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Purpose: To monitor changes in time spent on pediatric physical therapy actions during a COPing With and CAring for Infants With Special Needs (COPCA) course., Methods: Data were collected before (T0), during, and after (T3) the course, which was attended by 15 Swiss physical therapists. Four treatment sessions of each therapist were video recorded and analyzed with the Groningen Observation Protocol 2.0, allowing for quantification of relative duration of therapeutic actions., Results: Between T0 and T3, time spent on caregiver coaching and hands-off approaches significantly increased., Conclusions: The shift from caregiver trainer to family coach and the increasing hands-off techniques represent successful changes in various domains of behavior. The moderate changes in hands-off approaches suggest that changing habits requires specific attention. The COPCA course will be adapted accordingly.

Background: Physical therapy workforce shortages are expected to increase for all 50 states through 2030. There is a recognized nationwide unprecedented shortage of well-prepared physical therapy instructors. One practical solution can be to share instructors among Doctor of Physical Therapy (DPT) programs using a blended teaching and learning model., Objective: The purpose of this project was to evaluate the effectiveness of a blended teaching and learning model for a neuroscience course in a DPT program., Methods: Faculty members from two DPT programs collaborated to develop, implement, and evaluate a blended teaching and learning model. The Blackboard Learning Management System (LMS) was available at both institutions and chosen as the learning platform. The design of this research study was retrospective nonexperimental observational., Results: The overall feedback from the students was positive. Most students (91.6%) strongly agreed or agreed that the content of the course was appropriate for learning neuroscience. The students taking this blended course performed slightly better than the students taking the traditional course, though there was no significant difference (p=0.06)., Conclusions: The results support the use of a blended teaching and learning model to meet faculty shortage challenges. Future research with a larger sample size is necessary.

Background: Physical therapist program level successes have been associated with cognitive and noncognitive predictors. To our knowledge, no studies in physical therapy have explored predictive criteria for positive professional performance (PPP) in one's career beyond an educational program. The two-fold purpose of this study was to analyze what traits were key indicators of PPP beyond one's academic preparation, with secondary goal to determine whether traits related to PPP could be mediated by academic preparation., Methods: A three-round Delphi survey targeted expert academicians with a specialization in programmatic performance and student success., Results: Twenty-one Delphi respondents completed all survey rounds; identifying and determining consensus on traits associated with PPP. Respondents determined whether the traits could be influenced by programmatic training. The majority of traits identified with PPP were noncognitive and over half were considered modifiable through academic training. Traits such as critical thinking, promoting and engaging in an active learning process, ethical practice, good communication skills, conveying professionalism, and responsibility for one's own actions scored the highest in the survey., Discussion: Findings may serve to benefit curricular designs of academic health professional programs to improve both programmatic and post-academic success.

Purpose: Occupational Performance Coaching (OPC) has been proposed as an intervention for working with caregivers towards achievement of goals for themselves and their children. Preliminary studies indicate the effectiveness of OPC; however, translation into practice requires an understanding of therapists' perceptions of applying OPC in their service delivery settings. This study explored physio- and occupational-therapists' experiences of using OPC and their perceptions of the contextual factors which influence its implementation., Method: Interviews and a focus group were used to gather physio- (n = 4) and occupational- (n = 12) therapists' perspectives of applying OPC in their work with caregivers of children with disabilities. Data were analysed thematically., Results: One overarching theme and three major themes emerged. The overarching theme, "Listening better" pervaded all other themes. Three major themes, each with subthemes, were: (1) Sharing power, (2) Reprioritising processes, and (3) Liberating but challenging. Implementing OPC drew on skills that were familiar to therapists and aligned with existing values when working with families but challenged some aspects of their practice., Conclusions: From physio- and occupational-therapists' perspectives, OPC is applicable in a range of paediatric service environments. However, therapist and service-level flexibility appeared to be key contextual factors in adhering to intervention principles. Implications for Rehabilitation Occupational Performance Coaching (OPC) is a strengths-focused intervention in which caregiver engagement and active involvement is prioritised. Therapists reported distinct changes to the process of therapy and outcomes achieved following OPC training and implementation. Most therapists indicated that OPC enabled them to operationalisation person-centred principles to a greater extent which they perceived enhanced the way therapy was delivered and the benefit to services users. Some flexibility in service structures may be needed to implement OPC in the way it was intended.

Capstone courses in professional curricula provide opportunities for students to synthesize and integrate clinical and theoretical information from previous coursework. The purpose of this research was to ascertain the number and type of capstone projects utilized by Doctor of Physical Therapy (DPT) programs in the United States. Programs accredited by the Commission on Accreditation in Physical Therapy Education (CAPTE) that published web-accessible curricula were evaluated for the presence of the word capstone in the course title or description. Of the DPT program curricula analyzed (n=204 of 218 possible), 36% designated a capstone course. These capstone courses focused on research (49%), professional development (14%), evidence-based practice (12%), managing complex patients (7%), licensure preparation (4%), clinical education (3%), community service (1%), or a combination or choice between these categories (10%). Consensus regarding capstone courses may serve to promote best practice in entry-level professionals.

Objectives: Defining professional competence and identifying the best way to evaluate these skills has become a topic of study for physiotherapists. The aims of this study were: (1) to reveal and compare the level of competence declared by physiotherapy students with that of professional physiotherapists in the investigated competencies, and (2) to show any associations between the level of competences of physiotherapists and their age or education level., Design: A descriptive cross-sectional survey., Methods: A sample of 273 physiotherapists and 84 physiotherapy students executed self-assessment of their competences using a Likert scale., Results: Students declared a lower level of self-assessed competence (mean 2.76) than physiotherapists (mean 3.20), but some items regarding the ICF model and evidence-based practice (EBP) had higher scores for students than professionals. In the field of EBP, both groups showed insufficient scores for all items. For the investigated skills, we observed an association between the level of declared competence and age and education level (p<0.05)., Conclusions: Survey results could be used by academies, professional associations, and employers to identify specific learning goals of students and physiotherapists.

Introduction: Simulation is increasingly used in health care education, yet the organizational and financial costs can be prohibitive. This study aimed to investigate whether peer simulation is perceived by third-year undergraduate physiotherapy students as valuable for clinical placement preparation., Methods: Third-year undergraduate physiotherapy students participated in a 9-week peer simulation program, using each other as patients, and were invited to complete two surveys evaluating perceptions of the program. The program consisted of weekly patient interactions during which students were required to assess and treat a "patient" under strict simulation guidelines and in accordance with stated learning objectives. Items rated included self-perceived skills, confidence, time management, and clinical placement readiness and included collection of qualitative responses. Surveys were released at commencement and completion of the simulation program., Results: Of 79 third-year students, 63% completed survey 1 and 66% completed survey 2. Students had high expectations of the program and these were consistently met. Peer simulation rated highly for all items, including identifying knowledge and skill deficits, and improving confidence, clinical reasoning, time management, and communication. Simulation was considered safe, supportive, engaging, and valuable for clinical placement preparation. Students identified some lack of authenticity when working with peers., Conclusions: Peer simulation was perceived by students as valuable in preparing them for clinical placement, despite a perceived lack of realism. These findings support the use of peer simulation as an alternative to the use of more formalized standardized patients in an undergraduate physiotherapy program. Further investigation is required to establish a detailed cost analysis of the program and to determine the amount of realism required to optimize the benefits of this promising educational strategy.

Background/aim: Within the United Kingdom (UK), physiotherapy preregistration training is provided at both undergraduate and postgraduate level at 17 higher education institutions (HEIs). Some course teams approach this by teaching preregistration BSc and MSc students simultaneously to meet the same learning outcomes. This is often termed "parallel learning" and it is not known how students perceive this mode of learning. The aim of the study was to explore the perceived benefits and challenges to parallel learning of preregistration BSc and MSc physiotherapy students., Methods: Students from two different UK-based HEIs participated in an exploratory qualitative research design, with data collected in focus groups of each cohort and HEI. Data were analyzed using thematic analysis., Results: Several themes arose from student perceptions of parallel learning that were sceptical: "starting over again," "misunderstanding each other's motivations," "establishing knowledge hierarchies," and "competing for space". However, some themes emerged from students reflections on the perceived benefits of parallel learning including "healthy competition" and "learning from difference.", Conclusions: It is clear from findings that students perceive the benefits of parallel learning of mixed groups. However, to avoid perceptions that it is merely cost cutting, learning resources need to be maintained and from the outset clear explanations of the purposes should be given to students.

