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Umlauf JA, Cervero R, Teng Y, Battista A. Influencing Physical Therapist's Self-efficacy for Musculoskeletal Ultrasound Through Blended Learning: A Mixed Methods Study. JOURNAL, PHYSICAL THERAPY EDUCATION 2024; 38:125-132. [PMID: 38625694 DOI: 10.1097/jte.0000000000000332] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/29/2023] [Accepted: 12/15/2023] [Indexed: 04/17/2024]
Abstract
BACKGROUND AND PURPOSE With the growing interest for physical therapists to incorporate musculoskeletal (MSK) ultrasound comes a need to understand how to organize training to promote the transfer of training to clinical practice. A common training strategy blends asynchronous learning through online modules and virtual simulations with synchronous practice on live simulated participants. However, few physical therapists who attend MSK ultrasound continuing education courses integrate ultrasound into clinical practice. Self-efficacy is a significant predictor of training transfer effectiveness. This study describes to what degree and how a blended learning strategy influenced participants' self-efficacy for MSK ultrasound and transfer of training to clinical practice. SUBJECTS Twenty-one outpatient physical therapists with no previous MSK ultrasound training. METHODS Twenty-one participants assessed their self-efficacy using a 26-item self-efficacy questionnaire at 3 intervals: before asynchronous, before synchronous training, and before returning to clinical practice. Participants were interviewed within 1 week of training using a semi-structured interview guide. Quantitative analysis included descriptive statistics and repeated-measures ANOVA. Thematic analysis was used to examine participants' experiences, and "following the thread" was used to integrate findings. RESULTS Self-efficacy questionnaire mean scores increased significantly across the 3- time points ( F [2, 40] = 172.7, P < .001, η 2 = 0.896). Thematic analysis indicated that asynchronous activities scaffolded participants' knowledge, enhanced their self-efficacy, and prepared them for synchronous learning; however, it did not replicate the challenges of MSK ultrasound. Synchronous activities further improved self-efficacy and helped participants better calibrate their self-judgments of their abilities and readiness to integrate MSK ultrasound training into clinical practice. Despite individual-level improvements in self-efficacy, interviewees recognized their limitations and a need for longitudinal training in a clinical environment. DISCUSSION AND CONCLUSION A blended learning approach positively affects participants' self-efficacy for MSK ultrasound; however, future training designs should provide learners with additional support during the transition phase.
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Affiliation(s)
- Jon A Umlauf
- Jon A. Umlauf is the assistant professor in the Army-Baylor University Doctoral Program in Physical Therapy, 134 Hiler Road San Antonio, TX 78209 ( ). Please address all correspondence to Jon A. Umlauf
- Ronald Cervero is the professor and deputy director in the Center for Health Professions Education at the Uniformed Services University of the Health Sciences
- Yating Teng is the adjunct assistant professor in the Center for Health Professions Education at the Uniformed Services University of the Health Sciences
- Alexis Battista is the scientist II in the The Henry M Jackson Foundation for the Advancement of Military Medicine, and is the associate professor of medicine in the Center for Health Professions Education at the Uniformed Services University of the Health Sciences
| | - Ronald Cervero
- Jon A. Umlauf is the assistant professor in the Army-Baylor University Doctoral Program in Physical Therapy, 134 Hiler Road San Antonio, TX 78209 ( ). Please address all correspondence to Jon A. Umlauf
- Ronald Cervero is the professor and deputy director in the Center for Health Professions Education at the Uniformed Services University of the Health Sciences
- Yating Teng is the adjunct assistant professor in the Center for Health Professions Education at the Uniformed Services University of the Health Sciences
- Alexis Battista is the scientist II in the The Henry M Jackson Foundation for the Advancement of Military Medicine, and is the associate professor of medicine in the Center for Health Professions Education at the Uniformed Services University of the Health Sciences
| | - Yating Teng
- Jon A. Umlauf is the assistant professor in the Army-Baylor University Doctoral Program in Physical Therapy, 134 Hiler Road San Antonio, TX 78209 ( ). Please address all correspondence to Jon A. Umlauf
- Ronald Cervero is the professor and deputy director in the Center for Health Professions Education at the Uniformed Services University of the Health Sciences
- Yating Teng is the adjunct assistant professor in the Center for Health Professions Education at the Uniformed Services University of the Health Sciences
- Alexis Battista is the scientist II in the The Henry M Jackson Foundation for the Advancement of Military Medicine, and is the associate professor of medicine in the Center for Health Professions Education at the Uniformed Services University of the Health Sciences
| | - Alexis Battista
- Jon A. Umlauf is the assistant professor in the Army-Baylor University Doctoral Program in Physical Therapy, 134 Hiler Road San Antonio, TX 78209 ( ). Please address all correspondence to Jon A. Umlauf
- Ronald Cervero is the professor and deputy director in the Center for Health Professions Education at the Uniformed Services University of the Health Sciences
