Introducing Simulation Based Learning Activities to Physiotherapy Course Curricula

Simulation-based learning (SBL) activities in the health sciences provide students with opportunities to interact with realistic patients and environments. This study aimed to develop and then implement a novel activity using simulation for a large group of mostly millennial physiotherapy students, to enhance their ability to communicate with a challenging patient and to assess their motivation to learn. Students enrolled in asecond-year communicationunit were invited to participate in a non-compulsory uniqueSBL activity in groups offour for 40minutes, undertaking two 5-minute simulation scenarios and twodebriefing sessions. On completion of the activity, 140 students scored their motivation to learn during the activity using the Instructional Materials Motivation Scale (IMMS) questionnaire. Of the physiotherapy students enrolled in the unit, 83percent took part in the SBL and 100percent of the participants completed the follow-up survey. Mean scores for each subscale ranged from 3.8 to 4.0, reflecting that students agreed more than moderately with the statements made in the scale. The median total IMMS score for all students was 149, well above the published median total score of the scale (108). Simulation-based learning activities provide students with opportunities to interact withrealistic patients and environments DISCUSSION: The SBL activity model was successfully implemented and received positively by the students in terms of their motivation to learn. It gained the attention of participants by providing an opportunity to practise the non-technical skill of 'communicating with patients', previously learned in the classroom, in a simulated realistic environment and by using a design that seemed to consider the needs of the millennial generation.

IntroductionDevelopment of clinical reasoning (CR) is a critical skill for physical therapy (PT) students. A consensus of the most effective way to teach CR is lacking. The purpose of this study was to identify educational methods that PT education programs in the United States and abroad are utilising to develop CR skills and compare the effectiveness of those methods.MethodsPreferred Reporting Items for Systematic Review (PRISMA) guidelines were followed. A literature search was conducted in September 2021 and March 2022 in the following databases: PubMed, CINAHL, Health Source: Nursing/Academic Edition, and Academic Search Ultimate (EBSCO). Articles that investigated instructional methods used to teach and measure CR in PT students were included. Data extracted included instructional method details and results of outcome measures used to assess CR.ResultsOf 324 articles, 12 met eligibility. Instructional methods included simulated patients (n = 3), case activities (n = 6), patient care activities (n = 2), and curriculum design considerations (n = 2). Results suggested that CR performance improved with all but was better when students worked in dyads or groups (n = 3). A variety of outcome measures were used to assess CR, the majority relying on student self-assessment of CR skills.ConclusionsThis systematic review illustrates great variety in the methods used to teach and measure CR in PT education, all of which resulted in improved CR. Further research comparing the effectiveness of teaching methods and the reliability and validity of outcome measures of CR is needed.

Introduction. Clinical reasoning is a multifaceted skill set crucial to optimal patient care. The ability to assess development of clinical reasoning skills in entry-level physical therapist students continues to be challenging. The Clinical Reasoning Assessment Tool (CRAT) was developed in order to assess students' progress in the essential link between clinical reasoning and the development of knowledge. Based on a previously published tool (Clinical Reasoning Grading Rubric), the CRAT considers 3 domains representing clinical reasoning and knowledge development (content knowledge, procedural knowledge and psychomotor skills, and conceptual reasoning). The purpose of this study was to determine whether the use of the CRAT would reliably reflect student progress in acquisition and application of clinical reasoning skills across didactic and clinical components of physical therapist education and to determine whether case context impacts performance. Methods. A cross-sectional study was performed using the CRAT to assess student performance at 4 specific time points across 2 years of a physical therapy curriculum. Fifty-five students from 2 consecutive class cohorts were assessed using the CRAT. Eleven assessors scored 172 completed tools using a visual analog scale representing a learner continuum (beginner, intermediate, competent, and proficient). Analysis of variance (ANOVA) was used to determine whether time and case context were predictors of performance in each of the 3 clinical reasoning domains. Results. Mean scores in each of the 3 domains steadily increased at each performance assessment point, and results of the ANOVA showed that each specified time point was significantly predictive of performance in each of the 3 domains of interest (P < .0001 for each). In addition, case context is predictive of procedural knowledge (P = .007) and conceptual reasoning (P = .0297). Discussion and Conclusions. The results of this study, and observations related to use of the tool, demonstrate the utility of the CRAT in measuring the performance of physical therapy students.