Background and Purpose: Studies of healthcare students report increased levels of stress, with academic pressures being the greatest source. The objective of this study was to examine the differences in the overall stress level, stressors, and reactions to stressors between physiotherapy students at the University of Gothenburg (GU) and those at the Hanze University of Applied Sciences (HUAS)., Methods: The Student-life Stress Inventory was used. The participants (n = 116) included physiotherapy students at GU and HUAS. The distribution of the questionnaire occurred during a regular lecture or in a lecture that was scheduled particularly for its distribution., Results: At GU, 13.7% of the students rated their level of stress as mild, whereas 72.5% of them rated it as moderate. The corresponding values for HUAS students were 43.9% and 43.9%, respectively. This difference between two universities was significant (p = 0.006). The total score of the subcategories indicated that the students at GU reported significantly higher levels of stressors (p = 0.027) and reactions to stressors (p = 0.003). However, there were no significant differences in the male participants between the universities., Conclusion: Female students in their three-year educational program in Sweden experienced significantly more stress than Dutch female students in their four-year educational program.

This study assesses the feasibility of training U.S. Navy Physical Therapy staff members (PT staff) aboard a U.S. Navy Aircraft Carrier in psychologically informed physical therapy (PiPT). Training was conducted prior to deployment over 3 d and included background information, skills development, and application in the form of role playing and case studies. During deployment, nine phone conferences were conducted to reinforce training, assess skills, and discuss implementation. PiPT knowledge was assessed by a written test and role-playing skills. The adoption of the training was determined by analysis of clinical notes and verbal responses of the PT staff during phone conferences. There were two PT staff members on the carrier. Both received passing knowledge test scores and demonstrated role-playing proficiency. Clinical note assessment and discussions during conference calls also indicated successful implementation. The feasibility of training Navy PT staff to implement PiPT was demonstrated. PT staff successfully translated training into practice. This is significant, since PiPT has the potential to limit attrition due to musculoskeletal injuries in Navy personnel. Factors believed to be associated with the success of the training include adoption of the PiPT model by PT staff and reinforcement of changes in clinical practice during deployment.

Objectives: Obstetric anal sphincter injuries (OASISs) are a devastating postpartum complication; reducing rates is paramount to improving quality of care. In Norway, implementation of a perineal protection program decreased the incidence of OASIS by 48%. We sought to assess impact on OASIS rates following a similar program., Methods: This institutional review board-approved, retrospective cohort study was performed in an academic hospital system. The periods of analysis were November 2014 through October 2015 for the preintervention arm and November 2015 through October 2016 for the postintervention arm. From November 2 to 6, 2015, 2 Norwegian experts conducted a didactic and hands-on, on-site workshop focusing on perineal protection. The experts were then present on labor and delivery wards to reinforce perineal protection in live deliveries. Teachings were emphasized at departmental meetings for the remainder of the year. Data were extracted from electronic medical records and manually audited., Results: The rate of vaginal delivery was similar among both periods (6504 and 6650; P = 0.059). Obstetric anal sphincter injury rates decreased from 211 (3.2%) preintervention to 189 (2.8%) after the workshop. Although this represented 32 fewer injuries, it was not statistically significant (P = 0.179). Obstetric anal sphincter injuries following forceps-assisted deliveries did decline significantly from 103 (28%) to 81 (21%) (P = 0.014). In addition, incidence of fourth-degree lacerations during resident deliveries decreased significantly from 10 (0.6%) to 3 (0.2%) (P = 0.047)., Conclusions: An educational workshop focusing on perineal support was not associated with a significant reduction in overall OASIS rates. Nevertheless, decreased forceps-related OASIS and fourth-degree lacerations rates support positive influence of the intervention.

Objective: Direct access to physiotherapy services is currently discussed in Germany. Its introduction would mean that initial diagnoses must be made in physiotherapy practices as well. However, it was not yet investigated whether the current training in physiotherapy is sufficient for this, and whether there are differences between the training systems. This study aims to answer the question of whether trainees at the end of Bachelor's studies (BS) are more reliably able to assess the case-related suitability of examination methods than professional college students (FS). Methodology: Questionnaires were developed to assess the suitability of examination methods for diagnostic inquiries. All professional colleges and bachelor's study courses listed with the German Physiotherapy Association were asked to present the questionnaires to their final classes. Results: In 216 addressed professional colleges and 24 bachelor's study courses, the return rate was 9.26% for professional colleges and 33.33% for study courses. One hundred thirty-eight questionnaires from students in 8 study courses and 368 questionnaires from students at 20 professional colleges were evaluated. The mean of correct decisions in total (of max. 54) was 19.01 (BS) or 15.73 (FS); in structure-related and function-related examination methods (of max. 42), it was 17.22 (BS) and 14.8 (FS); in activity-related methods (of max. 12), it was 1.97 (BS) and 0.89 (FS). Out of a max. of 49 examination methods, 23.45 (BS) and 26.72 (FS) were stated as unknown. Conclusion: The university students made correct decisions on the suitability of examination methods significantly more frequently than the professional college students. However, the determined group difference is low. Overall, the results do not appear sufficient for direct access. Training would have to be adapted for this purpose.

Background: Provider training programs are frequently underevaluated, leading to ambiguity surrounding effective intervention components., Objective: The purpose of this study was to assess the effectiveness of a training program in guiding physical therapists to deliver the Self-management of Osteoarthritis and Low back pain through Activity and Skills (SOLAS) group education and exercise intervention (ISRCTN49875385), using a communication style underpinned by self-determination theory (SDT)., Design: This was an assessment of the intervention arm training program using quantitative methods., Methods: Thirteen physical therapists were trained using mixed methods to deliver the SOLAS intervention. Training was evaluated using the Kirkpatrick model: (1) Reaction-physical therapists' satisfaction with training, (2) Learning-therapists' confidence in and knowledge of the SDT-based communication strategies and intervention content and their skills in applying the strategies during training, and (3) Behavior-8 therapists were audio-recorded delivering all 6 SOLAS intervention classes (n = 48), and 2 raters independently coded 50% of recordings (n = 24) using the Health Care Climate Questionnaire (HCCQ), the Controlling Coach Behavior Scale (CCBS), and an intervention-specific measure., Results: Reaction: Physical therapists reacted well to training (median [IRQ]; min-max = 4.7; [0.5]; 3.7-5.0). Learning: Physical therapists' confidence in the SDT-based communication strategies and knowledge of some intervention content components significantly improved. Behavior: Therapists delivered the intervention in a needs-supportive manner (median HCCQ = 5.3 [1.4]; 3.9-6.0; median CCBS = 6.6 ([0.5]; 6.1-6.8; median intervention specific measure = 4.0 [1.2]; 3.2-4.9). However, "goal setting" was delivered below acceptable levels by all therapists (median 2.9 [0.9]; 2.0-4.0)., Limitations: The intervention group only was assessed as part of the process evaluation of the feasibility trial., Conclusions: Training effectively guided physical therapists to be needs-supportive during delivery of the SOLAS intervention. Refinements were outlined to improve future similar training programs, including greater emphasis on goal setting., (© 2017 American Physical Therapy Association)

Objective: To determine the effect of a training intervention on physiotherapy students' self-efficacy and skills in the area of patient education., Methods: Final year physiotherapy students were randomised to an intervention group or a wait-list control group. The intervention group participated in a 3.5h training intervention about patient education that included video observation, simulated patient practice and structured feedback. The control group did not receive any training. Self-efficacy was assessed at baseline (T1) and after the intervention (or no intervention for the control group) (T2). Patient education performance was assessed by a blinded rater from a video-recorded standardised clinical examination., Results: 83 students were randomised to the intervention group and 81 students to the control group. There were no differences in demographic variables or self-efficacy between groups at baseline. There was significant improvement in self-efficacy for the intervention group, but no change for the control group. The intervention group performed significantly better than the control group for nine of the eleven performance items, with significantly higher scores overall., Conclusion: A training intervention enhances physiotherapy student self-efficacy and performance in patient education., Practice Implication: Use of patient education training is recommended to enhance student self-efficacy and performance., (Copyright © 2017 Elsevier B.V. All rights reserved.)