- Yating Teng is the adjunct assistant professor in the Center for Health Professions Education at the Uniformed Services University of the Health Sciences
- Alexis Battista is the scientist II in the The Henry M Jackson Foundation for the Advancement of Military Medicine, and is the associate professor of medicine in the Center for Health Professions Education at the Uniformed Services University of the Health Sciences
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Strike K, Chan A, Maly MR, Newman AN, Solomon P. Scoping Review of Curricula and Pedagogical Approaches for Physiotherapist Performed Point of Care Ultrasonography. Physiother Can 2023; 75:322-336. [PMID: 38037585 PMCID: PMC10686305 DOI: 10.3138/ptc-2021-0079] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2021] [Revised: 12/07/2021] [Accepted: 02/18/2022] [Indexed: 12/02/2023]
Abstract
Purpose This study collates and maps physiotherapy pre- and post-licensure curricula and pedagogical approaches for point of care ultrasonography (POCUS). Method We used a standardized scoping review methodology and reporting framework. A total of 18,217 titles and abstracts, and 1,372 full text citations were screened, with 209 studies classified as physiotherapist performed POCUS. Results Of the 209 studies, 15 evaluated pre- and post-licensure curricula and pedagogical approaches. Seventy-two to 98% of pre-licensure programs reported including theoretical knowledge of POCUS and 44-45% reported practical teaching or competency assessment. In post-licensure studies of POCUS, 0-61% of physiotherapists reported training for POCUS. All studies of post-licensure pedagogical approaches included an assessment of theoretical knowledge of POCUS, but only one study included a practical assessment of competency. There was considerable variability in POCUS methods and duration of pedagogical approaches. Except for one study, all pedagogical approaches reported improvement in theoretical knowledge. Conclusion Progress in physiotherapy-specific, standardized, competency-based curricula and pedagogical approaches in POCUS has been limited, with minimal research available, and considerable variability both pre- and post-licensure. These findings could be used to advocate for the inclusion of POCUS in pre- and post-licensure physiotherapy curriculum, and suggest a need for clear guidelines from regulatory colleges and licensing bodies, and a common terminology for physiotherapist performed POCUS. Future directions for research include a systematic review of the psychometric properties of physiotherapist performed POCUS within and across anatomical areas, an assessment of value of different forms of training, and an evaluation of the impact of physiotherapist performed POCUS on patient outcomes.
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Affiliation(s)
- Karen Strike
- From the:
From the: School of Rehabilitation Science, Faculty of Health Science, McMaster University, Hamilton, Ontario, Canada, L8S1C7
| | - Anthony Chan
- Department of Pediatrics, McMaster University, Hamilton, Ontario, Canada
| | - Monica R. Maly
- Department of Kinesiology, Faculty of Health, University of Waterloo, Waterloo, Ontario, Canada, N2L 3G1
| | - Anastasia N.L. Newman
- From the:
From the: School of Rehabilitation Science, Faculty of Health Science, McMaster University, Hamilton, Ontario, Canada, L8S1C7
| | - Patricia Solomon
- From the:
From the: School of Rehabilitation Science, Faculty of Health Science, McMaster University, Hamilton, Ontario, Canada, L8S1C7
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Cormack CJ, Childs J, Kent F. Point-of-Care Ultrasound Educational Development in Australasia: A Scoping Review. ULTRASOUND IN MEDICINE & BIOLOGY 2023; 49:1375-1384. [PMID: 36941181 DOI: 10.1016/j.ultrasmedbio.2023.02.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/24/2022] [Revised: 01/12/2023] [Accepted: 02/16/2023] [Indexed: 05/11/2023]
Abstract
Point-of-care ultrasound (PoCUS) technology is evolving rapidly and is being adopted by many health professionals in their clinical practice. Ultrasound is a complex skill requiring dedicated training. Appropriate integration of ultrasound education into medical, surgical, nursing and allied health professions is a current challenge worldwide. There are patient safety implications for use of ultrasound without adequate training and frameworks. The purpose of the review was to overview the status of PoCUS education in Australasia; investigate what is being taught and learned about ultrasound across the health professions; and identify potential gaps. The review was limited to postgraduate and qualified health professionals with established or emerging clinical use for PoCUS. A scoping review methodology was used to include literature in peer-reviewed articles, policies, guidelines, position statements, curricula and online material relating to ultrasound education. One hundred thirty-six documents were included. The literature revealed heterogeneity in ultrasound teaching and learning across the health professions. Several health professions lacked any defined scopes of practice, policies or curricula. Significant investment in resourcing ultrasound education is required to address the current needs in Australia and New Zealand.
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Affiliation(s)
- Carolynne J Cormack
- Monash University, Faculty of Medicine Nursing and Health Sciences, Victoria, Australia; Monash Health, Department of Medical Imaging, Victoria, Australia.
