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Objectives: Physical impairments associated with dementia include reduced gait speed, and diminished postural control, which can lead to an increase in falls and hip fractures. Physiotherapy can play a key role in many aspects of dementia care, including falls risk prevention, gait re-education and end of life care. However, there is a lack of dementia education in entry level physiotherapy programmes. The aim of this study was to map the dementia content and delivery in the current undergraduate and entry level physiotherapy curricula in Ireland the United Kingdom and New Zealand., Design: This cross-sectional survey-based study was distributed via the online survey tool Qualtrics XM. The survey was designed using the map of Kern's curriculum design framework., Setting: Higher educational institutes (HEIs) that offered an undergraduate (BSc) and/or MSc (entry level) physiotherapy programmes in Ireland United Kingdom and New Zealand were included., Participants: The academic lead for dementia education in the HEI was invited to participate in the survey., Results: Of the 69 eligible HEIs contacted, 49 responded, giving a response rate of 71%. Different sources informed curriculum design, including patient and public involvement, published guidelines and policies and expert clinicians. The time allocated to dementia teaching across the curricula varied, with under half of the programmes only allocating two hours. The lack of service user input was seen as a perceived weakness of many programmes as was the non-standardisation and generalisability of teaching., Conclusion: Whilst dementia education is included in many HEI programmes, we need to consider more time, a curriculum that meets learner's needs and include the patient voice. Further research is needed to develop bespoke dementia curricula specific to physiotherapy. CONTRIBUTION OF THE PAPER., Competing Interests: Conflict of interest None declared., (Copyright © 2024 The Authors. Published by Elsevier Ltd.. All rights reserved.)

Background: Digital health technology is progressively transforming physiotherapy practice. Despite a maturing body of literature relating to physiotherapy digital health capability, research examining digital health physiotherapy competency standards is both lacking and lagging., Objective: Examine international professional practice competency standards for physiotherapists to identify themes common to digital health practice competency, published by international peak organizations governing physiotherapy practice., Methods: Systematic meta-synthesis of international peak organization physiotherapy practice competency standards. The study was undertaken over nine stages. Competency statements related to digital health were extracted, and further coded into resultant themes., Results: Eleven documents were analyzed. Fifty-two statements explicitly referenced digital health competency. Identified themes were as follows: 1) digital health data governance; 2) digital health data translation; and 3) digital health technologies. Where digital health-related competency statements do exist, they are skewed toward health information management activities., Conclusions: Digital health practice is currently under-represented in competency standards for physiotherapists. Workforce advancement in light of the burgeoning impact of digital health will prompt further updates to professional competency standards set by our peak organizations. This will have a flow on effect, whereby education providers (e.g. universities and other professional development providers) should consider curriculum and training that prepares individuals for digitally enabled practice.

Purpose: To develop recommendations to support the range of patient education interventions relevant in the management of patients with subacromial pain syndrome (SAPS) in physical therapy., Materials and Methods: A 3-round modified Delphi consultation was used to obtain consensus agreement on the relevance of 12 preliminary recommendations. These were developed from a literature review and an expert consultation on general educational strategies and specific patient education interventions for the management of SAPS. The analysis assessed the rate of consensus on the relevance of these recommendations. Delphi panelists were rehabilitation professionals including physical ( n  = 21) and occupational therapists ( n  = 1) with SAPS experience, and patient-partners ( n  = 2) presenting shoulder pain., Results: The Delphi consultation resulted in 13 revised consensus recommendations. Six consensus recommendations addressed general educational strategies to facilitate patient education, including teaching methods and materials, and seven addressed specific educational interventions, including teaching symptom self-management and tailoring activities and participation. These recommendations were incorporated into a clinical decision-making tool to support the selection of the most relevant patient education interventions., Conclusion: The recommendations developed in this study are relevant to guide physical therapist's clinical decisions making regarding interventions using patient education for SAPS. They promote active engagement and empowerment of individuals with SAPS.

Wheelchair provision training is essential to overcome barriers related to the lack of knowledge of health professionals on this topic. Appropriate knowledge of the service provision process may lead to higher quality service and products, and thus be more likely to help people with mobility impairments achieve the fundamental human right of personal mobility. This study aimed to describe a training intervention for two groups of future physiotherapists in Colombia, assess cohort differences in performance on a knowledge test, and explore their post-training perceptions. A quantitative retrospective study with a historical, descriptive-comparative design was conducted. 525 sixth-semester participants completed the International Society of Wheelchair Professionals Wheelchair Service Provision - Basic Test online in Spanish after curriculum modifications were implemented. The test assesses knowledge in seven domains: Assessment; Prescription; Products; Fitting; User training; Follow-up, maintenance, and repairs; and Process. The training intervention was successfully implemented with Physiotherapy students from two institutions, resulting in a 57% increase in test approval rates. Participants demonstrated increased knowledge, satisfaction with the course content, and application of learning to their current work. These results suggest implications for what pedagogical approach to employ, when curricular change may be warranted, and specific considerations for the Colombian context. Furthermore, identifying the minimal knowledge basis for undergraduate programs and facilitating its dissemination can support interprofessional education and enhance professionals' capacity to support wheelchair provision services.

Hybrid e-learning offered flexibility for students who could not attend in-person classes during the COVID-19 pandemic, but its effectiveness in teaching chest physiotherapy remains to be determined. This retrospective case-control study assessed physiotherapy students' academic performance and satisfaction with a hybrid classroom approach adopted during the COVID-19 pandemic for teaching airway clearance techniques. Physiotherapy students participated in a 'Critical area and airway clearance techniques' seminar in person or remotely. The evaluation included a multiple-choice quiz (0-20 points) for theoretical knowledge, a checklist (0-10 points) for practical skills, and a total score (0-30 points). Satisfaction was measured using a 5-point Likert scale. Quartile regression tests calculated median differences, 95% confidence intervals (CIs), and Cohen's d effect sizes for each assessment component. The analysis included 41 students (54% men, mean age: 23 ± 2.1). The face-to-face group outperformed the remote group in total scores (median difference: 6 [95% CI 2.89; 9.10], effect size: 1.48 [0.72; 2.23]) and practical skills (median difference: 4 [2.31; 5.68], effect size: 2.05 [1.35; 2.76]). However, there was no conclusive difference in theoretical knowledge (median difference: 2 [-0.24; 4.24], effect size: 0.61 [-0.07; 1.29]). Student satisfaction was similar. Physiotherapy students attending the 'Critical area and airway clearance techniques' seminar remotely achieved lower scores than their in-person counterparts, highlighting the potential limitations of hybrid teaching for this subject. The mean scores indicated that this method allowed students to acquire the necessary knowledge during the COVID-19 pandemic., (© 2024. The Author(s).)

Background: Clinical education is a crucial process in which students learn how to use theoretical knowledge in clinical settings. However, there is no standardized assessment tool routinely used to evaluate the clinical performance of physiotherapy students in Turkey. This study aimed to examine the psychometric (validity and reliability) and edumetric (acceptability, feasibility, and educational impact) properties of the Turkish version of the Assessment of Physiotherapy Practices (APP-T)., Methods: This methodological study included 7 clinical educators and 174 4th-grade physiotherapy students at three universities in Turkey. Students were assessed with the APP-T on completion of 4-week clinical placements. The construct validity was examined using the exploratory factor analysis. The internal consistency was determined using Cronbach's α-coefficient. The test-retest and inter-rater reliability were evaluated with the intra-class correlation coefficient (ICC). For the measurement error of the APP-T, standard error of measurement (SEM) and minimum detectable change (MDC) values were calculated. After the administration of the APP-T was completed, clinical educators were requested to provide feedback on the acceptability, applicability, and educational impact of the APP-T., Results: Exploratory factor analysis demonstrated the 20 items of the APP-T represent a single dominant dimension explaining 76.28% of the variance. Excellent test-retest and inter-rater reliability was detected by ICC = 0.94 and ICC = 0.77, respectively, and good internal consistency was detected by Cronbach's α = 0.935. The MDC 90 values for test-retest and inter-rater reliability were 3.11 and 6.86, respectively. Clinical educators provided generally positive feedback on the acceptability, feasibility, and educational impact of the APP-T., Conclusions: The current findings provided evidence for universities and clinical educators that the APP-T has sufficient psychometric and educational properties for evaluating the clinical performance of physiotherapy students in Turkey., (© 2024. The Author(s).)