The purpose of this study was to examine the existence of preprofessional stereotypes in physical therapy (PT) and occupational therapy (OT) students at an urban midwestern university. Forty-two junior PT students and 42 junior OT students completed the Health Team Stereotyping Scale (HTSS) as a self-administered survey questionnaire. The students' total and individual word-pair scores on the HTSS were then compared. The first comparison, between the PT students' and the OT students' views of the PT profession, indicated that the PT students' assessment of the PT profession was more positive than that of the OT students. The second comparison, between the OT students' and the PT students' views of the OT profession, indicated that the OT students' perception of the OT profession was more positive than that of the PT students. Each student group chose both positive and negative descriptors for the other group. Some positive adjectives chosen by the OT students to describe PT students were "proud," "passive," and "precise." The PT students chose "casual" and "intentional" to positively describe OT students. Some negative adjectives chosen by the OT students to describe PT students were "overrated," "competitive," and "strict." The PT students described OT students as "passive," "dull," and "narrow." Both groups thought the other group was conventional and conservative. Awareness of the existence of positive and negative stereotypes may influence behaviors in preprofessional and professional environments.

Neck pain and headaches are highly prevalent, often presenting a challenge for physiotherapists when considering differential diagnoses. For guidance, the International Federation of Manual and Musculoskeletal Physical Therapists (IFOMPT) created the International IFOMPT Cervical Framework. Its purpose is to improve clinical reasoning through various functional objectives and design principles. Although the Cervical Framework supports clinical reasoning among physiotherapy students, how this is achieved is unexplored. 1. To explore physiotherapy students' perceptions of how the Cervical Framework's functional objectives influence their clinical reasoning. 2. To explore physiotherapy students' perceptions of how the Cervical Framework's design principles influence their clinical reasoning. Qualitative, constructivist, exploratory, single-case study. Semi-structured interviews of physiotherapy students enrolled in one of three educational programs at one university were conducted. Directed qualitative content analysis informed by the Cervical Frameworks' functional objectives and design principles was used to interpret data. From eighteen participants, meaningful data were found for all functional objectives, with particular value when informing clinical reasoning during assessment and improving understanding of risk. Students showed mixed perceived value in informing clinical reasoning during treatment and facilitating patient-centred practice. Physiotherapy students' perceptions of the Cervical Framework align with most of its design principles, especially its informative, simple, and non-prescriptive nature. Students also perceived the Cervical Framework as long and this may have affected engagement. Physiotherapy students in this case study perceive the Cervical Framework to influence their clinical reasoning by achieving its functional objectives and by successfully adhering to its design principles.

BackgroundClinical reasoning is a critical skill for physical therapy (PT) students to provide effective care. This study aimed to assess the reliability, internal consistency, and construct validity of the Arabic version of the Self-Assessment of Clinical Reflection and Reasoning (SACRR) questionnaire in physical therapy students at Majmaah University.Materials and MethodsA quasi-experimental, non-randomized design was employed, with 76 students divided into three groups: intern (n = 19), pre-clinical (n = 21), and post-clinical (n = 36). Pretest and posttest assessments were conducted. Internal consistency of the Arabic version of the SACRR was analyzed using Cronbach’s alpha coefficient. Statistical analyses were performed using SPSS 19.0.ResultsThe mean age was 22.8 ± 1.3 years, 58 (76.3%) were females, and 18 (23.7%) were males. Significant differences were found between pretest and posttest SACRR scores for Items 7–11 and 14–26 (P<0.05), with mean score increasing from 109.36 ± 11.41 to 116.95 ± 7.40 (P<0.0001). Cronbach’s alpha values indicated strong internal consistency: pretest α = 0.915 and posttest α = 0.860.ConclusionClinical exposure improved clinical reasoning skills among physical therapy students, highlighting the importance of clinical education in healthcare curricula. The Arabic version of the SACRR questionnaire demonstrated good reliability for assessing clinical reasoning skills in this population. Further studies are warranted to validate the SACRR questionnaire in diverse cultural and linguistic contexts, as well as to validate the tool across different cultures and healthcare disciplines.

IntroductionThe ability to utilize the electronic health record (EHR) without compromising the doctor-patient relationship (DPR) is an essential skill of all physicians and trainees, yet little time is spent on educating or assessing learners on needed techniques. To address this gap, we developed a conventional OSCE station coupled with a simulated patient chart within the Epic program in order to assess our students' skills utilizing the EHR during a patient encounter.MethodsOf third-year medical students, 119 were given full access to the patient's simulated chart 24 hours in advance of their OSCE to review clinical data. During an in-person OSCE with a standardized patient (SP), students performed a focused history and physical, using the EHR to verify allergies and medications. Students completed an electronic patient note graded by faculty. SPs evaluated the students on communication and interpersonal skills with specific rubric elements. Faculty graded the students' notes to evaluate their expression of clinical reasoning in the assessment and plan.ResultsTraining SPs and faculty to assess students on EHR skills was feasible. After implementation of a comprehensive curriculum focused on EHR and DPR, there was a significant difference on EHR-related communication skills (M = 76.4, SD = 17.6) versus (M = 37, SD = 28.9) before curriculum enhancement t (117.9) = −12.4, p <.001.DiscussionThe EHR OSCE station provided a standardized method of assessing students' EHR skills during a patient encounter. Challenges still exist in the technological requirements to develop and deliver cases in today's EHR platform.

