Which learning activities enhance physiotherapy practice? A systematic review and meta-analysis

Mr Edmund Leahy1,2,3, Dr Lucy Chipchase4, Ms Marlena Calo3, Dr Felicity Blackstock2

1Northern Health , Melbourne, Australia, 2Western Sydney University, Sydney, Australia, 3La Trobe University, Melbourne, Australia, 4University of Canberra, Canberra, Australia

Abstract:

Aim:
Physiotherapy expertise requires career-long participation in learning activities due to a rapidly expanding evidence base. Determining which learning activities are effective would enable the physiotherapy profession to enhance clinical expertise and incorporate research into practice. This systematic review aimed to evaluate which learning activities enhance physiotherapy practice. Method: Eight databases were searched through to March 2017. Randomised controlled trials (RCTs) evaluating physiotherapy learning activities were included. Both clinician (physiotherapist knowledge, affective attributes and behaviour) and patient outcomes were of interest. Risk of bias assessment was completed using the PEDro scale. Meta-analysis and GRADE were used to synthesise results where possible.

Results:
Twenty-six RCTs were identified. Twenty studies reported therapist outcomes and nine reported patient outcomes. There was limited evidence that professional development courses improved physiotherapist knowledge, and low-level evidence that peer assessment and feedback was more effective than case discussion at improving knowledge. There were inconsistent results for the effect of learning activities on affective attributes. Professional development courses with active learning components appeared to be more effective at changing physiotherapist behaviour. Professional development courses completed by physiotherapists did not improve patient outcomes, however the addition of a mentored patient interaction appeared impactful.

Significance of findings to allied health:
Physiotherapy knowledge and clinical behaviour appears to be enhanced by completion of professional development courses. Professional development courses that included active learning strategies such as peer assessment and feedback were of most value. Patient outcomes were only enhanced when a professional development course was combined with mentored patient interactions.

Biography:

Ed Leahy is a physiotherapist with over 20 years of clinical experience, currently working as a senior clinician at Northern Health in Victoria. He also has over 10 years of experience as a clinical educator, teaching at both Australian Physiotherapy Association continuing education courses and on university post-graduate physiotherapy programs. He is the co-ordinator of Graduate Certificate of Musculoskeletal Physiotherapy and Master of Musculoskeletal Physiotherapy courses at La Trobe University. He is a PhD candidate at Western Sydney University, where he is exploring best practice for physiotherapy professional development.