Physiotherapy Work Readiness: has integrated problem based learning made a difference? Ms Kay Skinner and Dr Sarah Hyde stroke4carers.org Contact: [email protected] SCHOOL OF COMMUNITY HEALTH AIM: The aim of this study was to determine whether integrated problem-based learning in the Physiotherapy course resulted in changes to new graduands’ perception of their work readiness for physiotherapy practice. physioindia.webs.com stroke4carers.org heart.unit9.com SCHOOL OF COMMUNITY HEALTH WHAT IS Problem Based Learning (PBL)? emz2.ca Student-centred educational methods • students learn actively • are engaged in small groups • follow a process where a clinical problem is presented as a trigger and focus for the learning that ensues (Barrows & Tamblyn (1980); and Engel (1997), cited in Morris, 2003, p. 25) SCHOOL OF COMMUNITY HEALTH WHAT DO WE KNOW? swcenter.fortlewis.edu • Appears as effective as traditional approaches • Students enjoy learning process • More comfortable seeking/using information • Limited evidence around effectiveness in different contexts/with different groups (Newman, 2003, p.7) SCHOOL OF COMMUNITY HEALTH WHAT ELSE DO WE KNOW? • no convincing evidence that PBL is more effective than traditional didactic education for entry-level therapy professions O’Donoghue, McMahon, Doody, Smith & Cusack (2011) • no difference in student clinical performance between PBL, mixed model PBL and traditional approaches. Van Duijn & Bevins (2005) SCHOOL OF COMMUNITY HEALTH WHAT ELSE DO WE KNOW? • PBL medical graduates felt more highly prepared for practice in the areas of: interpersonal skills, confidence, collaboration with other health care workers, preventative care, holistic care and self directed learning (Hill, Rolfe, Pearson & Heathcote,1998) • PBL students feel they lag behind in basic sciences and disease processes. (Albanese & Mitchell, 1993 as cited in Van Duijn & Bevins, 2005; Jones, McArdle & O’Neill, 2002). • PBL graduates were at least as well prepared for their intern year as graduates from traditional programs (Dean, Barratt, Hendry & Lyon, 2003). SCHOOL OF COMMUNITY HEALTH RESEARCH APPROACH • based on previous studies in medical education (Hill et al 1998; Dean et al 2003) • determining: • • • • perceptions of work readiness for physiotherapy practice of those graduands in the traditional course with one PBL subject in final year perceptions of work readiness for physiotherapy practice of those graduands in the integrated PBL course Whether this perception of work readiness for physiotherapy practice of the graduands in the integrated PBL course changes after 6 months working as a physiotherapist whether there are any differences between the two educational approaches in graduands’ perceptions of work readiness for physiotherapy practice SCHOOL OF COMMUNITY HEALTH PARTICIPANTS: physioindia.webs.com •graduands from the traditional didactic course with one PBL subject in final year (2012) - Traditional cohort •graduands from the integrated PBL course (2013) - PBL cohort SCHOOL OF COMMUNITY HEALTH DESIGN: Self-report survey at time of final undergraduate assessment. SCHOOL OF COMMUNITY HEALTH Survey: Based on “Preparation for Hospital Practice” Questionnaire, with modifications. (Hill et al. 1998; Dean et al. 2003) • 41 questions - 8 subscales • five-point Likert scale (1= very inadequately to 5= very adequately) SCHOOL OF COMMUNITY HEALTH Subscales: Perceptions of work readiness for physiotherapy practice in eight key domains: •interpersonal skills •confidence and coping •collaboration •patient management & practical skills •understanding science •prevention •holistic care •self directed learning SCHOOL OF COMMUNITY HEALTH Sample: page from survey My undergraduate physiotherapy degree has prepared me to: •Evaluate the impact of family factors on illness. Very inadequately Inadequately Neutral Adequately •Cope with stress caused by my work. Very inadequately Inadequately Neutral Adequately •Recognize my own clinical limitations. Very inadequately Inadequately Neutral Adequately Very adequately Don’t know Very adequately Don’t know Very adequately Don’t know •Carry out basic