eLearning in Physical Therapy: Lessons Learned From Transitioning a Professional Education Program to Full eLearning During the COVID-19 Pandemic

Workload of the Director of Clinical Education in Doctor of Physical Therapy Programs

INTRODUCTION

Directors of clinical education (DCEs) have complex roles in Doctor of Physical Therapy (DPT) programs. Workload imbalances affect the DCEs' ability to perform tasks efficiently and effectively. In this study, our purpose was to examine the DCEs' formal and actual workload, and factors that influence workload.

REVIEW OF LITERATURE

Variations in DCE workload exist among DPT programs. The DCEs' day-to-day workload often differs from their formal workload. Programmatic and individual factors may influence workload. We did not find any large-scale studies that compared the DCEs' actual and formal workloads.

SUBJECTS

We examined data from 143 DCEs for DPT programs in the United States.

METHODS

Subjects were recruited using email and Listserv to take a novel online survey. In this quantitative, nonexperimental study, we examined data through descriptive statistics, Wilcoxon signed-rank tests, and multiple regressions.

RESULTS

Respondents worked significantly more hours than they were expected to work. A significant difference existed between the percentage of time formally designated and the time actually spent performing administrative, scholarship, and teaching tasks. Respondents reported lacking time in all workload categories. Collective programmatic and DCE characteristics statistically significantly affected the DCEs' scholarship and service workloads. The number of clinical education experiences independently significantly affected the DCEs' administrative and service workloads. The amount of training a DCE received independently significantly affected the DCEs' administrative, scholarship, and service workloads.

DISCUSSION AND CONCLUSION

A consistent method of calculating DCE workload should be developed that considers DCE and program characteristics. More time is needed for DCEs to perform their roles effectively. If workload imbalances, program variations, and time constraints are not addressed, DCEs may become dissatisfied with their jobs and leave the position.

A Comparison of Physical Therapist Educational Outcomes Before and During the COVID-19 Pandemic: A Multicenter Study

INTRODUCTION

The purpose of this study was to analyze and compare educational outcomes of Doctor of Physical Therapy (DPT) graduates before and during the COVID-19 pandemic.

REVIEW OF LITERATURE

Reports show increased stress, anxiety, and burnout during the COVID-19 pandemic, which may have negatively affected academic performance. Historically, academic performance is predictive of National Physical Therapy Examination (NPTE) scores. Yet, there is little evidence analyzing student outcomes during the pandemic.

SUBJECTS

Doctor of Physical Therapy graduate records (N = 1,897) were retrospectively collected from a multicenter convenience sample consisting of 5 blended programs. Records were sampled from existing "prepandemic" graduates of Fall 2018-2019 (n = 988) and "pandemic" graduates of Fall 2021-2022 (n = 909).

METHODS

A causal comparative and correlational study design was used. Grade point average (GPA) and NPTE scores were collected. A general linear model examined differences between groups, and a multiple linear regression examined predictors of NPTE performance.

RESULTS

Grade point average was a significant predictor of NPTE score (r2 = 0.56; P < .01) for the overall sample and for the prepandemic and pandemic cohorts (r2 = 0.38, P < .01; r2 = 0.45, P < .01, respectively). Grade point average was not significantly different between the groups (P = .09), nor did it significantly influence differences in NPTE scores (P = .13). Pandemic graduates displayed a significantly lower NPTE pass rate (85.1%) compared with prepandemic graduates (89.7%; P < .01). Pandemic graduates experienced higher rates of academic difficulty (20%; P < .01) and had a approximately 5 times higher likelihood of not passing the NPTE.

DISCUSSION AND CONCLUSION

This is the first study to report on DPT graduate outcomes spanning the COVID-19 pandemic. Similar to previous studies, GPA remained the most significant predictor of NPTE scores. Pandemic graduates demonstrated significantly lower NPTE scores and higher rates of academic difficulty (GPA < 3.0). Continued monitoring of NPTE performance is warranted between prepandemic, pandemic, and postpandemic cohorts across modes of program delivery.

