The impact of simulation-based learning on the knowledge, attitude and performance of physiotherapy students on practice placement.

BACKGROUND: Practice placement is a crucial part of pre-registration physiotherapy education worldwide. However, educators face challenges in finding practice sites for students to undertake placement. The use of simulation-based (SBL) learning has the potential to replace some traditional placement, thereby increasing placement capacity, but the benefits have not been fully explored. This study aimed to assess the impact of SBL placement on students' knowledge, attitude, and performance during practice placements with external providers. METHODS: This study utilised an exploratory qualitative research design using a semi-structured interview to collect data from Year 2 students of a 2-year MSc pre-registration physiotherapy programme in the UK. To be eligible to be included in the study, students must have participated in the 4-week simulation placement and have completed all their practice placements with external providers. All the interviews were conducted virtually in a 1:1 setting and recorded. The interviews lasted an average of 45 min. An inductive thematic analysis based on Braun and Clarke's approach was utilised in this study. RESULTS: Twelve students consented to participate in this study. The 56 codes generated from the data were categorised into 5 themes; [1] Working together, [2] Working with Service Users, [3] Professionalism, [4] Profession-specific practical skills and [5] Generic practical skills. Participants unanimously expressed a positive view on working in groups, and they believe that engaging with service users who acted as patients enhanced the authenticity of the simulation placement. Subjective and objective assessments were considered important profession-specific skills gained during the simulation. Despite the benefits derived from the simulation placement, some participants felt that the learning experience would have been enriched by periodically changing the groups they were working in and having the opportunity for more 1:1 feedback throughout the four weeks. CONCLUSIONS: SBL has the potential to be a valuable educational experience for physiotherapy students. It may assist in better preparing students for successful integration into the dynamic healthcare environment. To enhance and improve the authenticity of this type of placementour recommendations include recruiting more service users, incorporating and encouraging more intervention-based elements, and increasing the practice educators' and students' contact time.

A place to call our home: innovative rural physical therapy training in Canada.

BACKGROUND: To promote rural practice and increase enrollment in the entry-level Master of Science Physical Therapy program at the University of Alberta, the Department of Physical Therapy developed a rural physical therapy satellite campus located in a farming region in central Alberta. A distributed learning format was used to connect the rural cohort to the main urban campus. Real time video conferencing was used to connect the two campuses for all lectures, seminars and clinical skills classes. This evaluation aimed to describe a unique rural training program for physical therapy students and its effectiveness in promoting work in rural communities after graduation. METHODS: Physical Therapy students in the first three years (2012-2015) of commencing the rural satellite program (n = 280) were surveyed, and six focus groups were held to capture student experiences, satisfaction and engagement. Data were collected on employment locations of the 2012-2019 graduates' first physical therapy position and current employment. RESULTS: Survey results suggested comparable levels of satisfaction and engagement for all physical therapy students regardless of campus. Focus group data revealed that students quickly accepted the distributed learning technological interface, enjoyed their local campuses, and felt connected to instructors and student colleagues. Compared to the overall physical therapy workforce, a higher percentage of physical therapists graduating from the rural campus reported working in rural centers for both their first and current jobs. CONCLUSION: Regardless of campus, students were satisfied and equally engaged in the physical therapy program. Students who completed the physical therapy program in a rural setting tended to work rurally after graduation. A distributed learning model may be useful for other healthcare training programs to promote engagement in rural health.

Interpretation of course conceptual structure and student self-efficacy: an integrated strategy of knowledge graphs with item response modeling.