Background: and Purpose: In the global landscape, quality assurance is paramount for educational institutions to adapt and thrive. The accreditation process involves evaluating an institution's quality according to standards established by experts and officially documenting its level of quality. This study aimed to assess the impact of a single educational session on physiotherapy and rehabilitation students' awareness and understanding of accreditation processes, recognizing their vital role in quality assurance., Methods: A pretest-posttest design was employed with 211 students from a physiotherapy and rehabilitation department. Data were collected using a questionnaire assessing demographic information, knowledge about accreditation, and thoughts regarding accreditation. The educational session focused on accreditation criteria and processes, involving presentations and interactive discussions. McNemar's analysis was used to compare the response rates given by the students pre-and post-session., Results: Analysis after the education session revealed a significant increase in students' knowledge of accreditation concepts (p < 0.05). Positive attitudes towards accreditation were reinforced, with students recognizing its importance in education quality. Despite pre-existing positive attitudes, the educational intervention enhanced students' understanding and engagement in accreditation processes with a significant increase in three of the eight questions on thoughts about accreditation (p < 0.05)., Discussion: This study underscores the efficacy of educational interventions in fostering student engagement and awareness of accreditation. Findings suggest the need for integrating accreditation education into curricula and advocating its significance through seminars and literature support, ultimately enhancing student participation in quality assurance processes., (© 2024 John Wiley & Sons Ltd.)

Rationale: Advanced Practice Physiotherapy (APP) is a post-licensure higher level of practice that requires distinctly increased skills, clinical reasoning and experience. The four pillars that underpin APP are clinical practice, leadership, education and research. Multiple systematic reviews support that APP is beneficial to health care systems. While APP exists in over a dozen countries, it has yet to reach international recognition. A steppingstone in gaining global acknowledgement is understanding the educational pathway that physiotherapists traverse to become Advanced Practitioners. No systematic review has synthesized evidence to describe and evaluate the educational pathway for physiotherapists to APP. Therefore, the objectives of this review are 1) to describe the post-licensure educational pathways that physiotherapists engage in to advance their level of practice, 2) to evaluate the pillars of APP demonstrated by the physiotherapist after traversing a post-licensure educational pathway., Materials and Methods: A systematic mixed studies review using a data based convergent qualitative synthesis design will be conducted. MEDLINE (Ovid), Embase, CINAHL, the Cochrane Library, Web of Science, PEDro, SportDiscus, ProQuest Education databases as well as the grey literature will be searched from inception to 02/29/2024. Studies that aim to describe and or evaluate the capacity of educational pathways to influence the level of practice of the physiotherapist will be included. Two independent reviewers will screen studies, extract data and assess methodological quality (Quality Assessment of Diverse Studies). Quantitative data will be 'qualitized', and all data will be synthesized via a clustered textual description and directed content analysis. After synthesis, two reviewers will assess confidence in the cumulative evidence (GRADE-CERQual), which will inform the discussion., Implications: The optimal pathway(s) to Advanced Practice for the physiotherapist will be evaluated to inform future high-quality research investigating the effectiveness of post-licensure education in developing Advanced Practice physiotherapists., Competing Interests: The authors have declared that no competing interests exist., (Copyright: © 2024 Maddigan et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.)

Scholarly practice (SP) is considered a key competency of occupational therapy and physiotherapy. To date, the three sectors-education/research, practice, and policy/regulation-that support SP have been working relatively independently. The goals of this project were to (a) understand how representatives of the three sectors conceptualize SP; (b) define each sector's individual and collective roles in supporting SP; (c) identify factors influencing the enactment of SP and the specific needs of how best to support SP; and (d) co-develop goals and strategies to support SP across all sectors. We used interpretive description methodology. Consistent with an integrated knowledge translation approach, partners representing the three sectors across Canada recruited individuals from each sector, developed the content and questions for three focus groups, and collected and analyzed the data. Inspired by the Consolidated Framework for Implementation Research, we developed the questions for the second focus group. We analyzed the data using an inductive thematic analysis method. Thirty-nine participants from the three sectors participated. Themes related to participants' conceptualization of SP included (a) ongoing process, (b) reflective process, (c) broad concept, and (d) collective effort. Themes describing factors influencing and supporting SP were (a) recognition, (b) appropriate conceptualization, (c) social network, (d) accessibility to resources, and (e) forces outside of practitioners' effort. Goals to support SP included (a) further recognizing SP, (b) sustaining SP competency, and (c) ensuring access to information. SP requires collaborative and integrated intersectoral support and further recognition of its importance through the collaboration of multiple stakeholders., (© 2023. The Author(s), under exclusive licence to Springer Nature B.V.)

Purpose: To explore student and tutor perspectives on the learning efficacy of virtual, compared to in-person, problem-based tutorial (PBT) in occupational therapy, physiotherapy, and speech-language pathology health professional programs., Materials and Methods: This was a quality improvement study using a cross sectional survey at a single institution. Separate student and tutor surveys were disseminated online. Students received the survey at two timepoints, tutors received the survey at one timepoint. Descriptive statistics summarized quantitative survey questions. Chi-squared or Fischer's Exact analyses explored differences between in-person and virtual PBT. Exploratory analyses determined if associations amongst programs and/or between cohorts existed on variables of interest. Open-ended survey questions were analyzed using content analysis., Results: A total of 241 students and 85 tutors completed the survey. Results demonstrate most students and tutors were satisfied with the use of virtual tutorials (77%; 89% respectively) and felt that they were effective in exploring content within the PBT course. However, students in the most recent cohort rated virtual tutorials more highly ( p  = 0.01)., Conclusions: Virtual modes of PBT were successful in achieving course objectives and led to high satisfaction in users. Health professional programs can use this information when designing virtual problem-based tutorial courses in the post-pandemic era.

2024 marks the 50th anniversary of the International Federation of Orthopaedic Manipulative Physical Therapists (IFOMPT). IFOMPT became the first subgroup of World Physiotherapy. IFOMPT aims and works for global promotion of excellence and unity in clinical and academic standards for manual/musculoskeletal physiotherapists. This dissertation reflects on some of IFOMPT's initiatives and achievements as an international organisation in its first 50 years as well as challenges for next 50 years. IFOMPT has achieved in several initiatives. These include the development of an international educational curriculum in manipulative/musculoskeletal physiotherapy which underpins education standards for membership. Educational standards for membership is a relatively unique requirement of a professional organisation. IFOMPT has achieved in developing several initiatives to disseminate knowledge for best standards of practice for its members and the wider community. The pinnacle is its four yearly international scientific conferences where the latest issues in both research and practice are presented and discussed. IFOMPT has also developed frameworks to guide clinical practice in key areas for safe practice - vascular pathologies of the neck, a clinical reasoning pathway to identify 'red flags', and the use of spinal manipulation in paediatrics. Other resources include on-line lectures, podcasts and research reviews. IFOMPT has challenges for the future. These include increasing the number of member countries and further establishing its profile and position of leadership in manual/musculoskeletal physiotherapy in the international context, particularly with decision makers in world health., (Copyright © 2024. Published by Elsevier Ltd.)

Objective: This pilot study aimed to evaluate a training programme for primary care physiotherapists focused on the assessment and management of benign paroxysmal positional vertigo., Methods: A six-month training programme and toolkit utilising the revised Standards for Quality Improvement Reporting Excellence ('SQUIRE 2.0') guidelines was developed to facilitate the learning of new knowledge and skills in the assessment and management of benign paroxysmal positional vertigo following Gagne's model of instructional design. A pre- and post-training knowledge and confidence questionnaire evaluated the impact of the training programme., Results: Eleven participants started the training programme and five completed it. On average, knowledge increased by 54 per cent (range, 41-95 per cent) and confidence increased by 45 per cent (range, 31-76 per cent). A 73 per cent improvement in practical skills acquisition was demonstrated after the initial training session., Conclusion: A structured approach to learning demonstrates improvements in knowledge, skills and confidence of physiotherapists in the evidence-based management of benign paroxysmal positional vertigo.

