iSAP: an innovative case based learning tool to encourage health practitioners to share authentic experiences with future practitioners

Professor Marilyn Baird1

Monash University, Victoria

Aim:
The aim of iSAP is to authentically re-create the emotive experience of the work environment of health practitioners for sharing with future practitioners.

Method:
The case based learning program is based on integrating Science And Practice (iSAP) and employs a design process to engage students in professional issues and clinical decision-making. Learning takes place at the level of pseudo-engagement with the health professional, providing a unique zone for intrinsic feedback modulation. This modelling environment uses the learners’ input of addressing the case professional issues and prompts for a reflective comparison with the model output provided by the expert practitioner. Supported with audio/video interviews, expert practitioner responses evoke the sense of tensions and pressures of the work environment.

Result:
In 2016, we provided access to iSAP within the learning management platform for adoption across disciplines in the Faculty of Medicine, Nursing and Health Sciences. iSAP has been used or is being adopted for use across the disciplines of Radiography, Radiation Therapy, Ultrasound, Health Sciences, Forensic Medicine and Specialist Paramedic Practice.
The use of various media techniques in case scenarios and expert responses has provided the learner with an immersive, authentic practice-learning environment that inculcates all of the work skills required by the future health practitioner.

Significance of the findings to allied health:
Reflective capacity is a critical attribute for certifying professional competence and increasingly described as an essential attribute of the competent health care professional. Through the process of reflection, new knowledge is created daily by allied health practitioners. The iSAP platform encourages future practitioners to bridge the theory practice gap through the use of authentic cases and an iterative learning cycle of investigation, critique and application.

What happens on allied health clinical education placements? An audit of current practice in pre-registration physiotherapy, occupational therapy and nutrition and dietetics

Dr Fiona Kent1,2, Mrs Kelly Saber1

1Monash Health, Cheltenham, Australia

2Monash University, Clayton, Australia

 

Background: Staff time is required for the organisation of clinical placements, student teaching, feedback and assessment, resulting in an impact of service delivery. Multiple clinical education models may be utilised, including peer assisted learning (PAL), simulation (SIM) and interprofessional education (IPE). There is a need to understand current education practices to ensure equity, sustainability and alignment to best practice.

 

Aims: To determine the time and models of clinical education currently in use. To align educational literature with current practice and make recommendations regarding future directions.

 

Methods: A two week prospective audit of clinical education practice was conducted from the perspectives of students and clinical educators.

 

Results: 207 clinical placement days were audited. Reasonable variation in education practice was identified, with clinical staff engaging in embedded supervisor activities 160 mins per day (median) and learner facilitator activities 55 minutes per day (median). Final year physiotherapy students saw a median of five patients per day, occupational therapy students saw three patients per day and third year dietetic students two patients per day. Education models in use by clinical placement day were PAL (34%), IPE (18%) and SIM (3%).

 

Significance of the findings to allied health: There are opportunities for standardisation of clinical education practice. Educational leadership and continued investment in upskilling clinical educators in PAL, IPE and SIM models will be key to this process.

Skill set matrix: A learning framework for occupational therapists at South West Healthcare

Ms Leanne Jackson1

1South West Health Care, Warrnambool, Australia

 

Through the process of revising the South West Healthcare Grade One Occupational Therapy Rotation Program, it was identified that a formal framework for accelerated, evidence based, skill and knowledge development, would be essential to guide a self-directed learning program to support Grade One Occupational Therapists.

Our objective was to support the skill and knowledge development in our Grade One staff members, in the rotation program, using an evidence based methods, in line with the Allied Health Credentialing, Competency and Capability framework (2014).

We developed and populated a “Skills Set Matrix” to facilitate skill and knowledge development in our Grade One Occupational Therapist as they rotate through our service.  These matrixes identify areas of learning, from basic, through intermediate and advanced, creating a targeted approach to the clinician’s professional development, in their current clinical field.  With the matrix as a guide, the clinicians are able to demonstrate their skills and knowledge, using the framework that is populated by evidence based resources.

Physiotherapists’ knowledge about dementia

Ms Patricia  Maggs1, Ms  Jacqui Kay1, Ms Tina Ovaskainen1

1Melbourne Health, Parkville, Australia

 

AIM: To identify and rectify knowledge gaps that exist about dementia amongst physiotherapists working in a major metropolitan hospital.

METHOD: A cross-sectional survey of 50 acute & subacute physiotherapists working within a major metropolitan hospital was completed using The Dementia Knowledge Assessment Tool version 2.  Following collation of results a 45 minute dementia education session was provided by Senior Aged Care physiotherapists and 42 staff were re-surveyed.

RESULTS:

Pre-education: 100% (N=50) of physiotherapists were aware that dementia occurs because of brain changes, 94%(N=47) recognised that these changes are often progressive, 96% (N= 48) were aware that exercise can be beneficial in this patient population.

Physiotherapists demonstrated limited knowledge around dementia limiting life expectancy (58%, N=29); and in late stages of dementia, swallowing difficulties may be present (66%, N=33), movement is limited (72%, N= 36) and it is possible to establish presence of pain 76% (N=38).

