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... Likewise, although minimal required skills for entry-level physical therapists have been described (APTA, 2009), the anatomic content required to meet those skills is not defined. Further, no uniform international standard for entry-level PTE exists concerning the degree required, while the program types and lengths vary widely (WCPT, 2011;Moffat, 2012;Adam et al., 2013;FAP, 2016;Barradell, 2017;Shead et al., 2018). As a result, despite the long-standing history of including anatomy education within PTE, no consensus exists regarding how much is needed, what specific content should be included, or how anatomy should be taught (McKenzie and Gutierrez, 2007;Youdas et al., 2015;Shead et al., 2016Shead et al., , 2018Blum et al., 2020;Simons et al., 2022). ...
... To facilitate the discussion, the following threshold concepts are suggested as a starting point (Table 1), with recognition that these suggestions may not accurately capture the needs of all physical therapist educators worldwide due to variation in practice acts and legal rights of the profession (WCPT, 2011;Moffat, 2012;FAP, 2016;Barradell, 2017). However, knowing the unique nature of physical therapy practice allows for anatomy threshold concepts that are bounded in MST to be developed as a shared resource to anatomy educators. ...
This viewpoint proposes eight anatomy threshold concepts related to physical therapist education, considering both movement system theory and anatomical competence. Movement system theory provides classifications and terminology that succinctly identifies and describes physical therapy practice from a theoretical and philosophical framework. The cardiovascular, pulmonary, endocrine, integumentary, nervous, and musculoskeletal systems are all included within this schema as the movement system theory encompasses all body systems interacting to create movement across the lifespan. Implementing movement system theory requires an ability to use human anatomy in physical therapist education and practice. Understanding the human body is a mandatory prerequisite for effective diagnosis, assessment, treatment, and patient evaluation. Anatomical competence refers to the ability to apply anatomic knowledge within the appropriate professional and clinical contexts. Exploring the required anatomical concepts for competent entry‐level physical therapist education and clinical practice is warranted. The recommended threshold concepts (fluency, dimensionality, adaptability, connectivity, complexity, stability or homeostasis, progression or development, and humanity) could serve as an integral and long‐awaited tool for guiding anatomy educators in physical therapy education.
... We identified competencies for direct access practitioners that are in common with usual musculoskeletal physiotherapy practice, such as assessment, interventions, communication and professional development. These competencies are defined in the World Physiotherapy entry-level standards for autonomous practice, which include screening and referring patients to appropriate health care providers such as physicians(Policy Statement, n. d.-b;WCPT, 2011WCPT, , 2021 World Physiotherapy, 2022).Other models of care that improve the efficiency of the health care system and patient care, such as advanced practice ...
Introduction:
To optimise the management of Musculoskeletal disorders (MSKDs), many countries have implemented direct access to physiotherapy; however, the core competencies required for first contact physiotherapists (PTs) have not been precisely defined. The aim of this scoping review is to identify and describe the core competencies required for first contact PTs treating adults with MSKDs.
Methods:
We conducted a scoping review of the literature by searching eight databases and grey literature up to July 2023. We performed a thematic analysis of the competencies identified based on predefined themes relevant to first contact physiotherapy in direct access models in primary or emergency care settings.
Results:
Sixty-five articles were included. Seventeen core competencies were identified and grouped into 5 themes: (1) Assessment and examination; (2) Management and interventions; (3) Communication; (4) Cooperation and collaboration; and (5) Professionalism and leadership.
Conclusions:
Our findings provide an international perspective on the core competencies required for first contact PTs.
... There were no sex-based differences between any anatomy course grade sub-component (written examinations, quizzes, and practical examinations) in this study, which was different than the results of Bogomolova et al. (2022) where male students scored higher on an anatomy practical examination. This could be a unique characteristic of DPT students, due to their training around physical manipulation and surface anatomy (Paris, 2000;Jensen et al., 2017), or because gross anatomy is a prerequisite for physical therapy educational programs (WCPT, 2011). Another possible explanation as to why there were no sex-based grade differences, is that anatomy courses can serve as an indirect visual-spatial training as described by Vorstenbosch et al. (2013) and Langlois et al. (2020). ...
