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Kirby RL, Smith C, Osmond D, Moore SA, Theriault CJ, Sandila N. A Remote-Learning Course can improve the subjective wheelchair-skills performance and confidence of wheelchair service providers: an observational cohort study. Disabil Rehabil Assist Technol 2024; 19:1729-1738. [PMID: 37384537 DOI: 10.1080/17483107.2023.2230259] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2023] [Revised: 06/21/2023] [Accepted: 06/22/2023] [Indexed: 07/01/2023]
Abstract
PURPOSE To test the hypothesis that a Remote-Learning Course improves the subjective wheelchair-skills performance and confidence of wheelchair service providers, and to determine the participants' views on the Course. METHODS This was an observational cohort study, with pre-post comparisons. To meet the objectives of the six-week Course, the curriculum included self-study and weekly one-hour remote meetings. Participants submitted their Wheelchair Skills Test Questionnaire (WST-Q) (Version 5.3.1) "performance" and "confidence" scores before and after the Course. Participants also completed a Course Evaluation Form after the Course. RESULTS The 121 participants were almost all from the rehabilitation professions, with a median of 6 years of experience. The mean (SD) WST-Q performance scores rose from 53.4% (17.8) pre-Course to 69.2% (13.8) post-Course, a 29.6% relative improvement (p < 0.0001). The mean (SD) WST-Q confidence scores rose from 53.5% (17.9) to 69.5% (14.3), a 29.9% relative improvement (p < 0.0001). Correlations between performance and confidence were highly significant (p < 0.0001). The Course Evaluation indicated that most participants found the Course useful, relevant, understandable, enjoyable, "just right" in duration, and most stated that they would recommend the Course to others. CONCLUSIONS Although there is room for improvement, a Remote-Learning Course improves the subjective wheelchair-skills performance and confidence scores of wheelchair service providers by almost 30%, and participants were generally positive about the Course.
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Affiliation(s)
- R Lee Kirby
- Division of Physical Medicine and Rehabilitation, Department of Medicine, Dalhousie University, Halifax, NS, Canada
| | - Cher Smith
- Department of Occupational Therapy, Nova Scotia Health, Halifax, NS, Canada
| | - Dee Osmond
- Department of Occupational Therapy, Nova Scotia Health, Halifax, NS, Canada
| | - Sarah A Moore
- School of Health and Human Performance, Faculty of Health, Dalhousie University, Halifax, NS, Canada
| | | | - Navjot Sandila
- Research Methods Unit, Nova Scotia Health, Halifax, NS, Canada
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Manocha RHK, Best KL, Charette C, Curlock H, Sigfusson M, Faure C, Miller WC, Routhier F. Walking aid training as a clinical competence in Canadian entry-to-practice professional academic programs. Disabil Rehabil Assist Technol 2024; 19:112-119. [PMID: 35510304 DOI: 10.1080/17483107.2022.2070675] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2021] [Accepted: 04/21/2022] [Indexed: 10/18/2022]
Abstract
PURPOSE Multiple healthcare professionals fit walking aids (WA) and train individuals on their use. The purpose of this investigation was to describe curricula on WA fitting and training in Canadian entry-to-practice professional programs. MATERIALS AND METHODS An online survey was administered to leads from all accredited programs (n = 199). Seventeen questions asked about the importance of WA education, instructional methods and time dedicated to WA fitting and skills training, and how the pandemic had affected WA curriculum delivery. RESULTS Responses were received from 97 programs. While most occupational therapy (OT, 8/15), physiatry (PM&R, 5/9), and physical therapy (PT, 12/19) trainees received more than 3 h of instruction on WA fitting, most nursing (29/40) and pharmacy (7/8) programs spent less than 3 h on this topic. Most OT (9/15) and PT (15/19) programs spent more than 3 h on WA skills training whereas most nursing (25/40), pharmacy (4/8), and PM&R (5/9) programs spent less than 3 h on this subject. Across all programs, 52% educated students on adapting activities of daily living for WA while 18% provided education on WA maintenance and repair. Only 19/89 programs consulted a formal WA skills training resource for curriculum development. Seventeen of 55 programs modified their WA curricula due to the pandemic. CONCLUSIONS There is a wide range in curricular approaches to WA education in Canadian professional programs. This highlights the need for a standardised WA education program to guide curricular development to ultimately improve safe WA use for clients with short- and long-term mobility impairments.IMPLICATIONS FOR REHABILITATIONCurricula on walking aids is extremely variable within and between programs.Navigating terrains, adapting activities of daily living, and maintenance are poorly taught.There is a need for a national standardized curriculum on walking aids.This curriculum should be modular and designed for practitioners, students, and patients.
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Affiliation(s)
- Ranita H K Manocha
- Division of Physical Medicine and Rehabilitation, Cumming School of Medicine, University of Calgary, Calgary, Canada
| | - Krista L Best
- Département de réadaptation, Faculté de médecine, Université Laval, Laval, Canada
- Centre intégré universitaire de santé et de services sociaux de la Capitale-Nationale, Québec City, Canada
| | - Caroline Charette
- Département de réadaptation, Faculté de médecine, Université Laval, Laval, Canada
- Centre intégré universitaire de santé et de services sociaux de la Capitale-Nationale, Québec City, Canada
| | - Hannah Curlock
- O'Brien Institute for Public Health, University of Calgary, Calgary, Canada
| | - Merissa Sigfusson
- Department of Occupational Therapy, University of Alberta, Edmonton, Canada
| | - Céline Faure
- Centre intégré universitaire de santé et de services sociaux de la Capitale-Nationale, Québec City, Canada
| | - William C Miller
- Department of Occupational Science and Occupational Therapy, University of British Columbia, Vancouver, Canada
| | - François Routhier
- Département de réadaptation, Faculté de médecine, Université Laval, Laval, Canada
- Centre intégré universitaire de santé et de services sociaux de la Capitale-Nationale, Québec City, Canada
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Goldberg M, Rushton P, Kirby RL, Muñera S, Kandavel K, Pearlman J, Tawashy A. Wheelchair service provision content in professional rehabilitation organisations' standards documents and contemporary initiatives: a rapid review. Disabil Rehabil Assist Technol 2024; 19:78-89. [PMID: 35446737 DOI: 10.1080/17483107.2022.2063421] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2021] [Accepted: 04/02/2022] [Indexed: 10/18/2022]
Abstract
PURPOSE We sought to identify opportunities, challenges, contemporary initiatives and strategies for preparing entry-level practitioners who are competent at the basic level of wheelchair service provision across four key international professional rehabilitation organisations as revealed by their educational standards, relevant guidelines and policy statements, and other publicly available information. METHOD A rapid review was conducted in 2021 from the International Society of Physical and Rehabilitation Medicine (ISPRM), the International Society for Prosthetics and Orthotics (ISPO), World Physiotherapy, and the World Federation of Occupational Therapists (WFOT). Additional grey-literature and grey-data searches were conducted to identify contemporary initiatives that may support competency development in wheelchair service provision. RESULTS A total of 17 standards, guidelines, and policy statement documents were selected for detailed review. Each of the four organisations published at least one document containing language relating to wheelchair service provision. Twelve contemporary initiatives relating to wheelchair service provision were identified from the grey literature across the four organisations. Six additional initiatives were identified from the organisations' social media accounts. Themes emerged in the areas of contemporary content, opportunities, and challenges. CONCLUSION Global standardisation could help harmonise professional societies' approach to training wheelchair service providers.IMPLICATIONS FOR REHABILITATIONThere is a need to provide more descriptive content on wheelchair service provision in education and service standards and related documents to influence what is taught in professional rehabilitation programs that are accredited or approved by professional rehabilitation organisations.The organisations' networks are vast and may also help to promote additional continuing education in this area.