Post-education: Physiotherapists demonstrated improvement in knowledge around dementia limiting life expectancy (98%, N=41); and in late stages of dementia, swallowing difficulties may be present (81% N=34), movement is limited (88%, N=37) and it is possible to establish presence of pain (83%, N=35).

SIGNIFICANCE OF THE FINDINGS TO ALLIED HEALTH: There are key knowledge gaps within physiotherapy regarding dementia, but these can be addressed through targeted education.

Physiotherapists’ lack of knowledge regarding dementia may have implications for clinical decision making and may be associated with adverse outcomes and costly futile interventions. Further research is required to develop specific education to increase physiotherapists’ knowledge to ensure best practice care.

Clinical supervision training – improving clinician skill and confidence

Ms Anna Nethercote1, Ms  Gabriela  Veliz1, Ms Prue Deckert1

1Western Health, Allied Health and Community Services Planning, Innovation, Research and Education (ASPIRE) Unit, St. Albans, Australia

 

Aim: To investigate whether Clinical Supervision training, developed by Western Health Allied Health and Community Services (AH&CS), improved clinician self-rated understanding and confidence related to Clinical Supervision.

 

Method: Pre and post study of AH&CS clinicians undertaking a training program consisting of a workbook and interactive workshops between April and June 2016. Supervisees participated in one 2.5 hour workshop.  Supervisors participated in two 3.75 hour workshops.  Participants completed an online survey before training and following each workshop to evaluate knowledge and confidence related to Clinical Supervision.

 

Results: 153 supervisees participated in supervisee workshops, 188 supervisors participated in Workshop 1 for supervisors and 139 in Workshop 2.   Survey response rate for supervisees was 89.5% pre training and 18.3% post workshop.  Supervisor response rate was 70.2% pre training, 27.7% post Workshop 1 and 31.7% post Workshop 2.  Improvements were found for both supervisors and supervisees (p<0.05).  Supervisees who are ‘very clear’ or ‘mostly clear’ regarding Clinical Supervision requirements increased from 69% to 89%.  Supervisors who are ‘very clear’ or ‘mostly clear’ about skills required of clinical supervisors increased from 70% to 100%.  Supervisors who are ‘very confident’ or ‘confident’ to practice Clinical Supervision increased from 53% to 84%.

 

Significance of the findings: This innovative program enhanced clinician knowledge of Clinical Supervision skills and improved supervisor confidence to deliver Clinical Supervision.  Effective Clinical Supervision is positively associated with developing clinical competence, improved communication and leadership skills.  Therefore, it is anticipated this training will lead to improved patient care although this requires testing.

 

Refining professional development programs for clinician-educators using their conceptions of teaching and learning

Ms Christine Frith1, Dr. Debra  Virtue1,2, Dr. Sallie  Cowan3, Associate Professor Clare Delany2

1St Vincent’s Hospital, Fitzroy, Australia

2The University of Melbourne, Carlton, Australia

3Clifton Hill Physiotherapy Practice , Clifton Hill, Australia

 

Aims:

  1. To explore physiotherapy clinician-educators’ conceptions of teaching and adult learning at St Vincent’s Hospital
  2. Explore the impact of educator experience on these conceptions
  3. Identify barriers and enablers to the development of educator expertise

Clinician-educators are responsible for facilitating the learning experiences of students. Their role as an educator is informed by their conceptions and beliefs about what constitutes good clinical teaching.  The impact of educators’ conceptions of their role and how this impacts on their teaching methods in everyday practice is not widely researched.

Method:

Two types of data were collected: a survey of clinician-educators about their conceptions of teaching and learning, and two focus groups of clinician-educators to explore their beliefs and practices about teaching and learning and their perceptions of barriers and enablers to developing educator expertise. Focus groups were recorded and transcripts were thematically analyzed by two independent researchers.

Results:

Clinician-educators held conceptions that supported the use of active student participation during clinical placements for optimal student learning. Educator experience impacted on identity as a clinician-educator and the teaching processes adopted by clinician-educators.

The most influential factors in the development of educator expertise were access to mentors for novice educators and reflection on past clinical and teaching experiences for experienced educators.

Significance of the findings to Allied health:

This small study supports the literature on the impact of clinician-educator experience and teaching conceptions on teaching approaches and educator expertise development. Accounting for these differences might improve the effectiveness of professional development programs in healthcare settings.

“Being absorbed in that environment… it’s just so beneficial” – the experiences of physiotherapy students in a situated learning pilot study

Ms Sarah Barradell1, Dr Felicity  Blackstock1,2, Dr Clarice Tang1, Ms  Joan Leo1,3

1La Trobe University, Bundoora, Australia,

2Western Sydney University, Penrith, Australia

3Mercy Public Hospital Inc, Heidelberg, Australia

 

Aim: Explore the experiences of students who have completed non-clinical subjects that were facilitated by a health-care based professional within the clinical environment.

