Variables influencing physical therapists' perceptions of continuing education

Physical and occupational therapists' learning needs and preferences for education on functional electrical stimulation: A qualitative descriptive study

BACKGROUND

Functional electrical stimulation (FES) is an evidence-based intervention that is rarely used by Canadian physical therapists (PTs) and occupational therapists (OTs). A common barrier to FES implementation is a lack of knowledge and training. FES learning resources that meet therapists' learning needs and preferences may address this barrier.

OBJECTIVE

To explore OTs' and PTs' perspectives on the utility of FES e-learning resources, including whether the resources met their learning needs and preferences.

METHODS

Through this qualitative descriptive study, feedback on FES e-learning resources was solicited from 5 PTs and 18 OTs who work clinically, but do not use FES. Participants reviewed ≥3 prerecorded lectures on FES topics and then completed a semi-structured interview. Participants were asked about the lectures' content, delivery, ease of use and comprehensibility, and were asked to suggest modifications to facilitate self-directed learning about FES. Interviews were analyzed using conventional content analysis.

RESULTS

Three themes were identified. (1) Feedback on FES e-learning: the content and delivery of the prerecorded lectures facilitated participants' learning, although opportunities to improve content and delivery were identified. (2) Factors influencing FES learning needs and preferences: Participants identified internal (i.e., baseline knowledge, learning style) and external (i.e., learning with colleagues, practice setting) factors that affected learning. Themes 1 and 2 impacted (3) the effects of FES e-learning: Participants described the outcomes of their FES e-learning, including increases in FES knowledge, confidence, and use in clinical practice.

CONCLUSION

Therapists' perceived the FES e-learning resources to be useful and to address their learning needs and preferences.

Exploring the Experiences and Perceptions of Pediatric Therapists who use Functional Electrical Stimulation in their Clinical Practice

Aim: This study aimed to 1) explore the experiences and perceptions of pediatric physical therapists (PTs) and occupational therapists (OTs) who use FES in their practice, and 2) provide recommendations for overcoming common barriers to FES implementation.Methods: Eight Canadian PTs (n = 6) and OTs (n = 2), who use FES in their pediatric practice, participated in semi-structured interviews. Open-ended questions queried the motivation, goals, perceived benefits and challenges, and facilitators and barriers of FES use. Interviews were audio recorded and transcribed verbatim. Interpretive description was used to analyze the transcripts.Results: One overarching theme emerged: FES is a useful adjunct to therapy for certain pediatric clients. Four sub-themes were identified: Participants described 1) motivation for incorporating FES into clinical practice, which led to 2) experiences with the implementation of FES in clinical practice, including strategies for overcoming implementation barriers. These experiences influenced 3) how FES is used in practice (e.g. for which populations and therapeutic goals), and informed 4) recommendations for pediatric FES practice (e.g. more educational opportunities, research, and access for families).Conclusions: Pediatric PTs and OTs who use FES in clinical practice view FES as a valuable adjunct, especially for motor training to improve functional skills.

Which Learning Activities Enhance Physical Therapist Practice? Part 2: Systematic Review of Qualitative Studies and Thematic Synthesis

OBJECTIVE

Post-professional physical therapy expertise requires career-long participation in learning activities. Understanding physical therapists' lived experience of learning activities provides novel insight into how best to enhance physical therapist practice from the perspective of the learner. The purpose of this study was to explore qualified physical therapists' experiences, beliefs, and perspectives with regard to learning activities and professional development.

METHODS

Eight databases were searched for studies published from inception through December 2018. Study selection included mixed-methods and qualitative studies exploring physical therapists' experiences, perspectives, beliefs, and attitudes. Thematic synthesis was performed, and the GRADE-Confidence in the Evidence from Reviews of Qualitative research was used to assess the level of confidence in the findings. A total 41 studies with 719 participants were included.

RESULTS

The key findings include physical therapists' perceptions that worthwhile post-professional learning requires more than attendance at professional development courses. Physical therapists perceived that worthwhile learning requires connection with others and being "taken out of one's comfort zone." Sufficient time and accessible, trustworthy resources were also valued.

CONCLUSIONS

Moderate- to low-level evidence suggests that the choice of professional development activities and education design for qualified physical therapists should consider the inclusion of connected activities, activities that take participants out of comfort zones, time to practice, and trustworthy resources that are easily accessible. Future research should evaluate the effectiveness of learning activities encompassing these factors, prioritizing those that minimize the barriers of time and distance.