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Affiliation(s)
- Mary Goldberg
- Department of Rehabilitation Science and Technology, University of Pittsburgh, Pittsburgh, PA, USA
- International Society of Wheelchair Professionals, Medellin, Colombia
| | - Paula Rushton
- International Society of Wheelchair Professionals, Medellin, Colombia
- Université de Montréal, Montreal, Canada
| | - R Lee Kirby
- International Society of Wheelchair Professionals, Medellin, Colombia
- Dalhousie University, Halifax, Canada
| | - Sara Muñera
- International Society of Wheelchair Professionals, Medellin, Colombia
| | - Krithika Kandavel
- International Society of Wheelchair Professionals, Medellin, Colombia
| | - Jonathan Pearlman
- Department of Rehabilitation Science and Technology, University of Pittsburgh, Pittsburgh, PA, USA
- International Society of Wheelchair Professionals, Medellin, Colombia
| | - Amira Tawashy
- International Society of Wheelchair Professionals, Medellin, Colombia
- Dalhousie University, Halifax, Canada
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Hartsgrove C, DeLauter G, Kirshblum S. Sustained Impact of a Virtual Disability Education Curriculum With Fourth-Year Medical Students in a Mandatory Physical Medicine and Rehabilitation Clerkship. Am J Phys Med Rehabil 2023; 102:780-786. [PMID: 36753447 DOI: 10.1097/phm.0000000000002201] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/09/2023]
Abstract
OBJECTIVE The aim of the study was to measure the short- and long-term impact of a virtual disability education curriculum associated with a 2-wk mandatory physical medicine and rehabilitation clerkship for fourth-year medical students. DESIGN A prospective pre-post intervention survey-based study measuring the impact of a virtual disability education series at 1-wk and 6-mo time points after a mandatory physical medicine and rehabilitation clerkship including 8 hrs of virtual didactics with an emphasis on physical disabilities. The surveys assessed the overall virtual curriculum, perceived benefit of a virtual encounter, and the long-term applicability of the information learned from the clerkship. RESULTS The physical medicine and rehabilitation clerkship was effective in improving medical students' perceived comfort and clinical knowledge regarding treatment of persons with disabilities ( P < 0.01). There were no statistical differences at the 6-mo time point, indicating sustained benefit and integration of knowledge in the long term ( P > 0.05). In addition, 84% of students reported using the information in clinical experiences at 6 mos. CONCLUSIONS The physical medicine and rehabilitation clerkship including a virtual disability education curriculum improved long-term perceived medical student comfort and knowledge of treating persons with disabilities, with a focus on those with physical disabilities. Virtual encounters with persons with disabilities are viable and impactful avenues to provide this education.
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Affiliation(s)
- Caitlin Hartsgrove
- From the Department of Physical Medicine and Rehabilitation, Rutgers New Jersey Medical School, Newark, New Jersey (CH, SK); Rutgers New Jersey Medical School, Newark, New Jersey (CH, SK); Kessler Institute for Rehabilitation, West Orange, New Jersey (CH, SK); and Select Medical, Mechanicsburg, Pennsylvania (GD)
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Evans W, Lisiecka D, Farrell D. Exploring the impact educational interventions have on nursing and medical students' attitudes and empathy levels towards people with disability. A systematic review. JOURNAL OF INTELLECTUAL DISABILITIES : JOID 2023:17446295231155781. [PMID: 36798039 DOI: 10.1177/17446295231155781] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/18/2023]
Abstract
This systematic review aimed to explore the impact educational interventions have on undergraduate nursing and medical students' attitudes and empathy levels towards people with disability. There are over one billion people with some form of disability currently. A growing body of research reveals that nurses and doctors display negative attitudes including decreased empathy towards people with disability. A systematic review using narrative synthesis of chosen randomized controlled trials was employed. A comprehensive search was completed in June 2021 on six databases (CINAHL, Medline, Science Direct, Health Research Premium - PROQUEST, Scopus. Cochrane Library). The search strategy yielded 21,616 studies and only three randomised controlled trials fulfilled the eligibility criteria. These trials included 125 participants (n = 50 medical students and n = 75 nursing students) and evaluated the effectiveness of a disabled health course, disability education module with bedside teaching and wheelchair workshop intervention. Findings from one study revealed that a disabled health course using affective learning method based on a transformative learning theory significantly improves attitudes to disability amongst nursing students however there was no statistically significant difference in empathy levels. More high-quality randomised controlled trials with greater theoretical and methodological complexity are needed to identify more effective educational approaches that enhance attitude and empathy levels of these key stakeholders.
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Affiliation(s)
- William Evans
- 8813Department of Nursing and Healthcare Sciences, School of Health and Social Sciences, Munster Technology University Tralee, Ireland
| | | | - Dawn Farrell
- 8813Munster Technology University Kerry, Tralee, Ireland
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Worobey LA, Kirby RL, Cowan RE, Dyson-Hudson TA, Shea M, Heinemann AW, Pedersen JP, Hibbs R, Boninger ML. Using remote learning to teach clinicians manual wheelchair skills: a cohort study with pre- vs post-training comparisons. Disabil Rehabil Assist Technol 2022; 17:752-759. [PMID: 32809896 PMCID: PMC8204376 DOI: 10.1080/17483107.2020.1804633] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2020] [Revised: 07/21/2020] [Accepted: 07/29/2020] [Indexed: 10/23/2022]
Abstract
PURPOSE To test the hypothesis that remote learning to teach clinicians manual wheelchair skills is efficacious. MATERIALS AND METHODS A convenience sample of therapists (physical and occupational) and students were enrolled in pairs in a cohort study with pre- versus post-training comparisons. The intervention was a hybrid of self-study and hands-on practice paired with remote feedback for ten intermediate and advanced manual wheelchair skills. Participants practiced with self-selected frequency and duration, uploading a session log and video(s) to an online platform. A remote trainer provided asynchronous feedback prior to the next practice session. Capacity and confidence in completing the ten skills were evaluated using the Wheelchair Skills Test Questionnaire (WST-Q). Knowledge of wheelchair skills training and motor learning was assessed using a 62-item Knowledge Test. Secondary outcome measures included skill achievement, as confirmed by submitted video recordings, and participant feedback about the training. RESULTS Across 41participants, scores were higher at follow-up compared to baseline for WST-Q capacity (73.9 ± 19.1 vs 16.8 ± 15.6, p < 0.001), WST-Q confidence (80.1 ± 12.2 vs 47.6 ± 18.2, p = 0.003) and knowledge (70.8 ± 7.5 vs 67.0 ± 5.4, p = 0.004). CONCLUSIONS Remote learning can increase wheelchair skills capacity and confidence as well as knowledge about such training and assessment. This model should be further investigated as a delivery method for training rehabilitation professionals. CLINICAL TRIAL REGISTRATION NUMBER NCT01807728.Implications for rehabilitationWheelchair skills training is one of the 8 steps of wheelchair provision as outlined by the World Health Organization.Wheelchair skills are not a core part of most clinical curriculums and many clinicians cite a lack of resources and uncertainty on how to implement wheelchair skills training into practice as major barriers to providing such training.Remote learning offers the benefits of structured wheelchair skills training with expert feedback on an individual's own schedule that is not afforded by one-day "bootcamp"-type courses or on-the-job training, which are how many clinicians currently learn wheelchair skills.In a sample of physical and occupational therapists and students, remote learning was effective at increasing capacity and confidence to perform manual wheelchair skills as well as knowledge of wheelchair training.
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Affiliation(s)
- Lynn A Worobey
- Department of Physical Medicine and Rehabilitation, University of Pittsburgh, Pittsburgh, PA, USA
- Department of Bioengineering, University of Pittsburgh, Pittsburgh, PA, USA
- Department of Physical Therapy, University of Pittsburgh, Pittsburgh, PA, USA
- Human Engineering Research Laboratories, Veterans Affairs Pittsburgh Healthcare system, Pittsburgh, PA, USA
| | - R Lee Kirby
- Division of Physical Medicine and Rehabilitation, Dalhousie University, Halifax, Canada
| | - Rachel E Cowan
- Department of Physical Medicine & Rehabilitation, University of Alabama, Birmingham, AB, USA
| | - Trevor A Dyson-Hudson
- Kessler Foundation, West Orange, NJ, USA
- Department of Physical Medicine and Rehabilitation, Rutgers New Jersey Medical School, Newark, NJ, USA
| | - Mary Shea
- Kessler Institute for Rehabilitation, West Orange, NJ, USA
| | - Allen W Heinemann
- Feinberg School of Medicine, Northwestern University, Chicago, IL, USA
- Shirley Ryan Ability Lab, Chicago, IL, USA
| | | | - Rachel Hibbs
- Department of Physical Medicine and Rehabilitation, University of Pittsburgh, Pittsburgh, PA, USA
| | - Michael L Boninger
- Department of Physical Medicine and Rehabilitation, University of Pittsburgh, Pittsburgh, PA, USA
- Department of Bioengineering, University of Pittsburgh, Pittsburgh, PA, USA
- Human Engineering Research Laboratories, Veterans Affairs Pittsburgh Healthcare system, Pittsburgh, PA, USA
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Hsieh S, Donovan J, Fyffe D, McKay O, Kirshblum S. Effect of Adding a Wheelchair Immersion Program to a Physical Medicine and Rehabilitation Clerkship on Emotions, Behavior, and Attitude: A Prospective Pilot Study. Am J Phys Med Rehabil 2022; 101:782-788. [PMID: 35034065 DOI: 10.1097/phm.0000000000001952] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
ABSTRACT People with disabilities encounter significant barriers in health care and report that healthcare providers often lack an understanding in caring for them. Currently, there is limited disability awareness training in medical school curricula. This mixed-methods pilot study examined the effects of integrating a short wheelchair immersion program in a physical medicine and rehabilitation clerkship, versus the clerkship alone, on attitudes toward people with disabilities, comfort in treating people with disabilities, knowledge of wheelchair etiquette, and understanding of wheelchair-associated challenges. The standard training group underwent the physical medicine and rehabilitation clerkship, consisting of a 2-wk clinical rotation and didactic program. The intervention group additionally underwent a newly developed 1-hr wheelchair program where they simulated mobility and some activities of daily living as a "wheelchair user" and "caregiver." Quantitative analysis demonstrated that all students who completed the clerkship had significantly improved attitudes toward and comfort in treating people with disabilities, knowledge of wheelchair etiquette, and understanding of wheelchair-associated challenges, whereas students in the wheelchair immersion program had a greater change in understanding wheelchair-associated challenges. Qualitative analysis revealed that the intervention resulted in positive attitudinal changes. These findings suggest that integrating a brief wheelchair immersion program with a physical medicine and rehabilitation clerkship may enhance disability awareness training in medical school curricula.