Background: 'Telehealth' online delivery of physiotherapy was the only option during the Covid 19 pandemic in many areas. This was a challenge for physiotherapy training in student clinics where students, clinical educators (CEs) and clients were in three separate locations. The aim of this study was to determine the usability and acceptability of online delivery in a physiotherapy student clinic., Methods: An observational cross-sectional design was used. Clients (adult clients or carers of paediatric clients), students and CEs participated in telehealth physiotherapy appointments over a Telehealth platform called NeoRehab. The three groups were then invited to complete the Telehealth Usability Questionnaire (TUQ). The 21 item TUQ uses a 7-point Likert scale and covers six constructs (Usefulness, Ease of Use, Interface quality, Interaction quality, Reliability, Satisfaction)., Results: Data were analysed from 39 clients, 15 students, and seven CEs. The respective domain scores (SD) for Usefulness [(5.3 (1.5), 5.4 (0.7), 5.1 (0.7)] and Satisfaction [5.1 (1.6), 5.0 (1.0), 5.4 (0.7)] were similarly high across groups, while scores for Reliability [3.7 (1.5), 3.6 (1.0), 3.0 (0.5)] were similarly low across groups. Interface Quality [5.0 (1.5), 4.5 (1.2), 4.1 (0.8)] scores were similarly moderate. Ease of Use [5.6 (1.5), 5.3 (1.0), 4.1 (1.1)] scores were significantly higher in clients than CEs (p = 0.043). Interaction Quality [5.0 (1.4), 3.9 (1.3), 4.2 (0.9)] scores were significantly higher in clients compared with students (p = 0.03)., Conclusions: All groups agreed that the delivery format was useful, easy to use and provided a satisfactory service but was not reliable., (© 2024 The Author(s). Musculoskeletal Care published by John Wiley & Sons Ltd.)

Background: Patient education can increase patient engagement and positive outcomes with physical therapy treatment. This study aimed to develop and evaluate the psychometric properties of a physical therapy patient education questionnaire., Methods: Candidate items were developed and evaluated by an expert panel for content validity. The resulting items were administered to 350 patients in physical therapy treatment, and the reliability and validity of the scale's subscales were evaluated., Results: The final version of the questionnaire consists of 36 items that assess six education domains for patients receiving physical therapy: 1) assessment and information provision (10 items), 2) hygiene and safety (9 items), 3) patient empowerment (8 items), 4) emergency and infection control (3 items), 5) adverse event prevention (4 items), and 6) identity confirmation (2 items). The internal consistency of the subscales ranged from 0.69 to 0.92, and support for the six-domain structure of the items was supported via factor analysis., Conclusions: The questionnaire was successfully developed and evidenced good psychometric properties for the assessment of the perceived importance of six physical therapy education domains. Research is needed to evaluate potential gaps between patients' perceived education needs and therapist education activities during physical therapy treatment.

Joint mobilizations are well-established and extensively researched treatment modality for adults. However, it remains largely unexplored in the pediatric population. Physical therapists hesitate to perform joint mobilization on children because of lack of knowledge, concern for the developing skeletal system, and the paucity of research on the topic. The aim of this article is to present a decision tool created for a continuing education course with the purpose to instruct pediatric therapists in the safe and effective use of joint mobilizations in children. It is based on the pediatric paradigm of developmental and functional assessment to best address the concerns and preferences of physical therapists (PTs). To advance research in pediatric joint mobilization, PTs should listen to the concerns of pediatric therapists and respond to those concerns with effective, evidence-supported training. This decision tree will serve as a resource for the education of pediatric therapists in the safe and effective use of joint mobilizations.

Background: Vascular pathologies of the head and neck are rare but can present as musculoskeletal problems. The International Federation of Orthopedic Manipulative Physical Therapists (IFOMPT) Cervical Framework (Framework) aims to assist evidence-based clinical reasoning for safe assessment and management of the cervical spine considering potential for vascular pathology. Clinical reasoning is critical to physiotherapy, and developing high-level clinical reasoning is a priority for postgraduate (post-licensure) educational programs., Objective: To explore the influence of the Framework on clinical reasoning processes in postgraduate physiotherapy students., Methods: Qualitative case study design using think aloud methodology and interpretive description, informed by COnsolidated criteria for REporting Qualitative research. Participants were postgraduate musculoskeletal physiotherapy students who learned about the Framework through standardized delivery. Two cervical spine cases explored clinical reasoning processes. Coding and analysis of transcripts were guided by Elstein's diagnostic reasoning components and the Postgraduate Musculoskeletal Physiotherapy Practice model. Data were analyzed using thematic analysis (inductive and deductive) for individuals and then across participants, enabling analysis of key steps in clinical reasoning processes and use of the Framework. Trustworthiness was enhanced with multiple strategies (e.g., second researcher challenged codes)., Results: For all participants (n = 8), the Framework supported clinical reasoning using primarily hypothetico-deductive processes. It informed vascular hypothesis generation in the patient history and testing the vascular hypothesis through patient history questions and selection of physical examination tests, to inform clarity and support for diagnosis and management. Most participant's clinical reasoning processes were characterized by high-level features (e.g., prioritization), however there was a continuum of proficiency. Clinical reasoning processes were informed by deep knowledge of the Framework integrated with a breadth of wider knowledge and supported by a range of personal characteristics (e.g., reflection)., Conclusions: Findings support use of the Framework as an educational resource in postgraduate physiotherapy programs to inform clinical reasoning processes for safe and effective assessment and management of cervical spine presentations considering potential for vascular pathology. Individualized approaches may be required to support students, owing to a continuum of clinical reasoning proficiency. Future research is required to explore use of the Framework to inform clinical reasoning processes in learners at different levels., (© 2024. The Author(s).)

Background: Access to pain education for healthcare professionals is an International Association for the Study of Pain's key recommendation to improve pain care. The content of preregistration and undergraduate physical therapy pain curricula, however, is highly variable., Objective: This study aimed to develop a list, by consensus, of essential pain-related topics for the undergraduate physical therapy curriculum., Methods: A modified Delphi study was conducted in four rounds, including a Delphi Panel ( N = 22) consisting of in pain experienced lecturers of preregistration undergraduate physical therapy of Universities of Applied Sciences in the Netherlands, and five Validation Panels. Round 1: topics were provided by the Delphi Panel, postgraduate pain educators, and a literature search. Rounds 2-4: the Delphi Panel rated the topics and commented. All topics were analyzed in terms of importance and degree of consensus. Validation Panels rated the outcome of Round 2., Results: The Delphi Panel rated 257, 146, and 90 topics in Rounds 2, 3, and 4, respectively. This resulted in 71 topics judged as "not important," 97 as "important," and 89 as "highly important." In total, 63 topics were rated as "highly important" by the Delphi Panel and Validation Panels., Conclusion: A list was developed and can serve as a foundation for the development of comprehensive physical therapy pain curricula.

Purpose: Doctor of Physical Therapy (DPT) education continues to progress with contemporary content and innovative teaching methods. The purpose of this study was to examine clinical assessment data from the Physical Therapist Clinical Performance Instrument (PT-CPI) focused on professionalism and safety in an initial clinical experience between an accelerated-hybrid and traditional DPT program., Methods: A retrospective analysis was performed on mid-term and final Safety, Professional Behavior, and Communication PT-CPI scores of each program's first clinical experience. The traditional program served as a control group. A total 186 students were examined: 100 from the traditional program and 86 from the accelerated-hybrid program., Results: There was a significant effect of learning environment on final test scores while controlling for midterm scores in Safety (p < 0.001), Professional Behavior (p < 0.001), and Communication (p < 0.001) with students in the accelerated-hybrid program scoring higher. Each program showed improvements from midterm to final PT-CPI, outperforming the set benchmark score with the accelerated-hybrid program showing larger growth in Communication and Safety., Conclusion: Students in both DPT programs display acceptable levels of professionalism and safety according to program benchmarks and demonstrate growth in these areas throughout the clinical experiences despite differences in program design.

Pain is one of the most prevalent and long-term adverse effects described by people who have undergone breast cancer surgery. Non-helpful perceptions and thoughts about pain may contribute to the transition of acute to persistent pain. Adding educational interventions to the current physical therapy program in this population may help to improve or prevent persistent pain. Pain neuroscience education (PNE) is a type of educational intervention that addresses the experience of pain in a broader sense by explaining pain not only from a biomedical perspective, but also from a psychological and social perspective. A double-blinded randomized controlled trial (EduCan trial) investigated whether PNE, in addition to a standard physiotherapy program immediately after surgery for breast cancer, was more effective on somatosensory functioning in the short (4 months postoperatively) and long term (18 months postoperatively), than providing a biomedical explanation for pain. Somatosensory functioning was evaluated using a self-reported questionnaire as well as a comprehensive quantitative sensory testing evaluation. The findings of this study revealed that adding six sessions of PNE to a standard physical therapy program (n = 184) did not result in a significantly different course of somatosensory functioning up to 18 months postoperatively as compared to biomedical pain education. These findings provide an interesting basis for future research into who should receive PNE after surgery for breast cancer (e.g., patient profiling or phenotyping) and how we can tailor it to the individual to increase its effectiveness., (© 2023 American Association for Anatomy.)