BACKGROUND: There is a scarcity of studies that quantitatively assess the difficulty and importance of knowledge points (KPs) depending on students' self-efficacy for learning (SEL). This study aims to validate the practical application of psychological measurement tools in physical therapy education by analyzing student SEL and course conceptual structure. METHODS: From the "Therapeutic Exercise" course curriculum, we extracted 100 KPs and administered a difficulty rating questionnaire to 218 students post-final exam. The pipeline of the non-parametric Item Response Theory (IRT) and parametric IRT modeling was employed to estimate student SEL and describe the hierarchy of KPs in terms of item difficulty. Additionally, Gaussian Graphical Models with Non-Convex Penalties were deployed to create a Knowledge Graph (KG) and identify the main components. A visual analytics approach was then proposed to understand the correlation and difficulty level of KPs. RESULTS: We identified 50 KPs to create the Mokken scale, which exhibited high reliability (Cronbach's alpha = 0.9675) with no gender bias at the overall or at each item level (p > 0.05). The three-parameter logistic model (3PLM) demonstrated good fitness with questionnaire data, whose Root Mean Square Error Approximation was < 0.05. Also, item-model fitness unveiled good fitness, as indicated by each item with non-significant p-values for chi-square tests. The Wright map revealed item difficulty relative to SEL levels. SEL estimated by the 3PLM correlated significantly with the high-ability range of average Grade-Point Average (p < 0.05). The KG backbone structure consisted of 58 KPs, with 29 KPs overlapping with the Mokken scale. Visual analysis of the KG backbone structure revealed that the difficulty level of KPs in the IRT could not replace their position parameters in the KG. CONCLUSION: The IRT and KG methods utilized in this study offer distinct perspectives for visualizing hierarchical relationships and correlations among the KPs. Based on real-world teaching empirical data, this study helps to provide a research foundation for updating course contents and customizing learning objectives. TRIAL REGISTRATION: Not applicable.

Evaluation and students' perception of a health equity education program in physical therapy: a mixed methods pilot study.

BACKGROUND: Health equity is a common theme discussed in health professions education, yet only some researchers have addressed it in entry-level education. PURPOSE: The purpose of this study is to serve as an educational intervention pilot to 1) evaluate students' perception of the effectiveness of the DPT program in providing a foundation for health equity education, with or without the benefit of a supplemental resource and 2) establishing priorities for the program related to educating students on health inequities in physical therapy clinical practice. A mixed method design with a focus-group interview was utilized to explore students' perceptions of the DPT program's commitment to advancing health equity. METHODS: A three-staged sequential mixed methods study was conducted. Stage 1 began with quantitative data collection after completing the DEI Bundle utilizing the Tripod DEI survey. Stage 2 involved identifying themes from the Tripod Survey data and creating semi-structured interview questions. Stage 3 consisted of a focus group interview process. RESULTS: A total of 78 students completed the Tripod DEI survey upon completing 70% of the curriculum. Thirty-five students, eight core faculty, 13 associated faculty, and four clinical instructors completed the APTA DEI Bundle Course Series. According to the Tripod DEI Survey results, program stakeholders found the program's commitment to DEI and overall climate to be inclusive, fair, caring, safe, welcoming, and understanding of individuals from different backgrounds, including a sense of student belonging where students feel valued and respected. Three themes emerged from the qualitative focus group interviews, including the value of inclusivity, health equity curricular foundations, and DEI in entry-level DPT education. CONCLUSIONS: This study highlights the value of incorporating health equity and DEI topics into curricula while fostering an incluse program culture.

Use of the International IFOMPT Cervical Framework to inform clinical reasoning in postgraduate level physiotherapy students: a qualitative study using think aloud methodology.

