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Forde C, O’Brien A, Croitoru O, Molloy N, Amisano C, Brennan I, McInerney A. Comparing Face-to-Face, Blended and Online Teaching Approaches for Practical Skill Acquisition: A Randomised Controlled Trial. MEDICAL SCIENCE EDUCATOR 2024; 34:627-637. [PMID: 38887423 PMCID: PMC11180044 DOI: 10.1007/s40670-024-02026-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Accepted: 03/08/2024] [Indexed: 06/20/2024]
Abstract
Introduction The efficacy of blended and online teaching methods for practical skill acquisition remains ambiguous, particularly for skills requiring haptic awareness and/or sensory training. This study aims to compare three teaching methods (face-to-face, blended, online) for the acquisition of skills requiring sensory learning and haptic awareness. A secondary aim was to explore student experience of each teaching approach. Design A post-test only randomised controlled trial. Methods Forty-seven participants chose between learning two skills: manual measurement of blood pressure during exercise (BPM) and/or skin fold measurement using callipers (SKM). Participants were randomised to one of three learning groups: face-to-face (n = 23), blended (n = 22) and online (n = 26). Assessors determined skill competency during an in-person skill demonstration session. A survey captured student experiences. Results For SKM, there was a statistically significant difference in skill competency between the online learning group (17% achieved competency) and both the face-to-face (75% achieved competency; p = 0.011) and blended (89% achieved competency; p = 0.001) learning groups. For BPM, the online group had the lowest percentage of participants achieve overall skill competency. Both knowledge-based and sensory-based sub-competencies were negatively affected by the online learning method. For both skills, students in the face-to-face and blended learning group were significantly more confident in their knowledge and their ability to perform the skill in a clinical setting, compared to the online learning group. Conclusion Both face-to-face and blended teaching methods were more effective at leading to skill acquisition and were preferred by students when compared to a fully online teaching method.
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Affiliation(s)
- Cuisle Forde
- Discipline of Physiotherapy, School of Medicine, Trinity College Dublin, Dublin, Ireland
| | - Annie O’Brien
- Discipline of Physiotherapy, School of Medicine, Trinity College Dublin, Dublin, Ireland
| | | | - Nadine Molloy
- Department of Physiology, School of Medicine, Trinity College Dublin, Dublin, Ireland
| | - Chiara Amisano
- School of Medicine, Trinity College Dublin, Dublin, Ireland
| | - Iain Brennan
- School of Medicine, Trinity College Dublin, Dublin, Ireland
| | - Adam McInerney
- School of Medicine, Trinity College Dublin, Dublin, Ireland
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Martinez ES, Redding D. An osteopathic orientation to interprofessional education. J Osteopath Med 2024; 0:jom-2022-0237. [PMID: 38712700 DOI: 10.1515/jom-2022-0237] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2022] [Accepted: 02/26/2024] [Indexed: 05/08/2024]
Abstract
CONTEXT The osteopathic tenets may serve as a useful guideline for an interprofessional program. There is an alignment between the osteopathic tenets and the concept of interprofessional education (IPE). IPE occurs when students from two or more professions work with each other to collaborate or improve healthcare outcomes. Holistic treatment is fundamental in both instances, and the interrelatedness of structure and function requires acknowledgment of all healthcare professionals' roles in treating a patient. IPE allows students to gain a better understanding of their own professional roles and the roles of their fellow healthcare providers in treating patients more effectively. OBJECTIVES The objectives of this analysis are to evaluate the ability of an interprofessional summer workshop/lecture utilizing an osteopathic focus to educate students from different healthcare colleges about the interconnectedness of the systems of the human body and how working with a team-based approach will ultimately benefit their collective patients. A secondary objective was to determine the students' perceptions before and after the lecture/workshop to see if there were any perceived differences among students in different healthcare professions at either time. METHODS This was a retrospective data analysis conducted on pretest/posttest surveys completed by 73 incoming students from six different healthcare colleges participating in the Summer Preparedness and Readiness Course (SPaRC), held annually at Western University of Health Sciences (WUHS) in Pomona, California. Analysis was conducted on responses collected during the SPaRC programs of 2013, 2016, and 2019. Participants were given surveys containing five questions scored on a five-point Likert scale. The surveys were given before and after an integrated lecture/hands-on workshop presented at SPaRC that reviewed multiple studies showing the utility of connecting the healthcare professions to best treat a patient. RESULTS A total of 73 students responded to both the prelecture and postlecture surveys. When the number of positive scores were totaled from students from all colleges, there was an increase in positive responses from 190 (52.2 %) in prelecture surveys when compared to 336 (92.3 %) in postlecture surveys. A Wilcoxon signed-rank test suggested that the lecture workshop elicited a significant improvement in scores from prelecture to postlecture for all students (Z=-6.976, p=0.000). Median scores improved from 3.60 at baseline to 4.40 after the lecture/workshop. Secondary analysis conducted utilizing Kruskal-Wallis H to examine the differences between the responses of the different colleges prelecture and postlecture showed no significant differences prelecture (H [6]=7.58, p=0.271) and a significant difference between postlecture answers (H [6]=14.04, p=0.029). A series of post hoc independent Kruskal-Wallis H analyses was conducted to identify where differences were, and the only identifiable difference after Bonferroni corrections was between students from the Doctor of Osteopathic Medicine college and the Physician Assistant's college after the lecture/survey (p=0.041). CONCLUSIONS An interprofessional program with the osteopathic principles of focusing on body unity and relatedness of structure and function may serve as a helpful tool for uniting healthcare professionals in their ultimate goal of better serving their patients.
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Affiliation(s)
- Eric S Martinez
- Department of Neuromusculoskeletal Medicine/Osteopathic Manipulative Medicine, College of Osteopathic Medicine of the Pacific at Western University of Health Sciences, Pomona, CA, USA
| | - David Redding
- Western University of Health Sciences, Pomona, CA, USA
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Farjami Rad Y, Shahmoradi L, Nakhostin Ansari N, Hasson S, Ebrahimi M, Rahmani Katigari M. Developing a Content Model of a Mobile-Based Application to Manage Patients with Low-Back and Neck Pain. Int J Telemed Appl 2024; 2024:8415777. [PMID: 38223335 PMCID: PMC10787052 DOI: 10.1155/2024/8415777] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2023] [Revised: 06/09/2023] [Accepted: 12/16/2023] [Indexed: 01/16/2024] Open
Abstract
Introduction As a complementary tool in health, the design of mobile applications to influence care and increase awareness of patients has grown a lot. The purpose of this study is to design and validate the content model of a mobile-based application for managing patients with low-back and neck pain. Methods This descriptive-analytical study was conducted in two main stages to determine the content model of the application. The first stage consisted of three steps: finding the right exercise, determining the right scale to assess the pain intensity, and determining the appropriate features of the application. In the second stage, data elements collected from the previous stage were prepared in the form of a questionnaire that was given to 12 experts in physical therapy and sports medicine for validation. After collecting the questionnaire, data elements in all parts were analyzed based on the content validity ratio (CVR) and descriptive statistics indicators. Result The content of the application was prepared in the three axes of exercises for low-back and neck pain, assessment of pain intensity, and features of the application. In the axis of sports exercises, 8 exercises for back pain and 3 exercises for neck pain were included according to the reference books. A Functional Rating Index (FRI) scale with 10 elements was selected in the axis of determining pain intensity. Also, 12 features such as the daily exercise section, using the animation, and using an audio file to explain how to do exercises were included in the model. Conclusion According to the gaps identified in the existing applications, determining the content model of the application that is based on evidence and according to the opinion of experts is useful in improving the apps. The content model of this study was presented in 3 axes to increase the patient's willingness to do exercises, the correct way to perform exercises, conservative treatment, and check the progress of the treatment. The software developers can use these findings as a basis for designing new apps to manage low-back pain and neck pain.
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Affiliation(s)
- Yasaman Farjami Rad
- Sports Medicine Research Center, Neuroscience Institute, Tehran University of Medical Sciences, Tehran, Iran
- Health Professions Education Research Center, Tehran University of Medical Sciences, Tehran, Iran
- Health Information Management Department, School of Allied Medical Sciences, Tehran University of Medical Sciences, Tehran, Iran
| | - Leila Shahmoradi
- Health Information Management Department, School of Allied Medical Sciences, Tehran University of Medical Sciences, Tehran, Iran
| | - Noureddin Nakhostin Ansari
- Department of Physiotherapy, School of Rehabilitation, Tehran University of Medical Sciences, Tehran, Iran
- Research Center for War-affected People, Tehran University of Medical Sciences, Tehran, Iran
| | - Scott Hasson
- Department of Physical Therapy, Augusta University, Augusta, Georgia, USA
| | - Maryam Ebrahimi
- Department of Health Information Technology, Neyshabur University of Medical Sciences, Neyshabur, Iran
| | - Meysam Rahmani Katigari
- Department of Health Information Technology, Saveh University of Medical Sciences, Saveh, Iran
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Särchen F, Springborn S, Mortsiefer A, Ehlers J. Digital learning about patients: An online survey of German medical students investigating learning strategies for family medical video consultations. Digit Health 2024; 10:20552076241230070. [PMID: 38323240 PMCID: PMC10846016 DOI: 10.1177/20552076241230070] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2023] [Accepted: 01/16/2024] [Indexed: 02/08/2024] Open
Abstract
Objective Training in video consultations is seldom included in the curriculum for future physicians. Exploration of preferred teaching methods and learning objectives in this context among medical students remains limited. This study addresses this research gap by conducting a survey among medical students in Germany to assess their educational requirements concerning video consultations and patient-centred distance learning. Methods This quantitative study employed an online questionnaire designed for German medical students, following the guidelines of the International Association for Health Professions Education. The study primarily focused on discerning the didactic preferences related to patient-centred digital teaching regarding family medical video consultations. We provided a detailed explanation of a concrete learning concept, a family medical synchronous distance learning seminar. Subsequently, we surveyed students to gauge their needs, expectations, and evaluations of this concept. The collected data were subjected to descriptive analysis. Results The analysis revealed that students aspire to offer video consulting services to their patients in the future (sample size (n) = 369, median (med) = 68 of 101 Likert scale points, interquartile range (IQR) = 53.75), despite having limited knowledge in this area (n = 353, med = 21, IQR = 33.25). To acquire expertise in telehealth, students favor blended learning models (n = 331, med = 76, IQR = 50). They also recognize the benefits of distance learning, particularly for students with family responsibilities or those who must travel long distances to their learning institutions,. The presented distance seminar concept resonated with them (n = 278, med = 72.5, IQR = 50.5), surpassing five other digital learning models in preference. Furthermore, they expressed a desire for its continued implementation beyond the Coronavirus SARS-CoV-2 pandemic (n = 188, med = 77.5, IQR = 44.75). Conclusions The deficiency in medical school education regarding video consultations requires attention. This issue could be resolved by integrating one of the five distance learning concepts outlined in this article.