Questions: What is the student experience of near peer-led simulation in physiotherapy education from the perspectives of students (near peer learners and near peer teachers)? What are their expectations, perceptions and engagement in this as a teaching and learning activity? Are there any short-term benefits?, Design: Convergent mixed-methods study., Participants: From a graduate entry Doctor of Physiotherapy course, 111 first-year and 20 second-year students participated., Intervention: Near peer-led simulation was delivered within first-year cardiorespiratory, musculoskeletal and neurological physiotherapy curricula and as a precursor to second-year clinical placements. First-year students were near peer learners. Second-year students were near peer teachers and the simulated patients., Outcome Measures: Focus groups, pre/post-simulation questionnaires and direct observation. Data were triangulated and presented in overall themes., Results: Five themes emerged: near peer-led simulation improved the students' confidence and the opportunity to make mistakes in a supportive and safe environment was valued; peer feedback was an integral part of the learning process that enriched the learning experience; the authenticity and realism created seriousness, promoted engagement and facilitated perceived knowledge transfer; there were benefits for learning for both peer learners and peer teachers; and the anticipation and emotional impact was evident., Conclusion: Near peer-led simulation was viewed by students as a valuable and engaging activity. Students perceived a broad range of benefits on their learning, especially from peer feedback (giving and receiving) on their performance, and had increased confidence following simulation. Peer-led simulation is an authentic and valuable component of entry-to-practice physiotherapy education., (Copyright © 2023 Australian Physiotherapy Association. Published by Elsevier B.V. All rights reserved.)

Introduction: It is now widely accepted in physiotherapy and in other health professions, that involving patients in the design, planning and implementation of services is best practice. Little is, however, known about how physiotherapy students perceive their professional development in applying person-centered practice., Objective: To analyze how undergraduate physiotherapy students experience the process of learning to work in a person-centered way in clinical practice., Method: Five focus-group interviews of final-year physiotherapy students., Results: It is important that students communicate in ways that accommodate the sociocultural characteristics of their patients. Students, where they experience that mutual understanding is not possible to achieve, tend to resort to the biomedical model and take on an expert instructor role that is met with acceptance from the patients. Some practice contexts were also found to strongly promote person-centered practice, others tightly restricting it., Conclusion: In the educational setting, attention should be paid to the practice learning context, to the improvement of the ability of students to grasp the lived world of patients, and to activate their own identities and experiences as a relational tool in practicing person-centered care.

Background: Student-led clinics (SLCs) are a mode of delivery whereby students take responsibility for the delivery of a health service or intervention. SLCs for physiotherapy have a wide range of uses, including enhancement of learning, replacement of clinical placement hours and serving population and community needs. Evidence is emerging globally as to the outcomes of SLCs in physiotherapy, but little exists in the United Kingdom (UK) context. The purpose of this study was to explore student perceptions of running, leading and participating in a UK physiotherapy student-led neurological rehabilitation clinic., Methods: A qualitative design using a focus group., Findings: Four themes were identified relating to students' perceptions of SLCs associated with the learning environment, self-development, enhanced clinical skill development and reflections on experience at the SLC., Discussion: The findings of this study suggest that physiotherapy SLCs in a UK context can contribute positively to student experience and skill development, particularly in relation to the learning environment, development of clinical skills, leadership and autonomy. Some aspects related to, for example, student induction and preparation could be further developed. Further research should explore if these findings are applicable in other countries where SLCs are less established., Conclusion: Further research in the UK and globally related to SLC models in different courses and across varying stages is required. Exploration of the SLC as a viable form of clinical placement experience is also warranted., (© 2023 The Authors. The Clinical Teacher published by Association for the Study of Medical Education and John Wiley & Sons Ltd.)

Evidence-based practice (EBP) is an integral competency for physical therapists; however, a knowledge-to-practice gap exists and best educational practices to facilitate EBP-related behaviors are unclear. This study describes the effects of a multi-semester learning activity on student-reported EBP behaviors. Students (n = 34) in their second and third years of a Doctor of Physical Therapy program participated in a 4-semester learning activity including journal club participation and student research, with integrated learning objectives. The Evidence-Based Practice Profile (EBP2) was administered at the beginning and the end of the learning activity to collect outcomes related to five EBP domains. Significant improvements were observed in four EBP domains, with medium to large effect sizes (relevance 0.63; sympathy 0.18; terminology 1.05; practice 0.94; confidence 0.90). The multi-semester activity described here is generalizable and relevant to a variety of allied health disciplines and shows promise to improve student EBP skills and knowledge.

Introduction: Musculoskeletal disorders (MSDs) are a primary cause of separation and long-term disability in active duty service members (ADSMs). Psychologically informed physical therapy (PiPT) is designed to identify and address modifiable psychological risk factors early in an MSD episode and has been proven effective in preventing chronicity in civilian populations. We developed a course to train military physical therapy (PT) personnel in PiPT for treating ADSM with MSD. This study tests the feasibility and effectiveness of our training., Objective: Establish the feasibility of implementing PiPT and its effectiveness in the U.S. military., Materials and Methods: An observational, prospective, comparative cohort study will test implementation and effectiveness. First, we will observe clinical outcomes in a cohort of ADSM with MSD receiving usual PT care at a military outpatient PT clinic. Next, we will train all PT staff in PiPT. Finally, PiPT will be implemented in a second cohort of ADSM. Data will be collected from each cohort at pre-treatment, fourth PT visit, 6 months post enrollment, and 12 months post enrollment. The primary outcomes are pain interference and psychological risk for chronicity., Results and Conclusions: Data collection is ongoing. Findings will identify the factors associated with PiPT outcomes in ADSM, inform the implementation of PiPT across health care settings, and allow us to document the prevalence of risk factors for chronicity in ADSM. Findings can help to prevent chronification from MSD, thereby reducing lost man-hours and enhancing military readiness, contribute to the development of a highly skilled workforce for the provision of health services to ADSM, and enhance the efficiency of health care delivery through optimal allocation of PT resources, resulting in significant cost savings for the military., (Published by Oxford University Press on behalf of the Association of Military Surgeons of the United States 2023. This work is written by (a) US Government employee(s) and is in the public domain in the US.)

Background: Self-assessment is a method that allows students to reflect on and critically evaluate their performance, increases students' involvement in learning, and improves academic achievement. In physiotherapy (PT) education, clinical training is a crucial component, guided by clinical educators (CEs), who assess and provide feedback, fostering student development. Limited research has investigated the impact of self-assessment on PT clinical training outcomes. This study aims to assess the effect of mid-term self-assessment during PT clinical training on students' competence and on level of agreement between students' self-assessment and CEs' assessment at the end of the training., Methods: 23 CEs and their 52 undergraduate PT students participated in the study. The students underwent eight weeks of clinical training in outpatient PT clinics in groups of two or three. For each group, one CE performed student assessment at the mid-term and the end of the training using the Assessment of Physiotherapy Practice (APP) form, an assessment tool used to evaluate clinical competence in PT clinical training. One student from each group was randomly assigned to join the intervention group (IG). These students completed a self-assessment process at the mid-term of the training. All students were asked to complete a self-assessment form at the end of the training., Results: The median CE's evaluation score halfway through the training was 80 [50-96] and 91 [65-100] at the end of the training, with no significant differences between the two groups. The level of agreement between the student and CE's evaluation at the end of the training was not significantly different between the groups (p = 0.05). It noted that students who scored themselves higher than their CEs tended to have lower APP scores than others, based on CEs' assessment. These students were found to have less academic experience. Nevertheless, those from the IG improved significantly, based on the CE's assessment, during the second half of the training, compared to the controls., Conclusion: The main finding of the present study is that student participation in self-assessment during PT clinical training is advantageous, mainly for individuals undergoing their initial clinical training and in the early stages of their academic studies., (© 2023. BioMed Central Ltd., part of Springer Nature.)

