- Email: [email protected]
Pain education in professional health courses - a scoping review of standards, protocols and frameworks
The 4th European Congress of the ER-WCPT / Physiotherapy 102S (2016) eS1–eS42
OA048 Interprofessonal learning in acute care through high fidelity simulation opportunities and challenges for faculty and students L. Johnson 1,∗ , C. Apps 1 , K. Bazin 1 , S. Bench 2 , C. Holland 3 , J. Frisby 3 , R. Hilton 1 1 King’s
College London, Academic Department of Physiotherapy, London, United Kingdom 2 King’s College London, Florence Nightingale School of Nursing and Midwifery, London, United Kingdom 3 King’s College London, School of Medicine, London, United Kingdom Relevance: A blended-learning 15 credit module (Interprofessional Working in Acute Care - IWAC) has been developed as an optional module for pre-qualification medical, nursing and physiotherapy students to explore and develop the non-technical and technical skills essential for effective collaborative working in an acute care setting. Its fundamental aim is to enable students to achieve optimum patient outcomes as well as provide sensitive support for both the patient and their family at a time of health crisis. Purpose: The module aims to provide students with learning opportunities to develop, practice and reflect upon the skills for effective, collaborative and patient-centred interprofessional (IP) working in acute care. Approach/Evaluation: A blended, technology-enhanced learning (TEL) approach is adopted: web-based resources to facilitate self-directed learning, clinical observation, simulation-based teaching, collaborative peer group working and reflective practice. High fidelity clinical simulation is a core element of the module using acute care scenarios that were designed so that they could not be managed successfully without IP collaboration. Each student is allocated to an IP group (comprising one student from each professional group) and an IP assignment is part of the assessment. This is a collaborative presentation from each IP group where students reflect on the role of a student from a different profession as well as the non-technical skills utilised to manage the presenting acute care scenario. A mixed method evaluation strategy using feedback from students through national student surveys and module questionnaires has informed module development. Outcomes: IWAC has been a popular optional module and is usually oversubscribed within all faculties. Students have commented favourably on their experience: 100% of students who completed the module in 2014/5 strongly agree that being part of a mixed professional group enhanced learning in this module and that they have gained greater awareness of other healthcare professionals’ roles and responsibilities. The value of developing and honing communication skills in a
eS37
safe yet pressurised simulated environment is a core theme in evaluation data, with 95% of students strongly agreeing that clinical simulation supported integration of knowledge, skills and decision making. Faculty report challenges timetabling students and facilitators from three difficult faculties with differing and often evolving timetables and regret that it is not currently possible to offer this learning opportunity to all senior students. The quality of the simulation experience reported is dependent on availability of highly skilled facilitators and has human resource implications. Discussion and conclusions: Experience and evaluation has prompted open discussion and reflection amongst both students and faculty as to opportunities to extend collaborative learning through simulation to other areas of practice. Enabling students to provide safe, optimal and patient centred care across the practice spectrum is imperative. Innovative solutions, that exploit TEL initiatives further, have potential to address challenges of faculty resourcing and timetabling. A collaborative interprofessional faculty modelling collaborative teaching and planning is essential to the success of this module and has been replicated in other developments. Impact and Implications: Opportunities for IP learning in a simulated setting and patient scenarios should be sought and exploited whenever possible to promote safe, effective patient-centred care. Key-Words: Interprofessional learning, High fidelity simulation, Blended learning Funding Acknowledgement: King’s College London, ´ development, College Teaching Fund awarded a grant for The piloting and evaluation of an interprofessional, practicebased, undergraduate module in acute care´in 2009; £20,000 http://dx.doi.org/10.1016/j.physio.2016.10.051 OA049 Pain education in professional health courses - a scoping review of standards, protocols and frameworks K. Thompson ∗ , J. Milligan, M. Johnson, M. Briggs Leeds Beckett University, Centre for Pain Research, Faculty of Health and Social Sciences, Leeds, United Kingdom Relevance: Pain education across professional health courses is known to be varied in method of delivery and number of taught hours, with the consensus that current pain education is inadequate. Physiotherapy is leading other health professions in the number of taught pain hours in preregistration curricula, having the potential to promote and influence pain education policy. To understand how pain education should be structured, we firstly conducted part one of this scoping review to identify empirical evidence that informs pain education across professional health courses. In general, pain was embedded
