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Montpetit-Tourangeau K, Diaz-Arenales AS, Dyer JO, Rochette A. The Black Box of Patient Education: An Expert Consultation on Patient Education Interventions and Strategies for the Management of Subacromial Pain Syndrome. Physiother Can 2023; 75:215-232. [PMID: 37736407 PMCID: PMC10510546 DOI: 10.3138/ptc-2022-0123] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2022] [Accepted: 04/25/2023] [Indexed: 09/23/2023]
Abstract
Purpose To identify patient education, interventions, and strategies to optimize the management of subacromial pain syndrome (SAPS) in physical therapy, based on the experiential knowledge of patient-partners and caregivers involved in the rehabilitation of this condition. Method Using a semi-deductive approach building on the evidence extracted from the literature, an expert consultation using focus groups was conducted. The experts were physical therapists (n = 5) and an occupational therapist with extensive clinical experience, as well as a patient-partner. Analysis followed the Framework method. Results Two main themes emerged: (1) interventions directly related to patient education, consisting of nine sub-themes, including symptom self-management and pain phenomenon, and (2) patient education strategies to broadly frame the interventions, consisting of 10 sub-themes, including educational materials and clinical teaching approaches. Conclusion The consultation confirmed and expanded the knowledge from the literature by adding knowledge that emerged from the experts' practical experience. It resulted in the development of preliminary statements on structured patient education interventions and management strategies for SAPS. These emerging statements are, to our knowledge, the first to inform patient education specifically as it relates to the management of SAPS taking into account psychosocial and contextual factors.
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Affiliation(s)
- Katherine Montpetit-Tourangeau
- From the:
School of Rehabilitation, University of Montreal, Montreal, Canada
- Centre for Interdisciplinary Research in Rehabilitation, Montreal, Canada
| | | | - Joseph-Omer Dyer
- From the:
School of Rehabilitation, University of Montreal, Montreal, Canada
- Interdisciplinary Research Group in Cognition and Professional Reasoning, Center for Applied Pedagogy in Health Sciences, University of Montreal, Montreal, Canada
| | - Annie Rochette
- From the:
School of Rehabilitation, University of Montreal, Montreal, Canada
- Centre for Interdisciplinary Research in Rehabilitation, Montreal, Canada
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Montpetit-Tourangeau K, Kairy D, Ahmed S, Anaby D, Bussières A, Lamontagne MÈ, Rochette A, Shikako-Thomas K, Thomas A. A strategic initiative to facilitate knowledge translation research in rehabilitation. BMC Health Serv Res 2020; 20:973. [PMID: 33097043 PMCID: PMC7585309 DOI: 10.1186/s12913-020-05772-8] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2020] [Accepted: 09/29/2020] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND While there is a growing body of literature supporting clinical decision-making for rehabilitation professionals, suboptimal use of evidence-based practices in that field persists. A strategic initiative that ensures the relevance of the research and its implementation in the context of rehabilitation could 1) help improve the coordination of knowledge translation (KT) research and 2) enhance the delivery of evidence-based rehabilitation services offered to patients with physical disabilities. This paper describes the process and methods used to develop a KT strategic initiative aimed at building capacity and coordinating KT research in physical rehabilitation and its strategic plan; it also reports the initial applications of the strategic plan implementation. METHODS We used a 3-phase process consisting of an online environmental scan to identify the extent of KT research activities in physical rehabilitation in Quebec, Canada. Data from the environmental scan was used to develop a strategic plan that structures KT research in physical rehabilitation. Seven external KT experts in health science reviewed the strategic plan for consistency and applicability. RESULTS Sixty-four KT researchers were identified and classified according to the extent of their level of involvement in KT. Ninety-six research projects meeting eligibility criteria were funded by eight of the fourteen agencies and organizations searched. To address the identified gaps, a 5-year strategic plan was developed, containing a mission, a vision, four main goals, nine strategies and forty-two actions. CONCLUSION Such initiatives can help guide researchers and relevant key stakeholders, to structure, organize and advance KT research in the field of rehabilitation. The strategies are being implemented progressively to meet the strategic initiative's mission and ultimately enhance users' rehabilitation services.