Aim: To provide a guideline of desired knowledge, clinical skills and education levels in Pelvic Physiotherapy (PT). Physiotherapy (PT) involves "using knowledge and skills unique to physiotherapists" and, "is the service only provided by, or under the direction and supervision of a physiotherapist." 1 METHODS: The PT Committee, within the body of the International Continence Society (ICS), collected information regarding existing educational levels for pelvic floor PT. Through face to face and on on-line discussion consensus was reached which was summarized in three progressive educational levels based on knowledge and skills and brought together in a guideline. The guideline was submitted to all physiotherapists and the Educational Committee of the ICS, and after approval, submitted to the Executive Board of the ICS., Result: The guideline lists, in a progressive way, knowledge areas and skills to be achieved by education. It is broad and allows for individual interpretation based on local situations regarding education and healthcare possibilities. It is intended to be dynamic and updated on a regular basis., Conclusion: The proposed Pelvic PT education guideline is a dynamic document that allows course creators to plan topics for continuing course work and to recognize educational level of a therapist in the field of Pelvic PT. This education guideline can be used to set minimum worldwide standards resulting in higher skill levels for local pelvic physiotherapists and thereby better patient care outcome., (© 2018 Wiley Periodicals, Inc.)

Background: Research training programmes are a knowledge translation (KT) intervention which aim to improve research evidence uptake by clinicians. Whilst KT training programmes have been reported to significantly improve evidence uptake by physiotherapists, it is unclear which aspects of training optimally assist KT into physiotherapy practice. The purpose of the review was to establish the body of evidence regarding KT training programmes to improve physiotherapists' use of evidence-based practice (EBP) and clinical practice guidelines (CPG)., Methods: A systematic scoping review was undertaken in line with the adapted Arksey and O'Malley framework. Nine electronic databases (CINAHL, BIOMED CENTRAL, Cochrane, Web of Science, PROQUEST, PUBMED, OTseeker, Scopus, ERIC) were searched. Targeted keywords identified primary research articles of any hierarchy, that described the nature and impact of KT training programmes for physiotherapists. Where systematic reviews were identified, the component primary studies were considered individually for relevance. Critical appraisal was not undertaken due to the nature of a scoping review, and data was reported descriptively., Results: Ten systematic reviews were identified (yielding four relevant primary studies). Five additional primary studies were identified (two randomised controlled trials, two non-randomised controlled trials and one pre-post study) which were not included in the original systematic reviews. This provided nine eligible primary research studies for review. The KT strategies were all multi-faceted. Interactive sessions, didactic sessions, printed material and discussion and feedback were consistently associated with effective outcomes. When KT strategies addressed local barriers to EBP utilisation, there were better success rates for EBP and CPG uptake, irrespective of the outcome measures used. There were no consistent ways of measuring outcome., Conclusion: Multi-faceted KT strategies designed to address local barriers to knowledge translation were most effective in improving EBP/ CPG uptake among physiotherapists.

Context: Health practitioner registration boards require health professionals to evaluate and maintain "fitness to practice" (FTP). This encompasses the professional behavior, clinical competence, and freedom from impairment required for safe and effective service provision. We developed and implemented policies to promote student self-assessment and support of FTP that were pre-emptive and designed to be helpful and sought clinician feedback on this initiative., Method: An innovative student-centered FTP approach was devised with consideration of defensible ethico-legal practice. A survey explored clinical educators' perceptions of the FTP policy and the associated education and support. Closed and open survey questions were analyzed using descriptive statistics, qualitative evaluation, and thematic analysis., Results: Seventy-nine physiotherapy clinical educators from 34 sites across eight Australian health services returned surveys. Educators had positive perceptions of policy components, particularly incorporating professionalism as a hurdle requirement and the attendance and incident reporting policies., Conclusions: The benefits of a student-centered FTP approach included clarity and consistency in managing FTP issues and facilitation of student awareness through active engagement in maintaining their FTP. To our knowledge, this paper is the first to report a comprehensive approach to the range of FTP issues incorporating student self-declaration of issues that may affect desirable progression through clinical placements. The policy and program of education and support are likely to be generalizable to health professional training programs that utilize workplace training.

Objective: Introduction:The level of people's health and its preservation is a medical problem that requires the optimal solution and the need to improve the management of the system of measures to achieve the goal. According to specialists, the health of Ukrainian people is accompanied by high mortality, significant parameters of disability and morbidity and a decrease in the average life expectancy. Diseases that lead to such negative medical and social and socio-economic consequences are so-called "illnesses of a way of life" or "diseases of civilization". These diseases have numerous methods of diagnosis, treatment and rehabilitation, among which physiotherapy is not the least. That is why the issue of training of highly qualified specialists in physical therapy is one of the most important tasks, especially in our days when there is a constant decrease in the level of health and physical preparedness of the population in Ukraine. The aim of the study is a comprehensive analysis of the conceptual approaches to the problem of professional training of future physical therapists in modern scientific interpretation., Patients and Methods: Materials and methods: The aim was achieved through the use of a set of general scientific methods, in particular, the analysis, systematization and synthesis of these scientific sources., Results: Review: The authors denoted the conception of professional training of physical therapists which is in higher educational establishments. It is specified that just competent approach is to be a dominant vector of updating of contents of higher education under the conditions of layered training of physical therapists. The attention in the article is accentuated on the substance and peculiarities of the indicated methodological approaches; it is also pointed out that complex use of these approaches gives an opportunity to regard the training of specialists as the pedagogical system which promotes forming of group of professional features, motives and valuables of specialist and pointing out the components of his availability for future activity., Conclusion: Conclusions: Consequently, we have revealed the role of conceptual approaches to the professional training of future specialists in physical therapy in higher education, which include competence, paradigm, synergetic, axiological, subject-activity, acmeological, systemic and cultural. It is specified that in the conditions of the medical sector's reformation, the application of these approaches is gradually becoming innovative, defining deep systemic transformations in the training system for physical therapy.

It aimed to conduct a personality oriented job analysis to identify non-cognitive factors that may predict successful performance or performance difficulties in doctorate in physical therapy (DPT) students. The study employed focus groups and a survey with 9 DPT subject matter experts. Focus group participants including 3 DPT faculty members and 4 recent graduates of the DPT program identified 22 non-cognitive factors. Out of them, 15 factors were possibly associated with successful performance and 7 factors were possibly associated with performance difficulties. The questionnaire employing the Combination Job Analysis Method resulted in 12 factors which could be used in selection, and 10 which could be incorporated into training. The present study employed an established job analysis method using subject matter experts to identify a broad array of factors that go beyond what previous studies have examined, and which may predict success or difficulties in a DPT program.

Background: Newly qualified physiotherapists may be required to interpret an unreported chest X-ray (CXR) as part of their physiotherapy assessment in "on call" situations. Their interpretation may influence the patient management strategies they adopt. There is no research published which have tested the reliability of final year physiotherapy students in CXR interpretation., Methods: Twenty-five final year physiotherapy students were asked to view and interpret the findings of six CXRs, together with a brief vignette, typical of a single commonly encountered diagnosis. Students were also asked if they had received additional CXR training on placement or had a desire to specialize in respiratory care., Results: The CXR interpretations were scored as incorrect 0, partially correct 1 (abnormality detected but not able to diagnose or missed some detail) and 2 correct. Scores for each of the six CXRs were added to give a total score (out of 12). The median score was 3 out of 12, (range 0-9). Median scores were slightly higher at 4 out of 12 in those students with additional training or a desire to specialize (range 1-7), but this was not statistically significant (p = 0.43)., Conclusions: Final year physiotherapy students were not able to reliably interpret CXRs. These findings were consistent with previous published research involving medical students. Therefore on graduation before starting "on call" duties it is recommended newly qualified physiotherapists receive additional training in CXR interpretation.

