Implementation of a ‘Supervision Snapshot’ Program for Allied Health Clinicians

Ms Phoebe Thomson1, Ms Elisha Matthews1, Mr Trent  Wilkie1, Dr Ruth Nicholls1

1The Royal Children’s Hospital, Parkville, Australia

Abstract:

Aim:
Upskilling a multi-disciplinary Allied Health workforce to supervise students and interns in an acute setting.

Method:
In early 2018, a needs analysis was conducted across the breadth of Allied Health Therapy and Science professions at the Royal Children’s Hospital (RCH) Melbourne regarding supervision practices and training needs. Outcomes indicated the need for local training to upskill clinicians supervising students and interns and the ‘Allied Health Student and Intern Supervision Snapshot Program’ was developed. This new program was implemented over 7 months and comprised 11 different topics targeted at beginner to advanced levels. Each 45 minute ‘Snapshot’ workshop was repeated 4 times on average (total of 37 sessions). A standard participant evaluation form was completed at the end of each session, comprising four 10-point rating-scale (quantitative) questions and three open-ended (qualitative) questions.

Results: A total of 276 participants attended sessions and evaluation data yielded positive results. Participants reported that what they learned in the workshops would be helpful in future supervision (average score of 8.3/10 where 10 = ‘Strongly Agree’; range 7.5- 8.9) and they felt confident to apply what they learned to their work with students and interns (average score of 8.3/10; range 7.8-8.6). Further evaluation is being undertaken at conclusion of the program.

Significance of the findings to Allied Health:
This multi-disciplinary program has enhanced clinician knowledge and skills when supervising students and interns. Consequently, staff have reviewed current supervision programs and practices, implemented changes where required, and feel more prepared, empowered and confident to manage supervision dilemmas.

Biography:

Phoebe Thomson is a Senior Prosthetist and Orthotist and an Allied Health Clinical Educator at the Royal Children’s Hospital (RCH) in Melbourne. Her job-share role allows her to work clinically providing prosthetics and orthotics to patients, as well as providing educational leadership for the collective Allied Health therapy and science professions at RCH. This includes developing and coordinating in-service education and training programs, providing training and support for clinical supervisors and promoting interprofessional education and learning opportunities. Phoebe has a passion for education, teaching and learning and is a strong advocate for Allied Health.

Exploring student fitness to practise (FTP) issue identification and management with allied health clinical educators in a tertiary health service

Dr Melanie Farlie1,2, Ms Joanne Thorpe1, Dr Kristin Lo2

1Monash Health , Clayton, Australia, 2Monash University, Frankston, Australia

Abstract:

Aim:
The aims of this research project were to 1) evaluate if a 1.5 hour interprofessional education workshop changed the knowledge, perceptions and confidence of clinical educators to manage student FTP issues, and 2) discuss personal experience clinical educators have had to date with students  FTP issues and management strategies they would recommend.

Method:
Seventy-seven allied health clinical educators from ten professions attended a 1.5 hour interprofessional education workshop about student FTP. Participants contributed to group discussions regarding identification and management strategies to address student FTP issues. Participants completed pre and post surveys. Quantitative data was analysed using independent t-testing. Qualitative data was analysed using content analysis.

Results:
There was pre and post data for 46 multidisciplinary participants. Clinical competency issues were discussed including the role of student insight. Participants preferred to have mental health issues such as anxiety disclosed early using feed forward mechanisms. The importance of clinical educator preparation was discussed as participants lacked confidence and felt that they had inadequate training to support students with FTP issues. There were indications to put the onus on the student, set expectations early and develop understanding of how to best provide feedback. Support from the university and other staff was important.

Significance of the findings to allied health:
A multidisciplinary group were able to elucidate a range of strategies that may assist supporting students with FTP issues across professions.

Biography:

Mel Farlie is Allied Health Education Lead at Monash Health in the Workforce Innovation, Strategy, Education & Research (WISER) Unit and Adjunct Senior Lecturer in the Physiotherapy Department at Monash University.