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Affiliation(s)
- Franziska Särchen
- Didactics and Education Research in the Health Sector, Faculty of Health, Witten/Herdecke University, Witten, Germany
| | | | - Achim Mortsiefer
- General Practice II and Patient-Centeredness in Primary Care, Faculty of Health, Witten/Herdecke University, Witten, Germany
| | - Jan Ehlers
- Didactics and Education Research in the Health Sector, Faculty of Health, Witten/Herdecke University, Witten, Germany
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Delafontaine A, Saiydoun G, Frigout J, Fabeck L, Degrenne O, Sarhan FR. Pedagogical impact of integration of musculoskeletal anatomy blended learning on physiotherapy education. Front Med (Lausanne) 2023; 10:1260416. [PMID: 37915328 PMCID: PMC10617513 DOI: 10.3389/fmed.2023.1260416] [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: 07/17/2023] [Accepted: 09/25/2023] [Indexed: 11/03/2023] Open
Abstract
Background In physiotherapy education, blended learning is recognized to be more effective compared to traditional teaching. The aim of this study was to assess the consequences of a musculoskeletal anatomy blended learning program on skills developed by students. Methods We conducted an observational retrospective monocentric study in a French physiotherapy school named "X." Ninety-two first-year students in the 2017-18 baseline group (students with traditional face-to-face learning), and ninety-eight first-year students and ninety-five second-year students in the 2018-19 and 2019-20 blended learning experimental groups was included. A success rate of the anatomy final written exam, defined by the percentage of students scoring 50% or above, was analyzed between 2017 and 2020. We also evaluated the pedagogical value of musculoskeletal e-learning and its usefulness for preparing the student for their anatomy final written exam at «X». Results We observed an improvement in the success rate of the anatomy final written exam between the 2017-18 baseline group, 2018-19 and 2019-2020 experimental groups during first (Kruskal-Wallis = 74.06, df = 2, p < 0.001) and second semester (Kruskal-Wallis = 173.6, df = 2, p < 0.001). We obtained a data survey and questionnaire response rate of 74% (n = 89/120) for the 2018-19 and 62% (n = 72/116) for the 2019-20 experimental groups. Concerning questionnaire response, they were no significant statistical difference between 2018-19 and 2019-20 experimental groups. Conclusion Blended learning could improve student success rate of the anatomy final written exam and learning of professional physiotherapy skills.
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Affiliation(s)
- Arnaud Delafontaine
- Université Libre de Bruxelles, Brussels, Belgium
- CIAMS, Univ. Paris-Sud., Université Paris-Saclay, Orsay, France
- CIAMS, Université d’Orléans, Orléans, France
- ASSAS, Ecole de Rééducation, Département international et Recherche, Villa Thoréton, Paris, France
| | - Gabriel Saiydoun
- Unisurg, Paris, France
- Department of Cardiac Surgery, Henri Mondor University Hospital, Créteil, France
- Créteil, UFR Médecine-Pharmacie, University of Paris-Est Créteil, Créteil, France
- Biomedicale, IMRB, Inserm, Institut Mondor de Recherche Biomédicale, Faculté de Santé de Créteil, Institut Mondor de Recherche Biomédicale, Creteil, France
- Department of Cardiovascular and Thoracic Surgery, Pitié-Salpêtrière University Hospital, Assistance Publique-Hôpitaux de Paris-Sorbonne University, Paris, France
| | - Jérôme Frigout
- I3SP Laboratory, Department of Sports Science and Physical Education, Université de Paris Descartes, Paris, France
| | | | | | - François-Régis Sarhan
- Physiotherapy School, Centre Hospitalier Universitaire Amiens – Picardie, Amiens, France
- UR CHIMERE, Université de Picardie Jules Verne, Amiens, France
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Luedtke K, Luebke L, Elizagaray-Garcia I, Schindler O, Szikszay TM. Effectiveness of online teaching during the COVID-19 pandemic on practical manual therapy skills of undergraduate physiotherapy students. J Man Manip Ther 2023; 31:349-357. [PMID: 36876463 PMCID: PMC10566393 DOI: 10.1080/10669817.2023.2179285] [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: 05/29/2022] [Accepted: 02/04/2023] [Indexed: 03/07/2023] Open
Abstract
OBJECTIVES This study includes two separate parts: the objective for part A was to evaluate the practical manual therapy skills of undergraduate physiotherapy students who had learned manual therapy techniques either online or in classroom depending on the phases of the pandemic. The objective for part B was to evaluate in a randomized prospective design the effectiveness of video-based versus traditional teaching of a manual therapy technique. DESIGN Cross-sectional cohort study (part A) and randomized controlled trial (part B). SETTING University of Luebeck, undergraduate physiotherapy students in years 1-3. METHOD In part A, physiotherapy students who had learned manual therapy either online (during the pandemic) or in classroom (prior to and after the lock down periods of the pandemic) were videotaped while performing two manual techniques on the knee joint and on the lumbar spine. Recordings were analyzed independently by two blinded raters according to a 10-item list of criteria. Inter-rater reliability was assessed using Cohen's kappa for each item. Performance across cohorts was analyzed using analysis of variance. In part B, students were randomized to learn a new technique on the cervical spine either from a lecturer or from the same lecturer on a video recording (independent variable). Practical performance of the technique was analyzed by two raters blinded to group allocation according to a 10-item list of criteria (dependent variable). Results were analyzed statistically by using ANCOVA with year of study as a covariate. RESULTS Sixty-three and 56 students participated in part A and part B of the study, respectively. The inter-rater reliability for video analyses for both parts of the study was moderate (k = 0.402 to 0.441). In part A, there was no statistically significant difference across years of study for the practical performance of the technique on the back F(2,59) = 2.271; p = 0.112 or the knee joint F(2,59) = 3.028; p = 0.056. In part B, performance was significantly better when learned from a lecturer and practiced on a peer than when learned from a video and practiced on a rescue dummy (p < 0.001). CONCLUSION Practical skill performance can be acquired from videos but immediate skill reproduction is significantly better when the technique is presented by a lecturer in classroom and practiced on peer students.
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Affiliation(s)
- Kerstin Luedtke
- Department of Physiotherapy, Pain and Exercise Research, Universität zu Lübeck, Institute of Health Sciences, Lübeck, Germany
| | - Luisa Luebke
- Department of Physiotherapy, Pain and Exercise Research, Universität zu Lübeck, Institute of Health Sciences, Lübeck, Germany
| | - Ignacio Elizagaray-Garcia
- Departamento de Fisioterapia. Centro Superiorde Estudios Universitarios La Salle, Universidad Autónoma de Madrid, Madrid, Spain
- CranioSPain Research Group, Centro Superiorde Estudios Universitarios La Salle, Madrid, Spain
- Motion in BrainsResearch Group, Centro Superiorde Estudios Universitarios La Salle, Madrid, Spain
| | - Oskar Schindler
- Department of Physiotherapy, Pain and Exercise Research, Universität zu Lübeck, Institute of Health Sciences, Lübeck, Germany
| | - Tibor M. Szikszay
- Department of Physiotherapy, Pain and Exercise Research, Universität zu Lübeck, Institute of Health Sciences, Lübeck, Germany
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O’Brien A, Forde C. Health science staff and student experiences of teaching and assessing clinical skills using digital tools: a qualitative study. Ann Med 2023; 55:2256656. [PMID: 37725836 PMCID: PMC10512752 DOI: 10.1080/07853890.2023.2256656] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/14/2023] [Accepted: 09/04/2023] [Indexed: 09/21/2023] Open
Abstract
INTRODUCTION Once considered a supplement to traditional teaching approaches, digital tools now play a pivotal role in building core clinical competencies. This study aims to explore staff and student experiences of navigating the challenges of teaching and assessing clinical skills using digital technology. It also aims to provide insight into what skills, or aspects of skills, may be best suited to digitally enhanced teaching, thereby advancing the future of health science education. METHODS This qualitative study comprises the second phase of data generation for a mixed-methods research project entitled DEPTH (Digitally Enhanced Practical Teaching in Health Science). Health science staff and students expressed interest in taking part in the current study during the first stage of data collection. Qualitative data was collected in January 2022 through semi-structured group interviews and individual semi-structured interviews. An interpretivist qualitative research design underpinned by a critical realist epistemological position was used. Themes were generated following Braun and Clarke's 6-step process for reflexive thematic analysis. RESULTS Overall, 10 staff and 8 students across 11 health science disciplines participated in this research. Fourteen hours of transcripts were analysed and 4 themes generated. Our findings highlight the suitability of digitally enhanced teaching for low-stake skills requiring visual and auditory training, while skills requiring tactile training require in-person practice to build student competency. Importantly, our findings indicate a desire for increased remote teaching. While our work was not specifically aimed at documenting experiences related to the Covid-19 pandemic, all participants had lived experience teaching or learning during the pandemic and many spoke specifically about this. CONCLUSIONS The timing of this paper captures a novel moment in the history of clinical pedagogy. Staff and students advocate for the continued integration of technology into health science education generally, and clinical skills teaching specifically. For this to be successful, judicious selection of methods, skills, skill components and technology, that can be appropriately mapped onto specific learning outcomes, is required.
