusions: Online workshops using active teaching methods, which are an essential element of students of physiotherapy preparation for clinical work, can stimulate the development of their communication skills.

Evaluation of the Effectiveness of Employers and H&S Services in Relation to the COVID-19 System in Polish Manufacturing Companies

With the advent of the COVID-19 pandemic, companies had to adapt quickly to survive in the market. During this time, employers played a key role, along with employees involved in Occupational Health and Safety (OHS) activities, as they were responsible for implementing the recommendations of the European Commission. There is no unambiguous definition of OHS in Polish legislation. It is assumed that it is a set of rules defining the manner of performing work, and above all, a method of providing employees with working conditions so that their performance is safe and hygienic. Responsibility for the health and safety in the workplace is imposed on the employer by the legislature. Thus, effective health and safety training is an essential element of the success of any properly operating company. In the literature, no studies have been identified that evaluate the effectiveness of actions during the COVID-19 outbreak. The aim of the article is to present the actions of Polish employers along with their effectiveness assessment related to the protection of employees during the COVID-19 outbreak. The article presents a proposal for conducting remote OHS (Occupational Health and Safety) training using the platform Moodle. The created course was implemented during OHS training conducted in a selected manufacturing company. At its end, an evaluation of the course was carried out, and the collected opinions of training participants allowed the formulation of interesting conclusions, which became the contribution of this paper. The authors pay special attention to three main points of the work. The first is the form of training, which gives the possibility to conduct training at a distance while maintaining its effectiveness. The second important point is the mandatory feedback of the trainees, ensuring the possibility of continuous improvement and quality enhancement of both the program and the form of training. The evaluation was developed on the basis of the extended Kirkpatrick model, which is a completely new approach to OHS training evaluation. The third point emphasized by the authors is the possibility of precise adaptation of the training to other plants and even industries. Therefore, it can be concluded that the course developed by the authors is a very interesting and practical didactic tool with great implementation potential.