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PHYSIO2PHYSIO: a formative-peer-feedback concept used in a physiotherapy-bachelor-programme
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The 4th European Congress of the ER-WCPT / Physiotherapy 102S (2016) eS67–eS282
POS143 Pioneering independent prescribing in physiotherapy in the UK – journey into the unknown J. Mullan 1,∗ , J. Smithson 2 , I. Frampton 2 1 University
of the West of England, Allied Health Professions, Bristol, United Kingdom 2 University of Exeter, College of Life and Environmental Sciences, Exeter, United Kingdom Relevance: Original research related to a new era in physiotherapy practice in the UK. Purpose: Aim: What are the anticipated drivers and challenges around independent physiotherapy prescribing as seen from the perspective of current physiotherapists undertaking a nonmedical prescribing programme? Objectives: Identify the physiotherapists’ personal and professional motivations for wanting to become independent prescribers. Explore their hopes and aspirations. Explore their perceptions of the anticipated opportunities and challenges, enablers and barriers that this journey may bring. Methods/analysis: Participants: Eight volunteer Chartered Physiotherapists undertaking a non-medical prescribing programme to become Physiotherapy Independent Prescribers. Semi-structured interviews, taped and transcribed. Thematic analysis to generate themes. Results: Emergent Themes. Positive personal and professional opportunity for themselves, their patients, their practice and the profession. Sense of responsibility and accountability. The clinical responsibility of prescribing is supported by their clinical “mileage” and experience and is therefore viewed as a positive responsibility. The other less certain responsibility is as trailblazers for the profession in terms of physiotherapy independent prescribing. Individual practice in context of service change – how their practice might change and how this could inform future practice for others and professional/service development. Discussion and conclusions: The physiotherapists demonstrated a clear sense of enthusiasm, personal and professional pride at being able to develop themselves in order to deliver more efficient and effective patient services. They reported a strong sense of responsibility and accountability, seeing themselves as early adopters of a new scope of practice for the profession, and having a desire to make a real difference with their independent prescribing. The clinical responsibility of prescribing was a welcome challenge with physiotherapists feeling enabled and prepared to prescribe due to their clinical experience, clinical reasoning confidence
and competence and the non-medical prescribing programme rigour. The physiotherapists also highlighted the importance of developing role clarity and expectations – for self and others, in order to meaningfully influence future personal and professional practice and service development. Impact and implications: The physiotherapists felt excited, privileged and competent to become independent prescribers, regarding themselves as pioneers for the profession, and anticipating it would make a significant difference to patient care and service efficiency. Some uncertainty was noted about how physiotherapy independent prescribing would pan out in reality. As more independent physiotherapy prescribers become registered, their experiences, the implications for the profession and practice, and the impact on patient care will warrant further research. Funding acknowledgement: This study is part of a Doctorate in Clinical Research at the University of Exeter. It is supported by time allocation from the Faculty of Health and Applied Sciences at the University of the West of England, Bristol and by unrestricted grants to support doctoral fees from Arthritis Research UK, the Chartered Society of Physiotherapy Charitable Trust and the National Ankylosing Spondylitis Society (NASS). http://dx.doi.org/10.1016/j.physio.2016.10.201 POS144 PHYSIO2PHYSIO: a formative-peer-feedback concept used in a physiotherapy-bachelor-programme J.T. Schmidt ∗ , L.E. Hansen University College of Northern Denmark, Physiotherapy, Aalborg, Denmark Relevance: The Physiotherapy-bachelor-programme is a praxis-oriented education attending student’s ability to transfer knowledge and skills in different contexts. This learning-process enhances through reflective practice and focus on personal learning-strategies. The Danish Physiotherapy bachelor-programme consists of 7½ semesters. Purpose: This study evaluated the concept ‘PHYSIO2PHYSIO’ that through peer-formative-feedback increases reflection and supports the development of professional skills within a learning environment. Approach/evaluation: The study presents mixed methods. A systematic literature study combined with an expert-interview was used to review the topic ‘Formativepeer-feedback’. The literature study was followed up by a concept-development to create PHYSIO2PHYSIO and an explorative one year trial-period. The study involved twelve students from the 5th-semester and 25 randomly selected 1st-semester-students. The 5th-semester-students received extra curriculum education with elements inspired by ‘Motivational Interviewing