Impact of the Covid-19 pandemic and lockdowns on the education and mental health of physiotherapy students in France: a descriptive cross-sectional study with national online survey

OBJECTIVE

To determine the impact of the SARS-CoV-2 (COVID-19) pandemic and lockdowns on the mental health status, training, perceptions of the physiotherapy profession, and career plans of French physiotherapy students.

DESIGN

A descriptive cross-sectional study was conducted, representing the first and only survey of its kind, using a national online survey.

SUBJECTS

A total of 2678 French physiotherapy students participated in the study.

METHODS

Mental health status was assessed using the validated French versions of established depression, anxiety, and insomnia scales.

RESULTS

The survey revealed that female sex, age below 21 years, living alone, and having a psychiatric history or COVID-19 risk factors were associated with more severe symptoms of depression, anxiety, and insomnia in the surveyed students. In addition, stress, anxiety, and depression induced by the COVID-19 crisis were linked to apprehension about continuing practical training in physiotherapy. These factors also affected students' perceptions of the profession and the initially envisioned mode of practice, particularly among fifth-year students (odds ratio (OR) = 2.25, 95% confidence interval (95% CI) = (1.69, 2.99), p < 0.001). Notably, the pandemic significantly reduced the desire of these students to pursue a career as physiotherapists (adjusted OR (aOR) 1.41 (1.06, 1.86)).

CONCLUSION

French physiotherapy students, especially those in their fifth year, have experienced significant impacts from the COVID-19 pandemic, affecting their mental health, education, perceptions of the physiotherapy profession, and career plans.

A Safe and Feasible Online Dance Intervention for Older Adults With and Without Parkinson's Disease

Introduction: Dancing is one way of maintaining an active lifestyle, and online dance interventions in group settings can be a solution when in-person classes are impossible. This study investigated the feasibility and potential clinical effects of an online dance program for older adults with and without Parkinson disease (PD). Methods: Participants attended 2 weekly dance classes in the same videoconference room for 2 months. The dance activities were mainly performed while seated (around 75%). Researchers monitored feasibility (ie, adherence, attendance, and technological barriers) and safety. Pre- and post-intervention assessments investigated self-perceptions, effects on emotional domains, quality of life, activity-specific balance confidence, lower-limb functional mobility, and PD non-motor symptoms. Individuals also reported their self-perceptions regarding technology usability, enjoyment, and social interaction. Results: Most of the participants with PD (n = 12) had moderate PD (Hoehn & Yahr score) and presented a greater risk of falls when compared to participants without PD (n = 14). Overall, we found a high rate of adherence (100%), attendance (87.5%-91.7%), and safety (100%) for both groups. No falls or near-falls occurred during the sessions. Only the PD group ameliorated emotional domains (anxiety and depression) and improved lower-limb functional mobility. All participants reported feeling safe and perceived benefits, although over a third of older adults with PD reported moderate difficulties in using technology and in socializing with the group. Conclusion: This online dance protocol is feasible, safe, and a potential strategy to improve clinical parameters in older adults and people with moderate PD.

Pedagogical impact of integration of musculoskeletal anatomy blended learning on physiotherapy education

Background

In physiotherapy education, blended learning is recognized to be more effective compared to traditional teaching. The aim of this study was to assess the consequences of a musculoskeletal anatomy blended learning program on skills developed by students.

Methods

We conducted an observational retrospective monocentric study in a French physiotherapy school named "X." Ninety-two first-year students in the 2017-18 baseline group (students with traditional face-to-face learning), and ninety-eight first-year students and ninety-five second-year students in the 2018-19 and 2019-20 blended learning experimental groups was included. A success rate of the anatomy final written exam, defined by the percentage of students scoring 50% or above, was analyzed between 2017 and 2020. We also evaluated the pedagogical value of musculoskeletal e-learning and its usefulness for preparing the student for their anatomy final written exam at «X».