BACKGROUND: Vascular pathologies of the head and neck are rare but can present as musculoskeletal problems. The International Federation of Orthopedic Manipulative Physical Therapists (IFOMPT) Cervical Framework (Framework) aims to assist evidence-based clinical reasoning for safe assessment and management of the cervical spine considering potential for vascular pathology. Clinical reasoning is critical to physiotherapy, and developing high-level clinical reasoning is a priority for postgraduate (post-licensure) educational programs. OBJECTIVE: To explore the influence of the Framework on clinical reasoning processes in postgraduate physiotherapy students. METHODS: Qualitative case study design using think aloud methodology and interpretive description, informed by COnsolidated criteria for REporting Qualitative research. Participants were postgraduate musculoskeletal physiotherapy students who learned about the Framework through standardized delivery. Two cervical spine cases explored clinical reasoning processes. Coding and analysis of transcripts were guided by Elstein's diagnostic reasoning components and the Postgraduate Musculoskeletal Physiotherapy Practice model. Data were analyzed using thematic analysis (inductive and deductive) for individuals and then across participants, enabling analysis of key steps in clinical reasoning processes and use of the Framework. Trustworthiness was enhanced with multiple strategies (e.g., second researcher challenged codes). RESULTS: For all participants (n = 8), the Framework supported clinical reasoning using primarily hypothetico-deductive processes. It informed vascular hypothesis generation in the patient history and testing the vascular hypothesis through patient history questions and selection of physical examination tests, to inform clarity and support for diagnosis and management. Most participant's clinical reasoning processes were characterized by high-level features (e.g., prioritization), however there was a continuum of proficiency. Clinical reasoning processes were informed by deep knowledge of the Framework integrated with a breadth of wider knowledge and supported by a range of personal characteristics (e.g., reflection). CONCLUSIONS: Findings support use of the Framework as an educational resource in postgraduate physiotherapy programs to inform clinical reasoning processes for safe and effective assessment and management of cervical spine presentations considering potential for vascular pathology. Individualized approaches may be required to support students, owing to a continuum of clinical reasoning proficiency. Future research is required to explore use of the Framework to inform clinical reasoning processes in learners at different levels.

Lesbian, gay, bisexual, and transgender clinical competence of physiotherapy students in Israel.

BACKGROUND: Clinical competence encompasses attitudes, skills, and knowledge regarding diverse client groups. Appropriate clinical competence requires an understanding of the cultural context in which healthcare is delivered. In conservative countries such as Israel, there is a noticeable scarcity of information regarding the clinical competency of physiotherapy students (PTSs) in effectively treating lesbian, gay, bisexual and transgender (LGBT) individuals. The objective of this study was to assess the level of LGBT clinical competence among PTSs in Israel. METHODS: Conducted through an anonymous online self-report survey, this study gathered personal and academic background information and self-reported data on previous LGBT education during undergraduate studies of PTSs. It utilized the Hebrew version of the Lesbian, Gay, Bisexual, and Transgender Development of Clinical Skills Scale (LGBT-DOCSS) questionnaire. Descriptive statistics were computed for all outcome measures. The internal reliability of the LGBT-DOCSS was assessed. Total scores of the LGBT-DOCSS, along with scores in each of the three subscales (clinical preparedness, knowledge, and attitudes), were compared across different levels of religiosity and gender. RESULTS: The sample comprised of 251 PTSs, with an average age of 25.57 ± 3.07 years (34.7% men, 65.3% women). All students reported a lack of LGBT community-related courses during their undergraduate studies. The translated Hebrew version demonstrated good internal consistency, with Cronbach's alpha ranging from 0.65 to 0.83. The LGBT-DOCSS total score was 4.55 ± 0.61 out of 7, indicating a low level of clinical competency. The highest mean score was in the attitudes subscale (6.55 ± 0.87), which was significantly higher than the scores for the knowledge subscale (3.14 ± 1.46) and clinical preparedness subscale (3.36 ± 0.86). Religiousness was significantly associated with clinical preparedness and attitudes. Men exhibited higher self-reported levels of knowledge and clinical preparedness, albeit with more negative attitudes compare to women. Sexual orientation was significantly associated with clinical competency, with PTSs who identified as heterosexual demonstrating a lower level of clinical competency compared to participants who identified as non-heterosexual. CONCLUSIONS: In Israel, PTSs demonstrated a low level of clinical competency in terms of self-reported knowledge and self-reported clinical preparedness but contrasting positive attitudes toward the LGBT community. Religiousness, gender and sexual orientation had a significant influence on competency levels.These preliminary findings highlight the urgent necessity to enhance the knowledge of PTSs regarding the LGBT community to improve their clinical competence. TRIAL REGISTRATION NR: Not applicable.

Personal characteristic differences among Doctor of Physical Therapy students with unique sociodemographic factors.

