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García-Acosta JM, Castro-Molina FJ, Delgado N, Díez-Fernández O, Rodríguez-Novo N, de Castro-Peraza ME, Lorenzo-Rocha ND, Torres-Jorge JM, Fernández-Martínez AD, Castellano-Fuenmayor MA. Virtual Reality and Simulation Videos as Effective Training Tools for Creating Safe and Inclusive Environments for Transgender People. NURSING REPORTS 2023; 14:42-55. [PMID: 38251182 PMCID: PMC10801482 DOI: 10.3390/nursrep14010004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2023] [Revised: 12/23/2023] [Accepted: 12/27/2023] [Indexed: 01/23/2024] Open
Abstract
BACKGROUND University education is undergoing a paradigm shift towards active methodologies, such as virtual reality and training videos, which have proven to be valuable resources, especially in the health sciences. The scarcity of existing research on the topic prompted us to conduct this study, which seeks to measure the knowledge gained from the aforementioned tools by users, their level of satisfaction with them, and their perceived utility. METHODS This is a quasi-experimental intervention study analysing the impact of virtual objects as learning resources for undergraduate nursing students. RESULTS Fifty-four participants completed the training, yielding highly significant differences between their mean scores, with a high statistical power and a large effect size. A total of 85.46% of participants confirmed that the virtual resources helped them considerably to empathise with the experiences of trans people in healthcare settings. Students were comfortable using the virtual resources, very satisfied with the methodology employed, and would recommend the training received. CONCLUSIONS University teaching must adapt to meet the current legislations and changing health needs of society, and teaching staff must be prepared to implement new active teaching methodologies that make learning a more dynamic process. Considering these results, our study serves as a guide for other nursing educators who seek to promote inclusive healthcare regarding gender diversity. This study is not registered.
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Affiliation(s)
- Jesús Manuel García-Acosta
- The Canary Islands Public Health Service, Tenerife, 38071 Canary Islands, Spain; (J.M.G.-A.); (M.E.d.C.-P.); (N.D.L.-R.); (M.A.C.-F.)
- Nuestra Señora de la Candelaria School of Nursing, University of La Laguna, Tenerife, 38010 Canary Islands, Spain
| | - Francisco Javier Castro-Molina
- The Canary Islands Public Health Service, Tenerife, 38071 Canary Islands, Spain; (J.M.G.-A.); (M.E.d.C.-P.); (N.D.L.-R.); (M.A.C.-F.)
- Nuestra Señora de la Candelaria School of Nursing, University of La Laguna, Tenerife, 38010 Canary Islands, Spain
| | - Naira Delgado
- Department of Cognitive, Social, and Organisational Psychology, University of La Laguna, Tenerife, 38200 Canary Islands, Spain;
| | - Olga Díez-Fernández
- Department of Education, Vocational Training, Physical Activity and Sport, Regional Government of the Canary Islands, Tenerife, 38071 Canary Islands, Spain (A.D.F.-M.)
| | | | - María Elisa de Castro-Peraza
- The Canary Islands Public Health Service, Tenerife, 38071 Canary Islands, Spain; (J.M.G.-A.); (M.E.d.C.-P.); (N.D.L.-R.); (M.A.C.-F.)
- Nuestra Señora de la Candelaria School of Nursing, University of La Laguna, Tenerife, 38010 Canary Islands, Spain
| | - Nieves Doria Lorenzo-Rocha
- The Canary Islands Public Health Service, Tenerife, 38071 Canary Islands, Spain; (J.M.G.-A.); (M.E.d.C.-P.); (N.D.L.-R.); (M.A.C.-F.)
- Nuestra Señora de la Candelaria School of Nursing, University of La Laguna, Tenerife, 38010 Canary Islands, Spain
| | - Jesús Miguel Torres-Jorge
- Department of Computer and Systems Engineering, University of La Laguna, Tenerife, 38200 Canary Islands, Spain;
| | - Alfredo David Fernández-Martínez
- Department of Education, Vocational Training, Physical Activity and Sport, Regional Government of the Canary Islands, Tenerife, 38071 Canary Islands, Spain (A.D.F.-M.)