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Affiliation(s)
- Shelly Hsieh
- From the Department of Physical Medicine and Rehabilitation, Rutgers New Jersey Medical School, Newark, New Jersey (SH, JD, DF, OM, SK); Kessler Institute for Rehabilitation, West Orange, New Jersey (SH, JD, SK); Burke Rehabilitation Hospital, White Plains, New York (SH); Montefiore Medical Center, Bronx, New York (SH); Kessler Foundation, West Orange, New Jersey (JD, DF, SK); and Roper Rehabilitation Hospital, Charleston, North Carolina (JD)
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Burrola-Mendez Y, Kamalakannan S, Rushton PW, Bouziane SA, Giesbrecht E, Kirby RL, Gowran RJ, Rusaw DF, Tasiemski T, Goldberg M, Tofani M, Pedersen JP, Pearlman J. Wheelchair service provision education for healthcare professional students, healthcare personnel and educators across low- to high-resourced settings: a scoping review. Disabil Rehabil Assist Technol 2022; 18:67-88. [PMID: 35436160 PMCID: PMC7614122 DOI: 10.1080/17483107.2022.2037757] [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: 02/08/2023]
Abstract
PURPOSE This review aimed to collate and summarize available research literature about wheelchair service provision education available to healthcare professional students, healthcare personnel and educators across low- to high-resourced settings. METHODS The Joanna Briggs Institute methodological steps for scoping reviews were followed. Included studies were mainly sourced from Medline, Embase, CINAHL, Scopus, Academic Search Complete and ProQuest. Independent title, abstract and full-text screening with defined inclusion and exclusion criteria was performed. All screening and extraction were performed independently by two authors. A thematic approach was used to synthesize results. Data extracted from included studies were charted according to a template that we created. The study quality was also appraised. RESULTS A total of 25 articles were included (11, 36% from high-income settings) with 12 (48%) observational studies and 13 (52%) experimental studies. The literature addressed three main topics: (1) assessing wheelchair service provision knowledge, (2) implementing training interventions using in-person, online and/or hybrid learning approaches and (3) describing current wheelchair service provision education globally. The most frequently reported training programs used were the Wheelchair Skills Program and the World Health Organization Wheelchair Service Training Package - Basic Level. CONCLUSION Limited information has been published about the integration of wheelchair content into the curricula of professional rehabilitation programs. Efforts to build international partnerships, improve the quality and currency of training programs and build resources that can assist educators in the integration of wheelchair-related content into professional rehabilitation programs should be prioritized.Implications for RehabilitationThis is the first review that examined and synthesized the current state of wheelchair service provision education for rehabilitation students and personnel across low- to high-income countries.Findings from this review indicate that there is limited information about the integration of wheelchair-related content into professional rehabilitation programs.Efforts to build international partnerships, standardize wheelchair service provision content and evaluation and integrate training into professional rehabilitation programs worldwide should be prioritized.
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Affiliation(s)
- Yohali Burrola-Mendez
- School of Rehabilitation, Université de Montréal, Montréal, Canada,CHU Sainte-Justine Research Centre, Montréal, Canada
| | - Sureshkumar Kamalakannan
- Department of Clinical Research, London School of Hygiene and Tropical Medicine, London, UK,Public Health Foundation of India, Indian Institute of Public Health, Hyderabad, India
| | - Paula W. Rushton
- School of Rehabilitation, Université de Montréal, Montréal, Canada,CHU Sainte-Justine Research Centre, Montréal, Canada
| | | | - Ed Giesbrecht
- Department of Occupational Therapy, College of Rehabilitation Sciences, University of Manitoba, Manitoba, Canada
| | - R. Lee Kirby
- Division of Physical Medicine and Rehabilitation, Dalhousie University, Halifax, Canada
| | - Rosemary J. Gowran
- School of Allied Health, Faculty of Education and Health Sciences, Health Research Institute, Health Implementation Science and Technology, University of Limerick, Limerick, Ireland,Assisting Living and Learning (ALL) Institute Maynooth University, Maynooth, Ireland
| | - David F. Rusaw
- School of Health and Welfare, Jönköping University, Jönköping, Sweden
| | - Tomasz Tasiemski
- Department of Adapted Physical Activity, Poznan University of Physical Education, Poznan, Poland
| | - Mary Goldberg
- Department of Rehabilitation Science and Technology, University of Pittsburgh, Pittsburgh, PA, USA
| | - Marco Tofani
- Department of Intensive Neurorehabilitation and Robotics, Bambino Gesú Children’s Hospital IRCCS, Rome, Italy
| | | | - Jon Pearlman
- Department of Rehabilitation Science and Technology, University of Pittsburgh, Pittsburgh, PA, USA
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Chardavoyne PC, Henry AM, Forté KS. Understanding Medical Students' Attitudes Towards and Experiences with Persons with Disabilities and Disability Education. Disabil Health J 2022; 15:101267. [DOI: 10.1016/j.dhjo.2021.101267] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2021] [Revised: 12/07/2021] [Accepted: 12/30/2021] [Indexed: 11/30/2022]
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Lee B, Park SY. Curriculum development on the human rights of people with disabilities for future medical education: using a modified Delphi. BMC MEDICAL EDUCATION 2021; 21:548. [PMID: 34715845 PMCID: PMC8555282 DOI: 10.1186/s12909-021-02961-9] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 06/13/2021] [Accepted: 09/14/2021] [Indexed: 06/13/2023]
Abstract
BACKGROUND In order for doctors to effectively provide medical services to patients with disabilities, an understanding of this population is necessary, along with the knowledge, attitudes, and technical abilities necessary to address health problems associated with each type of disability. One way of doing this is by educating doctors about disabilities and ensuring their frequent contact with people with disabilities while they are in medical school. Therefore, this study aimed to develop a systematic medical education curriculum to enhance doctors' understanding of people with disabilities. METHODS The authors conducted a systematic literature review to develop and verify the basic framework of the educational content and curriculum. Two surveys were also developed using the Delphi method to evaluate the adequacy and necessity of educational topics. Items with a content validity ratio equal to or greater than the minimum value were considered valid. Survey panels comprised academic experts and health care practitioners who were working with people with disabilities. We conducted two surveys, one for a basic and the other for an advanced course, in which 13 to 16 respondents took part. RESULTS The authors selected 13 topics for the 'Basic Introductory Course' and included general educational content on the health rights of people with disabilities focused on improving students' knowledge of disabilities. The authors also selected 12 topics for the 'Care and Communication for Patients with Disabilities Course' designed to improve students' understanding of interviewing and communicating with patients with disabilities. CONCLUSIONS In Korea, disability has received little attention in the medical curriculum to date. The curriculum developed in this study provides preliminary data for guiding future directions in medical education and developing specific support plans for an education that promotes people with disabilities' health rights.