eS38
The 4th European Congress of the ER-WCPT / Physiotherapy 102S (2016) eS1–eS42
within modules on broader topics. There was tentative evidence that pain education additional to the ‘usual’ curriculum, rather than embedded, was more effective. In addition to research findings, health courses are guided by membership and subject specialist organisations, and must adhere to standards set by professional regulatory bodies. This second part of the scoping review will aim to identify this important information relevant to pain education that is additional to empirical evidence located in databases. Purpose: To locate, map and report standards, protocols or frameworks that inform pain education in pre-registration professional health courses from non-research sources such as professional regulatory bodies and subject specialist organisations. Methods/Analysis: A scoping review methodology was used to identify any professional standards relevant to pain education (health regulators), protocols or frameworks (membership organisations and special interest organisations). The following health regulator websites were searched; General Medical Council (GMC), Nursing and Midwifery Council (NMC), Health and Care Professions Council (HCPC), General Dental Council (GDC), General Chiropractic Council (GCC), General Osteopathic Council, and General Pharmaceutical Council. This totalled 29 health professions. Seven membership organisations were searched; Chartered Society of Physiotherapy, Physiotherapy Pain Association (PPA), Royal College of Nursing (RCN), British Medical Association, British Psychological Society, British Dental Association, and Royal Pharmaceutical Society. Subject specialist pain organisations; British Pain Society and IASP were searched for any key documents relevant to pain education. Results: Only five of the 29 health professions had a regulatory standard of education and training or proficiency that made some reference to the keyword ‘pain’; the GMC, NMC, the HCPC standard of proficiency for Operating Department Practitioners, and the GCC (1 reference each). The GDC outcomes for registration referred to pain on 7 occasions. Two membership organisations provided profession specific pain frameworks describing values, behaviours, knowledge and skills (PPA and RCN). IASP provide subject specific pain curricula for Pharmacy, Psychology, Physiotherapy, OT, Nursing, Medicine, Dentistry and Social Work. Discussion and conclusions: Physiotherapy and nursing membership organisations provide good examples of frameworks that can influence pain curriculum design within and across professional health courses. There is no professional regulatory standard for physiotherapy specifically for pain education. Dentistry is leading in terms of standards of training for pain, and should be considered as an example of good practice.
Impact and Implications: Physiotherapy has the potential to influence pain education policy, resulting in graduates that are better equipped to manage patients experiencing pain. Further research is needed to investigate how pain education is structured within current physiotherapy courses, identifying examples of good practice that can be shared. Funding Acknowledgement: This work was supported by a Health Education England (HEE) PhD Studentship Key-Words: Pain, Education, Physiotherapy http://dx.doi.org/10.1016/j.physio.2016.10.052 OA050 Graduating physiotherapy students’ conceptions of their own competence M. Kurunsaari 1,∗ , P. Tynjälä 2 , A. Piirainen 1 1 University
of Jyväskylä, Faculty of Sport Sciences, Jyväskylä, Finland 2 University of Jyväskylä, Finnish Institute for Educational Research, Jyväskylä, Finland Relevance: A competency-oriented approach has emerged in higher education discussions and research in recent decades. Researchers in the field of physiotherapy education and practice have begun to pay attention to how physiotherapy students acquire generic and professional skills and competence for qualification. Despite the wide interest in the development of professional competences, less attention has been paid to how “competence” itself is understood in education. In physiotherapy, there is a need for conceptual analysis regarding how teachers, students and curriculum developers conceive competences required in their field. Purpose: The purpose of this study was to examine how do graduating physiotherapy students perceive their competence? Methods/Analysis: The longitudinal study investigates the development of the same physiotherapy students during their whole studies (n = 33; 26 female, 7 male; age varies 19-35 years). This partial study data were collected by recall interviewing the students within the last month of their studies. The students were asked in open interview to talk about their life and study process, moreover clarifying questions were asked to focus enough on their conceptions of their competence and development. The data, transcribed 145 pages, were analyzed phenomenographically. Results: The findings revealed four descriptive qualitatively categories of conceptions of competence: 1) 2) 3) 4)
mastering core skills; understanding the theoretical basis of physiotherapy; having a holistic view of physiotherapy; and engaging in and developing multi-professional collaboration.