| | - Jessie Childs
- Faculty of Allied Health and Human Performance, University of South Australia, Adelaide, Australia
| | - Fiona Kent
- Monash University, Faculty of Medicine Nursing and Health Sciences, Victoria, Australia
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Fernández-Carnero S, Martin-Saborido C, Achalandabaso Ochoa-Ruiz de Mendoza A, Ferragut-Garcias A, Cuenca-Zaldivar JN, Leal-Quiñones A, Calvo-Lobo C, Gallego-Izquierdo T. The Role of Rehabilitative Ultrasound Imaging Technique in the Lumbopelvic Region as a Diagnosis and Treatment Tool in Physiotherapy: Systematic Review, Meta-Analysis and Meta-Regression. J Clin Med 2021; 10:5699. [PMID: 34884401 PMCID: PMC8658262 DOI: 10.3390/jcm10235699] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2021] [Revised: 11/22/2021] [Accepted: 12/01/2021] [Indexed: 01/25/2023] Open
Abstract
Rehabilitative ultrasound imaging (RUSI) technique seems to be a valid and reliable tool for diagnosis and treatment in physiotherapy and has been widely studied in the lumbopelvic region the last three decades. The aims for this utility in clinical settings must be review through a systematic review, meta-analysis and meta-regression. A systematic review was designed following the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines with PROSPERO registration and per review in all phases of the process using COVIDENCE, analysis of risk of bias and meta-analysis using REVMAN, and meta-regression calculation using STATA. Database screening provided 6544 references, out of which 321 reported narrative synthesis, and 21 reported quantitative synthesis, while only 7 of them provided comparable data to meta-analyze the variables pain and muscle thickness. In most cases, the forest plots showed considerable I2 heterogeneity indexes for multifidus muscle thickness (I2 = 95%), low back pain (I2 = 92%) and abdominal pain (I2 = 95%), not important for transversus abdominis muscle thickness (I2 = 22%), significant heterogenity (I2 = 69%) depending on the subgroup and not important internal oblique muscle thickness (I2 = 0%) and external oblique muscle thickness (I2 = 0%). Meta-regression did not provide significant data for the correlations between the variables analyzed and the intervention, age, and BMI (Body Mass Index). This review reveals that RUSI could contribute to a high reliability of the measurements in the lumbopelvic region with validity and reliability for the assessments, as well as showing promising results for diagnosis and intervention assessment in physiotherapy compared to the traditional model, allowing for future lines of research in this area.
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Affiliation(s)
- Samuel Fernández-Carnero
- Physiotherapy and Pain Group, Department of Physiotherapy and Nursing, Alcalá University, 28801 Alcalá de Henares, Spain; (S.F.-C.); (A.A.O.-R.d.M.); (A.F.-G.); (T.G.-I.)
| | | | - Alexander Achalandabaso Ochoa-Ruiz de Mendoza
- Physiotherapy and Pain Group, Department of Physiotherapy and Nursing, Alcalá University, 28801 Alcalá de Henares, Spain; (S.F.-C.); (A.A.O.-R.d.M.); (A.F.-G.); (T.G.-I.)
- Área de Fisioterapia, Departamento de Ciencias de la Salud, Universidad de Jaén, Jaén, 23071 Andalucía, Spain
| | - Alejandro Ferragut-Garcias
- Physiotherapy and Pain Group, Department of Physiotherapy and Nursing, Alcalá University, 28801 Alcalá de Henares, Spain; (S.F.-C.); (A.A.O.-R.d.M.); (A.F.-G.); (T.G.-I.)
- Departamento de Enfermería y Fisioterapia, Islas Baleares University, 07122 Ciudad de Palma, Spain
| | | | | | - Cesar Calvo-Lobo
- Faculty of Nursing, Physiotherapy and Podiatry, Universidad Complutense de Madrid, 28040 Madrid, Spain;
| | - Tomas Gallego-Izquierdo
- Physiotherapy and Pain Group, Department of Physiotherapy and Nursing, Alcalá University, 28801 Alcalá de Henares, Spain; (S.F.-C.); (A.A.O.-R.d.M.); (A.F.-G.); (T.G.-I.)
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González-Seguel F, Pinto-Concha JJ, Ríos-Castro F, Silva-Gutiérrez A, Camus-Molina A, Mayer KP, Parry SM. Evaluating a Muscle Ultrasound Education Program: Theoretical Knowledge, Hands-on Skills, Reliability, and Satisfaction of Critical Care Physiotherapists. Arch Rehabil Res Clin Transl 2021; 3:100142. [PMID: 34589692 PMCID: PMC8463476 DOI: 10.1016/j.arrct.2021.100142] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
OBJECTIVE To evaluate learning results of critical care physiotherapists participating in a muscle ultrasound (MUS) educational program. DESIGN Cross-sectional study. SETTING A custom-made 20-hour MUS course was performed over a 2-week time period, including knobs familiarization, patient positioning, anatomic landmarks, image acquisition, and limb muscle measurements. PARTICIPANTS Nineteen critical care physiotherapists with little to no prior experience in ultrasound (N=19). INTERVENTIONS Not applicable. MAIN OUTCOME MEASURES Theoretical knowledge, hands-on skills acquisition, and satisfaction were assessed. Inter- and intrarater reliability on landmarks, thickness, and pennation angle of quadriceps between participants was evaluated using intraclass correlation coefficients (ICCs). Reliability among instructors measured prior to the course was also reported as a reference. RESULTS The percentage score (mean±SD) of knowledge questionnaires was 69±11 (pre-course), 89±10 (post-course), and 92±9 (hands-on skills). Course satisfaction scores ranged from 90%-100%. Pooled interrater reliability of participants (median ICC [interquartile range]) was good (0.70 [0.59-0.79]) for thickness, moderate (0.47 [0.46-0.92]) for landmarks, and absent (0.00 [0.00-0.05]) for pennation angle and the intrarater reliability was good (0.76 [0.51-0.91]) for thickness and weak (0.35 [0.29-0.52]) for pennation angle. Interrater ICC values for instructors were excellent (0.90) for thickness, good (0.67) for landmarks, and moderate (0.41) for pennation angle and intrarater ICC values were excellent (0.94) for thickness and good (0.75) for pennation angle. CONCLUSIONS Although our sample was quite small and homogeneous, increased theoretical knowledge, high hands-on performance acquisition, and good satisfaction of physiotherapists were observed. Reliability was moderate to excellent for thickness and landmarks and absent to weak for pennation angle. Landmarking and pennation angle remain challenges for physiotherapist training in the application of MUS. Further studies are needed to identify variables that could modify reliability during MUS training.