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Affiliation(s)
- Bomyee Lee
- Department of Medical Education and Medical Humanities, Kyung Hee University School of Medicine, Dongdaemun-gu, Seoul, 02447, South Korea
- Department of Policy & Research, Korea National Institute for Bioethics Policy, Jung-gu, Seoul, 04522, South Korea
| | - So-Youn Park
- Department of Medical Education and Medical Humanities, Kyung Hee University School of Medicine, Dongdaemun-gu, Seoul, 02447, South Korea.
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Worobey LA, Kirby RL, Cowan RE, Dyson-Hudson TA, Shea M, Heinemann AW, Pedersen JP, Boninger ML. Efficacy of a Remote Train-the-Trainer Model for Wheelchair Skills Training Administered by Clinicians: A Cohort Study with Pre- vs. Post-Training Comparisons. Arch Phys Med Rehabil 2021; 103:798-806. [PMID: 34090853 DOI: 10.1016/j.apmr.2021.03.042] [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] [Received: 10/06/2020] [Revised: 03/03/2021] [Accepted: 03/08/2021] [Indexed: 11/25/2022]
Abstract
OBJECTIVE To test the hypotheses that remote training improves trainer confidence and, when these trainers train others, the capacity and confidence of the trainees improves. DESIGN Cohort study with pre- vs post-training comparisons. SETTING Four Spinal Cord Injury Model Systems Centers. PARTICIPANTS Convenience sample of 7 clinician trainers and 19 able-bodied trainees. INTERVENTION Part 1 focused on trainer skill acquisition with self-study of the Wheelchair Skills Program Manual and instructional videos focused on motor learning, spotting, and 10 intermediate and advanced wheelchair skills. Trainers practiced in pairs, receiving asynchronous feedback on video-recordings from a remote instructor. Part 2 included additional video modules targeted at "how to" assess and train others in four wheelchair skills: gets over obstacle, ascends low curb, ascends high curb with caregiver assistance, and performs stationary wheelie. Upon completion, the trainers each provided 1:1 in-person training for 2-3 trainees. MAIN OUTCOME MEASURES Trainer confidence was assessed using the Self-Efficacy on Assessing, Training, and Spotting (SEATS) Test for Manual Wheelchairs. Trainee capacity ("Can you do it?") and confidence ("How confident are you?") were evaluated using the Wheelchair Skills Test Questionnaire (WST-Q). RESULTS Trainer confidence increased for assessment (p=0.003) and training (p=0.002), but not spotting (p=0.056). Trainee 4-item median [IQR] WST-Q scores significantly increased with training for capacity (13% [6,31] to 88% [75,88], p < 0.001) and confidence (13% [0,31] to 88% [81,100], p < 0.001). CONCLUSIONS Remote training improves trainers' confidence with respect to wheelchair-skills testing and training, and the wheelchair-skills capacity and confidence of their trainees.
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Affiliation(s)
- Lynn A Worobey
- Department of Physical Medicine and Rehabilitation, University of Pittsburgh, Pittsburgh, PA; Department of Bioengineering, University of Pittsburgh, Pittsburgh, PA; Department of Physical Therapy, University of Pittsburgh, Pittsburgh, PA; Human Engineering Research Laboratories, Veterans Affairs Pittsburgh Healthcare system, Pittsburgh, PA.
| | - R Lee Kirby
- Division of Physical Medicine and Rehabilitation, Dalhousie University, Halifax, NS, Canada
| | - Rachel E Cowan
- Department of Physical Medicine & Rehabilitation, University of Alabama, Birmingham, AB
| | - Trevor A Dyson-Hudson
- Kessler Foundation, West Orange, NJ; Department of Physical Medicine and Rehabilitation, Rutgers New Jersey Medical School, Newark, NJ
| | - Mary Shea
- Kessler Institute for Rehabilitation, West Orange, NJ
| | - Allen W Heinemann
- Feinberg School of Medicine, Northwestern University, Chicago, IL; Shirley Ryan Ability Lab, Chicago, IL
| | | | - Michael L Boninger
- Department of Physical Medicine and Rehabilitation, University of Pittsburgh, Pittsburgh, PA; Department of Bioengineering, University of Pittsburgh, Pittsburgh, PA; Human Engineering Research Laboratories, Veterans Affairs Pittsburgh Healthcare system, Pittsburgh, PA
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Gilbert C, Hsieh S, Donovan J, Dyson-Hudson T, Cabarle M, Granger S, Kirshblum S. Effect of an interventional educational wheelchair program on medical students' understanding of manual wheelchair use. PM R 2021; 13:1350-1356. [PMID: 33956395 DOI: 10.1002/pmrj.12628] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2020] [Revised: 11/02/2020] [Accepted: 04/05/2021] [Indexed: 12/14/2022]
Abstract
BACKGROUND There is limited literature exploring the benefits of interactive wheelchair educational programs in medical student curricula. OBJECTIVE To identify the effect of an educational interactive wheelchair program on medical students' understanding of wheelchair use. Researchers hypothesized that the program would increase understanding. DESIGN Repeated-measures survey study with postintervention comparison. SETTING Inpatient acute rehabilitation center. PARTICIPANTS Out of 123 eligible fourth-year medical students on a mandatory physical medicine and rehabilitation clerkship, 79 students participated. INTERVENTION All participants underwent a 2-hour educational wheelchair program consisting of (1) a disability lecture; (2) a video on the importance of proper wheelchair type and fit, wheelchair prescription, as well as recreational wheelchair use; and (3) an interactive wheelchair experience. MAIN OUTCOME MEASURES Pre- and postsurvey Likert scale questions measured medical students' understanding of four main areas: (1) impact of manual wheelchair use, (2) challenges of manual wheelchair use, (3) manual wheelchair skills, and (4) wheelchair etiquette. RESULTS A two-tailed sign test demonstrated a highly significant increase from pre- to postsurvey scores in each survey section (P < .001). Presurvey and postsurvey mean scores for impact of manual wheelchair use, challenges of manual wheelchair use, manual wheelchair skills, and wheelchair etiquette survey sections were 3.9 and 4.4, 3.1 and 4.4, 2.4 and 4.4, and 2.5 and 4.0, respectively. CONCLUSIONS This study demonstrates that an interactive educational wheelchair program effectively increases medical students' understanding of manual wheelchair use. The addition of an educational interactive wheelchair program to medical student curricula is recommended to improve medical students' understanding of manual wheelchair use and its impact on users.
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Affiliation(s)
- Courtney Gilbert
- Department of Physical Medicine and Rehabilitation, Rutgers New Jersey Medical School, Newark, New Jersey, USA.,Kessler Institute for Rehabilitation, West Orange, New Jersey, USA
| | - Shelly Hsieh
- Department of Physical Medicine and Rehabilitation, Rutgers New Jersey Medical School, Newark, New Jersey, USA.,Kessler Institute for Rehabilitation, West Orange, New Jersey, USA
| | - Jayne Donovan
- Department of Physical Medicine and Rehabilitation, Rutgers New Jersey Medical School, Newark, New Jersey, USA.,Kessler Institute for Rehabilitation, West Orange, New Jersey, USA
| | - Trevor Dyson-Hudson
- Department of Physical Medicine and Rehabilitation, Rutgers New Jersey Medical School, Newark, New Jersey, USA.,Kessler Foundation, West Orange, New Jersey, USA
| | - Mary Cabarle
- Kessler Institute for Rehabilitation, West Orange, New Jersey, USA
| | - Syndi Granger
- Kessler Institute for Rehabilitation, West Orange, New Jersey, USA
| | - Steven Kirshblum
- Department of Physical Medicine and Rehabilitation, Rutgers New Jersey Medical School, Newark, New Jersey, USA.,Kessler Institute for Rehabilitation, West Orange, New Jersey, USA.,Kessler Foundation, West Orange, New Jersey, USA
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Bosques G, Philip K, Francisco GE. Integration of Chronic Disability Management in a Medical Student Curriculum. Am J Phys Med Rehabil 2021; 100:S30-S33. [PMID: 32932360 DOI: 10.1097/phm.0000000000001590] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
ABSTRACT Increasing exposure to the needs of patients with chronic disability is important in fostering confidence and comfort in disability knowledge and management among medical students and residents of all disciplines. The 2013 Association of American Medical Colleges Graduation Survey of graduating medical students revealed that 33% expressed inadequate exposure to disability management and rehabilitative care. To address this, a 3- to 4-wk rehabilitation elective course was modified to include lectures, media-based reflections, and a hands-on wheelchair experience. Responses and reflections from students from November 2015 to February 2019 were analyzed to assess the impact of the intervention on medical student knowledge and clinical practice using a disability pretest and posttest design. Preintervention data revealed limited knowledge of terminology in disability health that improved greatly in the postelective assessment. Medical students also gained knowledge on disability laws, available resources, and improved identification of appropriate accommodations to limit barriers to care. Moreover, this novel, interdisciplinary rehabilitation elective experience increased medical student knowledge and exposure of disability management. Incorporating these changes into the medical school curriculum will be invaluable in training future physicians to close the gap in access to care for persons with disabilities.