Results

We observed an improvement in the success rate of the anatomy final written exam between the 2017-18 baseline group, 2018-19 and 2019-2020 experimental groups during first (Kruskal-Wallis = 74.06, df = 2, p < 0.001) and second semester (Kruskal-Wallis = 173.6, df = 2, p < 0.001). We obtained a data survey and questionnaire response rate of 74% (n = 89/120) for the 2018-19 and 62% (n = 72/116) for the 2019-20 experimental groups. Concerning questionnaire response, they were no significant statistical difference between 2018-19 and 2019-20 experimental groups.

Conclusion

Blended learning could improve student success rate of the anatomy final written exam and learning of professional physiotherapy skills.

Effectiveness of online teaching during the COVID-19 pandemic on practical manual therapy skills of undergraduate physiotherapy students

OBJECTIVES

This study includes two separate parts: the objective for part A was to evaluate the practical manual therapy skills of undergraduate physiotherapy students who had learned manual therapy techniques either online or in classroom depending on the phases of the pandemic. The objective for part B was to evaluate in a randomized prospective design the effectiveness of video-based versus traditional teaching of a manual therapy technique.

DESIGN

Cross-sectional cohort study (part A) and randomized controlled trial (part B).

SETTING

University of Luebeck, undergraduate physiotherapy students in years 1-3.

METHOD

In part A, physiotherapy students who had learned manual therapy either online (during the pandemic) or in classroom (prior to and after the lock down periods of the pandemic) were videotaped while performing two manual techniques on the knee joint and on the lumbar spine. Recordings were analyzed independently by two blinded raters according to a 10-item list of criteria. Inter-rater reliability was assessed using Cohen's kappa for each item. Performance across cohorts was analyzed using analysis of variance. In part B, students were randomized to learn a new technique on the cervical spine either from a lecturer or from the same lecturer on a video recording (independent variable). Practical performance of the technique was analyzed by two raters blinded to group allocation according to a 10-item list of criteria (dependent variable). Results were analyzed statistically by using ANCOVA with year of study as a covariate.

RESULTS

Sixty-three and 56 students participated in part A and part B of the study, respectively. The inter-rater reliability for video analyses for both parts of the study was moderate (k = 0.402 to 0.441). In part A, there was no statistically significant difference across years of study for the practical performance of the technique on the back F(2,59) = 2.271; p = 0.112 or the knee joint F(2,59) = 3.028; p = 0.056. In part B, performance was significantly better when learned from a lecturer and practiced on a peer than when learned from a video and practiced on a rescue dummy (p < 0.001).

CONCLUSION

Practical skill performance can be acquired from videos but immediate skill reproduction is significantly better when the technique is presented by a lecturer in classroom and practiced on peer students.

Remote, asynchronous training and feedback enables development of neurodynamic skills in physiotherapy students

BACKGROUND

During the COVID-19 pandemic, face-to-face teaching and learning of physiotherapy practical skills was limited. Asynchronous, remote training has been effective in development of clinical skills in some health professions. This study aimed to determine the effect of remote, asynchronous training and feedback on development of neurodynamic skills in physiotherapy students.

METHODS

Longitudinal repeated measurements study, across four training sessions. Participants engaged in a remote training program for development of upper limb neurodynamic techniques. In this sequential training, participants viewed the online tutorial, practiced independently, and uploaded a video of their performance for formative assessment and feedback from a trained instructor via a checklist and rubric.

RESULTS

Intra-subject analyses of 60 third-year physiotherapy students showed that the target standard of performance, with no further significant change in scores, was attained following session 2 for the checklist and session 3 for the rubric. This shows that two sessions are required to learn the procedures, and three sessions yield further improvements in performance quality.

CONCLUSION

The remote, asynchronous training and feedback model proved to be an effective strategy for students' development of neurodynamic testing skills and forms a viable alternative to in-person training. This study contributes to the future of acquiring physiotherapy clinical competencies when distance or hybrid practice is required.