BACKGROUND: The Association of American Medical Colleges suggests an Experiences-Attributes-Metrics framework for holistic review, but there is minimal research on demographic and personal characteristic attributes and the interplay between these Attributes subcategories. Understanding how personal attributes may vary among students considered represented and those considered underrepresented in one or more categories is critical to avoid unintentionally perpetuating practices that favor represented groups. This study explored differences in six personal characteristics either consistently related to academic performance or deemed positive professional traits based on diversity characteristics (categories of underrepresentation), age, and sex. METHODS: Three cohorts of first-year Doctor of Physical Therapy students at a single institution were invited to participate in this prospective, observational study. Participants completed six surveys: PROMIS® General Self-efficacy, PROMIS® Anxiety, 12-item Grit Scale, Perceived Stress Scale-10 (PSS-10), Brief Resilience Scale (BRS), and PROMIS® Positive Affect. T-tests and ANOVAs (or nonparametric equivalents) were used to examine differences in these measures by number of diversity characteristics, age, and sex. Multivariate linear regression was used to determine if diversity characteristics explained additional variance in each of the personal attribute scores after controlling for age and sex. RESULTS: One Hundred and Forty Five students participated (80.7% female, 77.9% < 25 years old, 51% 0 diversity characteristics). Students with more diversity characteristics and males reported higher self-efficacy and resilience (p's < 0.05). Females reported higher anxiety (p's < 0.01). Diversity characteristics explained additional variance in self-efficacy (3.3%, p = 0.02) and resilience (2.5%, p = 0.05) after controlling for age and sex. Grit, perceived stress, and positive affect did not show any group differences. CONCLUSIONS: Underrepresented students demonstrated higher self-efficacy and resilience than their represented peers, qualities that may be important to overcome challenges prior to and during graduate school. Males exhibited higher self-efficacy and resilience, but lower anxiety than females which is generally consistent across higher education. Grit, perceived stress, and positive affect were similar across all students and may be less useful to create a diverse learning environment. Further studies should investigate differences in attributes among admitted and unadmitted students and the relationship to future performance for admitted students.

Scientific approach, attitudes, and perspectives on research among Swedish physiotherapy students-a cross-sectional study.

BACKGROUND: Scientific evidence is important to evidence-based practice. Hence, the application of evidence-based practice requires relevant skills and an understanding of science, which therefore need to be learned and trained during the undergraduate program in physiotherapy. The aim of this study was to investigate attitudes, perceived competence, and conditions for a scientific approach among physiotherapy students in Sweden, and to compare attitudes and perceived competence between students in different program years. METHODS: Physiotherapy students from six universities (n = 1499) were invited to respond to a digital survey. The survey contained questions regarding attitudes toward science, perceived competence in research interpretations and open comments regarding requirements for a strengthened scientific approach during education. Comparisons between education years were performed with ANOVA/Kruskal‒Wallis test (scale outcomes) and logistic regression (binary outcomes). RESULTS: A total of 466 students responded to the survey. In total, 57% (n = 266) of the students had a high interest in science. No significant difference in interest in science was found between students in the three program years, but 75% (n = 347) reported increased interest during the program. A perceived high ability to understand the structure and performance of scientific studies was reported by 31% (n = 144), to evaluate the methodology by 16% (n = 72) and to interpret statistical results from scientific studies by 12% (n = 55). The lowest perceived competence was reported among students in their second year (p < 0.05). A majority of the students (88%; n = 410) reported a perceived personal need for strengthened conditions for a scientific approach, with suggested prerequisites during education via increased theoretical and applied understanding of the research. CONCLUSION: Even though this study does not fully cover physiotherapy students at all undergraduate programmes in Sweden, the results support that a scientific approach and training should be strengthened during education to enable physiotherapists to understand and interpret science and to fully apply an evidence-based approach in upcoming clinical practice. Both theoretical and applied knowledge and understanding are needed.

Effectiveness of digital and analog learning methods for learning anatomical structures in physiotherapy education.