The 4th European Congress of the ER-WCPT / Physiotherapy 102S (2016) eS67–eS282
(MI)’ and ‘Appreciative Inquiry (AI)’. Subsequently the students engaged in two to three one-on-one-conversations with the 1st-semester-students. Conversations were executed in a confidential setting, and were based on the 1st-semesterstudent’s private learning-portfolio. PHYSIO2PHYSIO were repeated six months later. Outcomes: The 1st-semester-students perception were evaluated in qualitative semi-structured focus-group inquiry and focused on how PHYSIO2PHYSIO had affected their reflection towards their professional skills and identity as future physiotherapist. 1st-semester-students found the experience valuable because the conversation was centered on their personal learning-process and they expressed that the 5th-semester-students were competent and increased their confidence as students. Formative qualitative semi-structured feedbackinterviews with the 5th-semester-students were performed by lecturers and aimed to increase the student’s AI- and MI-skills. The students experienced educational improvement towards their profession-skills. Furthermore it was rewarding to embrace their professional knowledge to peers. All students involved found it challenging to truly engage in PHYSIO2PHYSIO concept, due to the lack of personal relation with each other. In spite of the difficulty both student-groups expressed that they got new perspectives to their future profession. PHYSIO2PHYSIO requires attention to confidentiality to protect personal information for both student-groups, but especially to the 1st-semester-students due to the content in their personal learning portfolio. Lack of personal relations among the student-group makes it challenging truly to engage in the conversations. Discussion and conclusions: This study demonstrated the possible usefulness of peer-formative-feedback in higher education to enhance self-reflection among students towards their professional skills. Individual focus on students is important for the development of student-identity and to reflect on their profession-skills. Impact and implications: No ethical dilemmas. Verbal consent-statements were made with the informants who at all times could drop out of PHYSIO2PHYSIO. Funding acknowledgement: The education of physiotherapy at University College of Northern Denmark. http://dx.doi.org/10.1016/j.physio.2016.10.202
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POS145 The comparison of different level of cognitive impairment on falls and fall risks in community dwelling older adults G. ˙Iyigün 1,∗ , F. Can 2 , B. Kırmızıgil 1 , E. Angın 1 , S. Öksüz 1 , M. Malkoc¸ 1 1 Eastern
Mediterranean University, Physiotherapy and Rehabilitation, Famagusta, Cyprus 2 Hacettepe University, Physiotherapy and Rehabilitation, Ankara, Turkey Relevance: Although cognitive impairment has just been identified as a fall risk factor in clinical guidelines, there are very limited studies in the literature. Furthermore there is still lack of evidence for the effect of impairment level on falls and fall risks. No previous studies have compared cognitive performance level that are associated with fall risk between older adults without cognitive impairment and those with mild or severe impairment. Purpose: The aim of this study were to evaluate the association of cognitive impairment on falls and fall risks and, to determine, the effects of cognitive impairment level on falls in community older adults. Methods/analysis: 176 female (65.2%) and 94 male (43.5%), a total of 270 community-dwelling older adults were included and an informed consent was obtained from all subjects. The participants were classified into three groups regarding to their cognitive status level. According to the results of Mini Mental State Examination (MMSE), the groups were termed as, No Cognitive Impairment Group (NCI Group, MMSE = 24 to 30 points), Mild Cognitive Impairment Group (MCI Group, MMSE = 18 to 24 points) and Severe Cognitive Impairment Group (SCI Group, MMSE ≤ 17 points). The fall outcome was recorded by taking participants’ history of falls (recent falls within the past 6 months). The participant was considered as faller if she/he has fallen more than 2 times within the last 6 months. The fall risks were assessed using Fullerton Advanced Balance (FAB) Scale, Berg Balance Scale (BBS), Tinetti Performance Oriented Mobility Assessment (POMA) and Activities-Specific Balance Confidence (ABC) Scale. Results: Participants in the NCI Group (70.13 ± 6.02 years) were younger than the participants in the MCI Group (72.48 ± 6.51 years) (P < 0.053) and the SCI Group (75.07 ± 7.03 years) (P = 0.000) group. The mean age of MCI Group was also lower than the age of SCI Group (P < 0.027). There were significant differences in prevalence of falling between the groups. The percentage of fallers in the SCI was higher (26.7%) than the NCI (7.8%) and MCI Group (15.6%) (P < 0.003). The prevalence of fall risks was found significantly different among the groups. The percentage of older adults with higher fall risk was higher in the SCI Group than the NCI and the MCI Group according to the FAB Scale (NCI