SENSeAssess: Development and Implementation of an Evidence-Based Somatosensory Assessment for use in clinical practice settings with Adult Stroke Survivors

Ms Yvonne Mak-Yuen1,2, Ms Liana Cahill1,2,3, Professor Thomas Matyas4, Professor Leeanne Carey1,2

1La Trobe University, Bundoora, Australia, 2The Florey Institute of Neuroscience & Mental Health, Heidelberg, Australia, 3Australian Catholic University, Fitzroy, Australia, 4The University of Melbourne, Parkville, Australia

Abstract:

Aim:
To develop and trial an evidence-based sensory assessment tool using brief versions of standardised somatosensory assessments to quantify sensory discrimination capacity in stroke survivors across eight Australian Health organisations.

Method:
Data from existing cohorts of stroke survivors (n=50 and n=63) and age matched healthy controls (n=50) who had been assessed on quantitative measures of sensory performance was extracted and pooled. This data was then re-analysed to determine the ability of brief versions of the tests to detect impairment. Sensitivity and specificity were determined for brief versions of the Tactile Discrimination Test, Wrist Position Sense Test and functional Tactile Object Recognition Test.

Results:
High sensitivity and specificity were found for the Tactile Discrimination Test (15 or 25 vs 50 and 15 vs 25 trials; with sensitivity ranging between 76% – 79.4%, specificity 100%); Wrist Position Sense Test (10 vs 20 trials; sensitivity 93%, specificity 95%) and the functional Tactile Object Recognition Test (7 vs 14 trials; sensitivity 85.7%, specificity 92.9%).

Significance of the findings to allied health:
Evidence of high sensitivity and specificity of brief versions of quantitative measures of somatosensory performance support their use in the clinical setting. This tool, known as SENSeAssess is a valuable tool for assessing various modalities of somatosensation post-stroke and is currently being implemented across eight Australian Health organisations by Occupational Therapists and Physiotherapists.

Biography:

Yvonne is an Occupational Therapist, researcher and a current PhD Candidate at La Trobe University. She has worked across acute and inpatient rehabilitation settings, with a specialised focus in neurorehabilitation. Yvonne’s post-graduate research in the SENSe Implement Project focuses on the further development and trial of standardised quantitative somatosensory assessments, known as SENSeAssess, to be used in clinical rehab settings for adult stroke survivors.

Evaluation of a ward-based risk assessment manual handling program on workplace practice

Professor Nicholas Taylor2,3, Ms Helen Kugler1,2, Dr Natasha  Brusco1,2

1Centre for Allied Health Research and Education, Cabrini Health, Malvern, Australia, 2La Trobe Centre for Sport and Exercise Medicine Research, School of Allied Health, La Trobe University, Bundoora, Australia, 3Allied Health Clinical Research Office, Eastern Health, Box Hill, Australia

Abstract:

Aim:
To evaluate transfer of manual handling skillset into the workplace following participation in manual handling training, and the effect on staff injuries and patient falls.

Methods:
Staff (n=72) across two pilot wards participated in a full-day manual handling education program led by allied health as a part of local mandatory training. Training included two sessions, Manual Handling Fundamentals and Risk Assessment for Moving Patients (RAMP). Clinical observations audits were conducted on both pilot wards to observe staff engaging in patient transfers. Observations were conducted prior to, immediately following and at 6 months following training. Staff musculoskeletal injuries and patient falls was measured in the 6-month period following training and compared to pre-training periods.

Results:
From a total of 156 observations, ‘standing up’ was the most common transfer component. Following training, there was an increased consideration of the components of risk assessment, staff positioned themselves safely more often and were better able to educate the patient to participate in the transfer. These improvements were sustained at 6 months. There were no changes in staff musculoskeletal injuries or patient falls.