Can physiotherapy students develop and portray simulated patients authentically to their peers during an activity aimed at improving communication skills? A mixed methods study

The education of physiotherapists is disengaged from social control, which is one of the principles of the Brazilian public healthcare system. Social control ensures the participation of the population in the planning and monitoring of the public healthcare system and depends on qualified professionals. Thus, the aim of the present study was to investigate how training in social control occurs in undergraduate physiotherapy courses at public higher education institutions in the state of São Paulo, Brazil. Five teaching staff members were interviewed and six teaching projects were analyzed from a total sample of six public higher education institutions in the state of São Paulo using a qualitative method. The physiotherapy curriculum at Brazilian higher education institutions is based on the national curricular guidelines. However, these guidelines have gaps in the curricular guidance related to social control in terms of ensuring consistent training throughout the course, practical experiences, and a sufficient workload. To overcome barriers to training in social control, there is a need for the qualification of teaching staff, the adoption of skill-based education, the strengthening of social control, and a human resource policy favoring the hiring of physiotherapists in the Brazilian public healthcare system. Training in social control in physiotherapy courses at higher education institutions remains a challenge, considering the complex skills involved and the requirement of curricular changes. The present study only analyzed public educational institutions in the state of São Paulo, Brazil.

Introduction: Stress is the result of a set of disorders that occur on a daily basis, causing an irregularity in the individual's homeostasis. Entering the academic environment brings with it various divergent situations that can culminate in a possible appearance or increase in stress, bringing changes in the emotional state due to the more intense pace of life, learning difficulties, and a decline in academic performance. Aim: To carry out a comparative study on perceived stress among Physiotherapy and Law students at the Centro Universitário de Caratinga (UNEC) - Nanuque Campus. Methodology: This is a quantitative, exploratory and descriptive study, in which the presence of stress was studied and analyzed among Physiotherapy and Law students from the 1st and 9th periods enrolled at the UNEC - Nanuque Campus, using a structured and validated questionnaire that assessed the students' level of stress. Results: Composed of 107 students from the Physiotherapy and Law courses from the 1st and 9th periods, the sample identified that in both courses more than 50% of the students showed medium stress, the Physiotherapy course showed higher levels of stress than the Law course and when compared by gender between the courses, women showed a higher level of stress than men. Conclusion: The study highlighted the possible reasons for increased stress in students, showing that it can negatively affect some aspects of social and academic life, and that attitudes are needed to minimize damage and possible stressors.

BackgroundAlthough challenging to integrate within university curricula, evidence suggests that interprofessional education (IPE) positively impacts communication and teamwork skills in the workplace. The nature of Team-based learning (TBL) lends itself to interprofessional education, with the capacity to foster a culture of collaboration among health professional students. Our study was designed to pilot an interprofessional ‘back pain’ TBL module for physiotherapy and medical students, and to explore their experience of the TBL process, using the conceptual framework of ‘knowledge reconsolidation’ to discuss our finding.MethodsThree hundred and eleven students participated in the TBL session: 222/277 (80%) of Year 1 medical students and 89/89 (100%) of Year 2 physiotherapy students. Students completed one interprofessional Musculoskeletal Sciences TBL session on the topic of ‘back pain’. A questionnaire including closed and open-ended items, was distributed to students immediately following completion of the TBL session. Descriptive statistics were used to analyse the quantitative data. Thematic analysis was used to code and categorise qualitative data into themes. Pre-class quiz scores were compared between the groups using a one-way between groups Analysis of Variance (ANOVA) test with Tukeys Post Hoc test.ResultsIn total, 117/311 (38%) of participants completed the questionnaire. Both medicine and physiotherapy students appreciated the opportunity to learn about the curriculum of another healthcare discipline, and their scope of practice; gain multiple perspectives on a patient case from different disciplines; and recognised the importance of multidisciplinary teams in patient care. Students felt having an interprofessional team of facilitators who provided immediate feedback helped to consolidate student learning and promoted clinical reasoning. An analysis of variance revealed no difference between Physiotherapy and Medical students’ pre-class quiz scores.ConclusionOur study demonstrated that the small group and task-focused characteristics of TBL provided a student-centred teaching strategy to support the achievement of interprofessional learning goals. Students valued their interactions with other students from a different professional degree, the opportunity to problem solve together, and learn different perspectives on a patient case. The pre-class quiz results demonstrate that both groups of students had a comparative level of prior knowledge to be able to work together on the in-class activities.