Distance Education in Nutrition and Dietetics Education over the Past 30 Years: A Narrative Review

The coronavirus disease 2019 pandemic necessitated the use of distance education, which sparked a technological transformation that was long overdue in higher education. The purpose of this narrative review is two-fold: to summarize the state of knowledge regarding distance education in nutrition and dietetics education over the past 30 years to inform recommendations for future education/research and implications for practice and to determine the influence that distance education has had on the knowledge, skills, and attitudes of both nutrition and dietetics educators and their students. A narrative review of 822 publications yielded 25 that met the search criteria. In the scope of 30 years, the literature shows that attitudes and perceptions of distance education have changed as barriers to online access have diminished and the availability of online nutrition and dietetics courses and Accreditation Council for Education in Nutrition and Dietetics-accredited distance education programs has expanded. However, whereas the limited results are promising, the paucity of large-sample research about the use of distance education in nutrition and dietetics education restricts educators' knowledge of and ability to evaluate the learning outcomes of distance programs and courses. Moreover, differences in how accreditors, government agencies, and institutions define distance education could have significant influence on funding and financial aid benefits for students and research. Recommendations for future research and implications for practice are provided given the relevance and importance of distance education to nutrition and dietetics education.

"Burnout felt inevitable": Experiences of university staff in educating the nursing and allied health workforce during the first COVID-19 waves

Introduction

Maintaining progress in the face of looming burnout during the first 2 years of the COVID-19 pandemic was crucial for the health workforce, including those educating the next generation of health professionals. The experiences of students and healthcare practitioners have been explored to a greater degree than the experiences of university-based health professional educators.

Methods

This qualitative study examined the experiences of nursing and allied health academics at an Australian University during COVID-19 disruptions in 2020 and 2021 and describes the strategies that academics and/or teams implemented to ensure course continuity. Academic staff from nursing, occupational therapy, physiotherapy, and dietetics courses at Swinburne University of Technology, Australia provided narratives regarding the key challenges and opportunities they faced.

Results

The narratives highlighted the strategies generated and tested by participants amidst rapidly changing health orders and five common themes were identified: disruption; stress; stepping up, strategy and unexpected positives, lessons, and legacy impacts. Participants noted challenges related to student engagement in online learning and ensuring the acquisition of discipline-specific practical skills during periods of lock-down. Staff across all disciplines reported increased workload associated with converting teaching to on-line delivery, sourcing alternative fieldwork arrangements, and dealing with high levels of student distress. Many reflected on their own expertise in using digital tools in teaching and their beliefs about the effectiveness of distance teaching for health professional training. Ensuring students were able to complete required fieldwork hours was particularly challenging due to constantly changing public health orders and conditions and staffing shortages at health services. This was in addition to illness and isolation requirements further impacting the availability of teaching associates for specialist skills classes.

Discussion

Solutions such as remote and blended learning telehealth, and simulated placements were rapidly implemented in some courses especially where fieldwork could not be rescheduled or amended at the health settings. The implications and recommendations for educating and ensuring competence development in the health workforce during times when usual teaching methods are disrupted are discussed.

Development of Competency-based Online Genomic Medicine Training (COGENT)

The fields of genetics and genomics have greatly expanded across medicine through the development of new technologies that have revealed genetic contributions to a wide array of traits and diseases. Thus, the development of widely available educational resources for all healthcare providers is essential to ensure the timely and appropriate utilization of genetics and genomics patient care. In 2020, the National Human Genome Research Institute released a call for new proposals to develop accessible, sustainable online education for health providers. This paper describes the efforts of the six teams awarded to reach the goal of providing genetic and genomic training modules that are broadly available for busy clinicians.

Beliefs and expectations on digital learning and examinations among adult learners of a tertiary level health-care institution

BACKGROUND

Coronavirus disease 2019 (COVID-19) constrained the regular teaching in educational institutions and hampered the teaching-learning process across the globe. E-learning method is widely used in higher education in the current situation. the objective is to assess the beliefs and expectations of the students on e-learning among adult learners of a tertiary level health-care institution.

MATERIALS AND METHODS

A single group pre-post design was adopted. Microsoft Go two-in-one devices were used to find the effectiveness of e-learning, including digital exam solution. Depending on the availability of device, 25 participants were selected for the study from three different steams. A 5-point Likert scale was used for assessing the quality, adoptability, and acceptance of digital education developed by the researchers. Chi-square/Fisher's exact or McNemar's test was used to test the association between independent or related categorical variables. Comparison of the average score between different courses was performed using the Kruskal-Wallis test.