Background: Manual skills teaching, such as physiotherapy education, requires immediate teacher feedback for the students during the learning process, which to date can only be performed by expert trainers., Objectives: A machine-learning system trained only on correct performances to classify and score performed movements, to identify sources of errors in the movement and give feedback to the learner., Methods: We acquire IMU and sEMG sensor data from a commercial-grade wearable device and construct an HMM-based model for gesture classification, scoring and feedback giving. We evaluate the model on publicly available and self-generated data of an exemplary movement pattern executions., Results: The model achieves an overall accuracy of 90.71% on the public dataset and 98.9% on our dataset. An AUC of 0.99 for the ROC of the scoring method could be achieved to discriminate between correct and untrained incorrect executions., Conclusion: The proposed system demonstrated its suitability for scoring and feedback in manual skills training.

Background: As length of stay decreases for total joint arthroplasty, much of the patient preparation and teaching previously done in the hospital must be performed before surgery. However, the most effective form of preparation is unknown. This randomized trial evaluated the effect of a one-time, one-on-one preoperative physical therapy education session coupled with a web-based microsite (preopPTEd) on patients' readiness to discharge from physical therapy (PT), length of hospital stay, and patient-reported functional outcomes after total joint arthroplasty., Questions/purposes: Was this one-on-one preoperative PT education session coupled with a web- based microsite associated with (1) earlier achievement of readiness to discharge from PT; (2) a reduced hospital length of stay; and (3) improved WOMAC scores 4 to 6 weeks after surgery?, Methods: Between February and June 2015, 126 typical arthroplasty patients underwent unilateral TKA or THA. As per our institution's current guidelines, all patients attended a preoperative group education class taught by a multidisciplinary team comprising a nurse educator, social worker, and physical therapist. Patients were then randomized into two groups. One group (control; n = 63) received no further education after the group education class, whereas the intervention group (experimental; n = 63) received preopPTEd. The preopPTEd consisted of a one-time, one-on-one session with a physical therapist to learn and practice postoperative precautions, exercises, bed mobility, and ambulation with and negotiation of stairs. After this session, all patients in the preopPTEd group were given access to a lateralized, joint-specific microsite that provided detailed information regarding exercises, transfers, ambulation, and activities of daily living through videos, pictures, and text. Outcome measures assessed included readiness to discharge from PT, which was calculated by adding the number of postoperative inpatient PT visits patients had to meet PT milestones. Hospital length of stay (LOS) was assessed for hospital discharge criteria and 6-week WOMAC scores were gathered by study personnel. At our institution, to meet PT milestones for hospital discharge criteria, patients have to be able to (1) independently transfer in and out of bed, a chair, and a toilet seat; (2) independently ambulate approximately 150 feet; (3) independently negotiate stairs; and (4) be independent with a home exercise program and activities of daily living. Complete followup was available on 100% of control group patients and 100% patients in the intervention group for all three outcome measures (control and intervention of 63, respectively)., Results: The preopPTEd group had fewer postoperative inpatient PT visits (mean, 3.3; 95% confidence interval [CI], 3.0-3.6 versus 4.4; 95% CI, 4.1-4.7; p < 0.001) and achieved readiness to discharge from PT faster (mean, 1.6 days; 95% CI, 1.2-1.9 days versus 2.7 days; 95% CI, 2.4-3.0; p < 0.001) than the control group. There was no difference in hospital LOS between the preopPTEd group and the control group (2.4 days; 95% CI, 2.1-2.6; p = 0.082 versus 2.6 days; 95% CI, 2.4-2.8; p = 0.082). There were no clinically relevant differences in 6-week WOMAC scores between the two groups., Conclusions: Although this protocol resulted in improved readiness to discharge from PT, there was no effect on LOS or WOMAC scores at 6 weeks. Preoperative PT was successful in improving one of the contributors to LOS and by itself is insufficient to make a difference in LOS. This study highlights the need for improvement in other aspects of care to improve LOS., Level of Evidence: Level II, therapeutic study.

Objectives: To survey potential stakeholders to obtain information relevant to the production of a video on teaching acupressure for sports injury management, and gain feedback from potential users on the prototype video., Design: Focus groups and online survey methods nested within a knowledge translation framework., Participants: Four focus groups (n = 24) were conducted, two with sports medics and two with sports physiotherapists as a part of the development of a prototype video. Nineteen stakeholders viewed the prototype video and participated in the subsequent online survey., Main Outcome Measures: Focus groups' transcripts were analysed to develop themes using a general inductive approach. Survey data analysis incorporated quantitative and qualitative analysis., Results: Three key themes concerning the design of the video emerged from the focus groups: 1) the recommendation for both demonstration and verbal instructions on the acupressure technique; 2) keeping the content of the video to a minimum; and 3) the need for professionalism in the production of the video, and highlighting the presenter's expertise and qualifications. The survey participants found the video to be clear and professional., Conclusions: Collectively these studies described the development and assessment of a user-oriented instructional video on teaching of acupressure for the management of sports injuries., (Copyright © 2017 Elsevier Ltd. All rights reserved.)

Purpose: The purpose of this case report is to explore the active engagement model as a tool to illuminate the ethical reflections of student physical therapists in the context of service learning in a developing country., Methods: The study participants were a convenience sample of six students. The study design is a case report using a phenomenological perspective. Data were collected from students' narrative writing and semi-structured interviews. The steps of the active engagement model provided the structural framework for student responses. The analysis process included open coding, selective coding, and member checking., Results: Results showed the emergence of two main themes: 1) gathering rich detail and 2) developing independent moral identity. Students' descriptions of their relationships were detailed and included explanations about the complexities of the sociocultural context. Independent and deliberate agency was evident by the students' preparedness to be collaborative, to raise ethical questions, to identify ethically important aspects of their practice and to describe their professional roles. The students noted that the use of the model increased their engagement in the ethical decision-making process and their recognition of ethical questions., Conclusions: This case report illustrates attributes of the active engagement model which have implications for teaching ethical reflection: scaffolding for ethical reflection, use of narrative for reflection, reflection in action, and illumination of relevant themes. Each of these attributes leads to the development of meaningful ethical reflection. The attributes of this model shown by this case report have potential applications to teaching ethical reflection.

Background: To meet the expanding need for physical therapists universities are under increasing pressure to enroll, educate, and train physical therapists. Poor academic performance can result in student dismissal from a physical therapy program. The purpose of this study is to determine if implementation of a retention program would improve student academic performance in the foundational science curriculum in a physical therapy program., Methods: A prospective observational cohort design was used. The retention program centered on three approaches: 1. Early identification of at-risk students. 2. Supplemental instruction in Human Anatomy. 3. Offering peer tutoring for the foundational science courses., Results: A significant association existed between the implementation of the retention program and the reduction of dismissals from the Fall Semester of 2012 to the fall 2013 semesters., Conclusion: Implementation of a retention program had a beneficial effect on decreasing student dismissals in a physical therapy program.