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Affiliation(s)
- Annie O’Brien
- Discipline of Physiotherapy, School of Medicine, Trinity College Dublin, Dublin, Ireland
| | - Cuisle Forde
- Discipline of Physiotherapy, School of Medicine, Trinity College Dublin, Dublin, Ireland
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Byungura JC, Nyiringango G, Fors U, Forsberg E, Tumusiime DK. Online learning for continuous professional development of healthcare workers: an exploratory study on perceptions of healthcare managers in Rwanda. BMC MEDICAL EDUCATION 2022; 22:851. [PMID: 36482342 PMCID: PMC9733237 DOI: 10.1186/s12909-022-03938-y] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 08/03/2022] [Accepted: 12/01/2022] [Indexed: 06/17/2023]
Abstract
BACKGROUND Due to outbreaks of new diseases, development of new treatment regimens and requirement of evidence-based practice, health professionals continuously need to acquire updated knowledge and skills. This type of learning is known as continuous professional development (CPD). The scarcity of skilled health care professionals in developing countries further increases the need of CPD. Traditionally, face-to-face approach has been preferred as the best mode of CPD. Currently, health professionals have started using online learning for continued professional growth in different parts of the world. Consequently, research studies from different settings are needed to investigate the significance of online learning for CPD. Therefore, the aim of this study was to investigate the importance and challenges attributed to online learning by the managers of health facilities in Rwanda. Moreover, the study aimed to identify the status of infrastructures that could support online CPD, and assess the perceived enhancement and barriers for implementing online CPD. METHODS The study used a convergence mixed-method design to explore quantitative and qualitative data from 42 health care managers. A descriptive analysis was conducted on quantitative data while qualitative data were thematically analyzed to inform the study findings. RESULTS It was revealed that 90.5% of managers, who participated in this study, consider positively the use of online learning for CPD. All managers acknowledged that online learning could improve the knowledge and practice skills of health care professionals. Nevertheless, 52.4% of health institutions who participated in this study currently do not use online for CPD. Participants demonstrated challenges such as the lack of access to digital devices, poor or lack of internet access, poor online learning design, low digital skills of healthcare professionals, lack of time dedicated to online learning, and heavy workload of staff. CONCLUSION These findings indicate then that the managers of health institutions value the importance of online learning for CPD of health professionals. However, online learning should be designed to fit for the purpose and with a high consideration on needs and preferences of healthcare professionals and thereby improve information communication technology infrastructure that support online learning for CPD. Traditional in-person CPD courses are still recommended in health institutions with shortage in resources and technology. Also, the barriers of online CPD delivery such as low internet connectivity and lack of access to digital devices by healthcare professionals need to be co-creatively addressed through the pyramidal structure of the Rwandan health system.
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Affiliation(s)
- Jean Claude Byungura
- Department of Business Information Technology, University of Rwanda, Kigali, Rwanda.
- Department of Computer and Systems Sciences, Stockholm University, Stockholm, Sweden.
| | - Gerard Nyiringango
- Department of Computer and Systems Sciences, Stockholm University, Stockholm, Sweden
- Department of Nursing, University of Rwanda, Kigali, Rwanda
| | - Uno Fors
- Department of Computer and Systems Sciences, Stockholm University, Stockholm, Sweden
| | - Elenita Forsberg
- School of Health and Welfare, Halmstad University, Halmstad, Sweden
| | - David K Tumusiime
- Center of Excellence in Biomedical Engineering and E-health, University of Rwanda, Kigali, Rwanda
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Forde C, OBrien A. A Literature Review of Barriers and Opportunities Presented by Digitally Enhanced Practical Skill Teaching and Learning in Health Science Education. MEDICAL EDUCATION ONLINE 2022; 27:2068210. [PMID: 35445632 PMCID: PMC9037199 DOI: 10.1080/10872981.2022.2068210] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/15/2023]
Abstract
INTRODUCTION An evidence gap exists identifying the challenges and opportunities presented by digitally enhanced practical skill teaching and learning in health science education. A literature review was carried out to address this gap and to provide recommendations for overcoming identified challenges. METHOD A systematic search strategy was carried out using PRISMA guidelines. The research databases PubMed, ERIC, Medline and CINHL, were searched using MeSH terms. Barriers and opportunities were identified through deductive thematic analysis of the included articles. RESULTS Of the 602 articles identified through the database screening, 29 were included in the current review. Potential challenges posed by technologically supported practical skill teaching identified were i) Inaccessibility and Inequity of Online Learning (ii) Digital illiteracy Among Staff (iii) Technological Challenges (iv) Lack of Engagement with Preparatory Material Hinders Practical Learning (v) Lack of Staff-Student Interaction (vi) Negative Attitudes Towards Online Learning and (vii) Skill Suitability. The opportunities presented by digital technologies identified were (i) Facilitates Higher Order Learning (ii) Ability to Practice in a Safe Environment (iii) Efficacious Use of Class Time (iv) Access to Education (v) Learning Brought to Life (vi) Diverse Range of Learning Materials (vii) Promotes Autonomous Learning. DISCUSSION This literature review demonstrates the acceptability and usability of digitally enhanced practical teaching in health science education among students and educators. CONCLUSION To consolidate the positive disturbances in higher education from the Covid-19 pandemic, potential barriers to online delivery and student engagement must be acknowledged and addressed by relevant stakeholders. Recommendations detailed as part of this paper suggest means of overcoming barriers and leveraging opportunities.
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Affiliation(s)
- Cuisle Forde
- Discipline of Physiotherapy, School of Medicine, Trinity College Dublin, the University of Dublin, Dublin, Ireland
- CONTACT Cuisle Forde Discipline of Physiotherapy, School of Medicine, Trinity College Dublin, the University of Dublin, DublinD08 W9RT, Ireland
| | - Annie OBrien
- Discipline of Physiotherapy, School of Medicine, Trinity College Dublin, the University of Dublin, Dublin, Ireland
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Brown T, Robinson L, Gledhill K, Yu ML, Isbel S, Greber C, Parsons D, Etherington J. Predictors of undergraduate occupational therapy students' academic performance during the Covid-19 pandemic: A hierarchical regression analysis. Scand J Occup Ther 2022; 30:475-487. [PMID: 36121118 DOI: 10.1080/11038128.2022.2123854] [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: 10/14/2022]
Abstract
BACKGROUND The rapid switch to online learning in response to the Covid-19 pandemic affected occupational therapy students' education delivery. It is, therefore, important to investigate these impacts. AIMS/OBJECTIVES This study investigated the potential predictors of academic performance in undergraduate occupational therapy students after moving to online or blended learning post-Covid-19. MATERIAL AND METHODS A total of 208 students from three Australian universities completed a demographic questionnaire and the Distance Education Learning Environment Scale (DELES). Hierarchical linear regression analyses were completed to identify significant students' academic performance predictors. RESULTS Hierarchical regression explained a cumulative total variance of 24.6% of students' academic performance. The following independent variables were significant predictors: DELES student autonomy (p = 0.033), number of hours per semester week dedicated to indirect online study (p = 0.003), number of hours per semester week dedicated to indirect offline study time (p = 0.034), gender (p = 0.005) and English as a first language (p = 0.045). CONCLUSIONS The findings add to the knowledge base on the range of factors that have impacted occupational therapy students' academic performance during the Covid-19 pandemic. SIGNIFICANCE The outcomes will assist faculty in developing supportive and pedagogically sound learning modes across online, hybrid and traditional forms of instruction within occupational therapy curricula.
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Affiliation(s)
- Ted Brown
- Department of Occupational Therapy, School of Primary and Allied Health Care, Faculty of Medicine, Nursing and Health Sciences, Monash University, Frankston, Australia
| | - Luke Robinson
- Department of Occupational Therapy, School of Primary and Allied Health Care, Faculty of Medicine, Nursing and Health Sciences, Monash University, Frankston, Australia
| | - Kate Gledhill
- Department of Occupational Therapy, School of Primary and Allied Health Care, Faculty of Medicine, Nursing and Health Sciences, Monash University, Frankston, Australia
| | - Mong-Lin Yu
- Department of Occupational Therapy, School of Primary and Allied Health Care, Faculty of Medicine, Nursing and Health Sciences, Monash University, Frankston, Australia
| | - Stephen Isbel
- Occupational Therapy Program, Faculty of Health, The University of Canberra, Canberra, Australia
| | - Craig Greber
- Occupational Therapy Program, Faculty of Health, The University of Canberra, Canberra, Australia
| | - Dave Parsons
- Curtin School of Allied Health, Faculty of Health Sciences, Curtin University, Perth, Australia
| | - Jamie Etherington
- Department of Occupational Therapy, School of Primary and Allied Health Care, Faculty of Medicine, Nursing and Health Sciences, Monash University, Frankston, Australia
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Öztürk B, Akarsu R, Kayıhan H, Çelik Y, Kayhan SE. Investigation of the factors affecting the e-learning process in occupational therapy education during the pandemic with principal component analysis. Br J Occup Ther 2022; 85:694-703. [PMID: 38603093 PMCID: PMC8894908 DOI: 10.1177/03080226211070472] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2021] [Accepted: 12/08/2021] [Indexed: 11/17/2022]
Abstract
Introduction The aim of this study is to examine the factors affecting the e-learning process in occupational therapy education in the COVID-19 period. Method In the study, a form containing personal information and questions about the e-learning process, the International Physical Activity Questionnaire, the Academic Self-Efficacy Scale, the Perceived Stress Scale, and the Rosenberg Self-Esteem Scale were applied to 253 occupational therapy students via the Google form. Principal component analysis was used to evaluate the data. Results A large number of questionnaires were applied in the study, and principal component analysis, an advanced statistical method that enables the interpretation of this type of big data more effectively, was used. 13 components were determined, and a variance of 88% was explained. The main components were listed as students' self-perception about the education system, learning methods, home and university environment, information technologies, physical activity level, and academic performance/participation. Conclusion We hope that the results of our study will provide a perspective on what innovations can be made for quality improvement in occupational therapy education. It would be beneficial to increase student feedback by applying similar studies in other education programs.
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Affiliation(s)
- Başar Öztürk
- Faculty of Health Sciences,
Deparment of Occupational Therapy, Biruni University, İstanbul, Turkey
| | - Remziye Akarsu
- Faculty of Health Sciences,
Deparment of Occupational Therapy, Biruni University, İstanbul, Turkey
| | - Hülya Kayıhan
- Faculty of Health Sciences,
Deparment of Occupational Therapy, Biruni University, İstanbul, Turkey
| | - Yusuf Çelik
- Department of Biostatistics and
Medical Informatics, Medical School, Biruni University, İstanbul, Turkey
| | - Saynur Elif Kayhan
- Faculty of Health Sciences,
Deparment of Occupational Therapy, Biruni University, İstanbul, Turkey
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12
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Katlen JN, Manlapaz MR, Hoffman A. Considerations for Appropriateness of Virtual Learning in the Postpandemic Environment. J Nurs Educ 2022; 61:503-509. [PMID: 36098542 DOI: 10.3928/01484834-20220705-04] [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: 11/20/2022]
Abstract
BACKGROUND During the coronavirus disease 2019 (COVID-19) pandemic, health professions educators who traditionally used a face-to-face mode to deliver education transitioned to virtual formats. With the widespread use of vaccines, restrictions on social distancing requirements have waned. Some educators have reverted to a face-to-face modality, whereas others have maintained a virtual modality. METHOD A framework was developed to evaluate the suitability of curricular elements to be presented in a virtual platform to guide educators in modality decision making. RESULTS Learner motivation, context and content compatibility, social learning community requirements, and technological infrastructure should be considered when planning future curricula delivery. CONCLUSION The virtual learning environment must be compatible with content and context. Appropriate technology infrastructure, which includes institutional support, virtual learning platform, and technological support, also must be in place. Hybrid modalities that divide content into face-to-face and virtual components can be used to ease demands on logistics and technology infrastructure limitations. [J Nurs Educ. 2022;61(9):503-509.].