ObjectivesPatients do better in research-intense environments. The importance of research is reflected in the accreditation requirements of Australian clinical specialist colleges. The nature of college-mandated research training has not been...

It is suggested that 80% of people attending the emergency department following an unexplained fall have possible vestibular dysfunction. However, patients have limited access to clinicians trained in vestibular assessment and rehabilitation. To date, no studies have investigated pre-registration physiotherapy vestibular education in the United Kingdom (U.K.). This research uses an online mixed-method survey to investigate U.K. physiotherapy students’ perceptions of their ability to assess and treat vestibular pathology. A multi-modal internet recruitment strategy was employed to elicit responses from final-year U.K. physiotherapy students (73). Findings indicate that students feel ‘not at all’ confident in vestibular assessment (64%), diagnosis (85%), and management (70%). Qualitatively, students suggest a need for increased pre-registration vestibular training, and a desire to seek further vestibular education. With students reporting a desire to develop their knowledge in this area, it is logical to suggest that more attention is dedicated to vestibular education in U.K. physiotherapy curricula. This article was published open access under a CC BY licence: https://creativecommons.org/licences/by/4.0 .

PurposeAlternative flexible (Flex) path Doctor of Physical Therapy (DPT) programs may have an emerging footprint. The differences between Flex and traditional residential DPT program clinical experience outcomes remain unknown. The purpose of this study was to evaluate Flex and residential DPT students’ clinical reasoning self-efficacy, confidence with treating, and Clinical Performance Instrument (CPI) clinical reasoning and summative scores during clinical experiences.MethodsA descriptive and exploratory cross-sectional survey was used with a voluntary convenience sample of 211 university DPT students during Fall 2020 full-time clinical experiences. Descriptive and inferential statistics evaluated differences in Flex and residential DPT program students’ (1) Physical Therapist Self-Efficacy (PTSE) scale scores, (2) confidence with treating initial and subsequent same-patient visits, and (3) final CPI clinical reasoning and summative scores during clinical experiences.ResultsMean PTSE scores were significantly lower for Flex (x̄ = 14.2) compared to residential DPT students (x̄ = 15.2) (P < 0.05). No significant student differences were found in (1) Flex (x̄ = 2.1) and residential (x̄ = 2.2) confidence with treating at the initial visit (P = 0.59), (2) Flex (x̄ = 2.8) and residential (x̄ = 3.0) confidence with treating subsequent same-patient visits (P = 0.15), and (3) Flex (x̄ = 15.8) and residential (x̄ = 16.5) CPI clinical reasoning (P = 0.17), and (4) Flex (x̄ = 16.1) and residential (x̄ = 16.7) CPI summative scores (P = 0.21).ConclusionClinical reasoning self-efficacy among Flex DPT students was lower, but there was no difference in CPI clinical reasoning or summative results between Flex and residential DPT students. In the university investigated, the Flex distance learning DPT program curriculum appeared effective in preparing students’ clinical reasoning readiness for the available full-time clinical experiences. We recommend academic institutions consider expanding Flex entry-level DPT program availability options because the outcomes were comparable. Additional flex entry programs may help address the underrepresentation of nontraditional students in entry-level DPT programs and societal demands for physical therapy services.

Interprofessional education aims to prepare students in health professional programmes for collaborative practice. Because of its ubiquity in healthcare, clinical reasoning can be used as a vehicle for designing interprofessional education initiatives. However, little is known about how design features of interprofessional education initiatives involving clinical reasoning are experienced by students from different professions. This evaluation study aimed to identify design features from feedback provided by students from two health professions after participating in an interprofessional education workshop involving clinical reasoning. Content analysis was used to analyse written responses from 88 fourth-year undergraduate medicine and physiotherapy students (80% response rate). Eight design features were identified and three of them were represented disproportionately when professions were compared. More medicine students requested practice presenting cases, whereas more physiotherapy students suggested emphasis on management reasoning and expressed appreciation for exchanging professional perspectives and working collaboratively. Features common to both groups of students were requests for a greater focus on case discussions, guidance about how to think about case information, explanations about how to apply knowledge to the cases, more demonstrations of how experienced clinicians think, and opportunities to learn how to be open to possibilities and consider the bigger picture. These insights can be used by educators when they design interprofessional education initiatives featuring clinical reasoning.