Background: Threshold concepts describe learning experiences that transform our understanding of a concept. Threshold concepts are variously: troublesome, transformative, irreversible, integrative and bounded., Purpose: The aim of this narrative review is to consider the case for characterising pain science and practice as a threshold concept within undergraduate and pre-registration physiotherapy education. This article considers the underlying tenets of threshold concepts as they relate to teaching and learning and the relative merits and limitations of characterising pain science and practice as a threshold concept within undergraduate and pre-registration physiotherapy education from both pedagogical and epidemiological perspectives. By evaluating pain, as it relates to physiotherapy education and practice, according to the five defining characteristics of a threshold concept then presenting data related to the epidemiology and impact of pain, the worthiness of characterising pain science and practice as a threshold concept will be discussed and further debate invited., (© 2023. BioMed Central Ltd., part of Springer Nature.)

Background: Evidence-based practice (EBP) is the gold standard approach in physiotherapy, and it is essential that students are aware that it is the appropriate way to provide the patient with the best possible treatment. Undergraduate research (UR) can positively influence learning outcomes and research competencies related to EBP compared to traditional methods of higher education. The aim of this study was to evaluate the effect of implementing a research-based activity (i.e., active participation in a randomised controlled trial [RCT]) in the UR programme on the learning and acquisition of research methodology-related competencies by first-year physiotherapy students., Methods: Students in the first academic year of the Bachelor´s Degree in Physiotherapy of University of Deusto (Donostia-San Sebastian, Spain) who were enrolled in the subject 'Introduction to Research Methodology' were invited to take part in a real RCT which consisted of three groups: intervention, placebo, and control group. While the RCT was carried out, researchers and/or participants roles were combined among students during the semester. At the end, a questionnaire that included open and closed questions was used to evaluate the effectiveness of the UR strategies used in students´ acquisition of theoretical knowledge, research competencies, self-efficacy of RCT skills and procedures. Lecturers also completed the questionnaire to evaluate their experience., Results: From the 114 students enrolled in the subject, 102 participated in the RCT and 110 answered the final questionnaire. Regarding the development of research competencies, UR had a positive or very positive impact on critical thinking (67% and 18%, respectively) and in the assessment of methodological quality (66% and 23%, respectively). Furthermore, most students reported that the implementation of the RCT facilitated their knowledge of placebo, detection of bias, development of critical thinking and a better understanding of methodological issues in research. Lecturers reported an additional burden that was difficult to reconcile with daily duties., Conclusion: The novel UR program provided students with a new opportunity to improve their knowledge of RCT procedures, thus making the learning process more meaningful. Therefore, ways of teaching and learning focused on improving research and inquiry attitudes should be considered and integrated into the health care curriculum, especially in physiotherapy programs, to ensure the transfer of EBP for the provision of the best care., Trial Registration: Australian New Zealand Clinical Registry: ACTRN12622000263796p (14/02/2022)., (© 2023. BioMed Central Ltd., part of Springer Nature.)

Background: Exposure to clinical practice experiences ensures undergraduate physiotherapy students meet the clinical competencies required to graduate as autonomous practitioners. Much of the research literature has investigated the clinical experiences of medical students. While recent studies have explored physiotherapy students' experiences with simulation, few have explored their perspectives of a clinical placement in a hospital setting at the early learning stage of a four-year programme., Objective: To explore the perspectives of novice undergraduate physiotherapy students on a clinical placement in a real hospital setting., Methods: Fifteen Year 3 undergraduate physiotherapy students participated in semi-structured interviews midway through a three-week tertiary care clinical placement. Interviews were transcribed, coded and analyzed using thematic analysis., Results: Three main themes emerged: 1) student attributes affecting placement experience; 2) impact of the educator on student experience; and 3) effects of the clinical environment on student experiences., Conclusion: The real clinical environment promotes a rich learning experience for students, while the clinical educator is pivotal to guiding student learning through provision of resources and feedback. Provision of early orientation and timely clarification of expectations is important to alleviate anxiety and allow students to prepare themselves.

Objectives: This study includes two separate parts: the objective for part A was to evaluate the practical manual therapy skills of undergraduate physiotherapy students who had learned manual therapy techniques either online or in classroom depending on the phases of the pandemic. The objective for part B was to evaluate in a randomized prospective design the effectiveness of video-based versus traditional teaching of a manual therapy technique., Design: Cross-sectional cohort study (part A) and randomized controlled trial (part B)., Setting: University of Luebeck, undergraduate physiotherapy students in years 1-3., Method: In part A, physiotherapy students who had learned manual therapy either online (during the pandemic) or in classroom (prior to and after the lock down periods of the pandemic) were videotaped while performing two manual techniques on the knee joint and on the lumbar spine. Recordings were analyzed independently by two blinded raters according to a 10-item list of criteria. Inter-rater reliability was assessed using Cohen's kappa for each item. Performance across cohorts was analyzed using analysis of variance. In part B, students were randomized to learn a new technique on the cervical spine either from a lecturer or from the same lecturer on a video recording (independent variable). Practical performance of the technique was analyzed by two raters blinded to group allocation according to a 10-item list of criteria (dependent variable). Results were analyzed statistically by using ANCOVA with year of study as a covariate., Results: Sixty-three and 56 students participated in part A and part B of the study, respectively. The inter-rater reliability for video analyses for both parts of the study was moderate (k = 0.402 to 0.441). In part A, there was no statistically significant difference across years of study for the practical performance of the technique on the back F(2,59) = 2.271; p  = 0.112 or the knee joint F(2,59) = 3.028; p  = 0.056. In part B, performance was significantly better when learned from a lecturer and practiced on a peer than when learned from a video and practiced on a rescue dummy ( p  < 0.001)., Conclusion: Practical skill performance can be acquired from videos but immediate skill reproduction is significantly better when the technique is presented by a lecturer in classroom and practiced on peer students.

Introduction: Restrictions on in-person gatherings during the 2020 COVID-19 pandemic required educational programs to explore alternative educational formats. The nature of physical therapy education as a blend of cognitive and psychomotor skill presents additional challenges. During a gradual return to in-person learning, the authors' institution chose to break a full-length 15-week semester into 3, 5-week blocks. The first aim of this study was to evaluate the effects of semester design on course performance. The second aim was to assess the effects of semester design on knowledge and skill retention., Review of Literature: In undergraduate studies, blocked courses or semesters held over a short period of time may result in equal or better performance compared with courses performed over a longer time. Few studies have been performed on the graduate student population. Most studies have focused on short-term cognitive knowledge acquisition., Subjects: Three cohorts of Doctor of Physical Therapy (DPT) students were eligible to participate., Methods: Two DPT courses (1 first year and 1 second year) were selected to assess cognitive and psychomotor performance. Examination results were compared at the end of a full-length semester and blocked semester. A third course was selected to assess retention at 4 time points. Students were assessed on their cognitive retention using computer-based quizzes and psychomotor retention using in-person skills quizzes., Results: Median cognitive performance scores for both courses were slightly better during the blocked semester. There were no significant differences in median psychomotor scores. There was no significant interaction effect between semester structure and retention of cognitive knowledge or psychomotor skills, although there were significant changes in scores over time., Discussion and Conclusion: A blocked semester design may favor immediate cognitive performance. However, there is no significant effect on knowledge or skill retention over a 6-month period. Programs faced with the potential for in-person closures can select either semester structure based on their needs without compromising knowledge or skill retention., Competing Interests: The authors declare no conflicts of interest., (Copyright © 2023 Academy of Physical Therapy Education, APTA.)