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Virtual and Augmented Reality versus Traditional Methods for Teaching Physiotherapy: A Systematic Review. Eur J Investig Health Psychol Educ 2022; 12:1780-1792. [PMID: 36547026 PMCID: PMC9778016 DOI: 10.3390/ejihpe12120125] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2022] [Accepted: 11/29/2022] [Indexed: 12/05/2022] Open
Abstract
The use of virtual worlds in health-related education is increasingly popular, but an overview of their use in physiotherapy education is still needed. The aim of this review was to analyse the use of virtual and augmented reality (VR/AR) compared to traditional methods for teaching physiotherapy. A systematic review was performed up to October 2022 in PubMed, Web of Science, Scopus, CINAHL, and PsycInfo. The quality appraisal and risk of bias were assessed by the Joana Briggs Institute checklist and the Cochrane Collaboration's RoB Tool 2.0, respectively. A total of seven randomised and non-randomised controlled studies were included, involving 737 students. VR/AR-based teaching approaches included simulation and virtual worlds, and were conducted through immersive head-mounted displays, AR-based applications, and 3D visualisations. Three studies were focused on teaching anatomy content, two on clinical decision making skills, and the rest were focused on pathology, physiotherapy tasks or exercise performance, and movement analysis of lower limbs. Inconclusive results were found in terms of learning satisfaction and academic performance, showing VR/AR-based teaching models to be equally effective as traditional methods for teaching physiotherapy. We encourage researchers and teachers to include games in their VR/AR-based teaching approaches to enhance interaction and active learning in physiotherapy education.
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ShahAli S, Shahabi S, Kohan N, Ebrahimi Takamjani I, Ebrahimi R. Using e-learning methods for physiotherapy students learning – a systematic review and meta-analysis of the impact on knowledge, skills, satisfaction and attitudes. EUROPEAN JOURNAL OF PHYSIOTHERAPY 2022. [DOI: 10.1080/21679169.2022.2085789] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Affiliation(s)
- Shabnam ShahAli
- Rehabilitation Research Center, Department of Physiotherapy, School of Rehabilitation Sciences, Iran University of Medical Sciences, Tehran, Iran
- Department of Medical Education, Virtual University of Medical Sciences, Tehran, Iran
| | - Saeed Shahabi
- Health Policy Research Center, Institute of Health, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Noushin Kohan
- Department of Medical Education, Virtual University of Medical Sciences, Tehran, Iran
| | - Ismail Ebrahimi Takamjani
- Rehabilitation Research Center, Department of Physiotherapy, School of Rehabilitation Sciences, Iran University of Medical Sciences, Tehran, Iran
| | - Reyhane Ebrahimi
- School of Medicine, Tehran University of Medical Sciences, Tehran, Iran
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Jaramillo T, Scalise G, Nesbit KC. Learning activities without patient interactions can achieve pediatric curricular objectives for adult learners. Physiother Theory Pract 2022:1-14. [PMID: 35354360 DOI: 10.1080/09593985.2022.2057884] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
BACKGROUND The literature is lacking in studies about what specific types of learning activities are most effective for adult learners. PURPOSE To examine the effectiveness of a learning activity with patient interactions as compared to a learning activity without patient interactions. METHODS A convenience sample of third year Doctor of Physical Therapy students participated in this retrospective cross-sectional study (n = 47). Data were a clinical reasoning assignment, the Andragogy in Practice Inventory (API) and Intent to Use Scale, and the Behavioral Engagement Related to Instruction (BERI) protocol. Data analysis included descriptive frequencies, paired t-tests, Wilcoxon Signed Rank Tests and Multivariate Analysis of Variance. RESULTS Significant differences were noted between the learning activity with and the learning activity without patient interaction on several API subscales: prepare the learner, climate setting, setting of objectives and learning activities as well as in the conceptual reasoning area of the clinical reasoning assignment (p = .005, p = .036, p = .002, p = .047, and p = .038, respectively). No other significant differences were noted in other outcome variables. No significant influence of age or gender was found. CONCLUSION This study demonstrated that, overall, both the with and without patient interaction learning activities were compatible with the preferences of the adult learner.