RESULTS

Twenty-two participants who completed the final assessment were retained for the analysis. Majority of the participants believed that e-learning helps to achieve personal learning goals or objectives and bridge skill or knowledge gaps and caters to learning preferences. However, the overall quality score across the study groups was found to be statistically insignificant (Kruskal-Wallis statistic: 1.26; P value: 0.533).

CONCLUSION

The findings show that the adult learners in higher education, irrespective of their age differences, believe that intense e-learning support with Microsoft Go two-in-one device has a complementary effect on their learning outcome.

COMPARISON OF INFECTION RATES, QUARANTINE PERIODS, AND FEAR IN UNDERGRADUATE PHYSIOTHERAPY STUDENTS WHO HAD FACE-TO-FACE AND ONLINE EDUCATION DURING COVID-19 PANDEMIC: A SINGLE-CENTER, CROSS-SECTIONAL STUDY

Purpose: The objective of the present study was to compare the rates of COVID-19 infection and quarantine periods, and fear in undergraduate physiotherapy students who continued their educations as online or face-to-face. Methods: Three hundred and one students who continued their education as online (n= 144, for 1st and 4th degrees), or face-to-face under strict special precautions (n= 157, for 2nd and 3rd grades) during the 2020-2021 fall term were included. Demographic characteristics, COVID-19 infection diagnosis and quarantine due to contact were questioned via a structured online form. COVID-19 related fear was assessed by using the Fear of COVID-19 Scale. Results: No statistical differences were detected regarding demographical characteristics and COVID-19 infection rates between the groups (p> 0.05). The online education group had higher quarantine rates due to contact with an infected person (p= 0.040), while the face-to-face group reported higher COVID-19 related fear (p= 0.001). Conclusion: The physiotherapy students who had a face-to-face education under special precautions had more COVID-19 related fear, however less quarantine rate, and similar infection rates in comparison to online educated counterparts.

Perceptions of Physical Therapists of Online Introduction and Training in the Home-based Older Persons Upstreaming Prevention Physical Therapy (HOP-UP-PT) Program: A Qualitative Study

Introduction

Traditionally, physical therapy has adopted a tertiary approach to preventative care. However, recent trends in fall-related injuries and deaths among older individuals suggest a dire need for earlier intervention. The Home-based Older Persons Upstreaming Prevention Physical Therapy (HOP-UP-PT) program has been developed to improve the health and overall function of community-dwelling older adults at risk of functional decline. As demand continually rises for HOP-UP-PT services, online training modules have been developed to safely and efficiently provide HOP-UP-PT competency to physical therapists. The purpose of this study was to examine self-reported experiences and perceptions of physical therapists after completing an asynchronous training program to deliver HOP-UP-PT.

Methods

After securing Oakland University IRB approval, a qualitative study using a sample of convenience used two structured focus group interviews. Inclusion criteria required participants to be licensed physical therapists (PTs) in the state of Michigan providing at least 20 hours of direct patient care per week. Participants completed eight 30-minute training modules, each with a corresponding quiz. Upon completion, PTs attended one of two video conference focus groups. Data was analyzed using the constant comparative method to develop themes and concepts based on responses about the training modules and the overall HOP-UP-PT program.

Results

Twelve PTs with a median age of 31-40 years participated. Analysis of two focus group sessions identified three concepts (Novel Approach to Physical Therapy Care, Integration of a Preventative Approach into Clinical Practice, and Knowledge Translation) and ten themes (Addressing an Unmet Need, Establishing a Working Relationship with Community Centers, Applicability to Various Settings, Shifting the Mindset to a Prevention-focused Paradigm, Applicability to Physical Therapists that Care for Older Adults, Patient Engagement and Prevention, Value for the Professional, Importance of Availability of Options in a Learning Platform, Ongoing Availability of Program Resources and Tools, and Clinical Application Practice).