Predictors of academic success in anatomy have been studied, but not in Doctor of Physical Therapy (DPT) students. The objectives of this study were to (1) explore predictors of academic success in a DPT anatomy course, (2) evaluate sex‐based differences in the predictors of academic success and their influence on anatomy course grade, and (3) investigate the influence of the DPT anatomy course on visual–spatial ability. Forty‐nine DPT students completed a demographic questionnaire, Learning and Study Strategies Inventory (LASSI), and Mental Rotations Test (MRT) before the ten‐week anatomy course (MRT‐1) and repeated the MRT at the end of the course (MRT‐2). Anatomy course grade was determined based on quizzes and written and practical examinations. Multiple regression analysis showed significant associations between the predictor variables age (p = 0.010) and the LASSI anxiety subscale (p = 0.017), which measures anxiety coping, with the anatomy course grade. On the MRT‐1, male DPT students attempted and correctly answered more questions than females (both, p < 0.0001). Female students had higher LASSI self‐regulation and use of academic resources subscale scores (both, p < 0.05). In the 44 DPT students that completed the MRT‐2, the number of correct and attempted responses increased following the anatomy course (p < 0.0001). Age and anxiety coping, but not sex, are predictors of anatomy course grades in DPT students. Mental rotations test scores improved following the anatomy course. The LASSI should be used in other cohorts to identify students with low anxiety subscale scores in order to provide targeted support.
... were used to gather qualitative data on graduates' insights on EBP and their EBP education. Focus group method was used as it allowed for natural aspects of conversation to occur among participants who shared experiences regarding the same EBP education (Jackson, 1998;Wilkinson, 2004). Conversation exchanges enriched the data as responses from one participant triggered further responses from others. ...
Background and purpose:
Inclusion of evidence-based practice (EBP) in entry-level physical therapy (PT) curricula is meant to develop the necessary competencies for better EBP uptake in clinical practice. This study aimed to: 1) determine the practice, knowledge, and values for EBP of the graduates of an entry-level PT curriculum with EBP education; 2) compare graduates' EBP practice profile to their EBP knowledge and values; and 3) explore their views on their EBP education and how EBP education influenced their practice.
Methods:
A convergent parallel design was used to gather quantitative and qualitative data. The Evidence-based Practice Profile - 2 (EBP2) questionnaire was used for quantitative data. Focus group discussions and open-ended questions in the EBP2 were sources for qualitative data.
Results:
Seventy-seven completed the questionnaire and eight participated in focus group discussions. Participants scored highest for Relevance domain (standardized mean = 75.3) and lowest for Practice (standardized mean = 45.5). Three themes, 'Positive impact of EBP education,' 'Realities of PT clinical practice, and 'Strategies to improve EBP education' were derived. Data integration confirmed findings that graduates have good knowledge, value for, and confidence in doing EBP.
Discussion and conclusion:
Findings suggest that early EBP education led to adequate knowledge, confidence, and positive attitudes, but practice barriers hinder EBP uptake. The medical model of service delivery was identified as a factor that influences EBP use. There is a need to revisit the EBP education program to complement real-world demands.
... Since clinical education plays an important element in physiotherapy education, WCPT provides specific guideline for the physical therapy clinical education (WCPT, 2011e). The aim is to provide high quality clinical education, specifically for countries without physical therapy associations and appropriate education program. ...
Producing competent health workforce requires a robust assessment system to
validly measure graduates’ clinical competence. This study aimed to develop a valid
assessment tool to measure clinical competence at workplace and evaluate its effects on
clinical competence behaviors. A three-phase study was carried out using qualitative and
quantitative approaches. Phase 1 primarily focused on development of an assessment tool through narrative review, systematic review, Delphi technique and focus group discussion (FGD) with students. Phase 2, focused on validation of the assessment tool by examining response process validity from the users’ perspectives- students and clinical instructors (CIs). A 12-item questionnaire survey and FGD sessions was utilized to achieve this. Phase 3, implemented the assessment tool during a 4-week clinical placement, which produced data supporting internal structure, relation to other variables and consequences of the assessment tool. The qualitative data was thematically analyzed by coding protocol (open, axial and selective coding) while quantitative data by SPSS for descriptive statistics and reliability analysis. Phase 1, generated an assessment model guideline called CULTVATE and was used in designing a programmatic clinical portfolio (Pro-CP) as an assessment tool. Pro-CP consisted of Mini-CEX, DOPS and CREATE. The modifications made in phase 2 were 1) reduction of weekly caseloads to fortnightly due time factor, 2) modifications to the weekly and global rating scales, 3) increase training time, 4) provision of guideline for users 5) reduction of the assessment tool to pocket size. The modifications resulted in a revised assessment tool for phase 3, implementation. Feasibility study reported an acceptable completion time with ease of its use by CIs and students. High internal consistency of Pro-CP reported based on two clinical cases with Cronbach’s alpha value more than 0.8. Pearson correlation coefficient between Pro-CP and OSCE score was more
than 0.5, indicating moderate level predictive validity. Thematic analysis of FGD and in