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Affiliation(s)
- Theresa Jaramillo
- UCSF/SFSU Graduate Program in Physical Therapy, San Francisco, CA, USA
| | | | - Kathryn C Nesbit
- UCSF/SFSU Graduate Program in Physical Therapy, San Francisco, CA, USA
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Rossettini G, Turolla A, Gudjonsdottir B, Kapreli E, Salchinger B, Verheyden G, Palese A, Dell’Isola A, de Caro JX. Digital Entry-Level Education in Physiotherapy: a Commentary to Inform Post-COVID-19 Future Directions. MEDICAL SCIENCE EDUCATOR 2021; 31:2071-2083. [PMID: 34754600 PMCID: PMC8567978 DOI: 10.1007/s40670-021-01439-z] [Citation(s) in RCA: 19] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 10/05/2021] [Indexed: 05/10/2023]
Abstract
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.
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Affiliation(s)
- Giacomo Rossettini
- School of Physiotherapy, University of Verona, Via Bengasi 4, 37134 Verona, Italy
| | - Andrea Turolla
- Laboratory of Rehabilitation Technologies, San Camillo IRCCS Srl, Via Alberoni 70, 30126 Venice, Italy
| | - Bjorg Gudjonsdottir
- Department of Physical Therapy, School of Health Sciences, University of Iceland, Stapi At Hringbraut, 101 Reykjavík, Iceland
| | - Eleni Kapreli
- Department of Physiotherapy, School of Health Sciences, University of Thessaly, 3rd km Old National Road Lamia-Athen, 35100 Lamia, Greece
| | - Beate Salchinger
- Institute of Physiotherapy, FH JOANNEUM, Eggenberger Allee 13, 8020 Graz, Austria
| | - Geert Verheyden
- Department of Rehabilitation Sciences, KU Leuven, University of Leuven, Tervuursevest 101, 3001 Leuven, Belgium
| | - Alvisa Palese
- Department of Medical Sciences, School of Nursing, University of Udine, Viale Ungheria 20, 33100 Udine, Italy
| | - Andrea Dell’Isola
- Department of Clinical Sciences Orthopaedic, Faculty of Medicine, Lund University, Entrégatan 8, 22100 Lund, Sweden
- Department of Clinical Sciences Orthopaedics, Clinical Epidemiology Unit, Lund University, Lund, Sweden
| | - John Xerri de Caro
- Department of Physiotherapy, Faculty of Health Sciences, University of Malta, Triq Dun Karm, L-Imsida, Msida, 2090 MSD Malta
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Ødegaard NB, Myrhaug HT, Dahl-Michelsen T, Røe Y. Digital learning designs in physiotherapy education: a systematic review and meta-analysis. BMC MEDICAL EDUCATION 2021; 21:48. [PMID: 33441140 PMCID: PMC7805166 DOI: 10.1186/s12909-020-02483-w] [Citation(s) in RCA: 25] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/14/2020] [Accepted: 12/29/2020] [Indexed: 05/24/2023]
Abstract
BACKGROUND Digital learning designs have the potential to support teaching and learning within higher education. However, the research on digital learning designs within physiotherapy education is limited. This study aims to identify and investigate the effectiveness of digital learning designs in physiotherapy education. METHODS The study was designed as a systematic review and meta-analysis of randomized and non-randomized trials. A search of eight databases on digital learning designs and technology was conducted. Study selection, methodology and quality assessment were performed independently by three reviewers. The included studies were mapped according to the types of digital interventions and studies. For similar interventions, the learning effects were calculated using meta-analyses. RESULTS Altogether, 22 studies were included in the review (17 randomized controlled trials and five cohort studies). A blended learning design was used in 21 studies, a flipped classroom model in five and a distance learning design in one. Altogether, 10 of the 22 articles were included in meta-analyses, which showed statistically significant effects for flipped classrooms on knowledge acquisition (standardized mean difference [SMD]: 0.41; 95% confidence interval [CI]: 0.20, 0.62), for interactive websites or applications (apps) on practical skills (SMD: 1.07; 95% CI: 0.71,1.43) and for students self-produced videos on a practical skill in a cervical spine scenario (SMD: 0.49; 95% CI: 0.06, 0.93). Overall, the effects indicated that blended learning designs are equally as or more effective than traditional classroom teaching to achieve learning outcomes. Distance learning showed no significant differences compared to traditional classroom teaching. CONCLUSIONS The current findings from physiotherapy education indicate that digital learning designs in the form of blended learning and distance learning were equally or more effective compared to traditional teaching. The meta-analyses revealed significant effects on student learning in favour of the interventions using flipped classrooms, interactive websites/apps and students self-produced videos. However, these results must be confirmed in larger controlled trials. Further, research should investigate how digital learning designs can facilitate students' learning of practical skills and behaviour, learning retention and approaches to studying as well as references for teaching and learning in digital learning environments.