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Key Words
- CV, coefficient of variation
- Critical care
- Education
- ICC, intraclass correlation coefficient
- ICU, intensive care unit
- IQR, interquartile range
- Knowledge assessment
- MUS, muscle ultrasound
- Muscular atrophy
- PA, pennation angle
- Physiotherapy
- QC, quadriceps complex
- RF, rectus femoris
- Rehabilitation
- SEM, standard error of measurement
- Ultrasonography
- VI, vastus intermedius
- VL, vastus lateralis
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Affiliation(s)
- Felipe González-Seguel
- Servicio de Medicina Física y Rehabilitación and Departamento de Paciente Crítico, Facultad de Medicina, Clínica Alemana Universidad del Desarrollo, Santiago, Chile
| | | | - Francisco Ríos-Castro
- Servicio de Medicina Física y Rehabilitación and Departamento de Paciente Crítico, Facultad de Medicina, Clínica Alemana Universidad del Desarrollo, Santiago, Chile
| | | | - Agustín Camus-Molina
- Servicio de Medicina Física y Rehabilitación and Departamento de Paciente Crítico, Facultad de Medicina, Clínica Alemana Universidad del Desarrollo, Santiago, Chile
| | - Kirby P. Mayer
- Department of Physical Therapy, College of Health Sciences, University of Kentucky, Lexington, KY
| | - Selina M. Parry
- Department of Physiotherapy, The University of Melbourne, Parkville, Victoria, Australia
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Ellis R, Helsby J, Naus J, Bassett S, Fernández-de-Las-Peñas C, Carnero SF, Hides J, O'Sullivan C, Teyhen D, Stokes M, Whittaker JL. Exploring the use of ultrasound imaging by physiotherapists: An international survey. Musculoskelet Sci Pract 2020; 49:102213. [PMID: 32861368 DOI: 10.1016/j.msksp.2020.102213] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/16/2019] [Revised: 06/10/2020] [Accepted: 06/22/2020] [Indexed: 12/12/2022]
Abstract
BACKGROUND National surveys in New Zealand, Australia and the United Kingdom suggest ultrasound imaging (USI) use by physiotherapists is increasing. However, concerns exist regarding clarity for scopes of practice, and availability and standardisation of training. OBJECTIVES To investigate physiotherapists' understanding of scopes of practice for the use of USI; clarify the professional contexts, clinical uses and levels of training; and identify barriers preventing physiotherapists' USI use. DESIGN A cross-sectional, observational survey. METHODS An Internet-based survey, offered in 20 different languages, was used including items covering five domains: (1) demographic and professional characteristics; (2) knowledge of scope of practice; (3) USI use; (4) USI training content and duration; and (5) perceived barriers to physiotherapists' use of USI. RESULTS 1307 registered physiotherapists from 49 countries responded; 30% were unsure of the scope of practice for physiotherapists' USI use. 38% of participants were users of USI, reporting varied contexts and clinical uses, reflected in the broader categories of: (i) biofeedback; (ii) diagnosis; (iii) assessment; (iv) injection guidance; (v) research; (vi) and teaching. The training users received varied, with formal training more comprehensive. 62% were non-users, the most common barrier was lack of training (76%). CONCLUSION These findings suggest physiotherapists' USI use is increasing in various contexts; however, there is uncertainty regarding scopes of practice. There are discrepancies in training offered, with a lack of training the most common barrier to physiotherapists' use of USI. International guidelines, including a USI training framework, are needed to support the consistent and sustainable use of USI in physiotherapy.
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Affiliation(s)
- Richard Ellis
- Active Living and Rehabilitation: Aotearoa New Zealand, Health and Rehabilitation Research Institute, School of Clinical Sciences, Auckland University of Technology, Auckland, New Zealand.