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13
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Comparing Domain-Specific Self-Efficacy in Pediatric Physical Therapy Education Across Classroom-Based, Online, and Hybrid Curriculum Designs. Pediatr Phys Ther 2022; 34:391-398. [PMID: 35616480 DOI: 10.1097/pep.0000000000000910] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
PURPOSE To describe the pediatric curriculum across 3 years when different instructional designs were used, quantify change in self-efficacy (SE) after completing the curriculum, and define relationships between pediatric experience, SE, and interest in future pediatric practice. METHODS Students (N = 137) were included over 3 consecutive years. Instructional design varied across cohorts: classroom-based (n = 48), online (n = 44), and hybrid (n = 45). Pediatric content hours were analyzed. Measures were the Pediatric Communication and Handling Self-Efficacy Scale, pediatric experience, and interest in future pediatric practice. RESULTS Pediatric content hours met published recommendations. Significant growth in SE occurred for all cohorts, with no significant differences in SE scores based on instructional design. Experience and interest in pediatrics were significantly related to communication SE. CONCLUSIONS The pediatric physical therapy curriculum delivered via classroom-based, online, or hybrid instruction can be effective in promoting pediatric-specific growth in student SE. Remote pediatric experiential learning is a feasible option for physical therapy programs with limited direct contact with children. What this adds to the evidence : When pediatric curricula meet recommended total hours of instruction, regardless of instructional method or amount of direct laboratory time with real children, pediatric-specific student SE increases. This supports the use of alternative approaches for experiential learning activities in programs with limited access and availability for direct in-person child interactions. Programs may expand integrated clinical experiences (ICE) opportunities to include telehealth when in-person ICE is limited due to distance or availability in nearby clinical settings. Online learning activities (asynchronous or synchronous) may be viable options for laboratory activities when live child volunteers are limited or unavailable. Use of multiple methods of instruction (classroom-based, online, or hybrid) can be beneficial in covering pediatric physical therapy content and improving SE. This evidence can help programs expand their options for exposing student physical therapists to pediatric practice.
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14
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Brown T, Robinson L, Gledhill K, Yu ML, Isbel S, Greber C, Parsons D, Etherington J. 'Learning in and out of lockdown': A comparison of two groups of undergraduate occupational therapy students' engagement in online-only and blended education approaches during the COVID-19 pandemic. Aust Occup Ther J 2022; 69:301-315. [PMID: 35233780 PMCID: PMC9111320 DOI: 10.1111/1440-1630.12793] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2021] [Revised: 02/13/2022] [Accepted: 02/14/2022] [Indexed: 11/25/2022]
Abstract
Introduction In many countries, the COVID‐19 pandemic resulted in sudden changes to the delivery of health professions education in response to local and national lockdowns. Within occupational therapy, university education programs traditionally delivered in face‐to‐face classroom, and clinical settings, the transition to online learning presented unique issues and challenges for faculty and students. This study compared the experiences and perceptions of learning in two groups of occupational therapy students during the pandemic: one group converted to online learning only and the other had a blended approach that combined face‐to‐face on‐campus learning with some online lecture content delivery. Methods Two hundred and eight (n = 208) undergraduate occupational therapy students from three Australian universities completed an online self‐report demographic questionnaire and two standardised instruments: the Student Engagement in the e‐Learning Environment Scale and the Distance Education Learning Environment Scale. An independent‐samples t test with bootstrapping was completed to examine differences in students' scores. Results Statistically significant differences were observed between the online and blended learning groups across a range of the SELES and DELES subscales. The strongest findings related to psychological motivation (p = 0.001), personal relevance (p = 0.001), interactions with instructors (p = 0.002), instructor support (p = 0.001), student interaction & collaboration (p = 0.001), and cognitive problem solving (p = 0.001). Conclusion Occupational therapy students who transitioned to online‐only learning experienced higher levels of motivation, interactions with instructors and peers, and self‐directed learning than students who experienced a blended education delivery approach of face‐to‐face and online learning. The findings extend educators' understanding of the matrix of factors that have impacted students' education during COVID‐19 and support the development of contemporary and pedagogically sound online and traditional modes of occupational therapy instruction. The results provide evidence of the importance of well‐structured programs that facilitate active and flexible learning, provide meaningful and positive experiences, and promote initiatives safeguarding social and personal well‐being. Further research in this area is recommended.
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Affiliation(s)
- Ted Brown
- Department of Occupational Therapy, School of Primary and Allied Health Care, Faculty of Medicine, Nursing and Health Sciences, Monash University, Peninsula Campus, Frankston, Victoria, Australia
| | - Luke Robinson
- Department of Occupational Therapy, School of Primary and Allied Health Care, Faculty of Medicine, Nursing and Health Sciences, Monash University, Peninsula Campus, Frankston, Victoria, Australia
| | - Kate Gledhill
- Department of Occupational Therapy, School of Primary and Allied Health Care, Faculty of Medicine, Nursing and Health Sciences, Monash University, Peninsula Campus, Frankston, Victoria, Australia
| | - Mong-Lin Yu
- Department of Occupational Therapy, School of Primary and Allied Health Care, Faculty of Medicine, Nursing and Health Sciences, Monash University, Peninsula Campus, Frankston, Victoria, Australia
| | - Stephen Isbel
- Occupational Therapy Program, Faculty of Health, The University of Canberra Hospital, Bruce, Australian Capital Territory, Australia
| | - Craig Greber
- Occupational Therapy Program, Faculty of Health, The University of Canberra Hospital, Bruce, Australian Capital Territory, Australia
| | - Dave Parsons
- Curtin School of Allied Health, Faculty of Health Sciences, Curtin University, Perth, Western Australia, Australia
| | - Jamie Etherington
- Department of Occupational Therapy, School of Primary and Allied Health Care, Faculty of Medicine, Nursing and Health Sciences, Monash University, Peninsula Campus, Frankston, Victoria, Australia
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15
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Allison K, Jones S, Hinman RS, Briggs AM, Sumithran P, Quicke J, Holden M, Chiavaroli N, Crofts S, George E, Foster N, Bennell K. Effects of an Online Education Program on Physical Therapists' Confidence in Weight Management for People With Osteoarthritis: A Randomized Controlled Trial. Arthritis Care Res (Hoboken) 2021; 75:835-847. [PMID: 34931477 DOI: 10.1002/acr.24828] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2021] [Revised: 09/20/2021] [Accepted: 11/30/2021] [Indexed: 12/14/2022]
Abstract
OBJECTIVE To evaluate effects of an online education program about weight management for osteoarthritis on physical therapists' self-reported confidence in knowledge and skills in weight management and attitudes toward obesity. METHODS In a 2-group randomized controlled trial, 80 physical therapists (58 female physical therapists) were randomized to education or control groups. The theoretically informed and evidence-informed online self-directed training program covered biopsychosocial elements of obesity and weight management. The primary outcome was self-reported confidence in knowledge in weight management using a customized validated tool (scale 14-70, higher scores indicating higher confidence) assessed at baseline and 6 weeks. Secondary measures included confidence in nutrition care, clinical skills in weight management, and weight stigma. Process measures evaluated participant experience. Differences in change between groups were compared using linear regression models adjusted for baseline scores and stratifying variables (clinical setting; confidence in weight management). Moderation analysis was performed using an interaction approach in a linear regression model and multivariable fractional polynomial interaction approach. RESULTS A total of 79 participants (99%) completed outcome measures at 6 weeks. The education group demonstrated greater improvement in confidence in knowledge than the control group (adjusted mean difference 22.6 units, 95% confidence interval 19.6, 25.5). Greater improvement in knowledge was associated with lower baseline values (interaction P = 0.002). Secondary outcomes showed greater improvements in confidence in skills and nutrition care and in weight stigma domains favoring the education group. Over 90% of participants would recommend the program to peers. CONCLUSION An online education program improves physical therapists' short-term confidence in knowledge and skills in weight management for people with osteoarthritis and reduces weight-stigmatized attitudes.
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Affiliation(s)
- Kim Allison
- Centre for Health, Exercise and Sports Medicine, The University of Melbourne, Melbourne, Victoria, Australia
| | - Sarah Jones
- Centre for Health, Exercise and Sports Medicine, The University of Melbourne, Melbourne, Victoria, Australia
| | - Rana S Hinman
- Centre for Health, Exercise and Sports Medicine, The University of Melbourne, Melbourne, Victoria, Australia
| | - Andrew M Briggs
- Curtin School of Allied Health, Curtin University, Perth, Western Australia, Australia
| | | | - Jonathan Quicke
- Primary Care Centre Versus Arthritis, Keele University, Keele, UK
| | - Melanie Holden
- Primary Care Centre Versus Arthritis, Keele University, Keele, UK
| | - Neville Chiavaroli
- Australian Council for Educational Research, Camberwell, Victoria, Australia
| | - Sam Crofts
- Centre for Health, Exercise and Sports Medicine, The University of Melbourne, Melbourne, Victoria, Australia
| | - Elena George
- Institute for Physical Activity and Nutrition, School of Exercise and Nutrition Sciences, Deakin University, Geelong, Victoria, Australia
| | - Nadine Foster
- Primary Care Centre Versus Arthritis, Keele University, Keele, UK, and Surgical Treatment and Rehabilitation Service, The University of Queensland and Metro North Health, Herston, Queensland, Australia
| | - Kim Bennell
- Centre for Health, Exercise and Sports Medicine, The University of Melbourne, Melbourne, Victoria, Australia
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16
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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: 15] [Impact Index Per Article: 5.0] [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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17
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Reinhart A, Malzkorn B, Döing C, Beyer I, Jünger J, Bosse HM. Undergraduate medical education amid COVID-19: a qualitative analysis of enablers and barriers to acquiring competencies in distant learning using focus groups. MEDICAL EDUCATION ONLINE 2021; 26:1940765. [PMID: 34128776 PMCID: PMC8208109 DOI: 10.1080/10872981.2021.1940765] [Citation(s) in RCA: 20] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/10/2023]
Abstract
Due to comprehensive social distancing measures related to the COVID-19 pandemic, medical faculties worldwide have made a virtue of necessity in resorting to online teaching. Medical faculties grapple with how to convey clinical competencies to students in this context. There is a need for research not only to map but also to explain the effect of these secondary measures on students' learning and mental wellbeing. During a period of ongoing comprehensive social distancing measures in Germany, we translated a competency-based curriculum including obstetrics, paediatrics, and human genetics to an e-learning course based on online patient and teacher encounters. In our qualitative study on students' and teachers' views, we identify potential enablers and drivers as well as barriers and challenges to undergraduate medical education under lockdown. In summer 2020, we conducted six focus group interviews to investigate medical students' and teachers' perspectives, experiences and attitudes. All focus groups were videotaped, transcribed verbatim and coded. To guide our deductive and inductive analysis, we applied the theoretical framework of Regmi and Jones. Content analysis was performed in a multi-perspective group. We identified five major themes contributing to a successful use of clinical competency-based e-learning under lockdown: Communication (with teachers, students, and patients), Mental wellbeing, Structure and self-organization, Technical issues, and Learning and commitment. We discuss enablers and potential barriers within all themes and their overlap and link them in an explanatory model. In our setting, students and teachers find e-learning holds strong potential and especially in times of COVID-19 it is greatly appreciated. We broaden the understanding of the impact of distant learning on acquiring competencies, on attitudes, and on mental wellbeing. Our model may serve for a thoughtful, necessary transition to future e-learning and hybrid programs for a competency-based medical education with ongoing social distancing measures.