BACKGROUND: According to the German Physiotherapy Education and Qualification Regulations, teaching of anatomical structures is one of the fundamental subjects of physiotherapy education. Besides exhibits and models, anatomy atlases are usually used as teaching and learning tools. These are available in both analog form such as printed books or in digital form as a mobile application. Furthermore, the use of digital teaching and learning tools is steadily increasing within the education of health professionals. AIM: To assess the efficacy of a digital educational tool in contrast to an analog anatomical atlas in acquiring knowledge about anatomical structures. MATERIAL AND METHOD: The data collection took place in the context of an anatomy tutorial for students of the bachelor's degree program in physiotherapy. In a cross-over design, the students completed two learning assignments, each, with different learning materials provided, either with an anatomy app on a tablet or with an anatomy atlas as a book. The tests to assess the newly acquired knowledge immediately after the task, consisted of questions about the anatomical structures of the knee as well as the shoulder. In addition, the students' satisfaction with the learning materials provided was surveyed using a questionnaire. The survey assessed their satisfaction, their assessment of learning success, and their affinity to digital learning materials. This was done using a 5-point Likert scale and a free-text field. The data was analyzed descriptively, and group differences were calculated using a t-tests. RESULTS: Thirty students participated. The group comparison showed a significantly better outcome for the group that prepared with the analog anatomy atlas for the questions on the knee than the comparison group that used the anatomy app (t(28) = 2.6; p = 0.007). For the questions concerning the shoulder, there was no significant difference between the digital and analog groups (t(28) = 1.14; p = 0.26). The questionnaire revealed that satisfaction with the analog anatomy atlas was significantly higher than with the anatomy app. A total of 93.34% rated their experience with the analog learning tool at least "somewhat satisfied". In contrast, 72.67% of students partially or fully agreed that they "enjoyed learning with digital learning tools". DISCUSSION: Learning anatomical structures with the Human Anatomy Atlas 2023 + app did not show a clear advantage when compared to an anatomy book in these two cohorts of physiotherapy students. The results of the questionnaire also showed greater satisfaction with the analog anatomy atlas than with the anatomy app, whereas most students stated that they frequently use digital learning tools, including some for anatomical structures. Satisfaction with the learning tool seems to play a central role in their effectiveness. In addition, sufficient time must be provided for users to familiarize themselves with the user interface of digital applications to use them effectively. REGISTRATION: Diese klinische Studie wurde nicht in einem Studienregister registriert.

Design specifications and capabilities of a 3D simulation software for clinical education of physiotherapy students in the neurology department.

INTRODUCTION: In this revolutionized era, thanks to cutting-edge technological breakthroughs like 3-dimensional (3D) computerized environments, physiotherapy trainers can improve their knowledge and confidence by using such training tools. Hence, there is room for developing these technologies for training medical students to expand their skills and expertise. This study aims to identify the design requirements and key functionalities of a 3D simulation software for the clinical education of physiotherapy students in neurology departments. METHOD: First, by carefully reviewing neurological books, scientific articles, curriculum, and medical records, and consulting with experts, a scenario was compiled. In the next step, a researcher-developed questionnaire was designed. Then, experts' opinions were considered to confirm the validity and reliability of the questionnaire. The designed questionnaire was distributed among several neurological physiotherapists. Finally, the information elements, contents, and functional capabilities of the 3D software were determined by analyzing the data obtained from the questionnaire. FINDINGS: The main components for the design of physiotherapy educational software were identified based on the findings of the literature review, curriculum analysis, and medical record review. A survey of physiotherapy professors was conducted using a questionnaire created by the researcher in order to enhance the capabilities of simulation software and ascertain its primary functions. Following an analysis of the data from the distributed questionnaire, 37 essential features and contents have been proven to be more crucial than the rest for the creation of 3D simulation software. As a result, the essential and fundamental needs for the patient's training in reading their medical records and performing muscle strength assessments were recognized and extracted. Based on these findings, a researcher-developed scenario for the various real cases was then established. In the patient's medical record reading scenario, the student is required to read the patient's record in text format. Similarly, in the section on cranial nerves, pictures are utilised to reinforce the student's assessment skills in addition to textual content. Together with the audio and pop-up texts, the simulated 3D environment also offers training for the assessment of muscle strength. CONCLUSION: As an educational tool, this software can enhance students' learning and assist in addressing the drawbacks of conventional teaching methods like lectures and hospital visits.