OA048 Interprofessonal learning in acute care through high fidelity simulation opportunities and challenges for faculty and students L. Johnson 1,∗ , C. Apps 1 , K. Bazin 1 , S. Bench 2 , C. Holland 3 , J. Frisby 3 , R. Hilton 1 1 King’s
College London, Academic Department of Physiotherapy, London, United Kingdom 2 King’s College London, Florence Nightingale School of Nursing and Midwifery, London, United Kingdom 3 King’s College London, School of Medicine, London, United Kingdom Relevance: A blended-learning 15 credit module (Interprofessional Working in Acute Care - IWAC) has been developed as an optional module for pre-qualification medical, nursing and physiotherapy students to explore and develop the non-technical and technical skills essential for effective collaborative working in an acute care setting. Its fundamental aim is to enable students to achieve optimum patient outcomes as well as provide sensitive support for both the patient and their family at a time of health crisis. Purpose: The module aims to provide students with learning opportunities to develop, practice and reflect upon the skills for effective, collaborative and patient-centred interprofessional (IP) working in acute care. Approach/Evaluation: A blended, technology-enhanced learning (TEL) approach is adopted: web-based resources to facilitate self-directed learning, clinical observation, simulation-based teaching, collaborative peer group working and reflective practice. High fidelity clinical simulation is a core element of the module using acute care scenarios that were designed so that they could not be managed successfully without IP collaboration. Each student is allocated to an IP group (comprising one student from each professional group) and an IP assignment is part of the assessment. This is a collaborative presentation from each IP group where students reflect on the role of a student from a different profession as well as the non-technical skills utilised to manage the presenting acute care scenario. A mixed method evaluation strategy using feedback from students through national student surveys and module questionnaires has informed module development. Outcomes: IWAC has been a popular optional module and is usually oversubscribed within all faculties. Students have commented favourably on their experience: 100% of students who completed the module in 2014/5 strongly agree that being part of a mixed professional group enhanced learning in this module and that they have gained greater awareness of other healthcare professionals’ roles and responsibilities. The value of developing and honing communication skills in a
eS37
safe yet pressurised simulated environment is a core theme in evaluation data, with 95% of students strongly agreeing that clinical simulation supported integration of knowledge, skills and decision making. Faculty report challenges timetabling students and facilitators from three difficult faculties with differing and often evolving timetables and regret that it is not currently possible to offer this learning opportunity to all senior students. The quality of the simulation experience reported is dependent on availability of highly skilled facilitators and has human resource implications. Discussion and conclusions: Experience and evaluation has prompted open discussion and reflection amongst both students and faculty as to opportunities to extend collaborative learning through simulation to other areas of practice. Enabling students to provide safe, optimal and patient centred care across the practice spectrum is imperative. Innovative solutions, that exploit TEL initiatives further, have potential to address challenges of faculty resourcing and timetabling. A collaborative interprofessional faculty modelling collaborative teaching and planning is essential to the success of this module and has been replicated in other developments. Impact and Implications: Opportunities for IP learning in a simulated setting and patient scenarios should be sought and exploited whenever possible to promote safe, effective patient-centred care. Key-Words: Interprofessional learning, High fidelity simulation, Blended learning Funding Acknowledgement: King’s College London, ´ development, College Teaching Fund awarded a grant for The piloting and evaluation of an interprofessional, practicebased, undergraduate module in acute care´in 2009; £20,000 http://dx.doi.org/10.1016/j.physio.2016.10.051 OA049 Pain education in professional health courses - a scoping review of standards, protocols and frameworks K. Thompson ∗ , J. Milligan, M. Johnson, M. Briggs Leeds Beckett University, Centre for Pain Research, Faculty of Health and Social Sciences, Leeds, United Kingdom Relevance: Pain education across professional health courses is known to be varied in method of delivery and number of taught hours, with the consensus that current pain education is inadequate. Physiotherapy is leading other health professions in the number of taught pain hours in preregistration curricula, having the potential to promote and influence pain education policy. To understand how pain education should be structured, we firstly conducted part one of this scoping review to identify empirical evidence that informs pain education across professional health courses. In general, pain was embedded