IMPACT

This study adds to the profession's understanding of physical therapists' lived experience of learning activities, providing novel insight into how best to enhance physical therapist practice from the perspective of the learner.

Is the supply of continuing education in the anatomical sciences keeping up with the demand? Results of a national survey

Continuing education (CE) is an essential element in the life-long learning of health care providers and educators. Despite the importance of the anatomical sciences in the training and practice of clinicians, no studies have examined the need/state of anatomy-related CE nationally. This study assessed the current landscape of CE in the anatomical sciences to contextualize preferences for CE, identify factors that influence the perceived need for CE, and examine the association between supply and demand. Surveys were distributed to educators in the anatomical sciences, practicing physical therapists (PTs), and anatomy training programs across the United States. Twenty-five percent (9 of 36) of training programs surveyed offered CE, certificates, or summer series programs related to anatomy. The majority of PTs (92%) and anatomy educators (81%) felt they had a potential or actual need for anatomy related CE with the most popular formats being online videos/learning modules and intensive, hands-on workshops. The most commonly perceived barriers to participating in CE for both groups were program location, cost, and duration, while educators also perceived time of year as a significant factor. Logistic regression analyses revealed that no investigated factor influenced the need or desire for PTs to engage in anatomy related CE (P ≤ 0.124), while teaching experience and the highest level of learner taught significantly influenced the perceived need among anatomy educators (P < 0.001). Overall, quantitative and qualitative analyses revealed a robust need for CE that strategically integrates anatomy with areas of clinical practice and education. Anat Sci Educ 11: 225-235. © 2017 American Association of Anatomists.

Ordering diagnostic imaging: a survey of ontario physiotherapists' opinions on an expanded scope of practice

PURPOSE

To explore Ontario physiotherapists' opinions on their ability to order diagnostic imaging (DI).

METHODS

An online questionnaire was sent to all registered members of the College of Physiotherapists of Ontario. Descriptive statistics were calculated using response frequencies. Practice characteristics were compared using χ(2) tests and Wilcoxon rank-sum tests.

RESULTS

Of 1,574 respondents (21% response rate), 42% practised in orthopaedics and 53% in the public sector. Most physiotherapists were interested in ordering DI (72% MRI/diagnostic ultrasound, 78% X-rays/computed tomography scans). Respondents with an orthopaedic caseload of 50% or more (p<0.001) and those in the private sector (p<0.001) were more interested in ordering DI. Respondents preferred a DI course that combined face-to-face and Web-based components and one that was specific to their area of practice. Most respondents perceived minimal barriers to the uptake of ordering DI, and most agreed that support from other health care professionals would facilitate uptake.

CONCLUSION

The majority of Ontario physiotherapists are interested in ordering DI. For successful implementation of a health care change, such as physiotherapists' ability to order DI, educational needs and barriers to and facilitators of the uptake of the authorized activity should be considered.

The New South Wales Allied Health Workplace Learning Study: barriers and enablers to learning in the workplace

Background

Workplace learning refers to continuing professional development that is stimulated by and occurs through participation in workplace activities. Workplace learning is essential for staff development and high quality clinical care. The purpose of this study was to explore the barriers to and enablers of workplace learning for allied health professionals within NSW Health.

Methods

A qualitative study was conducted with a purposively selected maximum variation sample (n = 46) including 19 managers, 19 clinicians and eight educators from 10 allied health professions. Seven semi-structured interviews and nine focus groups were audio-recorded and transcribed. The ‘framework approach’ was used to guide the interviews and analysis. Textual data were coded and charted using an evolving thematic framework.

Results

Key enablers of workplace learning included having access to peers, expertise and ‘learning networks’, protected learning time, supportive management and positive staff attitudes. The absence of these key enablers including heavy workload and insufficient staffing were important barriers to workplace learning.

Conclusion

Attention to these barriers and enablers may help organisations to more effectively optimise allied health workplace learning. Ultimately better workplace learning may lead to improved patient, staff and organisational outcomes.