Conclusion

PTs identified the HOP-UP-PT program as a novel, clinically applicable, and adding value to the profession. Furthermore, its upstream focus aligns with the growing role of preventative care by PTs; however, as HOP-UP-PT is not a traditional approach, additional training and clinical support materials may facilitate adoption and clinical application. HOP-UP-PT uses a preventative approach to clinical practice, but efforts to translate knowledge to PT are an important consideration. Additionally, the study identified a need for refinement and modifications to the existing HOP-UP-PT training modules.

Comparing Domain-Specific Self-Efficacy in Pediatric Physical Therapy Education Across Classroom-Based, Online, and Hybrid Curriculum Designs

PURPOSE

To describe the pediatric curriculum across 3 years when different instructional designs were used, quantify change in self-efficacy (SE) after completing the curriculum, and define relationships between pediatric experience, SE, and interest in future pediatric practice.

METHODS

Students (N = 137) were included over 3 consecutive years. Instructional design varied across cohorts: classroom-based (n = 48), online (n = 44), and hybrid (n = 45). Pediatric content hours were analyzed. Measures were the Pediatric Communication and Handling Self-Efficacy Scale, pediatric experience, and interest in future pediatric practice.

RESULTS

Pediatric content hours met published recommendations. Significant growth in SE occurred for all cohorts, with no significant differences in SE scores based on instructional design. Experience and interest in pediatrics were significantly related to communication SE.

CONCLUSIONS

The pediatric physical therapy curriculum delivered via classroom-based, online, or hybrid instruction can be effective in promoting pediatric-specific growth in student SE. Remote pediatric experiential learning is a feasible option for physical therapy programs with limited direct contact with children. What this adds to the evidence : When pediatric curricula meet recommended total hours of instruction, regardless of instructional method or amount of direct laboratory time with real children, pediatric-specific student SE increases. This supports the use of alternative approaches for experiential learning activities in programs with limited access and availability for direct in-person child interactions. Programs may expand integrated clinical experiences (ICE) opportunities to include telehealth when in-person ICE is limited due to distance or availability in nearby clinical settings. Online learning activities (asynchronous or synchronous) may be viable options for laboratory activities when live child volunteers are limited or unavailable. Use of multiple methods of instruction (classroom-based, online, or hybrid) can be beneficial in covering pediatric physical therapy content and improving SE. This evidence can help programs expand their options for exposing student physical therapists to pediatric practice.

Dietetics Students' Perceptions of Academic and Health Impacts of the COVID-19 Pandemic

This study examined dietetics students' perceptions of coronavirus disease-2019 (COVID-19) pandemic impacts on academics and mental and physical health. Data were collected via a cross-sectional online survey in February to March 2021 from undergraduate dietetics students across the United States. Among the 526 students who participated, during the fall 2020 semester, 87% experienced increased stress, 64% reported mental health concerns, and 32% reported disordered eating. Sixty-two percent agreed their program met educational needs; however, 62% also agreed COVID-19 negatively impacted the quality of education and 49% agreed to learning less than normal. Pandemic impacts are critical to consider as students enter dietetic internships and start careers.

Teaching Physiotherapy during the Initial Stages of the COVID-19 Pandemic: What Did We Learn?

The onset of the COVID-19 pandemic in March 2020 resulted in a rapid shift to online learning for physiotherapy education in Australia and around the world. This Sydney-based qualitative study explored the reflections of physiotherapy educators and leaders involved in delivering physiotherapy programs with the aim of gaining insight into what happened to physiotherapy education during the initial stages of the pandemic and what lessons were learnt that will inform future physiotherapy education. Many pedagogical challenges were identified including the need to rapidly shift content online whilst still meeting competency requirements, how to effectively engage students, and the challenges of teaching and assessing practical psychomotor skills. The benefits of the rapid shift were the upskilling of educators, innovations in teaching and resources, and recognising that some aspects of physiotherapy education were improved by the change. Overall educators and leaders felt time was needed to effectively design physiotherapy content to fit different delivery modes and it was important some aspects of physiotherapy education should continue to be taught in-person. Future physiotherapy education is likely to be a combination of in-person and online delivery and lessons learnt from this time need to be incorporated into physiotherapy programs to achieve the best educational outcomes.