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Affiliation(s)
- Glendaliz Bosques
- From the Department of Physical Medicine and Rehabilitation, University of Texas Health Science Center (UTHealth) McGovern Medical School, Houston, Texas (GB, KP, GEF); Pediatric Rehabilitation Program, Shriners Hospital for Children, Houston, Texas (GB); Pediatric Rehabilitation Medicine, TIRR Memorial Hermann Hospital, Houston, Texas (GB); Pediatric Rehabilitation Program, Children's Memorial Hermann Hospital, Houston, Texas (GB); and NeuroRecovery Research Center, TIRR Memorial Hermann, Houston, Texas (GEF)
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Giesbrecht E, Carreiro N, Mack C. Improvement and Retention of Wheelchair Skills Training for Students in Entry-Level Occupational Therapy Education. Am J Occup Ther 2021; 75:7501205160p1-7501205160p9. [PMID: 33399064 DOI: 10.5014/ajot.2021.040428] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
IMPORTANCE Although an essential component of best practice, wheelchair skills training is often inadequate; occupational therapy practitioners' professional preparation is a contributing factor. OBJECTIVE To assess the effectiveness of a boot camp on capacity and self-efficacy in wheelchair skills and self-efficacy in clinical practice, retention of improvements, and effective boot-camp attributes. DESIGN Concurrent, embedded, mixed-methods cohort design that used blinded, repeated-measures quantitative evaluation with 4-mo follow-up and directed content analysis of a qualitative questionnaire. SETTING University entry-to-practice program. PARTICIPANTS Convenience sample (N = 42) of final-year students. INTERVENTION A 4-hr boot camp with demonstration and supervised practice. Content incorporated skill performance, training and motor-learning strategies, and safe supervision. OUTCOMES AND MEASURES Skill performance capacity (Wheelchair Skills Test-Questionnaire), self-efficacy with manual wheelchair use (Wheelchair Use Confidence Scale), confidence in provision of manual wheelchair training services (Self-Efficacy in Assessing, Training, and Spotting test), and a boot-camp experience questionnaire. RESULTS Within-subjects analysis of variance revealed significant improvements on all measures (p < .001) with large effect sizes (ηp² = .68-.88). All measures except skill capacity demonstrated retention; skill capacity decreased 5.3% (95% confidence interval [2.0, 8.5]) but was significantly higher than baseline. Three themes influenced practice confidence: knowledge acquisition, experiential learning, and client empathy. CONCLUSIONS AND RELEVANCE Results confirm improved wheelchair self-efficacy, capacity, and self-efficacy with clinical intervention skills. Retention of outcomes suggests the potential impact on future practice. Experiential learning supports performance component acquisition and imparts empathy of client experience, which may improve occupational therapy practitioners' perceptions of client potential. WHAT THIS ARTICLE ADDS A 4-hr experiential boot camp can increase students' capacity and confidence to deliver wheelchair skills training to future clients. Experiential learning increased students' appreciation for clients' experience and expectation of client potential.
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Affiliation(s)
- Edward Giesbrecht
- Edward Giesbrecht, PhD, OT Reg (MB), is Associate Professor, Department of Occupational Therapy, University of Manitoba, Winnipeg, Manitoba, Canada;
| | - Nikita Carreiro
- Nikita Carreiro, MOT, OT Reg (MB), is Occupational Therapist, Rehabilitation Centre for Children, Winnipeg, Manitoba, Canada
| | - CindyMarie Mack
- CindyMarie Mack, MOT, OT Reg (MB), is Occupational Therapist, Deer Lodge Centre, Winnipeg, Manitoba, Canada
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Santoro JD, Whitgob EE, Huffman LC. Cluster Randomized Controlled Trial of Disability Education Module During Clinical Clerkship. Clin Pediatr (Phila) 2019; 58:1387-1393. [PMID: 31113214 DOI: 10.1177/0009922819850475] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
The effect of a randomized disability education program on medical student knowledge and attitudes concerning disability was performed. Intervention group received bedside teaching of physical examination/interview skills and case-based discussion. Twenty-three participants completed the study (control group n = 11; intervention group n = 12). Pre-clerkship, 39% of all participants reported no personal experience and 43% reported no professional experience with people with disabilities. Post-clerkship knowledge was higher for both groups; the test of group-by-time interaction was not significant. Qualitative analysis of post-clerkship attitude responses demonstrated that intervention group gave more detailed answers. Intervention group used terms representing functional aspects of disability twice as frequently as control group. Intervention group responses described long-term experience of a disability within community and family; control group responses focused on acute medical management. Participation in disability education resulted in changed attitude toward disability and better understanding of aspects of disability.
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Toro-Hernández ML, Mondragón-Barrera MA, Torres-Narváez MR, Velasco-Forero SE, Goldberg M. Undergraduate physiotherapy students' basic wheelchair provision knowledge: a pilot study in two universities in Colombia. Disabil Rehabil Assist Technol 2019; 15:336-341. [PMID: 31094586 DOI: 10.1080/17483107.2019.1580776] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
Purpose: Access to an appropriate wheelchair is a human right. Only between 5-15% of people who need a wheelchair have access to one. One of the key barriers to access is the lack of appropriately trained rehabilitation professionals. The objective of this study was to evaluate basic manual wheelchair provision knowledge in final-year physiotherapy undergraduate students in two programs in Colombia.Materials and methods: Students took the International Society of Wheelchair Professionals Wheelchair Service Provision - Basic Test which was administered online and in Spanish. The minimum score to pass the test is 70%; it assesses seven domains: Assessment; Prescription; Products; Fitting; User training; Follow-up, maintenance, and repairs; and Process.Results and conclusions: One-hundred sixteen students took the test and no one passed the test. The highest median domain scores were in Assessment and Process while the lowest were in Fitting and Products. The limitations of this study include that this sample does not represent all physiotherapy programmes or students in Colombia, there may be potential errors in the Spanish translation of the outcome measure, and students encountered Internet connectivity issues during the test that may have impacted their scores. Immediate interventions are required to improve teaching and students' learning outcomes related to basic manual wheelchair provision in these two programs. This study may serve as a foundation for future regional or national studies that assess the situation of wheelchair provision training in rehabilitation programs that will inform improvement actions. This manuscript is also available in Spanish as Supplemental Material.Implications for rehabilitationThis study indicates that students' current knowledge on basic appropriate manual wheelchair provision from two physiotherapy programs in Colombia is insufficient. Students' knowledge does not align with the minimum guidelines recommended for wheelchair service provision by the World Health Organization.Objectively identifying the gap in knowledge in rehabilitation trainees (i.e., physiotherapy students) is a strategy to promote the inclusion of assistive technology related content in formal academic training.The need to include formal training of appropriate wheelchair provision persists and without this training, people with disabilities who require a wheelchair for mobility will continue to face barriers to full participation in society.