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Affiliation(s)
- Anika Reinhart
- Department of General Paediatrics, Neonatology, and Paediatric Cardiology, Düsseldorf University Department (UKD), Heinrich-Heine-University, Düsseldorf, Germany
| | - Bastian Malzkorn
- Medical Didactics Office, Medical Faculty of the Heinrich-Heine-University, Heinrich-Heine-University, Düsseldorf, Germany
| | - Carsten Döing
- Department of General Paediatrics, Neonatology, and Paediatric Cardiology, Düsseldorf University Department (UKD), Heinrich-Heine-University, Düsseldorf, Germany
| | - Ines Beyer
- Department of Obstetrics and Gynaecology, Düsseldorf University Department (UKD), Heinrich-Heine-University, Düsseldorf, Germany
| | - Jana Jünger
- The German National Institute for State Examinations in Medicine, Pharmacy and Psychotherapy, Mainz, Germany
| | - Hans Martin Bosse
- Department of General Paediatrics, Neonatology, and Paediatric Cardiology, Düsseldorf University Department (UKD), Heinrich-Heine-University, Düsseldorf, Germany
- CONTACT Hans Martin Bosse Department of General Paediatrics, Neonatology and Paediatric Cardiology, Düsseldorf University Department (UKD), Heinrich-Heine-University, Moorenstrasse 5, Düsseldorf, D-40225, Germany
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18
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Nabolsi M, Abu-Moghli F, Khalaf I, Zumot A, Suliman W. Nursing Faculty Experience With Online Distance Education During COVID-19 Crisis: A Qualitative Study. J Prof Nurs 2021; 37:828-835. [PMID: 34742511 PMCID: PMC8564618 DOI: 10.1016/j.profnurs.2021.06.002] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2021] [Indexed: 11/28/2022]
Abstract
BACKGROUND COVID-19 pandemic influenced education and forced universities to shift from face-to-face teaching to remote online teaching. This sudden shift in educational pedagogy provoked several challenges to educators. PURPOSE The purpose of this study is to explore the first experience of nursing faculty members with online distant education (ODE) within the context of COVID-19 national curfew. METHODS A qualitative descriptive design guided by a phenomenological approach was used utilizing purposive sampling for exploring the experiences of fifteen nursing faculty members by two focus group discussions through Zoom. RESULTS Qualitative analysis, using Colaizzi's method revealed four major themes including: (1) resolving immediate reaction toward abrupt compulsory online teaching; fulfilling teaching responsibilities; managing the challenges of ODE, (2) struggling with available resources and capabilities; (3) ODE defeated geographic and time boundaries, and interrupted personal time management: yet a new learning experience; insufficiency of ODE; and (4) achieving clinical competencies and learning outcomes. CONCLUSIONS This study provides evidence on the importance of preparing and training faculty to embrace and sustain the mastery of ODE to ensure the success of ODE. It also emphasizes the institutional and infrastructure readiness to enhance the transition from traditional teaching and learning to ODE.
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Affiliation(s)
- Manar Nabolsi
- Clinical Nursing Department, School of Nursing, The University of Jordan, Jordan.
| | - Fathieh Abu-Moghli
- Community Nursing Department, School of Nursing, The University of Jordan, Jordan.
| | - Inaam Khalaf
- Maternal and Child Health Department, School of Nursing, The University of Jordan, Jordan.
| | - Arwa Zumot
- Community Nursing Department, School of Nursing, The University of Jordan, Jordan.
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19
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Scrivener K, Akkermans J, Svanetti S, Szilas C, Robson M, Love S. Examining user perspective of an online learning resource for physiotherapists: A mixed methods study of the TRAIN program. PHYSIOTHERAPY RESEARCH INTERNATIONAL 2021; 26:e1917. [PMID: 34058050 DOI: 10.1002/pri.1917] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2021] [Revised: 03/18/2021] [Accepted: 05/13/2021] [Indexed: 11/09/2022]
Abstract
BACKGROUND Implementing task specific training is a commonly reported challenge for less experienced therapists. A potential method to improve the ability of recent graduate and student therapists is to upskill regarding task specific training via an online education resource. PURPOSE To evaluate the use and acceptability of the TRAIN program as an online learning resource for physiotherapists. METHODS Data from Google Analytics was sourced to determine use of the program and details about the users. Users of the TRAIN program were also invited to complete two surveys; prior to beginning and upon completion of the program. The surveys collected information about the demographics of the users, perceptions of usefulness of the online resource and overall sentiment. RESULTS Almost 6000 new users interacted with the TRAIN modules during the 15-months study period. The surveys indicated a high level of usability (mean score 9/10, SD 1.5) and clinical utility (mean score 8.8/10, SD 1.6) of the TRAIN program. Perceived knowledge and user confidence in implementing task-specific training was higher for those users completing the post compared to those completing the pre-module survey (knowledge 1.9 and confidence 1.7 out of 10 points higher). Recurring comments in the open-ended feedback pertained to the usefulness, clarity, and ease of use of the TRAIN program. DISCUSSION AND CONCLUSION This study provides preliminary evidence supporting the use and acceptability of the TRAIN program as an online learning resource for physiotherapists. This further contributes to the growing body of literature indicating online learning is generally a well-received teaching tool for physiotherapists.
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Affiliation(s)
- Katharine Scrivener
- Department of Health Professions, Faculty of Medicine, Health and Human Sciences, Macquarie University, Sydney, NSW, Australia
| | - Jake Akkermans
- Department of Health Professions, Faculty of Medicine, Health and Human Sciences, Macquarie University, Sydney, NSW, Australia
| | - Sean Svanetti
- Department of Health Professions, Faculty of Medicine, Health and Human Sciences, Macquarie University, Sydney, NSW, Australia
| | - Chloe Szilas
- Faculty of Medicine, Health and Human Sciences, Macquarie University, Sydney, NSW, Australia
| | - Matthew Robson
- Faculty of Medicine, Health and Human Sciences, Macquarie University, Sydney, NSW, Australia
| | - Sherrie Love
- Faculty of Medicine, Health and Human Sciences, Macquarie University, Sydney, NSW, Australia
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20
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Jones SE, Campbell PK, Kimp AJ, Bennell K, Foster NE, Russell T, Hinman RS. Evaluation of a Novel e-Learning Program for Physiotherapists to Manage Knee Osteoarthritis via Telehealth: Qualitative Study Nested in the PEAK (Physiotherapy Exercise and Physical Activity for Knee Osteoarthritis) Randomized Controlled Trial. J Med Internet Res 2021; 23:e25872. [PMID: 33929326 PMCID: PMC8122295 DOI: 10.2196/25872] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2020] [Revised: 01/14/2021] [Accepted: 03/18/2021] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND The delivery of physiotherapy via telehealth could provide more equitable access to services for patients. Videoconference-based telehealth has been shown to be an effective and acceptable mode of service delivery for exercise-based interventions for chronic knee pain; however, specific training in telehealth is required for physiotherapists to effectively and consistently deliver care using telehealth. The development and evaluation of training programs to upskill health care professionals in the management of osteoarthritis (OA) has also been identified as an important priority to improve OA care delivery. OBJECTIVE This study aims to explore physiotherapists' experiences with and perceptions of an e-learning program about best practice knee OA management (focused on a structured program of education, exercise, and physical activity) that includes telehealth delivery via videoconferencing. METHODS We conducted a qualitative study using individual semistructured telephone interviews, nested within the Physiotherapy Exercise and Physical Activity for Knee Osteoarthritis randomized controlled trial, referred to as the PEAK trial. A total of 15 Australian physiotherapists from metropolitan and regional private practices were interviewed following the completion of an e-learning program. The PEAK trial e-learning program involved self-directed learning modules, a mock video consultation with a researcher (simulated patient), and 4 audited practice video consultations with pilot patients with chronic knee pain. Interviews were audio recorded and transcribed verbatim. Data were thematically analyzed. RESULTS A total of five themes (with associated subthemes) were identified: the experience of self-directed e-learning (physiotherapists were more familiar with in-person learning; however, they valued the comprehensive, self-paced web-based modules. Unwieldy technological features could be frustrating); practice makes perfect (physiotherapists benefited from the mock consultation with the researcher and practice sessions with pilot patients alongside individualized performance feedback, resulting in confidence and preparedness to implement new skills); the telehealth journey (although inexperienced with telehealth before training, physiotherapists were confident and able to deliver remote care following training; however, they still experienced some technological challenges); the whole package (the combination of self-directed learning modules, mock consultation, and practice consultations with pilot patients was felt to be an effective learning approach, and patient information booklets supported the training package); and impact on broader clinical practice (training consolidated and refined existing OA management skills and enabled a switch to telehealth when the COVID-19 pandemic affected in-person clinical care). CONCLUSIONS Findings provide evidence for the perceived effectiveness and acceptability of an e-learning program to train physiotherapists (in the context of a clinical trial) on best practice knee OA management, including telehealth delivery via videoconferencing. The implementation of e-learning programs to upskill physiotherapists in telehealth appears to be warranted, given the increasing adoption of telehealth service models for the delivery of clinical care.