The author presents a review of the experimental and clinical studies that have formed the basis of modern physiotherapy as a science, academic discipline, and clinical specialty. The analysis of the attributes of modern physical therapy has been undertaken with special reference to the definitions of the concepts, categories, classifications, therapeutic physical factors, and physical treatment methods that provide the basis of modern physical therapy. The directions of scientific and practical development of physiotherapy in the currently adopted system of organization of the medical care services in Russia are determined. The discussion presents arguments for the introduction of new concepts, terms, classifications, and treatment methods. The prerequisites for the formation of such notions and ideas, their composition and structure as well as the role of the therapeutic physical factors in the system of treatment and preventive measures are considered. The basic methodological approaches (both evidence-based and systematic) which are in line with modern physiotherapeutic research programs are substantiated. Special attention is given in the article to the currently adopted system of the training of physiotherapists accepting present-day ideas and practicing modern approaches in their practical work. The principal way to carry out this task under the present-day conditions is through education in a three-stage manner in accordance with the main categories of physical therapy. The current status and assessment of the use of the concepts of evidence-based and translational medicine in physiotherapy are discussed together with the prospects for its further systematic development and practical application.

Background: The recently passed legislation and proposed policy changes governing the healthcare system have been met with extensive debate and controversy., Objective: The primary objective of the study was to determine the attitudes of Doctor of Physical Therapy (DPT) students towards some of these controversial issues. The secondary objective was to determine the demographic factors, including number of years in a physical therapy program, that contribute to their attitude formation., Methods: The research design was a cross-sectional non-experimental survey. Purposive sampling was used to recruit subjects in a public university. Subjects took the survey including nine Likert scale questions/statements on controversial issues inspired from legislative efforts and news media sources and one open-ended question., Results: Of the 111 recruited, 106 students agreed to participate as subjects and completed the survey. Only 18.9% agreed or strongly agreed that the Patient Protection and Affordable Care Act is a positive solution for the healthcare system in America. Political affiliation, class level, and developmental environment were associated with a few questions/statements., Conclusions: DPT students in the sample had very diverse attitudes towards controversial issues in healthcare policy. Some of these attitudes revealed very different paradigms from the results found among medical students and the general public.

One common component of allied health education is clinical fieldwork. It is the bridge between the didactic curriculum and clinical practice. Clinical supervisors perceive that being a clinical supervisor has both benefits and challenges. A modified questionnaire was distributed to 75 physical therapists who had previously or were currently engaged in supervising physical therapy students in 12 public hospitals in the State of Kuwait. In addition to demographic data, the questionnaire asked about the benefits and challenges associated with supervising students. The results indicated that the clinical fieldwork supervisors regarded their student supervision process as highly beneficial and reported that it improved their professionalism, problem-solving skills, and clinical reasoning. Challenges to supervision included students' lack of theoretical knowledge, poor hands-on skills, and poor writing/documentation skills. Suggestions are put forth to promote additional benefits and overcome existing challenges to develop a more successful physical therapy clinical education process for the supervisors and the students.

Question: What strategies can clinical partners and universities implement to enhance physiotherapy student engagement in non-metropolitan clinical placements?, Design: Mixed-method research design combining focus groups and survey., Participants: First-year physiotherapy students from one university at the commencement of their course (n=26); third-year and fourth-year students who had completed a non-metropolitan placement (n=39 survey, n=25 focus group); and clinical educators from three non-metropolitan clinical sites (n=15)., Intervention: The cohort of first-year physiotherapy students was surveyed to establish their perceptions regarding non-metropolitan clinical education placements. A survey and four focus groups were conducted with third-year and fourth-year students after they had attended non-metropolitan clinical placements, to explore recent experiences. Two focus groups were conducted with clinical educators regarding student engagement at non-metropolitan placements. Quantitative data were summarised with descriptive statistics. Qualitative data were analysed using thematic analysis, synthesising the perspectives of students and clinical educators., Results: At the commencement of their physiotherapy course, interest in undertaking a non-metropolitan clinical placement was higher for students with a non-metropolitan upbringing. Concerns about attending non-metropolitan sites included finances, change in living situation, and perceived inferior quality of clinical education. After completing a non-metropolitan placement, four themes were identified in an analysis of student and educator perceptions: individual factors, clinical experience, logistical challenges and strategies for success., Conclusion: Strategies that were perceived to enhance student engagement in non-metropolitan placements included: tailoring preparation for students, paired rather than individual placements, and near-peer presentations for physiotherapy students prior to undertaking non-metropolitan placements. Dedicated clinical coordinator positions at non-metropolitan sites and assistance in accessing affordable accommodation are likely to positively influence the student experience. [Francis-Cracknell A, Maver S, Kent F, Edwards E, Iles R (2017) Several strategies for clinical partners and universities are perceived to enhance physiotherapy student engagement in non-metropolitan clinical placements: a mixed-methods study. Journal of Physiotherapy 63: 243-249]., (Copyright © 2017 Australian Physiotherapy Association. Published by Elsevier B.V. All rights reserved.)

Objectives: Clinical reasoning can be difficult to teach to pre-professional physiotherapy students due to their lack of clinical experience. It may be that tools such as clinical prediction rules (CPRs) could aid the process, but there has been little investigation into their use in physiotherapy clinical education. This study aimed to determine the perceptions and experiences of physiotherapy students regarding CPRs, and whether they are learning about CPRs on clinical placement., Design: Cross-sectional survey using a paper-based questionnaire., Participants: Final year pre-professional physiotherapy students (n=371, response rate 77%) from five universities across five states of Australia., Results: Sixty percent of respondents had not heard of CPRs, and a further 19% had not clinically used CPRs. Only 21% reported using CPRs, and of these nearly three-quarters were rarely, if ever, learning about CPRs in the clinical setting. However most of those who used CPRs (78%) believed CPRs assisted in the development of clinical reasoning skills and none (0%) was opposed to the teaching of CPRs to students. The CPRs most commonly recognised and used by students were those for determining the need for an X-ray following injuries to the ankle and foot (67%), and for identifying deep venous thrombosis (63%)., Conclusions: The large majority of students in this sample knew little, if anything, about CPRs and few had learned about, experienced or practiced them on clinical placement. However, students who were aware of CPRs found them helpful for their clinical reasoning and were in favour of learning more about them., (Copyright © 2016 Chartered Society of Physiotherapy. Published by Elsevier Ltd. All rights reserved.)

Background: Using simulated learning environments with standardised patients (SPs) provides a way to scaffold the development of skills for patient safety in a low risk environment. There are no data regarding whether adding SP interactions in early years of physiotherapy training improves safe performance on clinical placement. We assessed the feasibility of recruiting and collecting data from junior physiotherapy students during an SP workshop with a pilot non-randomised trial, also assessing time, cost and scheduling information., Methods: Second year physiotherapy students were invited to participate and allocated to either the SP workshop in a simulated hospital environment (with and without video feedback) or usual teaching comprising peer role play. The main outcome measures were participant recruitment, retention and survey response rates, whether the training and workshops were delivered as scheduled and costs for SPs and staff training and workshop attendance. Students self-reported confidence, communication, preparedness for clinic and satisfaction was measured using pre-post surveys., Results: The pilot trial proved feasible, with 108 students recruited (100%) and high retention (95%) and survey response rates (85%). The training sessions and SP workshops were delivered as scheduled, costing $4700AUD. Students rated their confidence and preparedness for clinical placement higher post intervention (p < 0.001) with high levels of satisfaction with the SP interactions (mean score 9.3/10)., Conclusions: In this setting the SP workshop was feasible. Further research incorporating a randomised trial investigating the integration of SPs for the development and assessment of patient safety skills in physiotherapy education is recommended., Trial Registration: ANZCTR no: 12,615,000,686,505.