 

Method: This qualitative study used a phenomenologically-oriented approach to explore the experiences of participants who were physiotherapy students enrolled in two non-clinical practicum-based subjects. Subjects were facilitated by health-care based professionals in classroom settings co-located on a clinical site.  Participants completed a total of 150 hours of either face-to-face or online learning activities across a 5-week time period. Two semi-structured interviews were conducted with each participant, one mid-way through, and the second at the end of the learning period. Data was thematically analysed by two investigators using an inductive approach.

 

Results: Three inter-related themes emerged. Firstly, meaning making is enhanced by the relevance and authenticity afforded by immersion in a practice-oriented classroom environment where health-care based professionals facilitate learning.  Secondly, learning from those ‘in practice’ challenges participants’ professional and academic accountability.  Finally, new educational processes infrastructures influences students’ agency to adopt a more independent and proactive learning approach.

 

Significance of the findings to allied health: Being taught by future potential supervisors/employers, plus learning within an environment that was different to the traditional university, unexpectedly created opportunities for students to adopt a more independent and proactive learning approach, albeit somewhat transiently.

How well are allied health students prepared for client interaction? A constructive alignment case study of student-client communication competencies

Dr Renee Mackenzie1

1La Trobe University , Bundoora, Australia

 

Aim: To develop a method for reviewing the constructive alignment of student-client communication competencies in an allied health tertiary context. Method: Educational documentation was reviewed, using the Master of Clinical Prosthetics and Orthotics as a contextual case study. Criterion by which the constructive alignment of the competency was established at three levels; learning outcomes (LOs), assessment tasks and student feedback. Results: Six subjects containing student-client interaction were identified, two of which were classified as off-site clinical education. Ten notable LOs were identified and all were mapped to assessment tasks. Learning activities showed limited description of the communication competency. Assessment matrices indicated students received minimal written feedback concerning their interaction with clients, until final assessments in final year. The review identified a much greater emphasis on students’ ability to communicate with an assessor and limited feedback on the interaction between student and client. Significance of the findings to allied health: Allied health professionals are united by their regular interaction with clients. Communication is widely cited as a core competency in allied health educational documentation, yet concerns arising from poor communication continue to be reported in a range of health contexts. This case study identified a lack of clarity in the translation of LOs to assessment tasks. Limited feedback may impact students’ perception of the importance of communication skills with potential to shape their behaviour in clinical practice. This type of review is easily replicated and may have broader application in allied health tertiary contexts.

Promoting 21st century student competencies: Piloting a wellbeing intervention

Dr Mary  Whiteside1, Dr  Emma  Bould1, Dr Annie Venville2

1La Trobe University, Bundoora, Australia, 2Australian Catholic University, Melbourne, Australia

Aim:

In Australia and internationally, universities are undertaking to prepare students for the 21st Century through building the social competencies fundamental for professional practice and wellbeing. There is little evidence on how these competencies can be fostered in curriculum. The aims of this study were to pilot an Aboriginal wellbeing intervention in order to assess the impact and relevance of the program for promoting social competencies and student wellbeing.

Method:

The Family Wellbeing program was delivered to 64 first year social work students. A questionnaire incorporating the validated Growth and Empowerment measure, the Australian Unity Personal Wellbeing Index and open ended qualitative questions was administrated pre and post the intervention.

Results:

Quantitative results indicated that the intervention is highly relevant for student wellbeing, particularly for those who rated themselves as below the median at baseline. Qualitatively students reported that participation impacted on their personal wellbeing and social competencies, for example their self-awareness and confidence, ability to manage life stressors and their relationship skills. The relevance of the program to their future profession helped them to engage more fully with their university studies.

Significance of the findings to allied health:

These findings are relevant beyond social work to all allied health disciplines. They highlight the relevance of this intervention for promoting social competencies that enable people to problem-solve and adapt in a complex world.

 

Less writing, more talking: Using Zoom video conferencing to facilitate reflective learning during final year OT students’ transition to practice

Mr Luke Robinson1, Mrs Annette Peart1, Dr Mong-Lin Yu1

1Monash University, Frankston , Australia

 

Introduction: Exploring innovative ways of delivering curricula to undergraduate students that enable reflection and link theory to practice during an important agenda for all educators. Video conferencing may be a cost-effective and flexible way to facilitate student learning. This research project will evaluate the use of video conferencing to deliver weekly tutorials to occupational therapy students undertaking their final fieldwork placement.

 

Aim: To trial the use of Zoom video conferencing to promote student reflection and critique of professional issues via a peer learning approach; support quality learning and assessment; create a positive and productive learning environment, and inform future use in other curricula.

 

Method: A cross-sectional study using mixed methods approach involving all students enrolled in the 4th year of Bachelor of Occupational Therapy (Honours) course at XXX University in 2016. Quantitative data of students’ online learning experiences was collected using the Online Learning Environment Survey, Constructivist On-Line Learning Environment Survey, and Social Media Learning Scale before and after placement. The students were also invited to participate in a focus group session to obtain information about their experiences of video conferencing.

 

Results: The findings to be presented will include the strengths and challenges that students experienced with video conferencing online learning in facilitating reflection on and critique of professional issues encountered in clinical environments during placement.

 

The significance of the findings to allied health: The results of this pilot will inform the use of video conferencing in both academic and fieldwork teaching and learning activities for allied health students.