The 4th European Congress of the ER-WCPT / Physiotherapy 102S (2016) eS67–eS282
POS143 Pioneering independent prescribing in physiotherapy in the UK – journey into the unknown J. Mullan 1,∗ , J. Smithson 2 , I. Frampton 2 1 University
of the West of England, Allied Health Professions, Bristol, United Kingdom 2 University of Exeter, College of Life and Environmental Sciences, Exeter, United Kingdom Relevance: Original research related to a new era in physiotherapy practice in the UK. Purpose: Aim: What are the anticipated drivers and challenges around independent physiotherapy prescribing as seen from the perspective of current physiotherapists undertaking a nonmedical prescribing programme? Objectives: Identify the physiotherapists’ personal and professional motivations for wanting to become independent prescribers. Explore their hopes and aspirations. Explore their perceptions of the anticipated opportunities and challenges, enablers and barriers that this journey may bring. Methods/analysis: Participants: Eight volunteer Chartered Physiotherapists undertaking a non-medical prescribing programme to become Physiotherapy Independent Prescribers. Semi-structured interviews, taped and transcribed. Thematic analysis to generate themes. Results: Emergent Themes. Positive personal and professional opportunity for themselves, their patients, their practice and the profession. Sense of responsibility and accountability. The clinical responsibility of prescribing is supported by their clinical “mileage” and experience and is therefore viewed as a positive responsibility. The other less certain responsibility is as trailblazers for the profession in terms of physiotherapy independent prescribing. Individual practice in context of service change – how their practice might change and how this could inform future practice for others and professional/service development. Discussion and conclusions: The physiotherapists demonstrated a clear sense of enthusiasm, personal and professional pride at being able to develop themselves in order to deliver more efficient and effective patient services. They reported a strong sense of responsibility and accountability, seeing themselves as early adopters of a new scope of practice for the profession, and having a desire to make a real difference with their independent prescribing. The clinical responsibility of prescribing was a welcome challenge with physiotherapists feeling enabled and prepared to prescribe due to their clinical experience, clinical reasoning confidence
and competence and the non-medical prescribing programme rigour. The physiotherapists also highlighted the importance of developing role clarity and expectations – for self and others, in order to meaningfully influence future personal and professional practice and service development. Impact and implications: The physiotherapists felt excited, privileged and competent to become independent prescribers, regarding themselves as pioneers for the profession, and anticipating it would make a significant difference to patient care and service efficiency. Some uncertainty was noted about how physiotherapy independent prescribing would pan out in reality. As more independent physiotherapy prescribers become registered, their experiences, the implications for the profession and practice, and the impact on patient care will warrant further research. Funding acknowledgement: This study is part of a Doctorate in Clinical Research at the University of Exeter. It is supported by time allocation from the Faculty of Health and Applied Sciences at the University of the West of England, Bristol and by unrestricted grants to support doctoral fees from Arthritis Research UK, the Chartered Society of Physiotherapy Charitable Trust and the National Ankylosing Spondylitis Society (NASS). http://dx.doi.org/10.1016/j.physio.2016.10.201 POS144 PHYSIO2PHYSIO: a formative-peer-feedback concept used in a physiotherapy-bachelor-programme J.T. Schmidt ∗ , L.E. Hansen University College of Northern Denmark, Physiotherapy, Aalborg, Denmark Relevance: The Physiotherapy-bachelor-programme is a praxis-oriented education attending student’s ability to transfer knowledge and skills in different contexts. This learning-process enhances through reflective practice and focus on personal learning-strategies. The Danish Physiotherapy bachelor-programme consists of 7½ semesters. Purpose: This study evaluated the concept ‘PHYSIO2PHYSIO’ that through peer-formative-feedback increases reflection and supports the development of professional skills within a learning environment. Approach/evaluation: The study presents mixed methods. A systematic literature study combined with an expert-interview was used to review the topic ‘Formativepeer-feedback’. The literature study was followed up by a concept-development to create PHYSIO2PHYSIO and an explorative one year trial-period. The study involved twelve students from the 5th-semester and 25 randomly selected 1st-semester-students. The 5th-semester-students received extra curriculum education with elements inspired by ‘Motivational Interviewing