depth interview data, generated 5 major themes related to perceived learning experience,
attitudinal change and behavioral change of the students. Theme related to perceived
learning experience was increased attitudinal behavior towards competence, with
categories relating to perceived assessment usefulness for learning and perceived ease of assessment use for learning. Theme related to attitudinal change was quality feedback
promotes clinical performance, promote student-centered learning and increased
perception of subjective norms towards competence development. Relevant categories
were task-level feedback improves clinical performance, application of constructive
feedback and normative believes towards Pro-CP. Theme related to behavioral change
were increased self-efficacy towards competence behavior, increased learning autonomy
towards competence behavior and need for institutional support. Categories were increased control belief towards behavior in practice, promote accountability towards learning autonomy, training and manpower resources, informing Pro-CP in curriculum and learning support. These qualitative results are evidence supporting Pro-CP’s consequential validity on learning experience, attitudinal and behavioral change. This study provided evidence to support validity of Pro-CP to content, response process, internal structure, relation to other variables and consequences. Hence, Pro-CP is a promising instrument that can be utilized by health professional educators to measure clinical competence of graduates
... Thus, professional competence has been related to practitioners' examination and assessment of patients, the provision of advice and guidance, the handling of manual therapies and therapeutic exercise, as well as to supporting clients in achieving optimal freedom of movement and the ability to function, and to promoting health and wellness using evidence-based knowledge. Having good communication skills and cultural competence as well as being able to consult other professionals are also regarded important in physiotherapy (see for example, ENPHE 2012; Larsson and Gard 2006;Lindquist et al. 2010;Thiele and Barraclough 2007;Ven and Vyt 2007;WCPT 2011;Włoszczak-Szubzda and Mirosław 2013). Furthermore, it has been emphasised that physiotherapists need to be versed in various special competencies, such as skills in chronic disease management, monitoring and making early referrals in addition to having disease-specific knowledge (Briggs et al. 2012). ...
A competence-oriented approach has recently emerged in higher education and thus far, not much attention has been paid to how “competence” itself is understood in education. The purpose of this study was to examine how graduating physiotherapy students perceive their competence at the end of their studies. The data comprised interviews with 33 graduating physiotherapy students. The data were analysed with the phenomenographic approach. The findings indicated that graduating students had different and wide-ranging conceptions of what competence in physiotherapy entails and what their own competence covers. The descriptive categories – mastering core skills, understanding the theoretical basis of physiotherapy, having a holistic view of physiotherapy, engaging in and developing multi-professional collaboration – varied hierarchically on the basis of seven themes. From a pedagogical point of view, four critical aspects were identified: focus of reflection, professional agency, cultural awareness and communication.
... Physical therapy training has evolved into a higher education program with courses at the undergraduate, graduate, and postgraduate levels. Aimed at shaping a critically thinking, evaluating physical therapist, training in scientific methods often begins in the very first semester and is expanded and deepened in following semesters, often culminating in an independent essay project in the advanced course in the final year [13,14]. There is widespread consensus among teachers concerning the importance of connections to research, but time and resource constraints can make this difficult to accomplish. ...
Movement and manual methods have always been the core of physical therapy practice. Since physical therapy is basically practical, this evokes the question of how well the field fits in with the scientific culture of higher education. The knowledge base of physical therapy should be based on science, supported in practice, and further methodically developed. The physical therapy performed within the health care system is shaped both by the professional community and by research findings. The aim of this study was to give a view on science in physical therapy professional practice and present aspects of difficulties to transfer research knowledge into clinical practice. Clinical practical skills and theoretical knowledge are both necessary components of physical therapy treatment. Physical therapists agree on the importance of research. Bringing science closer to clinical practice is required for the development of the physical therapy profession. However, there are barriers to incorporating research evidence into clinical practice, including lack of time and skills in searching for, and evaluating, research literature. This requires that the content of the educational programs is relevant and that sufficient time, understanding, and education are provided in clinical settings. The scientific basis in professional practice could further be strengthened through enhanced scientific skills and more easily accessible presentation of the research results. As yin and yang, research and professional practice should inter-relate to one another in a dynamic system and give rise to each other as an indivisible whole.
... Meeting the challenges of a competency-based framework and supporting these educational innovations require a robust faculty development program [5,6]. Although core competencies that are important for physiotherapists seem to be available [7][8][9] and the use ...