Context: To date, despite the relevance of manual skills laboratories in physiotherapy education, evidence on the effectiveness of different teaching methods is limited., Objectives: Peyton's four-step and the 'See one, do one' approaches were compared for their effectiveness in teaching manual skills., Methods: A cluster randomised controlled trial was performed among final-year, right-handed physiotherapy students, without prior experience in manual therapy or skills laboratories. The manual technique of C1-C2 passive right rotation was taught by different experienced physiotherapist using Peyton's four-step approach (intervention group) and the 'See one, do one' approach (control group). Participants, teachers and assessors were blinded to the aims of the study. Primary outcomes were quality of performance at the end of the skills laboratories, and after 1 week and 1 month. Secondary outcomes were time required to teach, time required to perform the procedure and student satisfaction., Results: A total of 39 students were included in the study (21 in the intervention group and 18 in the control group). Their main characteristics were homogeneous at baseline. The intervention group showed better quality of performance in the short, medium and long terms (F 1,111  = 35.91, p < 0.001). Both groups demonstrated decreased quality of performance over time (F 2,111  = 12.91, p < 0.001). The intervention group reported significantly greater mean ± standard deviation satisfaction (4.31 ± 1.23) than the control group (4.03 ± 1.31) (p < 0.001). Although there was no significant difference between the two methods in the time required for teaching, the time required by the intervention group to perform the procedure was significantly lower immediately after the skills laboratories and over time (p < 0.001)., Conclusions: Peyton's four-step approach is more effective than the 'See one, do one' approach in skills laboratories aimed at developing physiotherapy student competence in C1-C2 passive mobilisation., (© 2017 John Wiley & Sons Ltd and The Association for the Study of Medical Education.)

Background: This article describes the use of an activity worksheet and questionnaire to investigate the learning experience of students on clinical placement. The worksheet measures the amount of time students spend in different learning activities, and the questionnaire explores student satisfaction and preferred learning activities. An activity worksheet and questionnaire … investigate[d] the learning experiences of students on clinical placement METHODS: The activity worksheet and questionnaire were used in a cohort pilot study of physiotherapy students on clinical placement., Results: The activity worksheet provides details of the amount of time students engage in a range of clinical and non-clinical tasks while on placement, such as time spent treating patients, working individually, working with their peers and engaging in reflective practice. In combination with the questionnaire results, it allows clinicians to gain an understanding of the clinical learning environment experienced by their students., Discussion: The data collected using these tools provide a description of the students' activities while undertaking the clinical placement. This information may guide the refinement of the clinical experience, and offers an opportunity to individualise learning activities to match students' needs and preferences., (© 2016 John Wiley & Sons Ltd and The Association for the Study of Medical Education.)

Objective: The aim of this study is to investigate whether the curricula for physiotherapy education in Germany conform to standards recommended in the World Confederation for Physical Therapy (WCPT) guideline for physical therapist professional entry-level education, published by the WCPT. This Guideline specifies education standards for physical therapists that are able to act as independent practitioners, without referral from another health care professional. Methods: To assess the German curricula of physical therapist education, a list of assessment dimensions was derived from the WCPT-Guideline by means of content analysis. The content validity of this list was estimated by nine experts using Lawshe's method. The German Training and Examination Regulations for Physiotherapists (PhysTh-AprV) and all available regional curricula were studied. All documents were evaluated by 2 independent coders who rated the conformity of the documents with the assessment dimensions. Results: Based on the Lawshe procedure, the whole test content validity index of the 61 out of 67 examined assessment dimensions was 0,84. Cohen's kappa coefficient for intercoder reliability was 0,71-0,97. The German curricula showed high correlation with the WCPT Guideline on many theoretical basic subjects. Fulfillment of some of the requirements showed heterogeneous results. Autonomous practitioners largely lacked special competencies. Conclusions: None of the German educational standards meets the expectations of the WCPT Guideline in terms of direct access. Considering the deficits of the German educational standards and the release date of some of them, a continuous development of the German education does not appear to be adequate. This issue needs to be addressed in the current debate on health policy., Competing Interests: Interessenkonflikt:: Die Autoren geben an, dass kein Interessenkonflikt besteht., (© Georg Thieme Verlag KG Stuttgart · New York.)

Contemporary and future physiotherapists are, and will be, presented with challenges different to their forebears. Yet, physiotherapy tends to remain tied to historical ways of seeing the world: these are passed down to generations of physiotherapy graduates. These historical perspectives privilege particular knowledge and skills so that students gain competency for graduation. However, contemporary practice is inherently more complex than the focus on knowledge and skills would have us believe. Professional life requires students to develop the capability to deal with uncertain and diverse futures. This paper argues that physiotherapy needs to think differently about entry-level education; the focus on knowledge and competencies that has been the mainstay in physiotherapy education must now be understood in the context of an education that embraces knowing, doing, being. Two educational frameworks are offered in support of this argument - threshold concepts and ways of thinking and practicing (WTP). Taken together, these ideas can assist physiotherapy to think in fresh ways about disciplinary learning. Threshold concepts and WTP help to understand the nature of a discipline: its behaviors, culture, discourses, and methods. By interrogating the discursive aspects of the discipline, physiotherapy educators will be better placed to provide more relevant preparation for practice.

Background: The purpose of this qualitative study was to assess the perceptions of Doctor of Physical Therapy (DPT) students in performing collegiate athletes' strength and conditioning training., Methods: Four DPT students with the Certified Strength and Conditioning Specialist (CSCS) credential voluntarily provided collegiate athletes strength and conditioning training. Students were interviewed to obtain their perceptions of how the experience impacted performance in DPT school and perceptions of anticipated future benefits., Results: Seven themes emerged from interviews: improved communication skills, movement analysis experience, improved time management/organization, increased understanding of exercises, attention to psychosocial aspects, interprofessional experience, and improved performance in coursework., Conclusion: DPT students with the CSCS credential perceived benefits from performing strength and conditioning training outside the standard DPT curriculum.

Background: International service learning (ISL) is an instructional method used by physical therapist educators in the United States (US) to prepare students for rendering culturally competent care. ISL is a faculty led student learning opportunity that includes academic instruction and community service in an international context. Research exists that explores student experiences with ISL, but studies that evaluate ISL partnerships and include global stakeholder feedback are lacking. The purposes of this study were to: 1) integrate a partnership evaluation component into an existing curriculum-based ISL model and 2) through evaluation identify benefits, drawbacks, and suggestions for improving and sustaining the academic-community partnership., Methods: Community-based participatory research design using a mixed methods approach was used to evaluate a ISL partnership between a US-based physical therapy program and a service site in Ecuador. Participants were 31 staff working at the global service site. Over three years, 11 interviews were conducted and 26 surveys were administered to global partner staff. Data were analyzed using qualitative thematic content analysis and descriptive statistics., Results: Partnership benefits included the following: continuity of ISL team leadership, targeted rehabilitative efforts, sensitivity to cultural norms, respectful communication, and interaction with local community. Drawbacks were as follows: deficits in cultural awareness, language barriers, and poor treatment carryover. Suggestions for sustaining the relationship incorporated: additional pre-trip communication, education of staff, and improved language skills., Conclusion: As more US teams deliver clinical services abroad, intentional evaluation approaches must include the global stakeholder in the planning, implementation, and evaluation phases to maximize partnerships benefits.

Background: Good conceptual knowledge is an essential requirement for health professions students, in that they are required to apply concepts learned in the classroom to a variety of different contexts. However, the use of traditional methods of assessment limits the educator's ability to correct students' conceptual knowledge prior to altering the educational context. Concept mapping (CM) is an educational tool for evaluating conceptual knowledge, but little is known about its use in facilitating the development of richer knowledge frameworks. In addition, structured feedback has the potential to develop good conceptual knowledge. The purpose of this study was to use Kinchin's criteria to assess the impact of structured feedback on the graphical complexity of CM's by observing the development of richer knowledge frameworks., Methods: Fifty-eight physiotherapy students created CM's targeting the integration of two knowledge domains within a case-based teaching paradigm. Each student received one round of structured feedback that addressed correction, reinforcement, forensic diagnosis, benchmarking, and longitudinal development on their CM's prior to the final submission. The concept maps were categorized according to Kinchin's criteria as either Spoke, Chain or Net representations, and then evaluated against defined traits of meaningful learning., Results: The inter-rater reliability of categorizing CM's was good. Pre-feedback CM's were predominantly Chain structures (57%), with Net structures appearing least often. There was a significant reduction of the basic Spoke- structured CMs (P = 0.002) and a significant increase of Net-structured maps (P < 0.001) at the final evaluation (post-feedback). Changes in structural complexity of CMs appeared to be indicative of broader knowledge frameworks as assessed against the meaningful learning traits., Conclusions: Feedback on CM's seemed to have contributed towards improving conceptual knowledge and correcting naive conceptions of related knowledge. Educators in medical education could therefore consider using CM's to target individual student development.