The 4th European Congress of the ER-WCPT / Physiotherapy 102S (2016) eS67–eS282
(MI)’ and ‘Appreciative Inquiry (AI)’. Subsequently the students engaged in two to three one-on-one-conversations with the 1st-semester-students. Conversations were executed in a confidential setting, and were based on the 1st-semesterstudent’s private learning-portfolio. PHYSIO2PHYSIO were repeated six months later. Outcomes: The 1st-semester-students perception were evaluated in qualitative semi-structured focus-group inquiry and focused on how PHYSIO2PHYSIO had affected their reflection towards their professional skills and identity as future physiotherapist. 1st-semester-students found the experience valuable because the conversation was centered on their personal learning-process and they expressed that the 5th-semester-students were competent and increased their confidence as students. Formative qualitative semi-structured feedbackinterviews with the 5th-semester-students were performed by lecturers and aimed to increase the student’s AI- and MI-skills. The students experienced educational improvement towards their profession-skills. Furthermore it was rewarding to embrace their professional knowledge to peers. All students involved found it challenging to truly engage in PHYSIO2PHYSIO concept, due to the lack of personal relation with each other. In spite of the difficulty both student-groups expressed that they got new perspectives to their future profession. PHYSIO2PHYSIO requires attention to confidentiality to protect personal information for both student-groups, but especially to the 1st-semester-students due to the content in their personal learning portfolio. Lack of personal relations among the student-group makes it challenging truly to engage in the conversations. Discussion and conclusions: This study demonstrated the possible usefulness of peer-formative-feedback in higher education to enhance self-reflection among students towards their professional skills. Individual focus on students is important for the development of student-identity and to reflect on their profession-skills. Impact and implications: No ethical dilemmas. Verbal consent-statements were made with the informants who at all times could drop out of PHYSIO2PHYSIO. Funding acknowledgement: The education of physiotherapy at University College of Northern Denmark. http://dx.doi.org/10.1016/j.physio.2016.10.202
eS171
POS145 The comparison of different level of cognitive impairment on falls and fall risks in community dwelling older adults G. ˙Iyigün 1,∗ , F. Can 2 , B. Kırmızıgil 1 , E. Angın 1 , S. Öksüz 1 , M. Malkoc¸ 1 1 Eastern
Mediterranean University, Physiotherapy and Rehabilitation, Famagusta, Cyprus 2 Hacettepe University, Physiotherapy and Rehabilitation, Ankara, Turkey Relevance: Although cognitive impairment has just been identified as a fall risk factor in clinical guidelines, there are very limited studies in the literature. Furthermore there is still lack of evidence for the effect of impairment level on falls and fall risks. No previous studies have compared cognitive performance level that are associated with fall risk between older adults without cognitive impairment and those with mild or severe impairment. Purpose: The aim of this study were to evaluate the association of cognitive impairment on falls and fall risks and, to determine, the effects of cognitive impairment level on falls in community older adults. Methods/analysis: 176 female (65.2%) and 94 male (43.5%), a total of 270 community-dwelling older adults were included and an informed consent was obtained from all subjects. The participants were classified into three groups regarding to their cognitive status level. According to the results of Mini Mental State Examination (MMSE), the groups were termed as, No Cognitive Impairment Group (NCI Group, MMSE = 24 to 30 points), Mild Cognitive Impairment Group (MCI Group, MMSE = 18 to 24 points) and Severe Cognitive Impairment Group (SCI Group, MMSE ≤ 17 points). The fall outcome was recorded by taking participants’ history of falls (recent falls within the past 6 months). The participant was considered as faller if she/he has fallen more than 2 times within the last 6 months. The fall risks were assessed using Fullerton Advanced Balance (FAB) Scale, Berg Balance Scale (BBS), Tinetti Performance Oriented Mobility Assessment (POMA) and Activities-Specific Balance Confidence (ABC) Scale. Results: Participants in the NCI Group (70.13 ± 6.02 years) were younger than the participants in the MCI Group (72.48 ± 6.51 years) (P < 0.053) and the SCI Group (75.07 ± 7.03 years) (P = 0.000) group. The mean age of MCI Group was also lower than the age of SCI Group (P < 0.027). There were significant differences in prevalence of falling between the groups. The percentage of fallers in the SCI was higher (26.7%) than the NCI (7.8%) and MCI Group (15.6%) (P < 0.003). The prevalence of fall risks was found significantly different among the groups. The percentage of older adults with higher fall risk was higher in the SCI Group than the NCI and the MCI Group according to the FAB Scale (NCI