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Affiliation(s)
- Sarah E Jones
- Department of Physiotherapy, School of Health Sciences, Centre for Health, Exercise and Sports Medicine, The University of Melbourne, Melbourne, Australia
| | - Penny K Campbell
- Department of Physiotherapy, School of Health Sciences, Centre for Health, Exercise and Sports Medicine, The University of Melbourne, Melbourne, Australia
| | - Alexander J Kimp
- Department of Physiotherapy, School of Health Sciences, Centre for Health, Exercise and Sports Medicine, The University of Melbourne, Melbourne, Australia
| | - Kim Bennell
- Department of Physiotherapy, School of Health Sciences, Centre for Health, Exercise and Sports Medicine, The University of Melbourne, Melbourne, Australia
| | - Nadine E Foster
- Primary Care Centre Versus Arthritis, School of Medicine, Keele University, Keele, United Kingdom.,STARS Education and Research Alliance, School of Health and Behavioural Sciences, The University of Queensland, Brisbane, Australia
| | - Trevor Russell
- RECOVER Injury Research Centre, The University of Queensland, Brisbane, Australia
| | - Rana S Hinman
- Department of Physiotherapy, School of Health Sciences, Centre for Health, Exercise and Sports Medicine, The University of Melbourne, Melbourne, Australia
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21
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Ng L, Seow KC, Mac Donald L, Correia C, Reubenson A, Gardner P, Spence AL, Bunzli S, Ito Ramos De Oliveira B. eLearning in Physical Therapy: Lessons Learned From Transitioning a Professional Education Program to Full eLearning During the COVID-19 Pandemic. Phys Ther 2021; 101:6158909. [PMID: 33751113 PMCID: PMC7989157 DOI: 10.1093/ptj/pzab082] [Citation(s) in RCA: 20] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/31/2020] [Revised: 10/11/2020] [Accepted: 02/23/2021] [Indexed: 11/13/2022]
Abstract
OBJECTIVE The objectives of this cross-sectional qualitative study were to explore the perspectives of students enrolled in one physical therapist undergraduate education program in Australia about their experience with transitioning to full eLearning and student recommendations to improve the learning experience during the COVID-19 pandemic. METHODS Seven focus groups with 28 undergraduate physical therapist students were conducted following the transitioning to full eLearning as a result of strict physical distancing measures. Focus group questions explored the students' experiences of the transition from face-to-face to full eLearning approach and the students' recommendations for improving future eLearning experiences. Data were analyzed using inductive thematic analysis. RESULTS The 3 themes identified were: (1) students presenting heightened negative feelings such as anxiety, stress, and reduced motivation to study; (2) students continuing to value the face-to-face learning, as it provided social support and facilitated feedback from peers and tutors; (3) student recommendations for eLearning included having online lectures and supplementary videos but face-to-face practical classes and developing healthy learning habits such as scheduled times for studying, exercise, and other activities that regulate stress. CONCLUSIONS The transition to a full eLearning approach in an undergraduate physical therapist education program during the COVID-19 pandemic revealed that students had heightened negative emotions due to the pandemic. Students valued face-to-face practical classes to learn and receive social support from peers and tutors. Student recommendations to future eLearning suggested changes to curriculum development geared toward a greater blended approach to learning. Blended learning may include using online lectures instead of face-to-face lectures and online resources to supplement student learning of practical skills. IMPACT As higher education moves toward a more blended approach, lessons learned from this study can help educators design future physical therapist education programs. The findings can also assist programs in delivering a full eLearning approach as the COVID-19 pandemic continues.
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Affiliation(s)
- L Ng
- Address all correspondence to Dr Leo Ng, School of Physiotherapy and Exercise Science, Curtin University, GPO Box U1987, Perth, WA 6845, , @physio_leo
| | - K C Seow
- School of Physiotherapy and Exercise Science, Curtin University, Perth, WA
| | - L Mac Donald
- School of Physiotherapy and Exercise Science, Curtin University, Perth, WA
| | - C Correia
- School of Physiotherapy and Exercise Science, Curtin University, Perth, WA
| | - A Reubenson
- School of Physiotherapy and Exercise Science, Curtin University, Perth, WA
| | - P Gardner
- School of Physiotherapy and Exercise Science, Curtin University, Perth, WA
| | - A L Spence
- School of Physiotherapy and Exercise Science, Curtin University, Perth, WA
| | - S Bunzli
- The University of Melbourne, Department of Surgery, St Vincent's Hospital
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Ibrahim NK, Al Raddadi R, AlDarmasi M, Al Ghamdi A, Gaddoury M, AlBar HM, Ramadan IK. Medical students' acceptance and perceptions of e-learning during the Covid-19 closure time in King Abdulaziz University, Jeddah. J Infect Public Health 2021; 14:17-23. [PMID: 33341480 PMCID: PMC7836241 DOI: 10.1016/j.jiph.2020.11.007] [Citation(s) in RCA: 59] [Impact Index Per Article: 19.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2020] [Revised: 11/18/2020] [Accepted: 11/24/2020] [Indexed: 11/17/2022] Open
Abstract
BACKGROUND Nowadays, there is a paradigm shift in medical education. This shift occurred following the Covid-19 crisis. The world uses digital e-learning to support the public health response to this pandemic. The study's objective was to determine the medical students' acceptance and perceptions of e-learning during the Covid-19 closure time in Jeddah. METHODS A cross-sectional, web-based study was done among 340 medical students from King Abdulaziz University, 2020. A standardized, electronic, self-administered, Google Form data collection sheet was distributed. It included the E-learning acceptance measure (ElAM) containing three constructs, namely: tutor quality (TQ), perceived usefulness (PU), and facilitating conditions (FC). The sheet also inquired about the students' perceptions of the benefits, enablers, and barriers to e-learning. Descriptive, inferential statistics and multiple linear regression analyses were applied. RESULTS Blackboard and Zoom were the most preferred Learning Management Systems (LMS) by our medical students. The mean score of ElAM was 102.82 ± 24.102. Better achievers obtained significantly (P < 0.001) higher scores in all ElAM constructs. About three-fifths of the students confirmed that e-learning substituted classical on-campus learning and was an adaptable, and less time-consuming method. The educator's good e-learning skills, the subject, instructional design, interaction, motivation, and good LMS were agreed as enablers of e-learning. However, most students accepted that clinical teaching is the most challenging learning outcome and that exams could be affected by low internet quality. CONCLUSION Medical students moderately accepted e-learning during the Covid-19 Pandemic closure time. More training of the students and tutors, better designing e-courses, more interaction, motivation, and blended learning are recommended.
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Affiliation(s)
- Nahla Khamis Ibrahim
- Community Medicine Department, King Abdulaziz University, Jeddah, Saudi Arabia; Epidemiology Department, High Institute of Public Health, Alexandria University, Alexandria, Egypt.
| | - Rajaa Al Raddadi
- Community Medicine Department, King Abdulaziz University, Jeddah, Saudi Arabia
| | - Moroj AlDarmasi
- Community Medicine Department, King Abdulaziz University, Jeddah, Saudi Arabia
| | - Abdullah Al Ghamdi
- Community Medicine Department, King Abdulaziz University, Jeddah, Saudi Arabia
| | - Mahmoud Gaddoury
- Community Medicine Department, King Abdulaziz University, Jeddah, Saudi Arabia
| | - Hussain M AlBar
- Community Medicine Department, King Abdulaziz University, Jeddah, Saudi Arabia
| | - Iman Kamal Ramadan
- Community Medicine Department, King Abdulaziz University, Jeddah, Saudi Arabia
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Gagnon K, Young B, Bachman T, Longbottom T, Severin R, Walker MJ. Doctor of Physical Therapy Education in a Hybrid Learning Environment: Reimagining the Possibilities and Navigating a "New Normal". Phys Ther 2020; 100:1268-1277. [PMID: 32424417 PMCID: PMC7454843 DOI: 10.1093/ptj/pzaa096] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Revised: 05/08/2020] [Accepted: 05/12/2020] [Indexed: 11/25/2022]
Abstract
Professional physical therapist education has experienced a transformation over the last few decades, moving to a doctoring profession with more autonomy and a broader scope of practice. These changes have occurred in parallel with systemic and structural changes in health care and higher education, both of which have experienced challenges with improving access and controlling costs, and have become a centerpiece of legislative and political discourse. At the same time, advances in technology have introduced new possibilities in education, with the emergence of online, blended, and "flipped" learning models that supplement or replace face-to-face instruction with distance learning. Hybrid education is a type of blended learning, utilizing both face-to-face and online instructional strategies. In a hybrid learning environment, online content may be delivered synchronously or asynchronously, replacing traditional face-to-face instructional time and reducing "seat time" for students. Recent attention has been brought to online and hybrid/blended learning in physical therapist education in the wake of the COVID-19 pandemic, as programs have been required to abruptly move from face-to-face to remote instruction. Hybrid and other forms of blended learning strategies have been described at the physical therapist education course level. However, there is no literature describing hybrid learning implementation at the physical therapist education program "levels," and there has been limited discussion on best practices for delivering hybrid, blended, and online instruction in physical therapist education. This perspective provides an overview of hybrid education, describes theoretical frameworks that guide implementation of a hybrid education curriculum, and discusses future directions for hybrid physical therapist education and educational research.
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Affiliation(s)
- Kendra Gagnon
- Doctor of Physical Therapy Program, Baylor University, One Bear Place, #97264, Waco, TX 76798 (USA),Address all correspondence to Dr Gagnon at:
| | - Brian Young
- Doctor of Physical Therapy Program, Baylor University
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Darlow B, Brown M, Grainger R, Hudson B, Briggs AM, Haxby Abbott J, McKinlay E. Stakeholder views about a novel consumer health resource for knee osteoarthritis. OSTEOARTHRITIS AND CARTILAGE OPEN 2020; 2:100058. [DOI: 10.1016/j.ocarto.2020.100058] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2019] [Accepted: 03/02/2020] [Indexed: 01/14/2023] Open
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Regmi K, Jones L. A systematic review of the factors - enablers and barriers - affecting e-learning in health sciences education. BMC MEDICAL EDUCATION 2020; 20:91. [PMID: 32228560 PMCID: PMC7106784 DOI: 10.1186/s12909-020-02007-6] [Citation(s) in RCA: 196] [Impact Index Per Article: 49.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/31/2019] [Accepted: 03/18/2020] [Indexed: 05/19/2023]
Abstract
BACKGROUND Recently, much attention has been given to e-learning in higher education as it provides better access to learning resources online, utilising technology - regardless of learners' geographical locations and timescale - to enhance learning. It has now become part of the mainstream in education in the health sciences, including medical, dental, public health, nursing, and other allied health professionals. Despite growing evidence claiming that e-learning is as effective as traditional means of learning, there is very limited evidence available about what works, and when and how e-learning enhances teaching and learning. This systematic review aimed to identify and synthesise the factors - enablers and barriers - affecting e-learning in health sciences education (el-HSE) that have been reported in the medical literature. METHODS A systemic review of articles published on e-learning in health sciences education (el-HSE) was performed in MEDLINE, EMBASE, Allied & Complementary Medicine, DH-DATA, PsycINFO, CINAHL, and Global Health, from 1980 through 2019, using 'Textword' and 'Thesaurus' search terms. All original articles fulfilling the following criteria were included: (1) e-learning was implemented in health sciences education, and (2) the investigation of the factors - enablers and barriers - about el-HSE related to learning performance or outcomes. Following the PRISMA guidelines, both relevant published and unpublished papers were searched. Data were extracted and quality appraised using QualSyst tools, and synthesised performing thematic analysis. RESULTS Out of 985 records identified, a total of 162 citations were screened, of which 57 were found to be of relevance to this study. The primary evidence base comprises 24 papers, with two broad categories identified, enablers and barriers, under eight separate themes: facilitate learning; learning in practice; systematic approach to learning; integration of e-learning into curricula; poor motivation and expectation; resource-intensive; not suitable for all disciplines or contents, and lack of IT skills. CONCLUSIONS This study has identified the factors which impact on e-learning: interaction and collaboration between learners and facilitators; considering learners' motivation and expectations; utilising user-friendly technology; and putting learners at the centre of pedagogy. There is significant scope for better understanding of the issues related to enablers and facilitators associated with e-learning, and developing appropriate policies and initiatives to establish when, how and where they fit best, creating a broader framework for making e-learning effective.