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Affiliation(s)
| | | | | | | | - Mary Goldberg
- International Society of Wheelchair Professionals, Pittsburgh, PA, USA.,Human Engineering Research Laboratories, University of Pittsburgh, Pittsburgh, PA, USA
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Fung K, Miller T, Rushton PW, Goldberg M, Toro ML, Seymour N, Pearlman J. Integration of wheelchair service provision education: current situation, facilitators and barriers for academic rehabilitation programs worldwide. Disabil Rehabil Assist Technol 2019; 15:553-562. [PMID: 31012755 DOI: 10.1080/17483107.2019.1594408] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
Purpose: An estimated 75 million people with disabilities need wheelchairs globally, of whom 5-15% have one. Access to an appropriate wheelchair requires rehabilitation professionals trained to provide wheelchair service. One aim of the International Society of Wheelchair Professionals (ISWP) is to promote and facilitate the integration of wheelchair service provision education into academic rehabilitation programs worldwide. To inform the development of integration strategies, the purpose of this study was to develop an in-depth global portrait of the wheelchair service provision education offered in academic rehabilitation programs, the process of its integration and the associated facilitators and barriers.Method: Semi-structured qualitative interviews were conducted with a purposive sample of 14 representatives from academic rehabilitation programs (i.e., occupational therapy, physical therapy, and prosthetics and orthotics) in 11 countries, including low, middle and upper resourced settings.Findings: Thematic data analyses identified three overarching themes. The first theme, "impact of context", portrays factors related to local population needs, governance and supply chain of equipment and service delivery. The second theme, "current and planned wheelchair education", describes the content, pedagogic approach, student evaluation and feedback process. The third theme, "integration process", details five states of this process.Conclusions: This study describes in-depth the wheelchair service provision education across academic rehabilitation programs and resource settings, illustrating the context-dependent nature of its integration. This understanding may assist the global community of educators in preparing future rehabilitation professionals to better serve wheelchair users. This work has informed the development of ISWP's Seating and Mobility Academic Resource Toolkit (http://smart.wheelchairnetwork.org/).Implications for RehabilitationThe Dynamics of Context-Dependent Integration of Wheelchair Service Provision Education in Curricula model, depicting the findings of this study, may help to inform key stakeholders (i.e., academic institutions, health care providers and policy makers) about potential barriers and facilitators to the implementation of adequate wheelchair service provision education in the curricula of academic rehabilitation program.Study findings may lead to creative strategies, such as the expansion of ISWP's Seating and Mobility Academic Resource Toolkit (SMART; http://smart.wheelchairnetwork.org/), that may enable academic rehabilitation programs to be a part of the solution to strengthening rehabilitation systems worldwide, through appropriately trained rehabilitation professionals in wheelchair service provision.
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Affiliation(s)
- Karen Fung
- School of Occupational Therapy, Université de Montréal, Montreal, Quebec, Canada
| | - Taavy Miller
- Department of Rehabilitation Science and Technology, University of Pittsburgh, Pittsburgh, PA, USA
| | - Paula W Rushton
- School of Occupational Therapy, Université de Montréal, Montreal, Quebec, Canada
| | - Mary Goldberg
- Department of Rehabilitation Science and Technology, University of Pittsburgh, Pittsburgh, PA, USA
| | - Maria L Toro
- Department of Physical Therapy, Universidad CES, Medellín, Colombia
| | - Nicky Seymour
- Motivation Charitable Trust, Cape Town, South Africa
| | - Jonathan Pearlman
- Department of Rehabilitation Science and Technology, University of Pittsburgh, Pittsburgh, PA, USA
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- Department of Rehabilitation Science and Technology, University of Pittsburgh, Pittsburgh, PA, USA
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18
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Smith EM, Best KL, Miller WC. A condensed wheelchair skills training ‘bootcamp’ improves students’ self-efficacy for assessing, training, spotting, and documenting manual and power wheelchair skills. Disabil Rehabil Assist Technol 2019; 15:418-420. [DOI: 10.1080/17483107.2019.1572231] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Affiliation(s)
- Emma M. Smith
- Graduate Program in Rehabilitation Sciences, Faculty of Medicine, University of British Columbia, Vancouver, Canada
- Rehabilitation Research Program, GF Strong, Vancouver Coastal Health Research Institute, Vancouver, Canada
| | - Krista L. Best
- Department of Rehabilitation, Université Laval, Quebec City, Canada
- Center for Interdisciplinary Research in Rehabilitation and Social Integration, Centre integré de santé et de services sociaux de la Capitale-Nationale, Institut de réadaptation en déficience physique de Québec, Quebec City, Canada
| | - William C. Miller
- Graduate Program in Rehabilitation Sciences, Faculty of Medicine, University of British Columbia, Vancouver, Canada
- Rehabilitation Research Program, GF Strong, Vancouver Coastal Health Research Institute, Vancouver, Canada
- The Department of Occupational Sciences and Occupational Therapy, Faculty of Medicine, University of British Columbia, Vancouver, Canada
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20
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Keeler L, Kirby RL, Parker K, McLean KD, Hayden JA. Effectiveness of the Wheelchair Skills Training Program: a systematic review and meta-analysis .. Disabil Rehabil Assist Technol 2018; 14:391-409. [PMID: 29616832 DOI: 10.1080/17483107.2018.1456566] [Citation(s) in RCA: 56] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/17/2023]
Abstract
OBJECTIVE To conduct a systematic review synthesizing the evidence for the effectiveness of the Wheelchair Skills Training Program (WSTP). DATA SOURCES We searched PubMed, the Cochrane Library, CINAHL and Embase databases, as well as grey literature, up to 10 October 2017. STUDY SELECTION Randomized controlled trials (RCTs) assessing the effectiveness of the WSTP. DATA EXTRACTION Two independent reviewers screened articles and extracted data. Methodological quality was assessed using Cochrane's Risk of Bias Tool. DATA SYNTHESIS Meta-analyses (including sub-group analyses) were conducted for the Wheelchair Skills Test (WST) and WST Questionnaire (WST-Q) total capacity scores. We qualitatively assessed retention, WST/WST-Q subtotal and individual-skill capacity scores and other identified outcomes. The quality of evidence was determined using the Grades of Recommendation, Assessment, Development and Evaluation (GRADE) approach. Thirteen articles (581 participants) were included for analysis. The level of evidence was of moderate quality. The WSTP increased the post-training WST/WST-Q total capacity scores by 14.0% (95% CI: 7.4, 20.8; p < .0001) compared to no treatment, standard care or educational controls, a relative increase over baseline of 21.2%. Subgroup analyses showed that training was more effective for new wheelchair users. Retention of training effects was suggested by the absence of significant declines between tests post-training and at follow-up. The WSTP was found to have positive effects on some other outcomes. No serious adverse events were reported. CONCLUSIONS There is moderate quality evidence that the WSTP is a safe intervention that has a clinically meaningful effect on WST/WST-Q capacity scores and some other outcomes. Implications for rehabilitation A systematic review and meta-analysis of 13 randomized controlled trials on a total of 581 participants, using the Wheelchair Skills Training Program (WSTP) as the intervention, found that the WSTP increased Wheelchair Skills Test (WST) and WST Questionnaire (WST-Q) total capacity scores by 21.2% relative to baseline. Subgroup analyses showed that training was more effective for new wheelchair users. The WSTP was found to have positive effects on some other outcomes and no serious adverse events were reported. The WSTP warrants cautious implementation in clinical and educational settings.
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Affiliation(s)
- Laura Keeler
- a Department of Community Health and Epidemiology , Dalhousie University , Halifax , NS , Canada
| | - R Lee Kirby
- a Department of Community Health and Epidemiology , Dalhousie University , Halifax , NS , Canada.,b Division of Physical Medicine and Rehabilitation, Department of Medicine , Dalhousie University , Halifax , NS , Canada
| | - Kim Parker
- c Assistive Technology Program, Nova Scotia Health Authority , Halifax , NS , Canada
| | - Katie D McLean
- d Library Services , Nova Scotia Health Authority , Halifax , NS , Canada
| | - Jill A Hayden
- a Department of Community Health and Epidemiology , Dalhousie University , Halifax , NS , Canada
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Rushton PW, Smith EM, Miller WC, Kirby RL, Daoust G. Reliability and responsiveness of the Self-Efficacy in Assessing, Training and Spotting wheelchair skills (SEATS) outcome measure. Disabil Rehabil Assist Technol 2018; 14:250-254. [PMID: 29385845 DOI: 10.1080/17483107.2018.1428370] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
OBJECTIVES The aim of this study was to evaluate the internal consistency, test-retest reliability and responsiveness of the Self-Efficacy in Assessing, Training and Spotting manual wheelchair skills (SEATS-M) and Self-Efficacy in Assessing, Training and Spotting power wheelchair skills (SEATS-P). METHODS A 2-week test-retest design was used with a convenience sample of occupational and physical therapists who worked at a provincial rehabilitation centre (inpatient and outpatient services). Sixteen participants completed the SEATS-M and 18 participants completed the SEATS-P. RESULTS For the SEATS-M assessment, training, spotting and documentation sections, Cronbach's alpha coefficients ranged from 0.90 to 0.97, the 2-week intraclass correlation coefficients (ICC1,1) ranged from 0.81 to 0.95, the standard error of measurements (SEM) ranged from 5.06 to 8.70 and the smallest real differences (SRD) ranged from 6.24 to 8.18. For the SEATS-P assessment, training, spotting and documentation sections, Cronbach's alpha coefficients ranged from 0.83 to 0.92, the ICCs ranged from 0.72 to 0.86, the SEMs ranged from 4.54 to 8.91 and the SRDs ranged from 5.90 to 8.27. CONCLUSIONS There is preliminary evidence that both the SEATS-M and the SEATS-P have high internal consistency, good test-retest reliability and support for responsiveness. These tools can be used in evaluating clinician self-efficacy with assessing, training, spotting and documenting wheelchair skills included on the Wheelchair Skills Test. Implications for Rehabilitation There is preliminary evidence that the SEATS-M and SEATS-P are reliable and responsive outcome measures that can be used to evaluate the self-efficacy of clinicians to administer the Wheelchair Skills Program. Measurement of clinicians' self-efficacy in this area of practice may enable an enhanced understanding of the areas in which clinicians lack self-efficacy, thereby informing the development of improved knowledge translation interventions.