Mandatory continuing professional development in South Africa: Rehabilitation therapists' perspective

Aims:

In 2007, Health Professions Council of South Africa (HPCSA) introduced mandatory continuing professional development (CPD), which enables therapists to acquire new knowledge and skills to improve patient care. To remain registered, therapists must meet CPD standards by formal HPCSA audits; however, latest figures revealed a compliance rate of 35% due to non-attendance of CPD activities. This study reviewed the experiences of therapists to identify barriers and obtain suggestions to improve attendance.

Methodology:

This cross-sectional descriptive study used a questionnaire with closed and open questions to explore the aims from a sample of 138 rehabilitation therapists, comprising speech and language therapists (9%), occupational therapists (21%) and physiotherapists (70%), attending an ethics workshop.

Results:

Eighty five (62%) supported CPD and 97 (71%) supported compulsory ethics. Short 1 to 3 day courses, mini-congresses and journal club activities were the most frequently-attended events. Barriers to CPD were: time, cost of courses, cost of travel due to geographical distance, staff shortages, lack of employee support, and multi-disciplinary or inappropriate courses. Suggestions for improving attendance were: introducing state subsidised and corporate sponsorships, increased in-service journal club activities, tele- and video-conferences, on-line presentations, and profession-specific courses.

Conclusion:

Therapists support mandatory CPD, but stakeholders must take cognisance of the barriers and suggestions to improve CPD attendance and compliance.

Continuing education for advanced manual and manipulative physiotherapists in Canada: a survey of perceived needs

PURPOSE

Our purpose was to determine advanced manual and manipulative physiotherapists' (AMPTs') current use and awareness of continuing education (CE) opportunities; to establish their perceived CE needs by identifying facilitators and barriers to participation; and to explore the association of demographics with CE needs.

METHODS

A questionnaire was e-mailed to 456 registered members of the Canadian Academy of Manipulative Physiotherapy. Data analyses using frequencies and percentages of total responses and t-tests for group comparisons were performed.

RESULTS

One hundred thirty-three (29.2%) participants responded. Most lived in an urban region and worked predominantly in direct patient care. More respondents reported engaging in informal CE than in formal CE. Hands-on or practical workshops were the preferred CE format. Common barriers to CE included professional commitments and cost and time of travel; facilitators included interest in the topic and increasing knowledge and competency. AMPTs with less physical therapy experience found cost to be a greater barrier and were more interested in mentorship programs and CE as a means to obtain credentials.

CONCLUSIONS

AMPTs' preferred CE formats are inconsistent with the CE opportunities in which they participate. CE initiatives for AMPTs should include hands-on training and should account for time and cost to make CE opportunities more readily available to them.

The effect of knowledge translation procedures on application of information from a continuing education conference

PURPOSE

This study investigated the effect of knowledge translation procedures as part of a continuing education conference for pediatric physical therapists on knowledge and frequency of use of tests and measures.

METHODS

All attendees (28) were invited to complete a baseline self-report survey on knowledge and frequency of use of skills related to the use of standardized measures. Eleven attendees participated in the additional knowledge translation activities, including a 90-minute session during the conference and follow-up online interaction.

RESULTS

On the baseline survey, conference attendees rated themselves higher on frequency of use compared with knowledge. The 8 conference attendees who completed the follow-up survey rated themselves higher in some aspects of knowledge and frequency of use of the skills related to standardized assessment.

CONCLUSIONS

The knowledge translation activities were easy to implement and led to positive changes in level of knowledge and frequency of use of tests and measures.

From continuing education to personal digital assistants: what do physical therapists need to support evidence-based practice in stroke management?

RATIONALE, AIMS AND OBJECTIVES

Understanding how to structure educational interventions and resources to facilitate physical therapists' application of the research literature is required. The objective of this study was to explore physical therapists' preferences for strategies to facilitate their access to, evaluation and implementation of the stroke research literature in clinical practice.

METHODS

In-depth, qualitative telephone interviews were conducted with 23 physical therapists who treat people with stroke in Ontario, Canada and who had participated in a previous survey on evidence-based practice. Data were analysed using a constant comparative approach to identify emergent themes.