Significance of the findings to allied health:
An allied health led program was successful in improving the manual handling skills of ward-based staff. No short-term changes were observed in staff injuries or patient falls. Longer-term studies on larger samples would determine if the positive changes in manual handling skills results in fewer staff injuries or patient falls.

Biography:

Nicholas Taylor is Professor of Allied Health at La Trobe University and Eastern Health. He leads the Allied Health Clinical Research Office at Eastern Health. His research focuses on improving rehabilitation outcomes.

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.

What is the value of Spiritual Care? Patient reported outcome measures

Dr Heather Tan1

1Spiritual Health Victoria, Abbotsford, Australia

Abstract:

Aims:
To increase awareness of patient outcomes of spiritual care as reported by inpatients after discharge and to inform future spiritual care provision.

Method:
The Scottish Patient Reported Outcome Measure of Spiritual Care – a validated questionnaire,  (with permission Scottish NHS) was utilised. The study assumed spiritual care can be provided by other health professionals, as well as the professional spiritual care providers.  5000 copies were posted to patients meeting inclusion criteria, discharged from the following sites: 2 large Melbourne general hospitals, 1 small regional private hospital and 2 large Adelaide general hospitals. Participating patients returned the questionnaires anonymously in reply paid envelopes.

Results:
Results will be finalised by the conference. Data relating to Patient  spiritual care experience   (e.g. being listened to, free to talk about what matters to them, being understoodspiritual care and their faith/beliefs/values respected) will be discussed. Data will also inform our understanding of patient outcomes of spiritual care intervention e.g. their feelings (peace/anxiety), their outlook on life and sense of being in control. Demographic data (age, gender, spiritual/religious/none) may also yield information informing improved services to particular groups.

Significance of Findings to Allied Health:
Person centred care is an important objective for all health care providers and includes a person’s spiritual/religious beliefs, practices and values. Awareness and integration of best practice spiritual care is therefore of significance for all Allied Health practitioners – and increasingly recognised by government departments and health care providers.

Biography:

Heather has a background in education, research, pastoral care and counselling with a particular focus on palliative care. She has experience in tertiary education including at the post graduate level in the areas of loss, grief and bereavement, spiritual care, issues in death and dying, communication skills, research methods. She has been involved in research and publications in the areas of spiritual care, grief and bereavement, psychosocial and spiritual issues in palliative care and research literacy.

Her role at Spiritual Health Victoria as the Manager of Education and Research has included teaching into tertiary programs in pastoral care, educating about and facilitating research in the sector directed to developing an understanding of patient experience of spiritual care and an evidence base for best practice.

Clinical Supervision as an Evidence Translation Strategy

Dr David Snowdon

Sub-acute Allied Health Research Lead at Peninsula Health

Abstract:

Australian standards recommend that allied health professionals receive clinical supervision to maintain a high quality of care and support them in their professional role. Evidence has shown that clinical supervision can effectively support allied health professionals in their professional role, however the level of effectiveness can vary between the professions. This may influence the capacity of clinical supervision to influence quality of care. Clinical supervision must influence quality of care for it to be truly effective and models of clinical supervision that influence patient care are required. This presentation will explore how clinical supervision can be used to influence allied health professionals’ clinical practice and improve patient outcomes.

Biography:

David Snowdon is the Sub-acute Allied Health Research Lead at Peninsula Health and recently submitted his PhD thesis on the effectiveness of clinical supervision of allied health professionals. As a qualified Physiotherapist, he has worked in the healthcare sector for approximately 10 years.

David’s research has primarily investigated the effectiveness of clinical supervision in supporting allied health professionals and its effect on patient quality of care. He also has an interest in the translation of evidence into practice. In 2017/18 he was a successful recipient of the Felice Rosemary Lloyd scholarship, which afforded him the opportunity to tour McMaster University in OntClinical ario, Canada and advance his knowledge in teaching evidence-based practice to healthcare professionals.