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Affiliation(s)
- Paula W Rushton
- a School of Rehabilitation , Université de Montréal , Montréal , QC , Canada.,b CHU Sainte-Justine Research Center , Montréal , QC , Canada
| | - Emma M Smith
- c Rehabilitation Sciences Graduate Program , University of British Columbia , Vancouver , BC , Canada.,d Rehabilitation Research Program and GF Strong Rehabilitation Research Lab , Vancouver , BC , Canada.,e International Collaboration on Repair Discoveries , Vancouver , BC , Canada
| | - William C Miller
- c Rehabilitation Sciences Graduate Program , University of British Columbia , Vancouver , BC , Canada.,d Rehabilitation Research Program and GF Strong Rehabilitation Research Lab , Vancouver , BC , Canada.,e International Collaboration on Repair Discoveries , Vancouver , BC , Canada.,f Department of Occupational Science and Occupational Therapy , University of British Columbia , Vancouver , BC , Canada
| | - R Lee Kirby
- g Division of Physical Medicine and Rehabilitation, Department of Medicine , Dalhousie University , Halifax , NS , Canada
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Getting a Manual Wheelchair Over a Threshold Using the Momentum Method: A Descriptive Study of Common Errors. Arch Phys Med Rehabil 2017; 98:2097-2099.e7. [DOI: 10.1016/j.apmr.2017.04.023] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2016] [Revised: 04/14/2017] [Accepted: 04/27/2017] [Indexed: 11/23/2022]
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Fung KH, Rushton PW, Gartz R, Goldberg M, Toro ML, Seymour N, Pearlman J. Wheelchair service provision education in academia. Afr J Disabil 2017; 6:340. [PMID: 28936415 PMCID: PMC5594266 DOI: 10.4102/ajod.v6i0.340] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2016] [Accepted: 06/21/2017] [Indexed: 12/03/2022] Open
Abstract
Background An estimated 70 million people with disabilities need wheelchairs. To address this global crisis, the World Health Organization (WHO) proposed an eight-step wheelchair service provision model to ensure service quality regardless of resource setting. The International Society of Wheelchair Professionals (ISWP) aims to facilitate the integration of the WHO eight-step model into professional rehabilitation programmes. Objective To develop an enhanced understanding of the current wheelchair service provision education provided in professional rehabilitation programmes worldwide. Methods In a cross-sectional design, an online survey was distributed to ISWP contacts of educational institutions. Quantitative responses were analysed through summary statistics and qualitative answers were analysed by content analyses. When relevant, educational institutions were stratified into resource settings. Results Seventy-two representatives of educational institutions in 21 countries completed the survey. Wheelchair content was taught in 79% of represented institutions, of which 75% of respondents reported using original course material, 10% of respondents used WHO Wheelchair Service Training Packages and 15% of respondents used other available resources. The majority of educational institutions teaching with their own wheelchair-related course material taught ≤ 20 hours. Fourteen of the 15 respondents without wheelchair education, expressed an interest in integrating wheelchair education into their academic curricula. Conclusion The majority of the educational institutions teach wheelchair education; however, there is great variability in what and how it is taught and evaluated. The results demonstrate the need for more in-depth investigation regarding the integration process of wheelchair education in educational institutions, with the ultimate goal of improving wheelchair service provision worldwide.
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Affiliation(s)
- Karen H Fung
- School of Rehabilitation, Université de Montréal, Canada.,Marie Enfant Rehabilitation Center, Sainte-Justine University Hospital Research Center, Canada
| | - Paula W Rushton
- School of Rehabilitation, Université de Montréal, Canada.,Marie Enfant Rehabilitation Center, Sainte-Justine University Hospital Research Center, Canada
| | - Rachel Gartz
- Rehabilitation Science & Technology, University of Pittsburgh, United States
| | - Mary Goldberg
- Rehabilitation Science & Technology, University of Pittsburgh, United States.,Human Engineering Research Laboratories, VA Pittsburgh Healthcare System, United States
| | - Maria L Toro
- Department of Physiotherapy, Universidad CES, Colombia
| | | | - Jonathan Pearlman
- Rehabilitation Science & Technology, University of Pittsburgh, United States.,Human Engineering Research Laboratories, VA Pittsburgh Healthcare System, United States
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Kirby RL, Mitchell D, Sabharwal S, McCranie M, Nelson AL. Manual Wheelchair Skills Training for Community-Dwelling Veterans with Spinal Cord Injury: A Randomized Controlled Trial. PLoS One 2016; 11:e0168330. [PMID: 28002472 PMCID: PMC5176312 DOI: 10.1371/journal.pone.0168330] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2016] [Accepted: 11/29/2016] [Indexed: 11/18/2022] Open
Abstract
OBJECTIVES To test the hypotheses that community-dwelling veterans with spinal cord injury (SCI) who receive the Wheelchair Skills Training Program (WSTP) in their own environments significantly improve their manual wheelchair-skills capacity, retain those improvements at one year and improve participation in comparison with an Educational Control (EC) group. METHODS We carried out a randomized controlled trial, studying 106 veterans with SCI from three Veterans Affairs rehabilitation centers. Each participant received either five one-on-one WSTP or EC sessions 30-45 minutes in duration. The main outcome measures were the total and subtotal percentage capacity scores from the Wheelchair Skills Test 4.1 (WST) and Craig Handicap Assessment and Reporting Technique (CHART) scores. RESULTS Participants in the WSTP group improved their total and Advanced-level WST scores by 7.1% and 30.1% relative to baseline (p < 0.001) and retained their scores at one year follow-up. The success rates for individual skills were consistent with the total and subtotal WST scores. The CHART Mobility sub-score improved by 3.2% over baseline (p = 0.021). CONCLUSIONS Individualized wheelchair skills training in the home environment substantially improves the advanced and total wheelchair skills capacity of experienced community-dwelling veterans with SCI but has only a small impact on participation.
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Affiliation(s)
- R. Lee Kirby
- Division of Physical Medicine and Rehabilitation, Department of Medicine, Dalhousie University, Halifax, Nova Scotia, Canada
| | - Doug Mitchell
- Charlie Norwood Veterans Administration Medical Center, Augusta, Georgia, United States of America
| | - Sunil Sabharwal
- Veterans Administration Boston Health Care System and Harvard Medical School, Boston, Massachusetts, United States of America
| | - Mark McCranie
- Health Services Research & Development Center of Innovation on Disability and Rehabilitation Research (CINDRR), James A. Haley Veterans’ Hospital, College of Public Health, University of South Florida, Tampa, Florida, United States of America
| | - Audrey L. Nelson
- Health Services Research & Development Center of Innovation on Disability and Rehabilitation Research (CINDRR), James A. Haley Veterans’ Hospital, College of Public Health, University of South Florida, Tampa, Florida, United States of America
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Bar MA, Ratzon NZ. Enhancing Occupational Therapy Students' Knowledge, Competence, Awareness, and Interest in Accessibility. Hong Kong J Occup Ther 2016; 27:18-25. [PMID: 30186057 PMCID: PMC6091997 DOI: 10.1016/j.hkjot.2016.04.001] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2016] [Revised: 03/23/2016] [Accepted: 04/04/2016] [Indexed: 11/20/2022] Open
Abstract
OBJECTIVE/BACKGROUND The purpose of this study was to assess whether the incorporation of an environmental assessment for accessibility, as part of an "Activity Analysis" course, would enhance new students' knowledge, competence, awareness, and interest in accessibility issues for people with disabilities. METHODS In this research, we included an out-of-class training of environmental assessment for accessibility. One hundred and two 1st-year occupational therapy students at Tel Aviv University participated in this research. Of the 102 participants, 56 experienced the training and 46 did not but attended the regular Activity Analysis course. The students explored a typical community environment, during which a specific checklist was used for assessing levels of accessibility. The "Accessibility-Knowledge Competence Awareness and Interests" questionnaire was administered before and after the course to both groups. RESULTS Students who participated in the out-of-class training showed significant increases in their knowledge, competence, and partial awareness of accessibility and also had better grades in two separate courses that required knowledge of accessibility. There was no significant difference in the results of the Accessibility-Knowledge Competence Awareness and Interests before and after the Activity Analysis course in the control group. CONCLUSION The findings of the current study support the contribution of teaching 1st-year occupational therapy students the principles and practices of accessibility for people with disabilities, by improving their knowledge and level of competence at this early stage of their professional lives. Further studies are needed, however, to determine the optimal course of implementation in order to enhance awareness and interest in the subject of accessibility.