RESULTS

Participants preferred online access to research summaries or systematic reviews to save time to filter and critique research articles. To enable access in the workplace, an acceptable computer-to-staff ratio, permission to access web sites and protected work time were suggested. Participants considered personal digital assistants as excellent tools for quick access to online resources but were unsure of their advantage over a desktop computer. Therapists favoured use of non-technical language, glossaries of research terms and quality ratings of studies to ease understanding and appraisal. Teleconferencing or videoconferencing overcame geographical but not scheduling barriers to accessing education. To achieve behaviour change in clinical practice, therapists preferred multiple interactive, face-to-face education sessions in a group format, with opportunities for case-based learning and practice of new skills.

CONCLUSION

Physical therapists prefer technology-assisted access to resources and education and favour attending multiple interactive, expert-facilitated education sessions incorporating opportunities for case-based learning and practice of new skills to change behaviour related to evidence-based practice.

Preferences for and barriers to formal and informal athletic training continuing education activities

CONTEXT

Our previous research determined the frequency of participation and perceived effect of formal and informal continuing education (CE) activities. However, actual preferences for and barriers to CE must be characterized.

OBJECTIVE

To determine the types of formal and informal CE activities preferred by athletic trainers (ATs) and barriers to their participation in these activities.

DESIGN

Cross-sectional study.

SETTING

Athletic training practice settings.

PATIENTS OR OTHER PARTICIPANTS

Of a geographically stratified random sample of 1000 ATs, 427 ATs (42.7%) completed the survey.

MAIN OUTCOME MEASURE(S)

As part of a larger study, the Survey of Formal and Informal Athletic Training Continuing Education Activities (FIATCEA) was developed and administered electronically. The FIATCEA consists of demographic characteristics and Likert scale items (1 = strongly disagree, 5 = strongly agree) about preferred CE activities and barriers to these activities. Internal consistency of survey items, as determined by Cronbach α, was 0.638 for preferred CE activities and 0.860 for barriers to these activities. Descriptive statistics were computed for all items. Differences between respondent demographic characteristics and preferred CE activities and barriers to these activities were determined via analysis of variance and dependent t tests. The α level was set at .05.

RESULTS

Hands-on clinical workshops and professional networking were the preferred formal and informal CE activities, respectively. The most frequently reported barriers to formal CE were the cost of attending and travel distance, whereas the most frequently reported barriers to informal CE were personal and job-specific factors. Differences were noted between both the cost of CE and travel distance to CE and all other barriers to CE participation (F(1,411) = 233.54, P < .001).

CONCLUSIONS

Overall, ATs preferred formal CE activities. The same barriers (eg, cost, travel distance) to formal CE appeared to be universal to all ATs. Informal CE was highly valued by ATs because it could be individualized.

Formal and informal continuing education activities and athletic training professional practice

CONTEXT

Continuing education (CE) is intended to promote professional growth and, ultimately, to enhance professional practice.

OBJECTIVE

To determine certified athletic trainers' participation in formal (ie, approved for CE credit) and informal (ie, not approved for CE credit) CE activities and the perceived effect these activities have on professional practice with regard to improving knowledge, clinical skills and abilities, attitudes toward patient care, and patient care itself.

DESIGN

Cross-sectional study.

SETTING

Athletic training practice settings.

PATIENTS OR OTHER PARTICIPANTS

Of a geographic, stratified random sample of 1000 athletic trainers, 427 (42.7%) completed the survey.

MAIN OUTCOME MEASURE(S)

The Survey of Formal and Informal Athletic Training Continuing Education Activities was developed and administered electronically. The survey consisted of demographic characteristics and Likert-scale items regarding CE participation and perceived effect of CE on professional practice. Internal consistency of survey items was determined using the Cronbach alpha (alpha = 0.945). Descriptive statistics were computed for all items. An analysis of variance and dependent t tests were calculated to determine differences among respondents' demographic characteristics and their participation in, and perceived effect of, CE activities. The alpha level was set at .05.

RESULTS

Respondents completed more informal CE activities than formal CE activities. Participation in informal CE activities included reading athletic training journals (75.4%), whereas formal CE activities included attending a Board of Certification-approved workshop, seminar, or professional conference not conducted by the National Athletic Trainers' Association or affiliates or committees (75.6%). Informal CE activities were perceived to improve clinical skills or abilities and attitudes toward patient care. Formal CE activities were perceived to enhance knowledge.

CONCLUSIONS

More respondents completed informal CE activities than formal CE activities. Both formal and informal CE activities were perceived to enhance athletic training professional practice. Informal CE activities should be explored and considered for CE credit.