| | - Jake Helsby
- Department of Physiotherapy, School of Clinical Sciences, Auckland University of Technology, Auckland, New Zealand
| | - Jade Naus
- Department of Physiotherapy, School of Clinical Sciences, Auckland University of Technology, Auckland, New Zealand
| | - Sandra Bassett
- Department of Physiotherapy, School of Clinical Sciences, Auckland University of Technology, Auckland, New Zealand
| | - César Fernández-de-Las-Peñas
- Department of Physical Therapy, Occupational Therapy, Physical Medicine and Rehabilitation, Universidad Rey Juan Carlos (URJC), Alcorcón, Madrid, Spain; Cátedra Institucional en Docencia, Clínica e Investigación en Fisioterapia: Terapia Manual, Punción Seca y Ejercicio Terapéutico, Universidad Rey Juan Carlos, Alcorcón, Madrid, Spain
| | | | - Julie Hides
- School of Allied Health Sciences, Griffith University, Nathan Campus, 170 Kessels Road, Nathan, QLD, 4111, Australia
| | - Cliona O'Sullivan
- School of Public Health, Physiotherapy and Sports Science, University College Dublin, Belfield, Dublin 4, Ireland
| | - Deydre Teyhen
- Commander, U.S. Army Walter Reed Army Institute of Research, 503 Robert Grant Road, Silver Spring, MD, 20910, USA
| | - Maria Stokes
- School of Health Sciences, University of Southampton, Building 67, Highfield Campus, Southampton SO17 1BJ, UK
| | - Jackie L Whittaker
- Department of Physical Therapy, Faculty of Medicine, University of British Columbia, Vancouver, Canada; Arthritis Research Canada/Arthrite-recherche Canada, Richmond, Canada
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Innes S, Jackson J. Musculoskeletal ultrasound imaging - An exploration of physiotherapists' interests and use in practice. Musculoskelet Sci Pract 2019; 44:102068. [PMID: 31585403 DOI: 10.1016/j.msksp.2019.102068] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/26/2019] [Revised: 09/25/2019] [Accepted: 09/28/2019] [Indexed: 11/24/2022]
Abstract
BACKGROUND Musculoskeletal ultrasound imaging (MSKUSI) has gained popularity; several professions have expressed an interest in this application but the clinical use by physiotherapists has not been fully researched. OBJECTIVES To explore physiotherapists' interests and use of MSKUSI in practice. DESIGN Sequential mixed-methods; questionnaire followed by semi-structured interviews. METHOD A questionnaire was developed and distributed to gain initial information, (75 responses). Analysis informed topic-guide development and enabled a purposive-sampling strategy for semi-structured interviews that explored physiotherapists' interests, education and clinical use of MSKUSI (n = 11). Interview data were analysed thematically. RESULTS Five themes were identified: 1. Professional skill set - physiotherapists' suitability for MSKUSI. 2. Factors that have impacted physiotherapists' ability to use MSKUSI. 3. Physiotherapists' motivation to use ultrasound - improving patient focused care. 4. Quality assurance strategies. 5. Application of biopsychosocial model. Themes revealed links between physiotherapists' core skills, knowledge and professional experiences that align with MSKUSI requirements. Some participants reported support accessing education but many described challenges finding appropriate mentorship. Participants observed education did not always reflect practice typical of physiotherapists. Application of clinical reasoning processes utilised by physiotherapists was regarded as integral to patient-focused scanning. CONCLUSIONS Physiotherapists' professional training and musculoskeletal practice are seen as a foundation for education in MSKUSI. Accessing education can be challenging, in particular mentorship that fully incorporates the biopsychosocial model. Proposed roles for MSKUSI for physiotherapists include verification of clinical assessment findings for diagnosis and facilitation of patient education. The potential to streamline patient pathways and optimise resource management warrants investigation.
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Affiliation(s)
- Sue Innes
- School of Sport, Rehabilitation and Exercise Sciences, University of Essex. Wivenhoe Park, Colchester, CO4 3SQ, United Kingdom.
| | - Jo Jackson
- School of Sport, Rehabilitation and Exercise Sciences, University of Essex. Wivenhoe Park, Colchester, CO4 3SQ, United Kingdom.
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Innes S, Jackson J. Musculoskeletal ultrasound imaging - Integration with the biopsychosocial model. Musculoskelet Sci Pract 2019; 44:102067. [PMID: 31585404 DOI: 10.1016/j.msksp.2019.102067] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/09/2019] [Revised: 09/25/2019] [Accepted: 09/28/2019] [Indexed: 10/25/2022]
Abstract
BACKGROUND AND METHOD Musculoskeletal ultrasound imaging, (MSKUSI) has become a popular imaging modality in recent years and is being utilised by a variety of professions in clinical environments beyond radiology departments. A previously published study exploring physiotherapists' interests and use of MSKUSI in practice included in-depth interviews of participants, (n = 11). The data from this qualitative study were analysed thematically and five themes were identified; one was 'Application of the biopsychosocial model', the basis of this paper. RESULT The theme, 'Application of the biopsychosocial model' drew together three categories of analysed data: clinical reasoning, professional variance and communication opportunity. 'Clinical reasoning' reflected the participants' value on subjective assessment information and the integration of ultrasound imaging with physical examination findings. 'Professional variance' observed the scanning processes undertaken by physiotherapists tended to vary from other professionals, the physiotherapists perceived their use of dynamic imaging was greater, in particular scanning in symptom provoking positions. Another variance observed was the style of communication that physiotherapists used when scanning, this was categorised as a 'communication opportunity' as it represented an event that could be utilised to promote patient understanding of their presentation, link imaging findings to proposed management and enhance compliance with rehabilitation strategies. Participants emphasised their responsibility when communicating with patients to avoid language that could promote unhelpful behaviour, e.g. catastrophisation. CONCLUSION Participants placed value on integrating musculoskeletal ultrasound imaging into the biopsychosocial model, further research to explore the impact of this approach on patients' clinical outcomes and reported experiences is required.
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Affiliation(s)
- Sue Innes
- School of Sport, Rehabilitation and Exercise Sciences, University of Essex, Wivenhoe Park, Colchester, CO4 3SQ, United Kingdom.
| | - Jo Jackson
- School of Sport, Rehabilitation and Exercise Sciences, University of Essex, Wivenhoe Park, Colchester, CO4 3SQ, United Kingdom.