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Affiliation(s)
- Katherine Montpetit-Tourangeau
- School of Rehabilitation, Faculty of Medicine, Université de Montréal, P.O. Box 6128, Station Centre-Ville, Montreal, Quebec, H3C 3J7, Canada. .,Centre for Interdisciplinary Research in Rehabilitation, Montreal, Quebec, Canada.
| | - Dahlia Kairy
- School of Rehabilitation, Faculty of Medicine, Université de Montréal, P.O. Box 6128, Station Centre-Ville, Montreal, Quebec, H3C 3J7, Canada.,Centre for Interdisciplinary Research in Rehabilitation, Montreal, Quebec, Canada
| | - Sara Ahmed
- Centre for Interdisciplinary Research in Rehabilitation, Montreal, Quebec, Canada.,School of Physical and Occupational Therapy, Faculty of Medicine and Health Sciences, McGill University, 3654 Sir William Osler, Montreal, Quebec, H3G 1Y5, Canada.,Department of Epidemiology, Biostatistics, and Occupational Health, McGill University, 1020 Pine Avenue West, Montreal, Quebec, H3A 1A2, Canada
| | - Dana Anaby
- Centre for Interdisciplinary Research in Rehabilitation, Montreal, Quebec, Canada.,School of Physical and Occupational Therapy, Faculty of Medicine and Health Sciences, McGill University, 3654 Sir William Osler, Montreal, Quebec, H3G 1Y5, Canada.,CanChild Centre for Childhood Disability Research, McMaster University, 1400 Main Street West, Room 408, Hamilton, Ontario, L8S 1C7, Canada
| | - André Bussières
- Centre for Interdisciplinary Research in Rehabilitation, Montreal, Quebec, Canada.,School of Physical and Occupational Therapy, Faculty of Medicine and Health Sciences, McGill University, 3654 Sir William Osler, Montreal, Quebec, H3G 1Y5, Canada.,Département Chiropratique, Université du Québec à Trois-Rivières, 3351, boul. Des Forges, C. P. 500, Trois-Rivières, Quebec, G9A 5H, Canada
| | - Marie-Ève Lamontagne
- Département de réadaptation, Université Laval, Quebec, Quebec, G1V 0A6, Canada.,Center for Interdisciplinary Research in Rehabilitation and Social Integration, Institut de Réadaptation en Déficience Physique de Québec, 525 Boul Wilfrid-Hamel, Quebec, Quebec, G1M 2S8, Canada
| | - Annie Rochette
- School of Rehabilitation, Faculty of Medicine, Université de Montréal, P.O. Box 6128, Station Centre-Ville, Montreal, Quebec, H3C 3J7, Canada.,Centre for Interdisciplinary Research in Rehabilitation, Montreal, Quebec, Canada
| | - Keiko Shikako-Thomas
- Centre for Interdisciplinary Research in Rehabilitation, Montreal, Quebec, Canada.,School of Physical and Occupational Therapy, Faculty of Medicine and Health Sciences, McGill University, 3654 Sir William Osler, Montreal, Quebec, H3G 1Y5, Canada.,CanChild Centre for Childhood Disability Research, McMaster University, 1400 Main Street West, Room 408, Hamilton, Ontario, L8S 1C7, Canada
| | - Aliki Thomas
- Centre for Interdisciplinary Research in Rehabilitation, Montreal, Quebec, Canada.,School of Physical and Occupational Therapy, Faculty of Medicine and Health Sciences, McGill University, 3654 Sir William Osler, Montreal, Quebec, H3G 1Y5, Canada.,Institute of Health Sciences Education, Faculty of Medicine and Health Sciences, McGill University, 1110 Pine Avenue West, Montreal, Quebec, H3G 1A3, Canada
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Montpetit-Tourangeau K, Dyer JO, Hudon A, Windsor M, Charlin B, Mamede S, van Gog T. Fostering clinical reasoning in physiotherapy: comparing the effects of concept map study and concept map completion after example study in novice and advanced learners. BMC Med Educ 2017; 17:238. [PMID: 29191189 PMCID: PMC5709960 DOI: 10.1186/s12909-017-1076-z] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/08/2016] [Accepted: 11/16/2017] [Indexed: 05/31/2023]
Abstract