Background: To explore attitudes to telehealth education and experiences incorporating telehealth education into entry-to-practice physiotherapy programs in Australia, from the perspective of university educators., Methods: Qualitative design based on a constructivist paradigm and a phenomenological approach. Sixteen university educators (who had a responsibility for telehealth curriculum or oversight of the broader curriculum in an entry-to-practice physiotherapy programme at an Australian university) were recruited. Individual semi-structured interviews were conducted via Zoom. Interviews were recorded, transcribed verbatim, and analysed thematically using an inductive approach., Results: Three themes (with associated subthemes) were identified: (i) telehealth education has a role in contemporary physiotherapy practice (COVID-19 pandemic was a driver for telehealth education, acknowledgement that telehealth is here to stay and identified areas of focus for telehealth education and training); (ii) telehealth education and training vary substantially (content delivered and assessment of telehealth competency is ad hoc and student exposure to telehealth on clinical placements is inconsistent); (iii) challenges in telehealth education (finding space and time in the curriculum, as well as insufficient knowledge and expertise of staff, are challenges for implementation of telehealth education, however, course and subject development and/or reviews provide opportunities for implementing telehealth education and training)., Conclusion: Current content and volume of telehealth education and training in entry-to-practice physiotherapy programs across Australia varies substantially. Although educators believe telehealth is an important component of contemporary physiotherapy practice, many barriers exist for including telehealth training into the curriculum., (© 2022 The Authors. Musculoskeletal Care published by John Wiley & Sons Ltd.)

Background: Rehabilitative care in the home notably declined in the early onset of the COVID-19 pandemic and has been suggested to have greatly affected patient health¬care., Purpose: To examine the perspectives of home health physical therapists (PTs) on the impact of COVID-19 on patient management and fall risk assessment. METH¬ODS: The study utilized a 42-question internet-based survey to collect data from home health PTs., Results: A total of 116 responses were analyzed. Most PTs (68.1%) reported the belief that their patients were more impaired than prior to COVID-19, but the referral rate for physical therapy decreased (50%). PT fearfulness did not increase when in close contact with patients (62.1%) or in the home (72.4%). Patients expressed fear in engaging in close contact with PTs (49.1%) and receiving physical therapy in the home (52.6%). PTs (45.8%) believe patients experienced an increased incidence of falls, but PTs did not change their fall risk assessment methods (62.9%)., Conclusions: Patients would benefit from education by PTs to allay their fears while participating in physical therapy in the home setting. This was relevant since patients were reported by many PTs to have an increase in fall risk but may not have sought medical care due to fear of contracting COVID-19.

Introduction: Physiotherapy student-led services (SLS) are becoming increasingly prevalent in clinical education (CE) practice within physiotherapy curricula. This innovative model differs from traditional styles adopted by many, as its primary focus is on increased student responsibility and replicating the reality of practice. However, limited literature is currently available on its suitability as a CE model and on the perceptions of such a model., Purpose: This qualitative study aims to evaluate the suitability of physiotherapy SLS as a model of CE, as perceived by all involved stakeholders., Methods: A qualitative meta-synthesis of literature sourced from popular healthcare databases was conducted. Studies incorporating any stakeholder perspectives on physiotherapy SLS, or that focused on it as a method of CE were included. Quality appraisal and thematic analysis were conducted on nine included studies., Results: All included studies were deemed to be of high-quality following appraisal. Five key themes were developed, showcasing the added benefits and challenges of SLS. These included: 1) Development of Desirable Professional Skills and Attributes; 2) Need for Optimal Supervision; 3) Peer Learning Experience; 4) High-Quality Care; and 5) Student Autonomy., Conclusion: Physiotherapy SLS offers attractive opportunities for students conducting CE. Involved stakeholders believe that this model does not negatively impact the quality of care and safety provided to patients who attend.

Introduction and Objectives: There is a considerable lack of structure in training health professionals in geriatrics. The narratives can promote a collaborative reflection on different topics and might be used as a pedagogic strategy for undergraduate health students. This study aimed to explore the adoption of new perspectives on ageing after the implementation of dynamic narratives in the first graduate year for physiotherapy students., Materials and Methods: An exploratory qualitative study was performed. Participants were included if they were: ≥18 years old, physiotherapy students and agreed to participate. Physiotherapy students (n=44) were recruited from the School of Health Sciences, Polytechnic Institute of Leiria. Two gaming sessions were performed to help students, as narrators, express their visions and ways to deal with the geriatrics field. Students' perspectives about ageing at baseline (T1) and after the narratives experience (T2) were collected by answering the following question: What is your perception regarding ageing? Two evaluators were involved in qualitative data analysis by performing: (i) an individual analysis of themes/subthemes and a discussion meeting to evaluate discrepancies and to reach a consensus., Results: Negative perceptions about ageing were referred 39 times at T1 (most of them related to restriction; deterioration subthemes). There were no negative perceptions registered at T2. Positive perceptions increased at T2, from n=39 to n=52, and three new subthemes emerged (beginning of something, fighting ageism, challenge)., Conclusion: This study demonstrated the potential of narrative-based experiences as a desirable pedagogic methodology (board games-oriented) for geriatric education in undergraduate health students., (Copyright © 2023 SEGG. Publicado por Elsevier España, S.L.U. All rights reserved.)

Background: During workplace-based clinical placements, best practice assessment states students should expect consistency between assessors rating their performance. To assist clinical educators (CEs) to provide consistent assessment of physiotherapy student performance, nine paediatric vignettes depicting various standards of simulated student performance, as assessed by the Assessment of Physiotherapy Practice (APP), were developed. The APP defines adequate on the global rating scale (GRS) as the minimally acceptable standard for an entry-level physiotherapist. The project aimed to evaluate consistency of paediatric physiotherapy educators assessing simulated student performance using the APP GRS., Methods: Three paediatric scenarios representing neurodevelopment across three age ranges, infant, toddler and adolescent, were developed and scripted that depicted a 'not adequate', 'adequate' and 'good-excellent' performance based on the APP GRS. An expert panel (n = 9) conducted face and content validation. Once agreement was reached for all scripts, each video was filmed. A purposive sample of physiotherapists providing paediatric clinical education in Australia were invited to participate in the study. Thirty-five CEs, with minimum 3-years clinical experience and had supervised a student within the past year, were sent three videos at four-week intervals. Videos depicted the same clinical scenario, however performance varied with each video. Participants rated the performance on the four categories: 'not adequate', 'adequate', 'good' and 'excellent' Consistency among raters was assessed using percentage agreement to establish reliability., Results: The vignettes were assessed a combined total of 59 times. Across scenarios, percentage agreement at the not adequate level was 100%. In contrast, the adequate scenarios for the Infant, Toddler and Adolescent video failed to meet the 75% agreement level. However, when combining adequate or good-excellent, percentage agreement was > 86%. The study demonstrated strong consensus when comparing not adequate to adequate or better performance. Importantly, no performance scripted as not adequate was passed by any assessor., Conclusions: Experienced educators demonstrate consistency in identifying not adequate from adequate or good-excellent performance when assessing a simulated student performance using the APP. Recommendation for practice: These validated video vignettes will be a valuable training tool to improve educator consistency when assessing student performance in paediatric physiotherapy., (© 2023. The Author(s).)

Background and Introduction: A pilot experience of teaching innovation was developed in the masotherapy practice classes of the University of Seville's degree of physiotherapy using an active learning approach., Objective: Significant experiential learning-specific teaching strategies were implemented to address learning style diversity and promote dynamic participation, active listening, and the creation of clinical simulation learning environments., Methods: The strategies implemented included establishing an affective climate in the classroom that would encourage interaction among participants, facilitating the flow of information and the teaching-learning process, considering students' previous ideas, elaborating upon content maps and key questions to guide the teaching-learning process, establishing discussions favoring student brainstorming, using illustrations and videos ("visual thinking"), implementing experimental demonstrations and simulated clinical scenarios, and collaborative activities mediated by information and communication technology., Results: The evaluation, which was developed using a questionnaire (pretest-posttest) that allowed the development of learning ladders and considered the complexity of the generated knowledge, revealed significant advances in student learning., Conclusion: The implementation of significant experiential learning-specific teaching strategies is useful for achieving the learning objectives of this subject. Further research is needed to conclude firmly in this regard.

Physiotherapy has a strictly theoretical body of knowledge, but for the most part, the physiotherapist's learning is practical. The practical part is fundamental to acquire clinical skills that the physiotherapist will later use in professional practice. The main aim of this study was to assess the effectiveness of movement representation strategies (MRS) in the improvement of manual skills of physiotherapy students as an educational innovation strategy. We randomly assigned 30 participants to an action observation practice (AOP), motor imagery practice (MIP), or sham observation (SO) group. A high velocity, low amplitude lumbar manipulation technique that is widely used in clinical physiotherapy practice was taught in one session. The primary outcomes were required time and test score. The secondary outcomes were perceived mental fatigue and perceived difficulty for learning. The outcomes were assessed preintervention and immediately after the intervention (postintervention). The main results showed that both AOP and MIP improved the total time required and the test score, as well as entailed less perceived difficulty for learning. However, both strategies showed a higher level of mental fatigue after the intervention, which was higher in the MIP group. Based on the results obtained, it seems that the application of MRS promotes greater learning of manual motor tasks in physiotherapy students and could be used as educational innovation strategies.