Early mobilisation of patients in intensive care starts in a multiprofessional team with passive techniques continuing with assistive measures and finally going on to active training including mobilisation leading to sitting and standing positions as well as walking. Positive effects regarding these procedures have been proved in numerous studies and can also be found in the revision of the S2e guideline "Positioning and early mobilisation in prophylaxis or therapy of pulmonary disorders". In order to work with regard to the resources of the patient in intensive care, of the multiprofessional team, of the ward-specific structures and of the used equipment it is vital to apply a customised mobilisation concept. Consequently, intensive care medicine is personalised which means that the patient's needs are determined and precisely met. This and the patient's present physical capacity lead to the adaptation of nursing and therapeutic measures respectively. Some treatment methods and principles of training theory can be applied to the intensive care patient if beforehand the patient's current condition is evaluated by means of specific assessment methods. As a result, appropriate forms of therapy and adequate stimuli of training can be derived. The aim is a continuous process of early mobilisation with the best possible outcome guaranteed by a closed system of evaluation and re-evaluation.

Demand for physical therapists in the United States (U.S.) is currently robust and expected to grow further. There are currently 228 physical therapy programs accredited by the Commission on Accreditation in Physical Therapy Education (CAPTE), and 30 more are in development in the U.S.; 29,246 students are currently enrolled in these programs (2014-2015 data). A shortage of physical therapy faculty with an advanced doctoral degree (i.e., PhD, EdD, DSc) is a primary concern for these programs. Specialized residency and fellowship training in physical therapy continue to expand, preparing professionals to deliver advanced clinical care. The American Board of Physical Therapy Residency and Fellowship Education (ABPTRFE) reports that there are currently 179 accredited residency programs and 35 accredited fellowship programs in the U.S. A number of academic physical therapy programs also currently operate a clinical faculty practice. Currently, these aspects and trends in physical therapy education, advanced training, and clinical practice, for the most part, lack synergy and connectivity, in both planning and implementation amongst the various components. This professional theoretical article describes a novel model for academic physical therapy, with potential transformative implications for entry-level physical therapy education, advanced clinical training, and academic preparation.

Background: Learning activities are fundamental for the development of expertise in physiotherapy practice. Continuing professional development (CPD) encompasses formal and informal learning activities undertaken by physiotherapists. Identifying the most efficient and effective learning activities is essential to enable the profession to assimilate research findings and improve clinical skills to ensure the most efficacious care for clients. To date, systematic reviews on the effectiveness of CPD provide limited guidance on the most efficacious models of professional development for physiotherapists. The aim of this systematic review is to evaluate which learning activities enhance physiotherapy practice., Methods: A search of Ovid MEDLINE, EMBASE, Cumulative Index to Nursing and Allied Health Literature (CINAHL), PsycINFO (Psychological Abstracts), PEDro, Cochrane Library, AMED and Educational Resources and Information Center (ERIC) will be completed. Citation searching and reference list searching will be undertaken to locate additional studies. Quantitative and qualitative studies will be included if they examine the impact of learning activities on clinician's behaviour, attitude, knowledge, beliefs, skills, self-efficacy, work satisfaction and patient outcomes. Risk of bias will be assessed by two independent researchers. Grading of Recommendations Assessment, Development, and Evaluation (GRADE) and Confidence in the Evidence from Reviews of Qualitative research (CERQual) will be used to synthesise results where a meta-analysis is possible. Where a meta-analysis is not possible, a narrative synthesis will be conducted., Systematic Review Registration: PROSPERO CRD42016050157.

Background: Patient education is an integral component of physiotherapy practice. Little is known about the differences in reported use and perception of patient education between experienced and novice physiotherapists. Understanding these differences has important implications for training approaches and physiotherapy practice., Objectives: To compare how experienced and novice physiotherapists report frequency of patient education practices and their perceptions of the importance of these practices., Design and Methods: A web-based purpose-designed survey was developed, piloted and administered to practicing physiotherapists through direct email. Of 305 complete responses, two subgroups were explored for comparative analysis: 'novice' (≤5years' experience, n = 52); and 'experienced' (≥11 years' experience, n = 204)., Results: The experienced group rated 14 of 15 educational items higher than the novice group in relation to frequency of use and perceived importance. Experienced physiotherapists reported a significantly higher frequency of using one-to-one discussion, personalised handouts and explicitly seeking patient understanding (p < 0.05). Novice physiotherapists perceived more barriers to patient education, particularly those related to characteristics of the patient (p < 0.05)., Conclusion: Experienced physiotherapists report higher use of self-management education and education content that is patient-centred. Experienced therapists report a higher frequency of seeking explicit patient understanding to evaluate their teaching than novice physiotherapists and perceive fewer patient-related barriers to their practice. These findings are important when considering teaching and learning of patient education skills. Students or novice physiotherapists may benefit from strategies to facilitate patient-centred education, self-management education, evaluation approaches and strategies to manage barriers., (Copyright © 2017 Elsevier Ltd. All rights reserved.)

Background and Purpose: Little has been published about the effectiveness of training postgraduate physiotherapy coursework students in research methods and evidence-based practice (EBP) theory. Graduate qualities in most universities include lifelong learning. Inclusion of EBP in post-graduate coursework students' training is one way for students to develop the knowledge and skills needed to implement current best evidence in their clinical practice after graduation, thereby facilitating lifelong learning. This paper reports on change in confidence and anxiety in knowledge of statistical terminology and concepts related to research design and EBP in eight consecutive years of post-graduate physiotherapy students at one Australian university., Methods: Pre-survey/post-survey instruments were administered to students in an intensive 3-week post-graduate course, which taught health research methods, biostatistics and EBP. This course was embedded into a post-graduate physiotherapy programme from 2007 to 2014. The organization and delivery of the course was based on best pedagogical evidence for effectively teaching adult physiotherapists. The course was first delivered each year in the programme, and no other course was delivered concurrently., Results: There were significant improvements in confidence, significantly decreased anxiety and improvements in knowledge of statistical terminology and concepts related to research design and EBP, at course completion. Age, gender and country of origin were not confounders on learning outcomes, although there was a (non-significant) trend that years of practice negatively impacted on learning outcomes (p = 0.09). There was a greater improvement in confidence in statistical terminology than in concepts related to research design and EBP., Conclusion: An intensive teaching programme in health research methods and biostatistics and EBP, based on best practice adult physiotherapy learning principles, is effective immediately post-course, in decreasing anxiety and increasing confidence in the terminology used in research methods and EBP. Copyright © 2016 John Wiley & Sons, Ltd., (Copyright © 2016 John Wiley & Sons, Ltd.)

In recent decades, physiotherapists have become concerned with cultural, economic, philosophical, political, and social questions and have been exploring more flexible ways of speaking about and practicing physiotherapy. While recognizing the need to embrace a broader range of perspectives, physiotherapy educators and other medical educators have been at a loss as to how to best achieve this. Drawing on two examples from South Africa and New Zealand, we seek to illustrate possibilities and barriers to teaching social sciences to physiotherapy students, specifically theories of embodiment as an alternative to the biopsychosocial model. We review each educator's choice of embodiment theory in curriculum design and the role of the educator's disciplinary background on teaching, learning, and assessing that learning. Against this background, we explore physiotherapy students' experiences with theories of embodiment and possible transformative implications for their self-worth and/or professional practices. We suggest that students were able to explore physiotherapy's relation to the body and the profession's historical inattention toward the body as a philosophical/theoretical construct. From the lessons learned, some can perhaps be usefully passed onto others thinking of introducing a more diverse and inclusive approach of the body; one that we argue will be needed in the future.

