Which learning activities enhance physiotherapy practice? A systematic review protocol of quantitative and qualitative studies

Use of audience response systems (ARS) in physiotherapists' training: a qualitative study

OBJECTIVE

To explore the experience of using audience response systems (ARS) in postgraduate physiotherapy training.

DESIGN

Qualitative interview study following the 'reflexive thematic analysis' by Braun and Clarke.

SETTING

Higher education university.

PARTICIPANTS

Ten Italian students (60% men, N=6; 40% women, N=4) agreed to partake in the interviews.

RESULTS

We generated four themes. Specifically, the ARS were perceived: (1) as a 'Shared Compass' (theme 1) between the student and the lecturers to monitor and modify the ongoing students' learning journey; (2) useful to 'Come Out of Your Shell' (theme 2) as they help students to overcome shyness and build a team with peers; (3) as 'A Square Peg in a Round Hole' (theme 3) as they should not be used in situations that do not suit them; (4) as 'Not Everyone's Cup of Tea' (theme 4) as mixed opinions among ARS' utilities were found under some circumstances (eg, memorisation process and clinical reasoning).

CONCLUSION

Physiotherapy lecturers must use ARS critically, respecting when (eg, not at the end of the lesson) and how to propose them, keeping in mind that some skills (eg, practical ones) might not benefit from their use. Moreover, they need to consider that the ARS are not a tool for everyone, so ARS must be integrated into a multimodal teaching paradigm.

Views of physiotherapists on factors that play a role in ethical decision-making: an international online survey study

BACKGROUND

There is a lack of knowledge about the ways physiotherapists around the world learn about professional code of ethics and ethical decision-making frameworks. The profession has a gap in the understanding about physiotherapists' views on factors that play a role in ethical decision-making and whether these views differ between World Physiotherapy regions.

METHODS

An online survey study in English was conducted from October 2018 to October 2019. Participants included 559 physiotherapists located in 72 countries. The self-designed survey questionnaire contained 13 items asking about demographic information and means of learning about ethical codes and decision-making frameworks. A further 30 items were presented which included statements underpinned with individual, organisational, situational and societal factors influencing ethical decision-making. Participants were asked to express their level of agreement or disagreement using a 5-point-Likert-scale.

RESULTS

Participants' highest rated responses endorsed that the professional role of physiotherapists is linked to social expectations of ethical behaviour and that ethical decision-making requires more skills than simply following a code of ethics. A recognisable organisational ethical culture was rated as supporting good ethical decisions. Comparing responses by World Physiotherapy regions showed significant differences in factors such as culture, religion, emotions, organisational values, significant others, consequences of professional misconduct and professional obligations. Entry level education was not perceived to provide a solid base for ethical decision-making in every World Physiotherapy region. Participants reported multiple sources for learning about a professional code of ethics and ethical decision-making frameworks. What's more, the number of sources differed between World Physiotherapy regions.

CONCLUSIONS

Multiple factors play a role in physiotherapists' ethical decision-making internationally. Physiotherapists' ethical knowledge is informed by, and acquired from, several learning sources, which differ in both quality and quantity amongst World Physiotherapy regions. Easily accessible knowledge and education about professional codes of ethics and ethical decision-making can foster continuing professional development for physiotherapists. The establishment of constructive ethical cultures in workplaces can improve ethical decision-making, and should acknowledge the influence of individual, organisational, situational and societal factors. The establishment of collaborative learning environments can support knowledge translation which acknowledges practice-based methods of knowing and learning.

Professional development needs and decision-making of new graduate physiotherapists within Australian private practice settings

INTRODUCTION

Professional development contributes to new graduate health professionals' transition into the workplace. Current literature indicates that new graduate physiotherapists are often underprepared to work within private practice settings, however little is known of their professional development needs to facilitate their transition.

OBJECTIVES

This study aimed to understand new graduate physiotherapists' perceived needs and decision-making for professional development within private practice settings.

METHODS

This study used a qualitative interpretative phenomenological approach. A sample of new graduate physiotherapists employed within private practice settings (n = 14) participated in semi-structured telephone interviews, after being selected through convenience and randomized sampling. Interview data was subject to thematic analysis.

RESULTS

Four key themes emerged from the data: 1) practical and commercial relevance; 2) influence of self and others in decision-making; 3) professional development as a social construct; and 4) access is critical.

CONCLUSION

New graduate physiotherapists expressed needs for practically and clinically relevant professional development within formal and informal settings, and this extended to non-clinical skills specific to private practice. Their decision-making was shaped by social influences and perceived barriers to access. This study has identified implications for employers and professional development providers to support and cater to new graduate physiotherapists' perceived needs for professional development, which may facilitate their transition into private practice.