Background: Physiotherapy is an essential component in the management of cystic fibrosis (CF)., Objective: To explore how parents of infants with CF experience physiotherapy clinic consultations., Methods: A qualitative study, informed by hermeneutic phenomenology, utilizing in-depth semi-structured interviews and daily diaries was conducted with 13 parents of infants (aged 0-2 yrs.) receiving physiotherapy care for CF in Australia., Results: Three themes arose from the text. The first was that parents' physiotherapy clinic experience is influenced by the manner in which health professionals communicate to parents about physiotherapy in CF, as well as their own prior experience and knowledge. Secondly, parents receive conflicting messages from the physiotherapy consultation, but perceive the key message to be to prioritize adherence to physiotherapy. The final theme was that parents' expectations of the physiotherapy interaction were often not met, in particular a lack of practical physiotherapy education and training was reported., Conclusion: Parents of infants with CF seek an optimistic, practical and hands on approach during physiotherapy consultations. Exploring options for providing physiotherapy input outside of traditional clinic environments may help accommodate individual needs. Investigation into the manner in which physiotherapy education is communicated to parents is warranted in light of the influence on parents' expectations of physiotherapy.

Background: Specific personal and behavioural characteristics are required for competent health care practice. Research investigating relationships between these characteristics and course performance of health professions students is expanding, yet little research is conducted within the undergraduate physiotherapy student population. This study aimed to explore the relationships between personality, approaches to learning, and coping strategies of undergraduate physiotherapy students and their performance in academic, clinical and in-course assessment tasks and course progression., Methods: Participants from six cohorts of undergraduate physiotherapy students (commencing years 2012-2017, 66% response rate) completed questionnaires measuring personality (NEO-FFI-3), approaches to learning (RASI) and coping strategies (Brief COPE). Correlation and multiple regression analysis were conducted to investigate relationships between scores on written examinations, in-course assessment tasks and assessments of clinical performance. Mann-Whitney U test was used to compare subgroups on these measures in those who completed or did not complete the course., Results: Conscientiousness and a strategic approach to learning predicted higher scores in written examinations, and for most clinical and in-course assessments with conscientiousness being a stronger predictor. A lack of purpose (surface) learning approach was predictive of lower clinical placement scores. Non-course completers had higher scores for lack of purpose (surface) approach to learning and lower scores for the coping strategies of support seeking and humour., Conclusions: This study confirms the importance of conscientiousness and a strategic learning approach on the academic and clinical performance of undergraduate physiotherapy students. Identifying learners with a surface learning approach and low support seeking coping strategies could assist in providing support to students at risk of poor performance and minimising attrition., (© 2023. The Author(s).)

Objective: To investigate how a rural simulation activity influenced physiotherapy students' rural empathy, and to explore students' perception of the activity., Setting: A metropolitan university in Queensland, Australia., Participants: Second year undergraduate physiotherapy students., Design: A single cohort pre-test post-test evaluation was undertaken to evaluate a rural simulation activity. Participants received the rural simulation activity, featuring an immersive video and telehealth simulation with a standardised patient portrayed by an actor. Participants undertook a structured debrief and guided reflection following the simulation. Outcome measures included the Rural Comprehensive State Empathy Scale (R-CSES) and the Satisfaction with Simulation Experience Scale. Group interviews were undertaken regarding participant perceptions of the activity. Wilcoxon Rank-Sum tests were used to analyse survey data, and group interview data were subject to thematic analyses., Results: A total of 102 students undertook the activity, with an outcome measure response rate of 92.2% (94/102). Intra-personal rural empathy increased following the activity as demonstrated by the overall R-CSES score [pre-test: 101.5 (90-110.75) vs post-test 107 (100-120); p = <0.001; r = 0.39]. There was high satisfaction with the experience [mean SSES score = 18/21]. Two themes were generated from the group interview data: (1) effect on perceptions of rural practice and (2) feedback regarding the simulation., Conclusion: A rural simulation activity using an immersive video, standardised patient, and a structured debrief increased physiotherapy students' empathy towards Australians living in rural settings. Students were satisfied with the activity and felt that it improved their understanding of the challenges of rural healthcare., (© 2022 The Authors. Australian Journal of Rural Health published by John Wiley & Sons Australia, Ltd on behalf of National Rural Health Alliance Ltd.)

Background: The demand for physiotherapy clinical placements is rising which requires innovative approaches and an understanding of clinical placement models., Objective: To determine physiotherapy student contribution to direct patient care activity during a collaborative clinical placement model. Secondary aims determined the impact of clinical area and clinical educator to student (CE:student) ratio and if a group of students could reach equivalent direct patient care activity of a junior or senior physiotherapist., Method: Physiotherapy student, and junior and senior physiotherapist occasions of service (OOS) were collected from five Queensland Public Health Sector hospital information management systems from four physiotherapy clinical areas (i.e. cardiorespiratory, musculoskeletal, neurorehabilitation, and orthopedics). Number of days of clinical activity was recorded to provide average OOS/day., Results: Across a 5-week clinical placement a group of physiotherapy students in a collaborative clinical placement model provided on average 10.6 OOS/day (95%CI 10.1-11.2). In three (75%) clinical areas, a group of students participating in higher CE:student ratios produced more OOS/day. Clinical area and CE:student ratio predicted 39% of the variance in student average OOS/day. On average a group of students reached the equivalent direct patient care activity of a junior and senior physiotherapist by week two of a 5-week clinical placement., Conclusion: Physiotherapy students in a collaborative clinical placement model met or exceeded the direct patient care activity of a physiotherapist, irrespective of clinical area and CE:student ratio.

Falls are a significant cause of disability internationally. The purpose of this exploratory study was to examine the effectiveness of a community fall prevention program, Stepping On (SO), using nine student physical therapists and program faculty in a rural setting. A mixed-methods design was utilized. Students partnered with older adults to master exercises, demonstrate floor recovery techniques, and manage community navigation in line with program fidelity. A descriptive survey assessed program outcomes. Students participated in a follow-up focus group to discuss perspectives on their role in the program. One hundred and seventeen community-dwelling older adults (mean age: 75.2 ±   8.5) completed the program. Participants who lived alone were likely to limit their activities because of fear of falling (p = .045). Following SO most subjects (87.7%) described having a better understanding of falls and their causes, with a plan to arise from the floor (82.6%). Focus group themes underscored students' opportunity to facilitate, reinforce safety during mobility activities, and motivate participants. Furthermore, an increased awareness of other professions' contribution to fall prevention was noted. Following a community fall prevention program, older adults have a better understanding of fall prevention and plan for floor recovery. In turn, student coaching skills are reinforced.

Background: Various psychological issues and serious health concerns during the imposed lockdown by coronavirus disease 2019 (COVID-19) have induced many changes in the treatment of patients. More effective self-management strategies through tele-rehabilitation are suggested to be applied for patients with chronic neck pain to reduce referrals to health cares and disability support through COVID-19. Also, the pain neuroscience education (PNE) approach is an educational method used by health professionals to assist patients in understanding the biology, physiology, and psychosocial factors affecting their pain experience and aligning with the cognitions and beliefs associated with pain and recurrent disability. PNE combined with tele-rehabilitation could be a new solution to encourage patients to manage their condition by themselves and increase the continuity of practice instead of face-to-face sessions., Objective: This randomized control trial (RCT) aims to investigate the effects of PNE with online and face-to-face exercise interventions, and the control group received biomedical education + standardized physical therapy on neck pain and disability, psychological factors, and function in non-traumatic chronic neck pain., Methods/design: Patients with non-traumatic chronic neck pain (patient-centered care and active involvement of patients and the public) will be recruited via flyers displayed in hospitals and universities to participate in an RCT with two experimental and one control group designed to investigate the effects of PNE with online and face-to-face exercise interventions, and the control group received biomedical education + standardized physical therapy on neck pain and disability, psychological factors, and function in non-traumatic chronic neck pain. The outcomes will be measured at baseline, after PNE, and after 3 months of an exercise intervention. All outcomes are presented as mean ± SD, and statistical significance was set at α level of < 0.05. The normal distribution of the variables was verified by the Kolmogorov-Smirnov test, following a descriptive analysis., Discussion: It seems that PNE plus online and face-to-face exercise interventions are appropriate educational models for the treatment of patients with neck pain during COVID-19. Also, online training seems to encourage patients to continue their treatment., Trial Registration: Iranian Registry of Clinical Trials IRCT20150503022068N5. Registered on 09 September 2021., (© 2022. The Author(s).)