BACKGROUND Health profession learners can foster clinical reasoning by studying worked examples presenting fully worked out solutions to a clinical problem. It is possible to improve the learning effect of these worked examples by combining them with other learning activities based on concept maps. This study investigated which combinaison of activities, worked examples study with concept map completion or worked examples study with concept map study, fosters more meaningful learning of intervention knowledge in physiotherapy students. Moreover, this study compared the learning effects of these learning activity combinations between novice and advanced learners. METHODS Sixty-one second-year physiotherapy students participated in the study which included a pre-test phase, a 130-min guided-learning phase and a four-week self-study phase. During the guided and self-study learning sessions, participants had to study three written worked examples presenting the clinical reasoning for selecting electrotherapeutic currents to treat patients with motor deficits. After each example, participants engaged in either concept map completion or concept map study depending on which learning condition they were randomly allocated to. Students participated in an immediate post-test at the end of the guided-learning phase and a delayed post-test at the end of the self-study phase. Post-tests assessed the understanding of principles governing the domain of knowledge to be learned (conceptual knowledge) and the ability to solve new problems that have similar (i.e., near transfer) or different (i.e., far transfer) solution rationales as problems previously studied in the examples. RESULTS Learners engaged in concept map completion outperformed those engaged in concept map study on near transfer (p = .010) and far transfer (p < .001) performance. There was a significant interaction effect of learners' prior ability and learning condition on conceptual knowledge but not on near and far transfer performance. CONCLUSIONS Worked examples study combined with concept map completion led to greater transfer performance than worked examples study combined with concept map study for both novice and advanced learners. Concept map completion might give learners better insight into what they have and have not yet learned, allowing them to focus on those aspects during subsequent example study.
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Affiliation(s)
- Katherine Montpetit-Tourangeau
- School of Rehabilitation, Faculty of Medicine, Université de Montréal, P.O. Box 6128, Station Centre-Ville, Montreal, QC H3C 3J7 Canada
- Centre for Interdisciplinary Research in Rehabilitation of Greater Montreal (CRIR), Montreal, Canada
| | - Joseph-Omer Dyer
- School of Rehabilitation, Faculty of Medicine, Université de Montréal, P.O. Box 6128, Station Centre-Ville, Montreal, QC H3C 3J7 Canada
- Centre de pédagogie appliquée aux sciences de la santé (CPASS), Université de Montréal, Montreal, QC Canada
| | - Anne Hudon
- School of Rehabilitation, Faculty of Medicine, Université de Montréal, P.O. Box 6128, Station Centre-Ville, Montreal, QC H3C 3J7 Canada
- Centre for Interdisciplinary Research in Rehabilitation of Greater Montreal (CRIR), Montreal, Canada
| | - Monica Windsor
- School of Rehabilitation, Faculty of Medicine, Université de Montréal, P.O. Box 6128, Station Centre-Ville, Montreal, QC H3C 3J7 Canada
| | - Bernard Charlin
- Centre de pédagogie appliquée aux sciences de la santé (CPASS), Université de Montréal, Montreal, QC Canada
- Department of Neurology, Montreal General Hospital, Montreal, QC Canada
| | - Sílvia Mamede
- Institute of Medical Education Research Rotterdam, Erasmus Medical Center, Rotterdam, The Netherlands
- Department of Psychology, Erasmus University Rotterdam, Rotterdam, The Netherlands
| | - Tamara van Gog
- Department of Psychology, Erasmus University Rotterdam, Rotterdam, The Netherlands
- Department of Education, Utrecht University, Utrecht, The Netherlands
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Dyer JO, Hudon A, Montpetit-Tourangeau K, Charlin B, Mamede S, van Gog T. Example-based learning: comparing the effects of additionally providing three different integrative learning activities on physiotherapy intervention knowledge. BMC Med Educ 2015; 15:37. [PMID: 25889066 PMCID: PMC4414367 DOI: 10.1186/s12909-015-0308-3] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/22/2014] [Accepted: 02/13/2015] [Indexed: 05/04/2023]