musculoskeletal physiotherapy treatments. Very inadequately Inadequately Neutral Adequately Very adequately Don’t know SCHOOL OF COMMUNITY HEALTH Data Analysis: IBM Statistical Package for the Social Sciences (SPSS) v20. Questions grouped under subscales and analysed using descriptive statistics. Traditional N = 16 (37%) PBL N = 42 (72 %) SCHOOL OF COMMUNITY HEALTH Results Traditional cohort Mean rating and CI 4.5 4.0 3.5 3.0 2.5 2.0 1.5 1.0 0.5 0.0 PBL cohort Mean rating and CI 4.5 4 3.5 3 2.5 2 1.5 1 0.5 0 4.5 4.0 3.5 3.0 2.5 2.0 1.5 1.0 0.5 0.0 4.5 4 3.5 3 2.5 2 1.5 1 0.5 0 SCHOOL OF COMMUNITY HEALTH Results Subscales Traditional cohort 95%CI ** Mean rating * PBL Cohort P values 95%CI **2 Mean rating * Interpersonal skills 3.0 2.6-3.4 3.6 **** 3.4-3.7 Confidence 3.6 3.3-4.0 4.2 **** 4.0-4.3 Collaboration 4.3 3.9-4.6 4.4 4.3-4.6 Management 4.1 3.8-4.4 4.3 4.1-4.4 Science 4.1 4.0-4.3 4.2 4.0-4.3 Prevention 4.2 4.0-4.4 4.3 4.1-4.4 Holistic care 4.1 3.8-4.3 4.3 4.2-4.4 SDL 4.1 3.8-4.4 4.4 *** 4.3-4.5 SDL - self directed learning *Rating Scale 1 = very inadequately prepared 5 = very adequately prepared ** Confidence Interval *** P<0.05 **** P<0.01 SCHOOL OF COMMUNITY HEALTH Interpretation Confidence and coping tsaofoundation.org Interpersonal skills Self directed learning heartspiritmind.com alivecampus.com SCHOOL OF COMMUNITY HEALTH Discussion: Overall: Subscale : Understanding emz2.ca (as basis of disease and therapy) If we move on to look at this in a little more detail, we find SCHOOL OF COMMUNITY HEALTH Interpersonal Skills: tsaofoundation.org SCHOOL OF COMMUNITY HEALTH Where to next? Pedagogical approach: •Continuing PBL approach •Broader research approach Learning outcomes: •More explicit exploration of interpersonal skills in PBL subjects •Continue with palliative care module in 4th year PBL subject SCHOOL OF COMMUNITY HEALTH References: Albanese, M.A. & Mitchell, S. (1993) Problem-based learning: a review of literature on its outcomes and implementation issues. Academic Medicine,. Dean, S.J., Barratt, A.L., Hendry, G.D. & Lyon, P.M.A. (2003) Preparedness for hospital practice among graduates of a problem-based, graduate-entry medical program. Medical Journal of Australia, 178, 163-166. Hill, J., Rolfe, I.E., Pearson, S. & Heathcote, A. (1998) Do junior doctors feel they are prepared for hospital practice? A study of graduates from traditional and non-traditional medical schools. Medical Education, 32, 19-24. Jones, A., McArdle, P.J. & O’Neill, P. A. (2002) Perceptions of how well graduates are prepared for the role of pre-registration house officer: a comparison of outcomes from a traditional and integrated PBL curriculum. Medical Education, 36, 16-25. SCHOOL OF COMMUNITY HEALTH References 2: Lusardi, M.M., Levangie, P.K. & Fein, B.D. (2002) A problem-based learning approach to facilitate evidence-based practice in entry level health professional education. Journal of Prosthetics and Orthotics, 14(2), 40-50. Morris, J. (2003) How strong is the case for the adoption of problem-based learning in physiotherapy education in the United Kingdom? Medical Teacher, 25(1), 24-31. Newman, M. (2003) Campbell Collaboration Systematic Review Group on the Effectiveness of Problem Based Learning: A pilot systematic review and meta-analysis on the effectiveness of problem-based learning. Retrieved July 2012 from http://www.ltsn-01.ac.uk/static/uploads/resources/pbl_report.pdf SCHOOL OF COMMUNITY HEALTH References 3: O’Donoghue, G., McMahon, S., Doody, C., Smith, K. & Cusack, T. (2011) Problem-based learning in professional entry-level therapy education: a review of controlled evaluation studies. The Interdisciplinary Journal of Problem-Based Learning, 5(1), 54-73. Solomon, P. (2005) Problem-based learning: A review of current issues relevant to physiotherapy education. Physiotherapy Theory and Practice, 21(1), 37-49. Van Duijn, A.J., & Bevins, S.I. (2005) Clinical performances of Physical Therapist Students in Problem-Based, Mixed-Model, and Traditional Curricula. Journal of Physical Therapy Education. 19(2), 15-21. SCHOOL OF COMMUNITY HEALTH
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