Physical distance was one of the safety measures that were applied during the outbreak of COVID-19 and universities all over the world were forced to shift toward online teaching (OT). The aim of the study was to answer six research questions related to the profile of OT in Egyptian Physical Therapy Colleges during the COVID-19 outbreak. A google form questionnaire was used to survey 102 Egyptian Physical Therapy Educators (EPTEs) who were engaged in teaching Physical Therapy undergraduate programs in Egyptian universities during the spring semester of the academic year 2020-2021. Results showed that the EPTEs frequently (N= 51; 58.0%) used OT both from work and home. Private universities showed a significant advantage over public universities regarding the provision of institutional training (N= 101, P= 0.003) and availability of institutional educational support centers (N=99, P= 0.0001). Most (N= 30; 63.8%) university website users were full or associate professors, while (N= 24; 53.3%) Microsoft Teams users were lecturers. The EPTEs who had a positive attitude toward the suitability of OT for practical and clinical instructions were a minority (N= 48; 22.9%) and (N= 24; 29.2%) respectively. The EPTEs perceived different themes for advantages, disadvantages, and challenges regarding their experience with OT. Less than one-tenth (N= 10; 9%) of EPTEs showed the highest positive attitude toward the readiness of their colleges for the application of OT. Most (N= 68; 68%) of the EPTEs reported the presence of negative effects on their social life and (N= 30; 30%) of them reported high levels of financial overwhelming. In conclusion, the EPTEs had a limited and primitive profile of experience with OT during the COVID-19 outbreak in 2021. OT might not be the perfect teaching approach for Egyptian Physical therapy Colleges, especially for practical and clinical courses .                       .

Background: Knowledge regarding the impact of curricula with behavioral medicine content and competencies (BMCC) on physical therapy (PT) students' clinical reasoning skills is lacking., Objectives: The primary objective was to compare the clinical reasoning skills, focusing on clients' behavioral change, of entry-level PT students with or without BMCC in their curricula. The secondary objective was to compare students' attitudes and beliefs in a biomedical and biopsychosocial practice orientation., Methods: Swedish final-semester PT students (n = 151) completed the Reasoning 4 Change (R4C) instrument and the Pain Attitudes and Beliefs Scale for Physiotherapists. A blueprint was used for curricular categorization. The independent t-test was used., Results: Students attending programs with BMCC curricula (n = 61) had superior scores compared with students without BMCC curricula (n = 90) in the following R4C variables, all of which were related to clinical reasoning focused on behavioral change: Knowledge, Cognition, Self-efficacy, Input from the client, Functional behavioral analysis, and Strategies for behavioral change. Students who did not receive BMCC curricula scored higher in the R4C contextual factors and reported a greater biomedical practice orientation than students receiving BMCC curricula. There was no difference in the biopsychosocial practice orientation between groups., Conclusions: Our findings support the benefit of structured entry-level PT curricula with BMCC on final-semester students' clinical reasoning skills focused on behavioral change and their level of biomedical practice orientation. Further, our findings elucidated educational opportunities to augment students' self-efficacy and strengthen their behavioral competencies in clinical reasoning. For the generalizability of the results further research in other contexts is needed.

Objectives: This paper explores the decision-making processes involved in giving physiotherapy students responsibility on clinical placement and the impact on their developing professional autonomy., Methods: The qualitative study, using semi-structured interviews, involved physiotherapy students and clinical educators (CEs) from two higher education institutions, one in Australia, and the other in the United Kingdom (UK)., Findings: Findings led to the development of a heuristic framework of 'graduated supervision,' a process of progressively less direct observation and monitoring of students as clinical proficiency improved. By focusing on the measured exposure of students to increasing complexity and inverse levels of supervision, the framework captures tacit practices, and consistent, yet varied facilitation strategies adopted across specialties, and evident in clinical education settings in both countries. The framework formalizes, for the first time, assumptions and expectations previously unacknowledged. Factors identified as affecting students' progress toward autonomy include the student/CE relationship, the development of mutual trust through ongoing dialogue, and the importance of formal discussions at the commencement of a clinical placement to establish learning goals, preferred supervision styles and learner responsibilities., Conclusion: Insights have significance for the CE community, and students who at times have to second-guess what is required of them and how they might excel on clinical placement.

The World Health Organization states that gender has implications for health across the course of a person's life in terms of norms, roles and relations. It also has implications in rehabilitation. In this article, we argue the need of gender perspectives in the field of physiotherapy; gender matters and makes a difference in health and rehabilitation. We highlight a number of central areas where gender may be significant and give concrete examples of social gender aspects in physiotherapy practice and in diverse patient groups. We also discuss why it can be important to consider gender from an organizational perspective and how sociocultural norms and ideals relating to body, exercise and health are gendered. Further we present useful gender theories and conceptual frameworks. Finally, we outline future directions in terms of gender-sensitive intervention, physiotherapy education and a gendered application of the ICF model. We want to challenge physiotherapists and physiotherapy students to broaden knowledge and awareness of how gender may impact on physiotherapy, and how gender theory can serve as an analytical lens for a useful perspective on the development of clinical practice, education and research within physiotherapy.

Introduction: Entry-level students' conceptualizations of clinical reasoning can provide a starting point for program planning related to clinical reasoning development with a focus on patient-centered care., Objective: The aim of the study is to explore how physiotherapy students understand clinical reasoning midway through their education. Nine physiotherapy students were interviewed at the end of their third semester., Methods: Semi-structured individual interviews were conducted, recorded and transcribed verbatim. A phenomenographic approach to qualitative data analysis, seeking to explore variations in students' conceptions was applied., Results: The students' ways of understanding clinical reasoning could be described as: 1) the cognitive process of the physiotherapist; and 2) the relational process of the collaborative partnership between the physiotherapist and the patient. A contrastive analysis shows how the cognitive and relational perspectives are developed through the relationships among three dimensions of clinical reasoning: 1) problem-solving; 2) context of working; and 3) own learning., Conclusion: By identifying the critical variation in students' conceptions of clinical reasoning, focus can be placed on pedagogical arrangements to facilitate students' progression toward a person-centered approach.

Electrical currents are didactic contents widely applied in the training of physiotherapy students, but the treatment is considered a stressful situation for both the patient who receives it and the student who applies it. The aim of this study was to evaluate the stress-associated autonomic response of physiotherapy students receiving interferential current by measuring and analysing heart rate variability. An observational case-control study was conducted. Ninety healthy male volunteers, all physiotherapy degree students, were enrolled while attending laboratory practice during the 2020-2021 academic year. Participants were randomly allocated to a sham electrotherapy group (44 subjects), in which heart rate variability was recorded for 10 min, both at rest and during the application of sham technique on the lower back (10 min), and an electrotherapy group (46 subjects), applying the same procedure with the electrical current flowing. Outcome measures included baseline (seated position) and postintervention (prone position) time domain parameter, diameters of the Poincaré plot 1 and 2, stress score, and sympathetic/parasympathetic ratio. The sham electrotherapy group exhibited significant increases in time domain parameter ( p = 0.027) and diameters of the Poincaré plot 1 ( p = 0.032), with a small effect size (d ≤ 0.5). The electrotherapy group exhibited significant increases in time domain parameter and diameters of the Poincaré plot 1 and 2 ( p < 0.001) and decreases in the stress score and sympathetic/parasympathetic ratio ( p < 0.001), with a large effect size (d > 0.8) other than for the time domain parameter (d = 0.42), indicating increased parasympathetic and decreased sympathetic activity. After interventions, there were significant differences between groups in diameters of the Poincaré plot 2 ( p < 0.001), stress score ( p = 0.01) and sympathetic/parasympathetic ratio ( p = 0.003), with moderate effect size (d > 0.5). The application of the interferential current technique produces stress-associated autonomic response characterized by greater parasympathetic activity and decreased sympathetic activity. Further studies are needed to determine possible adverse effects.