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Ellis R, De Jong R, Bassett S, Helsby J, Stokes M, Cairns M. Exploring the clinical use of ultrasound imaging: A survey of physiotherapists in New Zealand. Musculoskelet Sci Pract 2018; 34:27-37. [PMID: 29247981 DOI: 10.1016/j.msksp.2017.12.002] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/05/2017] [Revised: 12/01/2017] [Accepted: 12/07/2017] [Indexed: 10/18/2022]
Abstract
BACKGROUND In New Zealand ultrasound imaging (USI) is being used increasingly by physiotherapists. To fully understand the extent to which physiotherapists in New Zealand are using USI, it is necessary to evaluate not only the context of its clinical use but also the barriers preventing its uptake. OBJECTIVES To examine the field and scope of use of USI, the type and content of training and the barriers restricting physiotherapists from using the technique. DESIGN Cross-sectional observational design utilising an Internet-based electronic survey. METHOD An electronic survey built on the design of previous research with guidance from an expert review panel. Participants were included if they were New Zealand registered physiotherapists. RESULTS Of the 465 participants who responded, 433 were eligible to complete the survey. There were 415 participants who completed the survey, 24% who said they used USI whilst 76% did not. For those using USI, the uses were varied including those within a rehabilitative paradigm (i.e. biofeedback; 52%) and also diagnostic (49%). USI training was also varied ranging from formal to informal. The main barriers preventing physiotherapists from using USI were lack of training, access to equipment, and equipment expense. CONCLUSIONS The participants reported a variety of clinical uses of USI and levels of training. A better understanding of the clinical uses and benefits of USI would enhance both training and clinical uptake. With the identification of barriers limiting physiotherapists' use of USI, ways to overcome these in New Zealand can now be explored further.
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Affiliation(s)
- Richard Ellis
- Department of Physiotherapy, School of Clinical Sciences, Faculty of Health and Environmental Sciences, Auckland University of Technology, Private Bag 92006, Auckland 1020, New Zealand; Health and Rehabilitation Research Institute, School of Clinical Sciences, Faculty of Health and Environmental Sciences, Auckland University of Technology, New Zealand. https://twitter.com/RichardEllisNZ
| | - Rachael De Jong
- Department of Physiotherapy, School of Clinical Sciences, Faculty of Health and Environmental Sciences, Auckland University of Technology, Private Bag 92006, Auckland 1020, New Zealand
| | - Sandra Bassett
- Department of Physiotherapy, School of Clinical Sciences, Faculty of Health and Environmental Sciences, Auckland University of Technology, Private Bag 92006, Auckland 1020, New Zealand.
| | - Jake Helsby
- Department of Physiotherapy, School of Clinical Sciences, Faculty of Health and Environmental Sciences, Auckland University of Technology, Private Bag 92006, Auckland 1020, New Zealand
| | - Maria Stokes
- Faculty of Health Sciences, University of Southampton, Building 45, Highfield Campus, Southampton SO17 1BJ, United Kingdom.
| | - Mindy Cairns
- School of Health and Social Work, University of Hertfordshire, Hatfield, Hertfordshire, United Kingdom.
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Henderson RE, Walker BF, Young KJ. Current and Prospective Use of Musculoskeletal Diagnostic Ultrasound Imaging at Chiropractic Teaching Institutions: A Worldwide Survey of Diagnostic Imaging Staff. J Chiropr Med 2017; 16:54-63. [PMID: 28228698 PMCID: PMC5310955 DOI: 10.1016/j.jcm.2016.10.001] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2016] [Revised: 09/28/2016] [Accepted: 10/03/2016] [Indexed: 02/07/2023] Open
Abstract
OBJECTIVE The purpose of this study was to survey the use of musculoskeletal diagnostic ultrasound imaging (MSK-DUSI) at chiropractic educational programs worldwide and to elicit opinions of academic diagnostic imaging staff of its prospective use at their teaching institutions. METHODS An electronic questionnaire was delivered in 2014 using SurveyMonkey and notifications were disseminated by e-mail to 127 diagnostic imaging staff at chiropractic programs worldwide. The questionnaire consisted of 27 items using multiple-choice, Likert-type, and open-ended questions. Descriptive statistics were used for basic demographic data and the results of the numerical scales used in each item. RESULTS Fifty-nine respondents (46.5%) from 24 (24/41) chiropractic programs returned questionnaires. The reported use of MSK-DUSI at chiropractic programs is low (n = 5/24); however, respondents from 9 institutions stated that it is planned to be implemented. Few respondents stated they had formal MSK-DUSI qualifications (4/59); however, 7 respondents stated they were in the process of becoming certified. Most respondents expressed an interest in the prospect of incorporating MSK-DUSI at their chiropractic program. Sixty-five percent stated that chiropractic programs should provide MSK-DUSI training to chiropractic students, and 75% of respondents stated that chiropractic programs should be providing accredited postgraduate MSK-DUSI courses. CONCLUSIONS The current use of MSK-DUSI among chiropractic programs that responded to this survey is low. The opinions of diagnostic imaging staff who responded suggest a positive attitude to its use and possible growth in its use if foundational work, including gaining funding, accreditation, and acceptance of within the scope of chiropractic practice, is undertaken.