Does UK Entry-Level Physiotherapy Education Prepare Graduates for a Future in Pediatric Clinical Practice? A Mixed-Methods Study.

AIMS: Identify the perceptions and experiences of how UK entry-level programs educationally prepared pediatric physiotherapists for their first clinical role. Review the extent programs taught essential, recommended, and additional content as per the International Organisation of Physical Therapists in Pediatrics (IOPTP). METHODS: Mixed methods design involving qualified UK pediatric physiotherapists. Forty-two physiotherapists completed an online questionnaire and nine (21%) completed a follow-up semi-structured interview. RESULTS: All 42 respondents felt they were "Not Well" (median 2, IQR 1.75-2.75) prepared for clinical practice. Not enough curricula emphasis was given to pediatric content (100%), with 31% (n = 13, CI 95% 19-46) reporting no pediatric content throughout their program. Only 15 (36%, 23-51) respondents experienced a pediatric placement. Themes from the follow-up interviews were (1) UK programs are adult focused; (2) placements are the only meaningful opportunity to develop competency; (3) programs lacked non-clinical content; and (4) experiencing pediatric patients was overwhelming due poor preparation. The majority of the IOPTP curriculum guidance is not embedded within UK curriculums. CONCLUSIONS: Respondents reported they were not well prepared for pediatric clinical practice. Some entry-level programs did not include any pediatric teaching throughout the entirety of the course.

Clinical learning evaluation among undergraduate physical therapy students during rotations in teaching hospitals of Sialkot and Lahore.

OBJECTIVE: To evaluate the clinical learning environment among undergraduate physical therapy students. METHODS: The descriptive, cross-sectional study was conducted from Januar y 23 to May 25, 2023, after approval from the ethics revie w committe e of Imran Id rees Ins titute of Rehabilitation Sciences, Sial kot, Pak istan, an d comprised undergraduate physical therapy students of either gender aged 19-26 years in their 3rd to 5th academic year studying in different institutions in Lahore and Sialkot. Data was collected using the clinical learning evaluation questionnaire. Data was analysed using SPSS 22. RESULTS: Of the 295 students, 269(91.2%) were females and 26(8.8%) were males. The overall mean age was 22.03±1.14 years. There were 210(71.2%) stude nts enrol led in the semester system , w hile 85(28.8%) we re part of the an nual system. The overall mean score was 71.05±10.20. Super vision (76.02±11.80) and motivation (80.21±11.71) were the most satisfying part of clinical learning identified by the students. CONCLUSIONS: The clinical learning environment demonstrated high satisfac tion levels in supervision and motivation domains, while im provements were nee ded in the areas of cas es, authenticity and organisation of doctor-patient encounters.

Revision of the Essential Core Competencies: Domains of Competence and Associated Competencies for Pediatric Physical Therapy Professional Education.

PURPOSE: The purpose of this Special Communication is to describe the processes of Education Summit III, sponsored by the Academy of Pediatric Physical Therapy, with an emphasis on the review, update, and integration of contemporary language and the Competency-Based Education framework into a revision of the Essential Core Competencies (ECCs). SUMMARY OF KEY POINTS: The Academy of Pediatric Physical Therapy has consistently supported pediatric professional education, including sponsoring 3 Education Summits in 2012, 2016, and 2023. The most recent summit focused on a revision of the ECCs and the development of materials to support their implementation. RECOMMENDATIONS FOR PRACTICE: These revised domains of competence and associated competencies will support and guide pediatric physical therapy education for professional students. Educators are encouraged to use their creativity and resources to integrate these into teaching and learning activities.

No More Excuses: Strategies for Inclusive Pediatric Physical Therapy Education.