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Affiliation(s)
- Krishna Regmi
- Faculty of Health and Social Sciences, Institute for Health Research, University of Bedfordshire, Luton, LU2 8LE UK
- Centre for Medical Education, School of Medicine, University of Dundee, The Mackenzie Building, Kirsty Semple Way, Dundee, DD2 4BF UK
| | - Linda Jones
- Centre for Medical Education, School of Medicine, University of Dundee, The Mackenzie Building, Kirsty Semple Way, Dundee, DD2 4BF UK
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Price T, Cartledge PT. Discovering Students' Personalised Uses of a Paediatrics Acute Care E-book - a Qualitative study. MEDEDPUBLISH 2019; 8:189. [PMID: 38089369 PMCID: PMC10712500 DOI: 10.15694/mep.2019.000189.1] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/06/2024] Open
Abstract
This article was migrated. The article was marked as recommended. Background: Medical educators are increasingly developing and recommending e-books to supplement students' learning. Despite this, there is a gap in the literature surrounding E-book developers' understanding of how students can personalize an e-book for multiple different purposes. This qualitative research project aimed to explore students' experiences of using a pediatric acute care E-book (pRRAPID) within a spiral, multi-method teaching package. The researchers aimed to get an insight into the ways that learners used E-books outside of the classroom. Methods: Three focus groups were conducted with 12 fourth-year medical students who had completed a pediatric acute care course. Students were invited to discuss their use of the E-book during the course. Thematic analysis was conducted on the transcripts to identify codes in the data; these were grouped to determine the overarching themes. Results: Students outlined five different ways that they personalized the use of the E-book. Three of these were related to uses of the E-book within the context of the pediatric acute care course; students using the E-book to prepare for a formal teaching session ("Flipped classroom"),students using the E-book as a workbook (going from start to end) and students using the E-book to prepare for an exam. The other two themes related to the use of the E-book outside of the acute care course; students using the E-book as a resource "on the go" and students using the E-book within clinical practice. Conclusions This qualitative study outlines how an educational resource can be utilized in numerous different ways in order to satisfy the needs of the student. Focus-group participants outlined how important it was to engage with the students, as the primary stakeholder, when developing an E-book.
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Briggs AM, Hinman RS, Darlow B, Bennell KL, Leech M, Pizzari T, Greig AM, MacKay C, Bendrups A, Larmer PJ, Francis-Cracknell A, Houlding E, Desmond LA, Jordan JE, Minaee N, Slater H. Confidence and Attitudes Toward Osteoarthritis Care Among the Current and Emerging Health Workforce: A Multinational Interprofessional Study. ACR Open Rheumatol 2019; 1:219-235. [PMID: 31777798 PMCID: PMC6857979 DOI: 10.1002/acr2.1032] [Citation(s) in RCA: 27] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022] Open
Abstract
Objective To measure confidence and attitudes of the current and emerging interprofessional workforce concerning osteoarthritis (OA) care. Methods Study design is a multinational (Australia, New Zealand, Canada) cross-sectional survey of clinicians (general practitioners [GPs], GP registrars, primary care nurses, and physiotherapists) and final-year medical and physiotherapy students. GPs and GP registrars were only sampled in Australia/New Zealand and Australia, respectively. The study outcomes are as follows: confidence in OA knowledge and skills (customized instrument), biomedical attitudes to care (Pain Attitudes Beliefs Scale [PABS]), attitudes toward high- and low-value care (customized items), attitudes toward exercise/physical activity (free-text responses). Results A total of 1886 clinicians and 1161 students responded. Although a number of interprofessional differences were identified, confidence in OA knowledge and skills was consistently greatest among physiotherapists and lowest among nurses (eg, the mean difference [95% confidence interval (CI)] for physiotherapist-nurse analyses were 9.3 [7.7-10.9] for knowledge [scale: 11-55] and 14.6 [12.3-17.0] for skills [scale: 16-80]). Similarly, biomedical attitudes were stronger in nurses compared with physiotherapists (6.9 [5.3-8.4]; scale 10-60) and in medical students compared with physiotherapy students (2.0 [1.3-2.7]). Some clinicians and students agreed that people with OA will ultimately require total joint replacement (7%-19% and 19%-22%, respectively), that arthroscopy is an appropriate intervention for knee OA (18%-36% and 35%-44%), and that magnetic resonance imaging is informative for diagnosis and clinical management of hip/knee OA (8%-61% and 21%-52%). Most agreed (90%-98% and 92%-97%) that exercise is indicated and strongly supported by qualitative data. Conclusion Workforce capacity building that de-emphasizes biomedical management and promotes high-value first-line care options is needed. Knowledge and skills among physiotherapists support leadership roles in OA care for this discipline.
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Affiliation(s)
- Andrew M Briggs
- School of Physiotherapy and Exercise Science Curtin University Perth Australia
| | - Rana S Hinman
- Department of Physiotherapy University of Melbourne Melbourne Australia
| | - Ben Darlow
- Department of Primary Health Care and General Practice University of Otago Wellington New Zealand
| | - Kim L Bennell
- Department of Physiotherapy University of Melbourne Melbourne Australia
| | - Michelle Leech
- Faculty of Medicine Nursing and Health Sciences Monash University Melbourne Australia
| | - Tania Pizzari
- La Trobe Sport and Exercise Medicine Research Centre La Trobe University Melbourne Australia
| | - Alison M Greig
- Department of Physical Therapy University of British Columbia Vancouver Canada
| | - Crystal MacKay
- Toronto Rehabilitation Institute University Health Network Toronto Canada
| | - Andrea Bendrups
- Department of Medicine (Royal Melbourne Hospital) University of Melbourne Melbourne Australia
| | - Peter J Larmer
- School of Clinical Sciences Auckland University of Technology Auckland New Zealand
| | | | - Elizabeth Houlding
- School of Physiotherapy and Exercise Science Curtin University Perth Australia.,Faculty of Science University of Ottawa Ottawa Canada
| | - Lucy A Desmond
- Department of Medicine Western Health Melbourne Australia
| | | | - Novia Minaee
- School of Physiotherapy and Exercise Science Curtin University Perth Australia
| | - Helen Slater
- School of Physiotherapy and Exercise Science Curtin University Perth Australia
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Health professionals and students encounter multi-level barriers to implementing high-value osteoarthritis care: a multi-national study. Osteoarthritis Cartilage 2019; 27:788-804. [PMID: 30668988 DOI: 10.1016/j.joca.2018.12.024] [Citation(s) in RCA: 55] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/26/2018] [Revised: 12/06/2018] [Accepted: 12/19/2018] [Indexed: 02/02/2023]
Abstract
OBJECTIVE Consistent evidence-practice gaps in osteoarthritis (OA) care are observed in primary care settings globally. Building workforce capacity to deliver high-value care requires a contemporary understanding of barriers to care delivery. We aimed to explore barriers to OA care delivery among clinicians and students. DESIGN A cross-sectional, multinational study sampling clinicians (physiotherapists, primary care nurses, general practitioners (GPs), GP registrars; total possible denominator: n = 119,735) and final-year physiotherapy and medical students (denominator: n = 2,215) across Australia, New Zealand and Canada. Respondents answered a survey, aligned to contemporary implementation science domains, which measured barriers to OA care using categorical and free-text responses. RESULTS 1886 clinicians and 1611 students responded. Items within the domains 'health system' and 'patient-related factors' represented the most applicable barriers experienced by clinicians (25-42% and 20-36%, respectively), whereas for students, 'knowledge and skills' and 'patient-related factors' (16-24% and 19-28%, respectively) were the most applicable domains. Meta-synthesis of qualitative data highlighted skills gaps in specific components of OA care (tailoring exercise, nutritional/overweight management and supporting positive behaviour change); assessment, measurement and monitoring; tailoring care; managing case complexity; and translating knowledge to practice (especially among students). Other barriers included general infrastructure limitations (particularly related to community facilities); patient-related factors (e.g., beliefs and compliance); workforce-related factors such as inconsistent care and a general knowledge gap in high-value care; and system and service-level factors relating to financing and time pressures, respectively. CONCLUSIONS Clinicians and students encounter barriers to delivery of high-value OA care in clinical practice/training (micro-level); within service environments (meso-level); and within the health system (macro-level).