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Affiliation(s)
- Rogan E.A. Henderson
- Discipline of Chiropractic, School of Health Professions, Murdoch University, Perth, Australia
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Cobbing S, Maddocks S, Govender S, Khan S, Mbhele M, Naidoo K, Tootla S, Weston C. Physiotherapy postgraduate studies in South Africa: Facilitators and barriers. SOUTH AFRICAN JOURNAL OF PHYSIOTHERAPY 2017; 73:335. [PMID: 30135897 PMCID: PMC6093091 DOI: 10.4102/sajp.v73i1.335] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2016] [Accepted: 11/14/2016] [Indexed: 11/01/2022] Open
Abstract
Aim To investigate the facilitators and barriers to attaining a postgraduate physiotherapy degree in South Africa. Methods A quantitative, cross-sectional design using an internet-based survey was employed. The population of the study included all qualified physiotherapists who had completed community service and who were on the South African Society of Physiotherapy e-mailing list at the time of the study. Results In all, 425 valid responses were received. The study participants were predominantly white women with a mean age of 36.9 and the majority were working in private practice. A total of 20.5% of respondents had completed a master's or doctoral degree in physiotherapy, while a further 13% of respondents were registered for a postgraduate degree in physiotherapy at the time of the study. Study participants who had obtained a postgraduate degree identified the same main barriers (namely cost/lack of financial support, family commitments and lack of time) and the same main facilitators (namely gaining of expertise, fulfilment of a personal goal and improvement of patient care) as participants who had not obtained a postgraduate degree. Participants who had not obtained a postgraduate degree were significantly more likely (p < 0.05) to report concerns regarding their own ability and a lack of motivation as barriers to further study. Conclusion South African physiotherapists with and without a postgraduate degree reported common facilitators and barriers to pursuing postgraduate studies. In order to ensure that a greater number and diversity of physiotherapists see postgraduate studies as a worthwhile career option, stakeholders in health and education in both the South African public and private sectors need to be engaged to limit the barriers to postgraduate study and seek novel methods of making postgraduate study a more attractive option from a personal development and career perspective.
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Affiliation(s)
- Saul Cobbing
- Department of Physiotherapy, University of KwaZulu-Natal, South Africa
| | - Stacy Maddocks
- Department of Physiotherapy, University of KwaZulu-Natal, South Africa
| | - Simoene Govender
- Department of Physiotherapy, University of KwaZulu-Natal, South Africa
| | - Shuaib Khan
- Department of Physiotherapy, University of KwaZulu-Natal, South Africa
| | - Mpilonhle Mbhele
- Department of Physiotherapy, University of KwaZulu-Natal, South Africa
| | - Kareena Naidoo
- Department of Physiotherapy, University of KwaZulu-Natal, South Africa
| | - Summaya Tootla
- Department of Physiotherapy, University of KwaZulu-Natal, South Africa
| | - Claire Weston
- Department of Physiotherapy, University of KwaZulu-Natal, South Africa
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Peek K, Carey M, Sanson-Fisher R, Mackenzie L. Physiotherapists’ perceptions of patient adherence to prescribed self-management strategies: a cross-sectional survey of Australian physiotherapists. Disabil Rehabil 2016; 39:1932-1938. [DOI: 10.1080/09638288.2016.1212281] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Affiliation(s)
- Kerry Peek
- Health Behaviour Research Group, School of Medicine and Public Health, Faculty of Health and Medicine, University of Newcastle, University Drive, Callaghan, NSW, Australia
| | - Mariko Carey
- Health Behaviour Research Group, School of Medicine and Public Health, Faculty of Health and Medicine, University of Newcastle, University Drive, Callaghan, NSW, Australia
| | - Robert Sanson-Fisher
- Health Behaviour Research Group, School of Medicine and Public Health, Faculty of Health and Medicine, University of Newcastle, University Drive, Callaghan, NSW, Australia
| | - Lisa Mackenzie
- Health Behaviour Research Group, School of Medicine and Public Health, Faculty of Health and Medicine, University of Newcastle, University Drive, Callaghan, NSW, Australia
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13
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Müllersdorf M, Ivarsson AB. What, Why, How - Creative Activities in Occupational Therapy Practice in Sweden. Occup Ther Int 2016; 23:369-378. [DOI: 10.1002/oti.1438] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2015] [Revised: 04/16/2016] [Accepted: 07/06/2016] [Indexed: 11/08/2022] Open
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Chong JNF, De Luca K, Goldan S, Imam A, Li B, Zabjek K, Chu A, Yeung E. Ordering diagnostic imaging: a survey of ontario physiotherapists' opinions on an expanded scope of practice. Physiother Can 2015; 67:144-56. [PMID: 25931666 DOI: 10.3138/ptc.2014-09] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
PURPOSE To explore Ontario physiotherapists' opinions on their ability to order diagnostic imaging (DI). METHODS An online questionnaire was sent to all registered members of the College of Physiotherapists of Ontario. Descriptive statistics were calculated using response frequencies. Practice characteristics were compared using χ(2) tests and Wilcoxon rank-sum tests. RESULTS Of 1,574 respondents (21% response rate), 42% practised in orthopaedics and 53% in the public sector. Most physiotherapists were interested in ordering DI (72% MRI/diagnostic ultrasound, 78% X-rays/computed tomography scans). Respondents with an orthopaedic caseload of 50% or more (p<0.001) and those in the private sector (p<0.001) were more interested in ordering DI. Respondents preferred a DI course that combined face-to-face and Web-based components and one that was specific to their area of practice. Most respondents perceived minimal barriers to the uptake of ordering DI, and most agreed that support from other health care professionals would facilitate uptake. CONCLUSION The majority of Ontario physiotherapists are interested in ordering DI. For successful implementation of a health care change, such as physiotherapists' ability to order DI, educational needs and barriers to and facilitators of the uptake of the authorized activity should be considered.
