has integrated problem based learning made a difference?

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)
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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).
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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
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DESIGN:
Self-report survey
at time of final
undergraduate
assessment.
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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
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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
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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 %)
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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
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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
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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
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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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