Abstract
BACKGROUND Example-based learning using worked examples can foster clinical reasoning. Worked examples are instructional tools that learners can use to study the steps needed to solve a problem. Studying worked examples paired with completion examples promotes acquisition of problem-solving skills more than studying worked examples alone. Completion examples are worked examples in which some of the solution steps remain unsolved for learners to complete. Providing learners engaged in example-based learning with self-explanation prompts has been shown to foster increased meaningful learning compared to providing no self-explanation prompts. Concept mapping and concept map study are other instructional activities known to promote meaningful learning. This study compares the effects of self-explaining, completing a concept map and studying a concept map on conceptual knowledge and problem-solving skills among novice learners engaged in example-based learning. METHODS Ninety-one physiotherapy students were randomized into three conditions. They performed a pre-test and a post-test to evaluate their gains in conceptual knowledge and problem-solving skills (transfer performance) in intervention selection. They studied three pairs of worked/completion examples in a digital learning environment. Worked examples consisted of a written reasoning process for selecting an optimal physiotherapy intervention for a patient. The completion examples were partially worked out, with the last few problem-solving steps left blank for students to complete. The students then had to engage in additional self-explanation, concept map completion or model concept map study in order to synthesize and deepen their knowledge of the key concepts and problem-solving steps. RESULTS Pre-test performance did not differ among conditions. Post-test conceptual knowledge was higher (P < .001) in the concept map study condition (68.8 ± 21.8%) compared to the concept map completion (52.8 ± 17.0%) and self-explanation (52.2 ± 21.7%) conditions. Post-test problem-solving performance was higher (P < .05) in the self-explanation (63.2 ± 16.0%) condition compared to the concept map study (53.3 ± 16.4%) and concept map completion (51.0 ± 13.6%) conditions. Students in the self-explanation condition also invested less mental effort in the post-test. CONCLUSIONS Studying model concept maps led to greater conceptual knowledge, whereas self-explanation led to higher transfer performance. Self-explanation and concept map study can be combined with worked example and completion example strategies to foster intervention selection.
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Affiliation(s)
- Joseph-Omer Dyer
- School of Rehabilitation, Faculty of Medicine, Université de Montréal, P.O. Box 6128, Station Centre-Ville, Montreal, QC, H3C 3J7, Canada.
- Centre de pédagogie appliquée aux sciences de la santé (CPASS), Université de Montréal, Montréal, QC, Canada.
| | - Anne Hudon
- School of Rehabilitation, Faculty of Medicine, Université de Montréal, P.O. Box 6128, Station Centre-Ville, Montreal, QC, H3C 3J7, Canada.
- Centre for Interdisciplinary Research in Rehabilitation of Greater Montreal (CRIR), Montreal, QC, Canada.
| | - Katherine Montpetit-Tourangeau
- School of Rehabilitation, Faculty of Medicine, Université de Montréal, P.O. Box 6128, Station Centre-Ville, Montreal, QC, H3C 3J7, Canada.
| | - Bernard Charlin
- Centre de pédagogie appliquée aux sciences de la santé (CPASS), Université de Montréal, Montréal, QC, Canada.
- Department of Neurology, Montreal General Hospital, Montreal, QC, Canada.
| | - Sílvia Mamede
- Institute of Medical Education Research Rotterdam, Erasmus Medical Center, Rotterdam, The Netherlands.
- Department of Psychology, Erasmus University Rotterdam, Rotterdam, The Netherlands.
| | - Tamara van Gog
- Department of Psychology, Erasmus University Rotterdam, Rotterdam, The Netherlands.
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