Introduction: Although there has been a shift towards competency-based medical education in the past decade, littlel iterature is available about the specific use of competency-based education in physiotherapy education. The purpose of this article is firstly to describe the development of a competency-based educational program for physiotherapy and secondly to present the results of the evaluation of the competency-based program by an independent panel of stakeholders.
Method: A role-based competency framework was gradually developed and implemented in a 5-year university-based physiotherapy education program leading to a Master of Science degree. A stakeholder panel was asked to which degree they agreed that the specified roles and competencies were important for physiotherapists.
Results: Competencies were defined for the roles of clinician, scientist and professional and linked to behavioural indicators, carefully checking that the model covered all Dublin descriptors. Although a vast majority of the stakeholder panel considered the proposed roles (92,8%) and competencies (100%) as a strong characteristic of the program, scientific competencies were generally considered less important than clinical or professional competencies.
Conclusions: Competencies of a role-based educational program for physiotherapy should be aligned with competencies expected in the professional field paying special attention to scientific competencies needed for evidence-based clinical practise and innovation of physiotherapy.
The physiotherapy profession and education have evolved aligned with over a century of worldwide historic moments, sociodemographic challenges, and advances in science and technology. The goal of this chapter is to describe future challenges in physiotherapy education, recognizing physiotherapists as allied health professionals with specific core competences, whose educational outcomes can be enhanced through active learning strategies integrated in a real context for practice, in a never ending continuous professional development leveraged by a lifelong learning experience.
Introduction: Physical therapy (PT) practice is expected to dynamically respond to the growing needs of older adults. Currently, there is paucity in meeting the demands of the aging Filipino population that may be linked to the status of undergraduate PT education. To date, there are no known systematically analyzed data that explores the breadth of geriatric content in the local BSPT programs. This study aimed to describe the integration of geriatric-related content in the pre-clinical and clinical entry-level PT curricula. Methods: Descriptive cross-sectional research design using survey instrumentation was conducted among heads and PT educators in higher educational institutions and healthcare institutions located in the National Capital Region, Philippines from December 2015 to March 2016. Results: Fifty-two responses from a total of 87 physical therapists were included in data analysis after screening. Many of the participants (>50%) determined that pre-clinical and clinical geriatric-related PT competencies were always (81-100% of the time) and often (61-80% of the time) taught. Among pre-clinical and clinical competencies, clinical attitudinal skills were the most taught. Clinical practical skills, pre-clinical practical skills, and pre-clinical knowledge competencies were never taught (0-20% of the time). Majority of the participants (93.3%) perceive the importance of integrating geriatric PT-related content in the curriculum but, only 65.8% perceive that the integration is sufficient. Discussion: The integration of geriatric-focused content on psychosocial changes with aging, multifactorial conditions, airway clearance techniques, use of best available evidence, interprofessional collaboration, and on clinical training is insufficient despite its importance. The incongruity may be influenced by lack of intentional exposure and role-modeling to students. The study findings should be interpreted with caution because of low sample size. Further research is recommended to understand the depth of integration of geriatric-related content in entry-level PT programs in the Philippines.
Introduction:
The use of physical agents in physical therapy (PT) requires clinical reasoning, as well as knowledge of their risks and contraindications; however, deficiencies may be observed when used in clinical practice.
Objective:
To implement the Objective Structured Clinical Evaluation (OSCE) method for the assessment of clinical skills among physical therapy specialty students when using physical agents.
Materials and methods:
A pilot, non-experimental, cross-sectional study was conducted in 114 physical therapy students enrolled during the first semester of 2019 in a physical agents course offered at the Universidad Andres Bello, Santiago, Chile. The OSCE consisted of 7 peer-validated stations, in which various skills were implemented in simulated clinical scenarios to achieve learning outcomes associated with the use of physical agents, namely: S1: connective tissue flexibility; S2: muscle relaxation; S3: analgesia; S4: drainage; S5: muscle strengthening; S6: parameter interpretation; and S7: equipment installation. Observers at each station assessed students' clinical skills and decision-making using a checklist. OSCE scores were described using medians and interquartile ranges, representing the data dispersion between the 25th and 75th percentile (P25-P75). Station scores by sex were compared using the Mann-Whitney U test.
Results:
Median scores were higher than the minimum passing score in stations S1 (66, IQR: 52-70), S2 (55, IQR: 45-60), S3 (60, IQR: 50-69), S4 (65, IQR: 55-73), and S7 (40, IQR: 33-45), but they were below the passing score in stations S5 (54, IQR:46-65) and S6 (10, IQR: 9-13). In addition, 101 (88.59%) students had a global passing score in the OSCE.