Predictors of distance learning in physiotherapy students during COVID-19 outbreak

BACKGROUND AND PURPOSE

Physiotherapy (PT) is an allied health profession that is generally taught at universities with face-to-face learning to deliver the required knowledge and practical skills of PT. The education sector has transitioned to distance learning (DL) during the COVID-19 pandemic. The study aimed to evaluate PT students' perception of quality of DL and satisfaction with DL, and identify potential predictors of student satisfaction with DL during the COVID-19 pandemic.

METHODS

A cross-sectional design was used. An online survey included demographic information, and the Distance Education Learning Environments Survey (DELES) was sent to PT students in Jordan. Regression analyses were used to identify the predictors of student satisfaction with DL.

RESULTS

A total of 296 students completed the survey. Most students rated the overall quality of DL as good. However, they were not satisfied with DL. Instructor support for students, personal relevance, previous experience in DL, and being a master's student were the potential predictors of DL satisfaction.

CONCLUSION

PT students rated the quality of DL as good with low level of satisfaction. Students' perceptions of and satisfaction with using DL were correlated to several potential predictors that could be considered for improving the DL experience in PT education.

Digital Entry-Level Education in Physiotherapy: a Commentary to Inform Post-COVID-19 Future Directions

Currently, the coronavirus disease 2019 (COVID-19) severely influences physiotherapy education which is based mostly on face-to-face teaching. Thus, educators have been compelled to adapt their pedagogical approaches moving to digital education. In this commentary, we debate on digital education highlighting its effectiveness, the users' perspectives, and its weakness in the context of physiotherapy teaching aimed at informing post-COVID-19 future directions in this educational field. Existing evidence on digital education produced before COVID-19 supports its implementation into entry-level physiotherapy education. However, some challenges (e.g. social inequality and evaluation of students) threaten its applicability in post-COVID-19 era, calling educators to take appropriate actions.

Online teaching in physiotherapy education during COVID-19 pandemic in Italy: a retrospective case-control study on students' satisfaction and performance

BACKGROUND

During COVID-19 pandemic, physiotherapy lecturers faced the challenge of rapidly shifting from face-to-face to online education. This retrospective case-control study aims to compare students' satisfaction and performances shown in an online course to a control group of students who underwent the same course delivered face-to-face in the previous five years.

METHODS

Between March and April 2020, a class (n = 46) of entry-level physiotherapy students (University of Verona - Italy), trained by an experienced physiotherapist, had 24-hours online lessons. Students exposed to the same course in the previous five academic years (n = 112), delivered with face-to-face conventional lessons, served as a historical control. The course was organized in 3 sequential phases: (1) PowerPoint presentations were uploaded to the University online platform, (2) asynchronous video recorded lectures were provided on the same platform, and (3) between online lectures, the lecturer and students could communicate through an email chat to promote understanding, dispel any doubts and collect requests for supplementary material (e.g., scientific articles, videos, webinars, podcasts). Outcomes were: (1) satisfaction as routinely measured by University with a national instrument and populated in a database; (2) performance as measured with an oral examination.

RESULTS

We compared satisfaction with the course, expressed on a 5-point Likert scale, resulting in no differences between online and face-to-face teaching (Kruskal-Wallis ² = 0.24, df = 1, p = 0.62). We weighted up students' results by comparing their mean performances with the mean performances of the same course delivered face-to-face in the previous five years, founding a statistical significance in favour of online teaching (Wilcoxon rank sum test W = 1665, p < 0.001).

CONCLUSIONS

Online teaching in entry-level Physiotherapy seems to be a feasible option to face COVID-19 pandemic, as satisfies students as well as face-to-face courses and leading to a similar performance. Entry-level Bachelors in Physiotherapy may consider moving to eLearning to facilitate access to higher education. Universities will have to train lecturers to help them develop appropriate pedagogical skills, and supply suitable support in terms of economic, organizational, and technological issues, aimed at guaranteeing a high level of education to their students.

TRIAL REGISTRATION

Retrospectively registered.