Background: Most health professions, including occupational therapy, have made the application of evidence-based practice a desired competency and professional responsibility. Despite the increasing emphasis on evidence-based practice for improving patient outcomes, there are numerous research-practice gaps in the health professions. In addition to efforts aimed at promoting evidence-based practice with clinicians, there is a strong impetus for university programs to design curricula that will support the development of the knowledge, attitudes, skills and behaviours associated with evidence-based practice. Though occupational therapy curricula in North America are becoming increasingly focused on evidence-based practice, research on students' attitudes towards evidence-based practice, their perceptions regarding the integration and impact of this content within the curricula, and the impact of the curriculum on their readiness for evidence-based practice is scarce. The present study examined occupational therapy students' perceptions towards the teaching and assessment of evidence-based practice within a professional master's curriculum and their self-efficacy for evidence-based practice., Methods: The study used a mixed methods explanatory sequential design. The quantitative phase included a cross-sectional questionnaire exploring attitudes towards evidence-based practice, perceptions of the teaching and assessment of evidence-based practice and evidence-based practice self-efficacy for four cohorts of students enrolled in the program and a cohort of new graduates. The questionnaire was followed by a focus group of senior students aimed at further exploring the quantitative findings., Results: All student cohorts held favourable attitudes towards evidence-based practice; there was no difference across cohorts. There were significant differences with regards to perceptions of the teaching and assessment of evidence-based practice within the curriculum; junior cohorts and students with previous education had less favourable perceptions. Students' self-efficacy for evidence-based practice was significantly higher across cohorts. Four main themes emerged from the focus group data: (a) Having mixed feelings about the value of evidence-based practice (b) Barriers to the application of evidence-based practice; (c) Opposing worlds and (d) Vital and imperfect role of the curriculum., Conclusion: This study provides important data to support the design and revision of evidence-based practice curricula within professional rehabilitation programs.

Background: It is important that all undergraduate healthcare students are equipped with evidence-based health care (EBHC) knowledge and skills to encourage evidence-informed decision-making after graduation. We assessed EBHC teaching and learning in undergraduate human nutrition (HN); occupational therapy (OT); physiotherapy (PT); and speech, language and hearing therapy (SPLH) programs at a sub-Saharan African university., Methods: We used methodological triangulation to obtain a comprehensive understanding of EBHC teaching and learning: (1) through a document review of module guides, we identified learning outcomes related to pre-specified EBHC competencies; we conducted (2) focus group discussions and interviews of lecturers to obtain their perspectives on EBHC and on EBHC teaching and learning; and we (3) invited final year students (2013) and 2012 graduates to complete an online survey on EBHC attitudes, self-perceived EBHC competence, and their experience of EBHC teaching and learning., Results: We reviewed all module outlines (n = 89) from HN, PT and SLHT. The OT curriculum was being revised at that time and could not be included. Six lecturers each from HN and OT, and five lecturers each from PT and SLHT participated in the focus groups. Thirty percent (53/176) of invited students responded to the survey. EBHC competencies were addressed to varying degrees in the four programs, although EBHC teaching and learning mostly occurred implicitly. Learning outcomes referring to EBHC focused on enabling competencies (e.g., critical thinking, biostatistics, epidemiology) and were concentrated in theoretical modules. Key competencies (e.g., asking questions, searching databases, critical appraisal) were rarely addressed explicitly. Students felt that EBHC learning should be integrated throughout the four year study period to allow for repetition, consolidation and application of knowledge and skills. Lecturers highlighted several challenges to teaching and practising EBHC, including lack of evidence relevant to the African context and lack of time within curricula.

Activity-limiting pain is common among older home care patients and pain management is complicated by the high prevalence of physical frailty and multimorbidity in the home care population. A comparative effectiveness study was undertaken at a large urban home care agency to examine an evidence-based pain self-management program delivered by physical therapists (PTs). This article focuses on PT training, methods implemented to reinforce content after training and to encourage uptake of the program with appropriate patients, and therapists' fidelity to the program. Seventeen physical therapy teams were included in the cluster randomized controlled trial, with 8 teams (155 PTs) assigned to a control and 9 teams (165 PTs) assigned to a treatment arm. Treatment therapists received interactive training over two sessions, with a follow-up session 6 months later. Additional support was provided via emails, e-learning materials including videos, and a therapist manual. Program fidelity was assessed by examining PT pain documentation in the agency's electronic health record. PT feedback on the program was obtained via semistructured surveys. There were no between-group differences in the number of PTs documenting program elements with the exception of instruction in the use of imagery, which was documented by a higher percentage of intervention therapists (p = 0.002). PTs felt comfortable teaching the program elements, but cited time as the biggest barrier to implementing the protocol. Possible explanations for study results suggesting limited adherence to the program protocol by intervention-group PTs include the top-down implementation strategy, competing organizational priorities, program complexity, competing patient priorities, and inadequate patient buy-in. Implications for the implementation of complex new programs in the home healthcare setting are discussed.

Background: Health professional students are expected to maintain Fitness to Practise (FTP) including clinical competence, professional behaviour and freedom from impairment (physical/mental health). FTP potentially affects students, clinicians and clients, yet the impact of supervising students across the spectrum of FTP issues remains relatively under-reported. This study describes clinical educators' perceptions of supporting students with FTP issues., Methods: Between November 2012 and January 2013 an online survey was emailed to physiotherapy clinical educators from 34 sites across eight health services in Australia. The self-developed survey contained both closed and open ended questions. Demographic data and Likert scale responses were summarised using descriptive statistics. The hypotheses that years of clinical experience increased clinical educator confidence and comfort in supporting specific student FTP issues were explored with correlational analysis. Open text questions were analysed based on thematic analysis., Results: Sixty-one percent of the 79 respondents reported supervising one or more students with FTP issues. Observed FTP concerns were clinical competence (76%), mental health (51%), professional behaviour (47%) and physical health (36%). Clinicians considered 52% (95% CI 38-66) of these issues avoidable through early disclosure, student and clinician education, maximising student competency prior to commencing placements, and human resources. Clinicians were confident and comfortable supporting clinical competence, professional behaviour and physical health issues but not mental health issues. Experience significantly increased confidence to support all FTP issues but not comfort. Student FTP issues affects the clinical educator role with 83% (95% CI 75-92) of clinicians reporting that work satisfaction was affected due to time pressures, emotional impact, lack of appreciation of educator time, quality of care conflict and a mismatch in role perception. Educators also considered that FTP issues affect service delivery and impact on those seeking health care., Conclusions: Strategies to support student FTP have potential to positively impact on students, clinicians and clients. Collaboration between these stakeholders is required, particularly in supporting mental health. Universities are strategically placed to implement appropriate support such as communication support.

Purpose To describe attitudes of doctoral physical therapy (DPT) students towards people with disability and examine predictive ability of demographic variables on those attitudes. Methods Two established surveys, Attitudes Towards Disabled Persons-Form O (ATDP-O) and Disability Attitudes in Health Care (DAHC) were completed by first (Y1) and third year (Y3) students in a DPT programme. Demographics and information about students' contact experience with people with disabilities were collected through a brief questionnaire. Multiple linear regression models were constructed from predictor variables. Results Scores on the ATDP-O and the DAHC were not significantly different between the Y1 and Y3 DPT students. There was a modest correlation (r = 0.342, p < 0.001) between the ATDP-O and the DAHC. Being female and having work contact with people with disabilities both explained about 9% of the variance in the DAHC; while having a close family member explains about 4% of the variance in the ATDP-O. Conclusion Attitudes of DPT students over the course of their education did not change. The DAHC is a more recently developed tool and should continue to be investigated for its usefulness in healthcare professional students. Faculty should consider measuring attitudes and developing specific educational strategies to improve attitudes with the goal to improve patient care. Implications for Rehabilitation Attitudes towards people with disability can impact their health care. Physical therapy students, in general, express positive attitudes towards people with disabilities and no differences in attitudes were determined in a group of Year 1 and Year 3 doctoral physical therapy students. Opportunities exist to intentionally thread educational strategies throughout a professional curriculum to facilitate further development of positive attitudes in doctoral physical therapy students.