Conclusion:
The OSCE scores obtained by the participants show their attainment of clinical skills when using physical agents since most of them obtained a global passing score; however, reinforcing the clinical skills for parameter interpretation is necessary, considering that the lowest mean score was obtained in said station.
Adaptive learning platforms that individualize each learner's experience according to their input have only recently become widely accessible. This chapter illustrates some of the potential of adaptive learning platforms and describes a case study where this emerging technology has been used with physiotherapy students in a simulated clinical setting. Aspects of patient care scenarios presented with an adaptive learning platform were interleaved with live simulated patient interactions. Evaluation of the projects and the benefits and challenges of using adaptive learning platforms in biomedical education are discussed.
Prevalência de encaminhamentos às doenças
musculoesqueléticas segundo a classificação
estatística internacional de doenças (CID-10):
reflexões para formação do fisioterapeuta
na área de musculoesquelética.
Background and purpose:
Physiotherapists practicing at clinical placement sites assigned the role as clinical instructors (CIs), are responsible for supervising physiotherapy students. For CIs to role model evidence-based practice (EBP) they need EBP competence. The aim of this study was to assess the short and long term impact of a six-month multifaceted and clinically integrated training program in EBP on the knowledge, skills, beliefs and behaviour of CIs supervising physiotherapy students.
Methods:
We invited 37 CIs to participate in this non-randomized controlled study. Three self-administered questionnaires were used pre- and post-intervention, and at six-month follow-up: 1) The Adapted Fresno test (AFT), 2) the EBP Belief Scale and 3) the EBP Implementation Scale. The analysis approach was linear regression modeling using Generalized Estimating Equations.
Results:
In total, 29 CIs agreed to participate in the study: 14 were invited to participate in the intervention group and 15 were invited to participate in the control group. One in the intervention group and five in the control group were lost to follow-up. At follow-up, the group difference was statistically significant for the AFT (mean difference = 37, 95% CI (15.9 -58.1), p < 0.001) and the EBP Beliefs scale (mean difference = 8.1, 95% CI (3.1 -13.2), p = 0.002), but not for the EBP Implementation scale (mean difference = 1.8. 95% CI (-4.5-8.1), p = 0.574). Comparing measurements over time, we found a statistically significant increase in mean scores related to all outcome measures for the intervention group only.
Conclusions:
A multifaceted and clinically integrated training program in EBP was successful in improving EBP knowledge, skills and beliefs among CIs. Future studies need to ensure long-term EBP behaviour change, in addition to assessing CIs' abilities to apply EBP knowledge and skills when supervising students.
Aims/background:
Occupational therapy (OT) and physiotherapy (PT) curricula content and preparedness for work-related practice and occupational health and safety (OHS) are not well documented. This study aimed to identify content and other elements of entry-level curricula in 23 OT and 17 PT programmes from Australia and New Zealand, and to identify educators' perceptions of OT and PT graduates' preparedness for work-related practice and OHS topics.
Method:
A telephone survey collected curricula content as well as teaching and assessment methods from 19 OT and PT work-related practice educators. Educators reported perceptions of new graduate preparedness for 22 topics in the field of work-related practice identified in an earlier study. Results included descriptive statistics and thematic analyses.
Findings:
Educators reported a high rate of inclusion (81%) of work-related practice topics in curricula. The main teaching method was theory (99.5%) and other methods included hands-on practical work with students and fieldwork with clients. Educators reported similar assessment processes across programmes. New graduates were prepared for practice with minimal supervision in the majority of topics (81%).
Conclusions:
Work-related practice content was included strongly and consistently in OT and PT entry-level curricula. However, as the majority of content was embedded in other courses, topics may not have been explicit and identifiable to students. New graduates were perceived to be prepared for practice with minimal supervision. This finding will assist employers to understand new graduates' preparedness for practice and needs for further development. Preparedness for practice in this field was similar to expectations of preparedness for other practice areas.
Evidence-based practice (EBP) is spreading in popularity in many health care disciplines. One of its main features is the reliance on the partnership among hard scientific evidence, clinical expertise, and individual patient needs and choices. Librarians play an important role in the spread of EBP because of the importance of identifying and retrieving appropriate literature from various sources for use in making health care decisions. This article gives an overview of how to search for therapy, diagnosis, etiology, and prognosis both for original studies and secondary publications such as systematic reviews, meta-analyses, and clinical practice guidelines. Understanding how this research is done, how it is indexed, and how to retrieve the clinical evidence are an important set of skills that librarians can provide for clinicians interested in EBP