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Affiliation(s)
- Nina Bjerketveit Ødegaard
- Department of Physiotherapy, Oslo Metropolitan University, Post Box 4. St. Olavsplass, 0130 Oslo, Norway
| | - Hilde Tinderholt Myrhaug
- Department of Nursing and Health Promotion, Oslo Metropolitan University, Post Box 4. St. Olavsplass, 0130 Oslo, Norway
| | - Tone Dahl-Michelsen
- Department of Physiotherapy, Oslo Metropolitan University, Post Box 4. St. Olavsplass, 0130 Oslo, Norway
| | - Yngve Røe
- Department of Physiotherapy, Oslo Metropolitan University, Post Box 4. St. Olavsplass, 0130 Oslo, Norway
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Roberts F, Cooper K. Effectiveness of high fidelity simulation versus low fidelity simulation on practical/clinical skill development in pre-registration physiotherapy students: a systematic review. ACTA ACUST UNITED AC 2020; 17:1229-1255. [PMID: 30964770 DOI: 10.11124/jbisrir-2017-003931] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/31/2022]
Abstract
OBJECTIVE The objective of this review is to evaluate the effectiveness of high fidelity simulation (HFS) versus low fidelity simulation (LFS) on practical/clinical skill development in pre-registration physiotherapy students. INTRODUCTION Evidence suggests that improved skill development in university can reduce anxiety in practice, improving performance of skills and overall learning at clinical placement for health professions students. However, evidence indicates that the clinical environment is most effective for learning. As a result, there has been increased interest in the use of HFS where students can test knowledge and skills in an increasingly self-directed way. No previous reviews on the effectiveness of HFS on skill development in physiotherapy students were identified. INCLUSION CRITERIA Experimental and quasi-experimental studies comparing HFS (simulated person, manikin, virtual simulation, video case-studies) to LFS (peer role-play, paper-based case-studies) in pre-registration physiotherapy education were included. Primary outcomes were objective measures of skills performance; secondary outcomes were students' perceptions of the impact of simulation on learning measured using quantitative outcomes. METHODS A three-step search strategy was employed. Following an initial search of MEDLINE and CINAHL and analysis of text words, MEDLINE, CINAHL, ERIC, AMED, EThOS and Google Scholar were searched in November 2017. Reference lists of studies included at critical appraisal stage were hand-searched. Studies published in English from 1978 onwards were included. Title/abstract screening, critical appraisal and data extraction were conducted by two independent reviewers; conflicts were resolved by discussion. RESULTS Meta-analysis was not possible due to heterogeneity; therefore, results were presented in narrative form. Three randomized controlled trials (RCT) and three quasi-experimental studies (310 participants) were included. They were conducted in the USA and Australia, and evaluated standardized patients (people who take on the role of a real patient), near-peers, computerized manikins and virtual simulation in pre-registration Bachelor of Science (Honors), Master of Science and Doctor of Physiotherapy students. One RCT was considered high quality, with the remainder moderate quality. The findings related to five main areas: i) In terms of motor skills performance, an increased number of safety fails were found with HFS (HFS = 13.5% safety fails, HFS plus video feedback = 15.4% safety fails, control [LFS] = 8.1% safety fails); ii) In terms of clinical performance, the Assessment of Physiotherapy Practice (APP) tool indicated no significant improvement in mean APP scores at week 6 of clinical placement (HFS mean APP score = 60.7 [9.1], control mean APP score = 58.7 [8.4]; P = 0.35); iii) In terms of self-efficacy, only one of two studies showed a statistically significant difference with HFS, as measured by the Acute Care Confidence Survey (P = 0.001); however, became non-significant once students were on clinical placement (P = 0.328); iv) Students did not perceive a significant difference in their communication skills with HFS, as measured on a visual analogue scale (simulation = 9.05 [1.27]; control 8.75 [1.2]; P = 0.482); and v) In terms of general perceptions, students were significantly more positive about HFS for increasing awareness of safety issues (P = 0.002), patients' emotional status (P = 0.002), handling skills (P < 0.0001) and ability to provide instructions to patients (P < 0.0001). CONCLUSIONS Currently, there is no high quality evidence that HFS improves motor skill performance in pre-registration physiotherapy students. There is a small amount of moderate-quality evidence it may improve students' perception of their self-efficacy but no evidence that it improves communication skills. However, a lack of studies and variation in outcome measures meant that meta-analysis was not possible. At present, no recommendations can be made regarding the use of HFS to improve skill performance in this population.
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Affiliation(s)
- Fiona Roberts
- School of Health Sciences, Robert Gordon University, Aberdeen, Scotland
| | - Kay Cooper
- School of Health Sciences, Robert Gordon University, Aberdeen, Scotland.,The Scottish Centre for Evidence-based, Multi-professional Practice: a Joanna Briggs Institute Centre of Excellence
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Walker CA, Roberts FE. Impact of Simulated Patients on Physiotherapy Students' Skill Performance in Cardiorespiratory Practice Classes: A Pilot Study. Physiother Can 2020; 72:314-322. [PMID: 35110801 DOI: 10.3138/ptc-2018-0113] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
Purpose: To date, no evidence exists that high-fidelity simulation improves skill development among physiotherapy students in the university setting. With pressures to reduce costs and maintain or improve the quality of the learning experience, and with pressures on clinical placement, it is essential to investigate methods that might improve students' skill performance before they undertake clinical practice. Our study set out to investigate (1) the impact of using simulated patients (SPs) in a practical class on physiotherapy students' skill acquisition and (2) the students' reflections on the intervention. Method: We devised a pilot study using a single-centre randomized controlled trial. A total of 28 undergraduate physiotherapy students, matched using previous practical examination grades, undertook a 2-hour practical class in which they practised their core cardiorespiratory skills. Pre-session resources were identical. The control group practised on peers; the intervention group practised on SPs. The students' skill performance was assessed 2 weeks later using the Mini-Clinical Evaluation Exercise (MiniCEX), including gathering qualitative data from the students' reflections. Twenty-eight students undertook the practical class and subsequent MiniCEX assessment. Results: A statistically significant difference was found for all aspects of the MiniCEX except medical interview (p = 0.07) and physical interview (p = 0.69), and a large effect size was found for all areas except physical interview (0.154) and medical interview (0.378). The students' reflections focused on three key themes: behaviours and attitudes, teaching the active cycle of breathing technique, and feedback. Conclusions: Our findings suggest that interacting with SPs improves student skill performance, but further research using a larger sample size and an outcome measure validated for this population is required to confirm this.
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Affiliation(s)
- Craig A Walker
- School of Health Sciences, Robert Gordon University, Aberdeen, Scotland
| | - Fiona E Roberts
- School of Health Sciences, Robert Gordon University, Aberdeen, Scotland
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