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Affiliation(s)
- Jodie Ng Fuk Chong
- Rouge Valley Sports Injury and Wellness, Pickering ; Sunnybrook Health Sciences Centre-St. John's Rehab
| | | | | | | | - Boris Li
- Liveactive Sports Medicine, MVMT Clinic
| | - Karl Zabjek
- Department of Physical Therapy, University of Toronto, Toronto, Ont
| | - Anna Chu
- Sunnybrook Health Sciences Centre-St. John's Rehab ; Department of Physical Therapy, University of Toronto, Toronto, Ont
| | - Euson Yeung
- Department of Physical Therapy, University of Toronto, Toronto, Ont
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McKiernan S, Chiarelli P, Warren-Forward H. The content of a training package in diagnostic ultrasound for physiotherapists. SONOGRAPHY 2015. [DOI: 10.1002/sono.12015] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Affiliation(s)
| | - Pauline Chiarelli
- School of Health Sciences; The University of Newcastle; Callaghan Australia
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Lohman CM, Smith MP, Dedrick GS, Brismée JM. Validity of musculoskeletal ultrasound for identification of humeroradial joint chondral lesions: a preliminary investigation. J Athl Train 2014; 49:7-14. [PMID: 24377960 DOI: 10.4085/1062-6050-49.1.03] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
CONTEXT Epicondylalgia is a common condition involving pain-generating structures such as tendon, neural, and chondral tissue. The current noninvasive reference standard for identifying chondral lesions is magnetic resonance imaging. Musculoskeletal ultrasound (MUS) may be an inexpensive and effective alternative. OBJECTIVE To determine the intrarater reliability and validity of MUS for identifying humeroradial joint (HRJ) chondral lesions. DESIGN Cross-sectional study. SETTING Clinical anatomy research laboratory. PATIENTS OR OTHER PARTICIPANTS Twenty-eight embalmed cadavers (14 women, 14 men; mean age = 79.5 ± 8.5 years). MAIN OUTCOME MEASURE(S) An athletic trainer performed MUS evaluation of each anterior and distal-posterior capitellum and radial head to identify chondral lesions. The reference standard was identification of chondral lesions by gross macroscopic examination. Intrarater reliability for reproducing an image was calculated using the intraclass correlation coefficient (3,k) for measurements of the articular surface using 2 images. Intrarater reliability to evaluate a single image was calculated using the Cohen κ for agreement as to the presence of chondral lesions. Validity was calculated using the agreement of MUS images and gross macroscopic examination. RESULTS Intrarater reliability was 0.88 (95% confidence interval = 0.77, 0.94) for reproducing an image and 0.93 (95% confidence interval = 0.80, 1.06) for evaluating a single image. Identifying chondral lesions on all HRJ surfaces with MUS demonstrated sensitivity = 0.93, specificity = 0.28, positive predictive value = 0.58, negative predictive value = 0.77, positive likelihood ratio = 1.28, and negative likelihood ratio = 0.27. CONCLUSIONS Musculoskeletal ultrasound is a reliable and sensitive tool for a clinician with relatively little experience and training to rule out HRJ chondral lesions. These results may assist with clinical assessment and decision making in patients with lateral epicondylalgia to rule out HRJ chondral lesions.
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Affiliation(s)
- Chelsea M Lohman
- Center for Rehabilitation Research, Texas Tech University Health Sciences Center, Lubbock
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McKiernan S, Chiarelli P, Warren-Forward H. Professional issues in the use of diagnostic ultrasound biofeedback in physiotherapy of the female pelvic floor. Radiography (Lond) 2013. [DOI: 10.1016/j.radi.2013.01.006] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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McKiernan S, Chiarelli P, Warren-Forward H. A comparison between workshop and DVD methods of training for physiotherapists in diagnostic ultrasound. Radiography (Lond) 2012. [DOI: 10.1016/j.radi.2012.07.004] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
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Müllersdorf M, Ivarsson AB. Use of creative activities in occupational therapy practice in Sweden. Occup Ther Int 2012; 19:127-34. [PMID: 22489029 DOI: 10.1002/oti.1327] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2011] [Revised: 02/12/2012] [Accepted: 02/14/2012] [Indexed: 11/11/2022] Open
Abstract
The aim of this study was to describe the prevalence of creative activities in occupational therapy in Sweden and how often Swedish occupational therapists use creative activities as a means of intervention. A web-mail survey was sent to 2975 Swedish occupational therapists working in health care at regional, county council or primary health care level, and those working in vocational rehabilitation. A total of 1867 (63%) answered the questionnaire and showed that 44% did use creative activities as a means of intervention and most often by practitioners working in psychiatric health care. The most commonly used form of creative activity was arts and crafts followed by gardening. This web-mail survey was based on a limited amount of items regarding creative activities. Further research should focus on in-depth inquiries about how occupational therapists and their patients perceive the use of creative activities as a means of treatment in occupational therapy.
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Use of ultrasound about the shoulder. CURRENT ORTHOPAEDIC PRACTICE 2012. [DOI: 10.1097/bco.0b013e318241522b] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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Early prognostic factors in patients with whiplash. J Orthop Sports Phys Ther 2011; 41:983; author reply 983-4. [PMID: 22146590 DOI: 10.2519/jospt.2011.0202] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
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