eS38
The 4th European Congress of the ER-WCPT / Physiotherapy 102S (2016) eS1–eS42
within modules on broader topics. There was tentative evidence that pain education additional to the ‘usual’ curriculum, rather than embedded, was more effective. In addition to research findings, health courses are guided by membership and subject specialist organisations, and must adhere to standards set by professional regulatory bodies. This second part of the scoping review will aim to identify this important information relevant to pain education that is additional to empirical evidence located in databases. Purpose: To locate, map and report standards, protocols or frameworks that inform pain education in pre-registration professional health courses from non-research sources such as professional regulatory bodies and subject specialist organisations. Methods/Analysis: A scoping review methodology was used to identify any professional standards relevant to pain education (health regulators), protocols or frameworks (membership organisations and special interest organisations). The following health regulator websites were searched; General Medical Council (GMC), Nursing and Midwifery Council (NMC), Health and Care Professions Council (HCPC), General Dental Council (GDC), General Chiropractic Council (GCC), General Osteopathic Council, and General Pharmaceutical Council. This totalled 29 health professions. Seven membership organisations were searched; Chartered Society of Physiotherapy, Physiotherapy Pain Association (PPA), Royal College of Nursing (RCN), British Medical Association, British Psychological Society, British Dental Association, and Royal Pharmaceutical Society. Subject specialist pain organisations; British Pain Society and IASP were searched for any key documents relevant to pain education. Results: Only five of the 29 health professions had a regulatory standard of education and training or proficiency that made some reference to the keyword ‘pain’; the GMC, NMC, the HCPC standard of proficiency for Operating Department Practitioners, and the GCC (1 reference each). The GDC outcomes for registration referred to pain on 7 occasions. Two membership organisations provided profession specific pain frameworks describing values, behaviours, knowledge and skills (PPA and RCN). IASP provide subject specific pain curricula for Pharmacy, Psychology, Physiotherapy, OT, Nursing, Medicine, Dentistry and Social Work. Discussion and conclusions: Physiotherapy and nursing membership organisations provide good examples of frameworks that can influence pain curriculum design within and across professional health courses. There is no professional regulatory standard for physiotherapy specifically for pain education. Dentistry is leading in terms of standards of training for pain, and should be considered as an example of good practice.
Impact and Implications: Physiotherapy has the potential to influence pain education policy, resulting in graduates that are better equipped to manage patients experiencing pain. Further research is needed to investigate how pain education is structured within current physiotherapy courses, identifying examples of good practice that can be shared. Funding Acknowledgement: This work was supported by a Health Education England (HEE) PhD Studentship Key-Words: Pain, Education, Physiotherapy http://dx.doi.org/10.1016/j.physio.2016.10.052 OA050 Graduating physiotherapy students’ conceptions of their own competence M. Kurunsaari 1,∗ , P. Tynjälä 2 , A. Piirainen 1 1 University
of Jyväskylä, Faculty of Sport Sciences, Jyväskylä, Finland 2 University of Jyväskylä, Finnish Institute for Educational Research, Jyväskylä, Finland Relevance: A competency-oriented approach has emerged in higher education discussions and research in recent decades. Researchers in the field of physiotherapy education and practice have begun to pay attention to how physiotherapy students acquire generic and professional skills and competence for qualification. Despite the wide interest in the development of professional competences, less attention has been paid to how “competence” itself is understood in education. In physiotherapy, there is a need for conceptual analysis regarding how teachers, students and curriculum developers conceive competences required in their field. Purpose: The purpose of this study was to examine how do graduating physiotherapy students perceive their competence? Methods/Analysis: The longitudinal study investigates the development of the same physiotherapy students during their whole studies (n = 33; 26 female, 7 male; age varies 19-35 years). This partial study data were collected by recall interviewing the students within the last month of their studies. The students were asked in open interview to talk about their life and study process, moreover clarifying questions were asked to focus enough on their conceptions of their competence and development. The data, transcribed 145 pages, were analyzed phenomenographically. Results: The findings revealed four descriptive qualitatively categories of conceptions of competence: 1) 2) 3) 4)
mastering core skills; understanding the theoretical basis of physiotherapy; having a holistic view of physiotherapy; and engaging in and developing multi-professional collaboration.