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Hurley DA, Keogh A, Mc Ardle D, Hall AM, Richmond H, Guerin S, Magdalinski T, Matthews J. Evaluation of an E-Learning Training Program to Support Implementation of a Group-Based, Theory-Driven, Self-Management Intervention For Osteoarthritis and Low-Back Pain: Pre-Post Study. J Med Internet Res 2019; 21:e11123. [PMID: 30843863 PMCID: PMC6427104 DOI: 10.2196/11123] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2018] [Revised: 11/20/2018] [Accepted: 12/10/2018] [Indexed: 12/27/2022] Open
Abstract
Background By adaptation of the face-to-face physiotherapist-training program previously used in the Self-management of Osteoarthritis and Low back pain through Activity and Skills (SOLAS) feasibility trial, an asynchronous, interactive, Web-based, e-learning training program (E-SOLAS) underpinned by behavior and learning theories was developed. Objective This study investigated the effect of the E-SOLAS training program on relevant outcomes of effective training and implementation. Methods Thirteen physiotherapists from across Ireland were trained via E-SOLAS by using mixed methods, and seven physiotherapists progressed to implementation of the 6-week group-based SOLAS intervention. The effectiveness of E-SOLAS was evaluated using the Kirkpatrick model at the levels of reaction (physiotherapist engagement and satisfaction with E-SOLAS training methods and content), learning (pre- to posttraining changes in physiotherapists’ confidence and knowledge in delivering SOLAS content and self-determination theory-based communication strategies, administered via a SurveyMonkey questionnaire), and behavior (fidelity to delivery of SOLAS content using physiotherapist-completed weekly checklists). During implementation, five physiotherapists audio recorded delivery of one class, and the communication between physiotherapists and clients was assessed using the Health Care Climate Questionnaire (HCCQ), the Controlling Coach Behaviour Scale (CCBS), and an intervention-specific measure (ISM; 7-point Likert scale). A range of implementation outcomes were evaluated during training and delivery (ie, acceptability, appropriateness, feasibility, fidelity, and sustainability of E-SOLAS) using a posttraining feedback questionnaire and individual semistructured telephone interviews. Results With regard to their reaction, physiotherapists (n=13) were very satisfied with E-SOLAS posttraining (median 5.0; interquartile range 1.0; min-max 4.0-5.0) and completed training within 3-4 weeks. With regard to learning, there were significant increases in physiotherapists’ confidence and knowledge in delivery of all SOLAS intervention components (P<.05). Physiotherapists’ confidence in 7 of 10 self-determination theory-based communication strategies increased (P<.05), whereas physiotherapists’ knowledge of self-determination theory-based strategies remained high posttraining (P>.05). In terms of behavior, physiotherapists delivered SOLAS in a needs supportive manner (HCCQ: median 5.2, interquartile range 1.3, min-max 3.7-5.8; CCBS: median 6.6, interquartile range 1.0, min-max 5.6-7.0; ISM: median 4.5, interquartile range 1.2, min-max 2.8-4.8). Fidelity scores were high for SOLAS content delivery (total %mean fidelity score 93.5%; SD 4.9%). The posttraining questionnaire and postdelivery qualitative interviews showed that physiotherapists found E-SOLAS acceptable, appropriate, feasible, and sustainable within primary care services to support the implementation of the SOLAS intervention. Conclusions This study provides preliminary evidence of the effectiveness, acceptability, and feasibility of an e-learning program to train physiotherapists to deliver a group-based self-management complex intervention in primary care settings, which is equivalent to face-to-face training outcomes and would support inclusion of physiotherapists in a definitive trial of SOLAS.
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Affiliation(s)
- Deirdre A Hurley
- School of Public Health, Physiotherapy and Sports Science, University College Dublin, Dublin, Ireland
| | - Alison Keogh
- School of Public Health, Physiotherapy and Sports Science, University College Dublin, Dublin, Ireland
| | - Danielle Mc Ardle
- School of Public Health, Physiotherapy and Sports Science, University College Dublin, Dublin, Ireland
| | - Amanda M Hall
- Faculty of Medicine, Memorial University, St Johns, NL, Canada
| | - Helen Richmond
- Centre for Rehabilitation Research in Oxford (RRiO), Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, University of Oxford, Oxford, United Kingdom
| | - Suzanne Guerin
- School of Psychology, University College Dublin, Dublin, Ireland
| | - Tara Magdalinski
- Faculty of Health, Arts and Design, Swinburne University of Technology, Melbourne, Australia
| | - James Matthews
- School of Public Health, Physiotherapy and Sports Science, University College Dublin, Dublin, Ireland
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Briggs AM, Valentijn PP, Thiyagarajan JA, Araujo de Carvalho I. Elements of integrated care approaches for older people: a review of reviews. BMJ Open 2018; 8:e021194. [PMID: 29627819 PMCID: PMC5892746 DOI: 10.1136/bmjopen-2017-021194] [Citation(s) in RCA: 98] [Impact Index Per Article: 16.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/11/2022] Open
Abstract
OBJECTIVE The World Health Organization (WHO) recently proposed an Integrated Care for Older People approach to guide health systems and services in better supporting functional ability of older people. A knowledge gap remains in the key elements of integrated care approaches used in health and social care delivery systems for older populations. The objective of this review was to identify and describe the key elements of integrated care models for elderly people reported in the literature. DESIGN Review of reviews using a systematic search method. METHODS A systematic search was performed in MEDLINE and the Cochrane database in June 2017. Reviews of interventions aimed at care integration at the clinical (micro), organisational/service (meso) or health system (macro) levels for people aged ≥60 years were included. Non-Cochrane reviews published before 2015 were excluded. Reviews were assessed for quality using the Assessment of Multiple Systematic Reviews (AMSTAR) 1 tool. RESULTS Fifteen reviews (11 systematic reviews, of which six were Cochrane reviews) were included, representing 219 primary studies. Three reviews (20%) included only randomised controlled trials (RCT), while 10 reviews (65%) included both RCTs and non-RCTs. The region where the largest number of primary studies originated was North America (n=89, 47.6%), followed by Europe (n=60, 32.1%) and Oceania (n=31, 16.6%). Eleven (73%) reviews focused on clinical 'micro' and organisational 'meso' care integration strategies. The most commonly reported elements of integrated care models were multidisciplinary teams, comprehensive assessment and case management. Nurses, physiotherapists, general practitioners and social workers were the most commonly reported service providers. Methodological quality was variable (AMSTAR scores: 1-11). Seven (47%) reviews were scored as high quality (AMSTAR score ≥8). CONCLUSION Evidence of elements of integrated care for older people focuses particularly on micro clinical care integration processes, while there is a relative lack of information regarding the meso organisational and macro system-level care integration strategies.
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Affiliation(s)
- Andrew M Briggs
- Department of Ageing and Life Course, World Health Organization, Geneva, Switzerland
- School of Physiotherapy and Exercise Science, Curtin University, Perth, Western Australia, Australia
| | - Pim P Valentijn
- Department of Patient and Care, Maastricht University Medical Center, Maastricht, The Netherlands
- Department of Health Services Research, Faculty of Health, Medicine and Life Sciences, Care and Public Health Research Institute (CAPHRI), Maastricht University, Maastricht, The Netherlands
- Integrated Care Evaluation, Essenburgh Research & Consultancy, Hierden, The Netherlands
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Effective online teaching and learning practices for undergraduate health sciences students: An integrative review. INTERNATIONAL JOURNAL OF AFRICA NURSING SCIENCES 2018. [DOI: 10.1016/j.ijans.2018.08.004] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
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Assessing Implementation Readiness and Success of an e-Resource to Improve Prelicensure Physical Therapy Workforce Capacity to Manage Rheumatoid Arthritis. J Orthop Sports Phys Ther 2017; 47:652-663. [PMID: 28859591 DOI: 10.2519/jospt.2017.7281] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
Study Design Prospective within-subject, cross-sectional, between-group, nested qualitative designs within an implementation science framework. Background Physical therapy is recommended for rheumatoid arthritis (RA) care, yet prelicensure RA curriculum time remains limited. Objectives To determine readiness for, and success of, implementing an e-learning tool, Rheumatoid Arthritis for Physiotherapists e-Learning (RAP-eL), within the prelicensure physical therapy curriculum. Methods All physical therapy students in a 1-year cohort in 2014 had RAP-eL embedded in their curriculum. Rheumatoid Arthritis for Physiotherapists e-Learning is an online platform that delivers RA disease information with translation to clinical practice. Implementation readiness, determined by acceptability of RAP-eL to students, was evaluated using focus groups (n = 23). Implementation success was measured using quantitative data from a previously validated questionnaire, including changes in students' self-reported confidence in knowledge (out of 45) and skills (out of 40) in managing RA after 4 weeks of access to RAP-eL, retention of learning over 14 months, and differences in workforce readiness between students in the cohort who had access to RAP-eL and a historical control cohort. Results Acceptability of RAP-eL was confirmed from qualitative data, demonstrating implementation readiness. Short-term improvements were observed in RA knowledge (mean difference, 16.6; 95% confidence interval [CI]: 15.7, 17.6) and RA skills (mean difference, 14.9; 95% CI: 13.9, 15.9; n = 137). Retention was demonstrated after 14 months (P<.001; n = 62). Students in the 1-year cohort who had RAP-eL embedded in the curriculum scored significantly higher on knowledge (mean difference, 3.6; 95% CI: 1.3, 5.9) and skills (mean difference, 3.3; 95% CI: 0.9, 5.7; n = 62) compared to those without RAP-eL (n = 36). Rheumatoid Arthritis for Physiotherapists e-Learning remains embedded in the curriculum. Conclusion This study demonstrated both readiness and success of the sustainable implementation of RAP-eL within a prelicensure physical therapy curriculum. J Orthop Sports Phys Ther 2017;47(9):652-663. doi:10.2519/jospt.2017.7281.
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Slater H, Dear BF, Merolli MA, Li LC, Briggs AM. Use of eHealth technologies to enable the implementation of musculoskeletal Models of Care: Evidence and practice. Best Pract Res Clin Rheumatol 2017; 30:483-502. [PMID: 27886943 DOI: 10.1016/j.berh.2016.08.006] [Citation(s) in RCA: 53] [Impact Index Per Article: 7.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2016] [Revised: 08/05/2016] [Accepted: 08/22/2016] [Indexed: 01/26/2023]
Abstract
Musculoskeletal (MSK) conditions are the second leading cause of morbidity-related burden of disease globally. EHealth is a potentially critical factor that enables the implementation of accessible, sustainable and more integrated MSK models of care (MoCs). MoCs serve as a vehicle to drive evidence into policy and practice through changes at a health system, clinician and patient level. The use of eHealth to implement MoCs is intuitive, given the capacity to scale technologies to deliver system and economic efficiencies, to contribute to sustainability, to adapt to low-resource settings and to mitigate access and care disparities. We follow a practice-oriented approach to describing the 'what' and 'how' to harness eHealth in the implementation of MSK MoCs. We focus on the practical application of eHealth technologies across care settings to those MSK conditions contributing most substantially to the burden of disease, including osteoarthritis and inflammatory arthritis, skeletal fragility-associated conditions and persistent MSK pain.
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Affiliation(s)
- Helen Slater
- School of Physiotherapy and Exercise Science, Curtin University, Perth, WA, Australia.
| | - Blake F Dear
- eCentreClinic, Department of Psychology, Macquarie University, NSW, Australia.
| | - Mark A Merolli
- Health and Biomedical Informatics Centre, The University of Melbourne, VIC, Australia.
| | - Linda C Li
- Department of Physical Therapy, University of British Columbia, Arthritis Research Canada, Vancouver, British Columbia, Canada.
| | - Andrew M Briggs
- School of Physiotherapy and Exercise Science, Curtin University, Perth, WA, Australia.
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Models of Care for musculoskeletal health: Moving towards meaningful implementation and evaluation across conditions and care settings. Best Pract Res Clin Rheumatol 2016; 30:359-374. [DOI: 10.1016/j.berh.2016.09.009] [Citation(s) in RCA: 45] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2016] [Accepted: 09/16/2016] [Indexed: 12/31/2022]
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