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Affiliation(s)
- Michal Avrech Bar
- Department of Occupational Therapy, School of Health
Professions, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv,
Israel
| | - Navah Z. Ratzon
- Department of Occupational Therapy, School of Health
Professions, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv,
Israel
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Worobey LA, Kirby RL, Heinemann AW, Krobot EA, Dyson-Hudson TA, Cowan RE, Pedersen JP, Shea M, Boninger ML. Effectiveness of Group Wheelchair Skills Training for People With Spinal Cord Injury: A Randomized Controlled Trial. Arch Phys Med Rehabil 2016; 97:1777-1784.e3. [PMID: 27153762 DOI: 10.1016/j.apmr.2016.04.006] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2015] [Revised: 03/28/2016] [Accepted: 04/08/2016] [Indexed: 11/17/2022]
Abstract
OBJECTIVE To assess the effectiveness of group wheelchair skills training to elicit improvements in wheelchair skills. DESIGN Randomized double-blinded controlled trial. SETTING Four Spinal Cord Injury Model Systems Centers. PARTICIPANTS Manual wheelchair users with spinal cord injury (N=114). INTERVENTION Six 90-minute group Wheelchair Skills Training Program (WSTP) classes or two 1-hour active control sessions with 6 to 10 people per group. MAIN OUTCOME MEASURES Baseline (t1) and 1-month follow-up (t2) Wheelchair Skills Test Questionnaire (WST-Q) (Version 4.2) for capacity and performance and Goal Attainment Scale (GAS) score. RESULTS Follow-up was completed by 79 participants (WSTP: n=36, active control: n=43). No differences were found between missing and complete cases. Many users were highly skilled at baseline with a WST-Q capacity interquartile range of 77% to 97%. There were no differences between groups at baseline in WST-Q measures or demographics. Compared with the active control group, the WSTP group improved in WST-Q capacity advanced score (P=.02) but not in WST-Q capacity or WST-Q performance total scores (P=.068 and P=.873, respectively). The average GAS score (0% at t1) for the WSTP group at t2 was 65.6%±34.8%. Higher GAS scores and WST-Q capacity scores were found for those who attended more classes and had lower baseline skills. CONCLUSIONS Group training can improve advanced wheelchair skills capacity and facilitate achievement of individually set goals. Lower skill levels at baseline and increased attendance were correlated with greater improvement.
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Affiliation(s)
- Lynn A Worobey
- Department of Physical Medicine and Rehabilitation, University of Pittsburgh, Pittsburgh, PA.
| | - R Lee Kirby
- Division of Physical Medicine and Rehabilitation, Dalhousie University, Halifax, NS, Canada
| | - Allen W Heinemann
- Feinberg School of Medicine, Northwestern University, Chicago, IL; Rehabilitation Institute of Chicago, Chicago, IL
| | - Emily A Krobot
- Department of Physical Medicine and Rehabilitation, University of Pittsburgh, Pittsburgh, PA
| | - Trevor A Dyson-Hudson
- Kessler Foundation, West Orange, NJ; Department of Physical Medicine and Rehabilitation, Rutgers New Jersey Medical School, Newark, NJ
| | - Rachel E Cowan
- Department of Neurological Surgery, University of Miami, Miami, FL
| | | | - Mary Shea
- Kessler Institute for Rehabilitation, West Orange, NJ
| | - Michael L Boninger
- Department of Physical Medicine and Rehabilitation, University of Pittsburgh, Pittsburgh, PA
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Carney PA, Palmer RT, Fuqua Miller M, Thayer EK, Estroff SE, Litzelman DK, Biagioli FE, Teal CR, Lambros A, Hatt WJ, Satterfield JM. Tools to Assess Behavioral and Social Science Competencies in Medical Education: A Systematic Review. ACADEMIC MEDICINE : JOURNAL OF THE ASSOCIATION OF AMERICAN MEDICAL COLLEGES 2016; 91:730-42. [PMID: 26796091 PMCID: PMC4846480 DOI: 10.1097/acm.0000000000001090] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/23/2023]
Abstract
PURPOSE Behavioral and social science (BSS) competencies are needed to provide quality health care, but psychometrically validated measures to assess these competencies are difficult to find. Moreover, they have not been mapped to existing frameworks, like those from the Liaison Committee on Medical Education (LCME) and Accreditation Council for Graduate Medical Education (ACGME). This systematic review aimed to identify and evaluate the quality of assessment tools used to measure BSS competencies. METHOD The authors searched the literature published between January 2002 and March 2014 for articles reporting psychometric or other validity/reliability testing, using OVID, CINAHL, PubMed, ERIC, Research and Development Resource Base, SOCIOFILE, and PsycINFO. They reviewed 5,104 potentially relevant titles and abstracts. To guide their review, they mapped BSS competencies to existing LCME and ACGME frameworks. The final included articles fell into three categories: instrument development, which were of the highest quality; educational research, which were of the second highest quality; and curriculum evaluation, which were of lower quality. RESULTS Of the 114 included articles, 33 (29%) yielded strong evidence supporting tools to assess communication skills, cultural competence, empathy/compassion, behavioral health counseling, professionalism, and teamwork. Sixty-two (54%) articles yielded moderate evidence and 19 (17%) weak evidence. Articles mapped to all LCME standards and ACGME core competencies; the most common was communication skills. CONCLUSIONS These findings serve as a valuable resource for medical educators and researchers. More rigorous measurement validation and testing and more robust study designs are needed to understand how educational strategies contribute to BSS competency development.
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Affiliation(s)
- Patricia A Carney
- P.A. Carney is professor of family medicine and of public health and preventive medicine, Oregon Health & Science University School of Medicine, Portland, Oregon. R.T. Palmer is assistant professor of family medicine, Oregon Health & Science University School of Medicine, Portland, Oregon. M.F. Miller is senior research assistant, Department of Family Medicine, Oregon Health & Science University School of Medicine, Portland, Oregon. E.K. Thayer is research assistant, Department of Family Medicine, Oregon Health & Science University School of Medicine, Portland, Oregon. S.E. Estroff is professor, Department of Social Medicine, University of North Carolina at Chapel Hill School of Medicine, Chapel Hill, North Carolina. D.K. Litzelman is D. Craig Brater Professor of Medicine and senior director for research in health professions education and practice, Indiana University School of Medicine, Indianapolis, Indiana. F.E. Biagioli is professor of family medicine, Oregon Health & Science University School of Medicine, Portland, Oregon. C.R. Teal is assistant professor, Department of Medicine, and director, Educational Evaluation and Research, Office of Undergraduate Medical Education, Baylor College of Medicine, Houston, Texas. A. Lambros is active emeritus associate professor, Social Sciences & Health Policy, Wake Forest School of Medicine, Winston-Salem, North Carolina. W.J. Hatt is programmer analyst, Department of Family Medicine, Oregon Health & Science University School of Medicine, Portland, Oregon. J.M. Satterfield is professor of clinical medicine, University of California, San Francisco, School of Medicine, San Francisco, California
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Giesbrecht EM, Wilson N, Schneider A, Bains D, Hall J, Miller WC. Preliminary Evidence to Support a “Boot Camp” Approach to Wheelchair Skills Training for Clinicians. Arch Phys Med Rehabil 2015; 96:1158-61. [DOI: 10.1016/j.apmr.2014.10.002] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2014] [Revised: 10/06/2014] [Accepted: 10/07/2014] [Indexed: 11/24/2022]
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Proportion of Wheelchair Users Who Receive Wheelchair Skills Training During an Admission to a Canadian Rehabilitation Center. TOPICS IN GERIATRIC REHABILITATION 2015. [DOI: 10.1097/tgr.0000000000000046] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Best KL, Miller WC, Routhier F. A description of manual wheelchair skills training curriculum in entry-to-practice occupational and physical therapy programs in Canada. Disabil Rehabil Assist Technol 2014; 10:401-6. [DOI: 10.3109/17483107.2014.907368] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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