Barreras para el desarrollo profesional continuo: una encuesta a fisioterapeutas argentinos/as

OBJETIVO

Conocer las barreras que los/as kinesiólogos/as argentinos presentan a la hora de emprender o mantener su desarrollo profesional continuo. Materiales y método: Se realizó un estudio descriptivo y transversal mediante una encuesta anónima y virtual a través de Google Forms en el mes de julio de 2021.

RESULTADO

229 profesionales completaron el cuestionario. 157 (68,6%) ejercían en la provincia de Córdoba, 19 (8,3%) en Buenos Aires, 11 (4,8%) en Santa Fe y el resto en otras provincias. 106 (46,3%) llevaban trabajando entre 1 a 5 años en la profesión, 42 (18,3%) entre 5 y 9 años, 34 (14,8%) entre 10 y 15 años y 47 (20,5%) más de 15 años. 128 (55,9%) se desempeñaban en el área de traumatología y ortopedia, 77 (31,9%) en respiratorio. 178 (77,7%) pertenecía al sector privado, 17 (7,4%) al sector público y 34 (14,8%) a ambos sectores. Conclusión: Del total de encuestados, el 84,3% manifestó tener barreras para realizar su desarrollo profesional continuo; el 15,7% declaró no tener inconvenientes. La principal barrera fue la economía personal, seguida de la percepción de costo beneficio y la falta de tiempo.

Which Learning Activities Enhance Physical Therapist Practice? Part 2: Systematic Review of Qualitative Studies and Thematic Synthesis

OBJECTIVE

Post-professional physical therapy expertise requires career-long participation in learning activities. Understanding physical therapists' lived experience of learning activities provides novel insight into how best to enhance physical therapist practice from the perspective of the learner. The purpose of this study was to explore qualified physical therapists' experiences, beliefs, and perspectives with regard to learning activities and professional development.

METHODS

Eight databases were searched for studies published from inception through December 2018. Study selection included mixed-methods and qualitative studies exploring physical therapists' experiences, perspectives, beliefs, and attitudes. Thematic synthesis was performed, and the GRADE-Confidence in the Evidence from Reviews of Qualitative research was used to assess the level of confidence in the findings. A total 41 studies with 719 participants were included.

RESULTS

The key findings include physical therapists' perceptions that worthwhile post-professional learning requires more than attendance at professional development courses. Physical therapists perceived that worthwhile learning requires connection with others and being "taken out of one's comfort zone." Sufficient time and accessible, trustworthy resources were also valued.

CONCLUSIONS

Moderate- to low-level evidence suggests that the choice of professional development activities and education design for qualified physical therapists should consider the inclusion of connected activities, activities that take participants out of comfort zones, time to practice, and trustworthy resources that are easily accessible. Future research should evaluate the effectiveness of learning activities encompassing these factors, prioritizing those that minimize the barriers of time and distance.

IMPACT

This study adds to the profession's understanding of physical therapists' lived experience of learning activities, providing novel insight into how best to enhance physical therapist practice from the perspective of the learner.

Which Learning Activities Enhance Physical Therapist Practice? Part 1: Systematic Review and Meta-analysis of Quantitative Studies

OBJECTIVE

Following graduation from professional education, the development of clinical expertise requires career-long participation in learning activities. The purpose of this study was to evaluate which learning activities enhanced physical therapist practice.

METHODS

Eight databases were searched for studies published from inception through December 2018. Articles reporting quantitative data evaluating the effectiveness of learning activities completed by qualified physical therapists were included. Study characteristics and results were extracted from the 26 randomized controlled trials that met the inclusion criteria. Clinician (knowledge, affective attributes, and behavior) and patient-related outcomes were extracted.

RESULTS

There was limited evidence that professional development courses improved physical therapist knowledge. There was low-level evidence that peer assessment and feedback were more effective than case discussion at improving knowledge (standardized mean difference = 0.35, 95% CI = 0.09-0.62). Results were inconsistent for the effect of learning activities on affective attributes. Courses with active learning components appeared more effective at changing physical therapist behavior. The completion of courses by physical therapists did not improve patient outcomes; however, the addition of a mentored patient interaction appeared impactful.

CONCLUSION

Current evidence suggests active approaches, such as peer assessment and mentored patient interactions, should be used when designing learning activities for physical therapists. Further high-quality research focused on evaluating the impact of active learning interventions on physical therapist practice and patient outcomes is now needed.

IMPACT

This study is a first step in determining which learning activities enhance clinical expertise and practice would enable the physical therapy profession to make informed decisions about the allocation of professional development resources.