PURPOSE: The purpose of this special communication is to provide practical, evidence-based recommendations and examples of inclusive and accessible teaching practices that can be effectively used in pediatric physical therapy (PT) education to: (1) ensure equity in education, (2) elevate all voices, and (3) facilitate anti-oppressive learning environments. SUMMARY OF KEY POINTS: Concrete action items and strategies addressing these 3 recommendations are provided at all levels of the ecological model framework. STATEMENT OF CONCLUSIONS AND RECOMMENDATIONS FOR CLINICAL PRACTICE: Pediatric PT clinical and academic educators must work proactively to ensure learning environments are inclusive of everyone. Pediatric PT educators need to take the time to self-reflect, change their behaviors, and use inclusive, accessible, and anti-oppressive education practices. This will create equitable learning opportunities to successfully meet the needs of our learners, children, and families with whom we engage regularly in our personal and professional lives.

Barriers and Facilitators to the Adoption of Evidence-Based Interventions for Adults Within Occupational and Physical Therapy Practice Settings: A Systematic Review.

OBJECTIVE: Synthesize data regarding barriers and facilitators of adoption (ie, adoption determinants) of evidence-based occupational (OT) and physical therapy (PT) interventions within real-world practice. Whether evidence varied across disciplines, settings, and use of theoretical frameworks was also examined. DATA SOURCES: Literature published from database inception to December 9, 2022, in OVID MEDLINE, EMBASE, OVID PsycINFO, Web of Science Core Collection, Cumulative Index to Nursing and Allied Health Literature, Cochrane Library, and Google Scholar. STUDY SELECTION: Original research including: (1) stakeholder insight into adoption determinants; (2) discrete evidence-based interventions delivered/supervised by an OT and/or PT; (3) intervention recipients aged 18 or older; and (4) data regarding adoption determinants. Two reviewers independently screened and evaluated studies for inclusion, with a third resolving discrepancies. Of the 3036 articles identified, 45 articles were included. DATA EXTRACTION: Data were extracted by a primary reviewer, independently evaluated by a second reviewer, and conflicts were resolved via group consensus. DATA SYNTHESIS: A descriptive synthesis approach was used to categorize adoption determinants according to constructs from the Consolidated Framework for Implementation Research. 87% of studies were published after 2014. Many studies: described PT interventions (82%); were within the outpatient setting (44%); had data gathered after implementing the intervention (71%); and did not report use of a theoretical framework to inform data collection (62%). Lack of available resources (64%) and knowledge/beliefs about the intervention (53%) were the most common barrier and facilitator, respectively. Variability in adoption determinants was observed according to discipline, setting, and use of a theoretical framework. CONCLUSIONS: Findings suggest a recent surge of scientific investment in understanding adoption determinants for evidence-based OT and PT interventions. Such knowledge can inform efforts aimed at improving OT and PT quality, thereby enhancing patient outcomes. However, our review highlighted gaps with significant implications for the delivery of evidence-based OT and PT within real-world practice settings.

Evidence-based practice confidence and behavior throughout the curriculum of four physical therapy education programs: a longitudinal study.

BACKGROUND: Evidence-based practice (EBP) is a foundational process taught in health professional education, yet it is unclear when EBP confidence and skills are obtained. Increases in EBP confidence and behaviors from the start of physical therapy programs to post graduation have been reported in studies that evaluated a single program or used non-valid questionnaires. This study aimed to describe changes in EBP confidence and behavior using validated questionnaires of students from four physical therapy education programs throughout their curriculum and one year post graduation. METHODS: One hundred and eighty-one students from a potential pool of 269 (67.3%) consented to participate. Students completed the Evidence-Based Practice Confidence (EPIC) Scale and the Evidence-Based Practice Implementation Scale (EBPIS) at 6 timepoints: start of the program, prior to first clinical experience, after first clinical experience, at the end of classroom instruction, graduation, and one year post. Medians (Mdn) and 25th and 75th percentiles (P25, P75) were calculated for 42 (23.2%) students with complete data across all timepoints. Change between timepoints was assessed using Friedman's test and Wilcoxon signed rank test with a Bonferroni correction for post hoc analysis. RESULTS: There were significant changes in EPIC scores (p < 0.001) from enrollment (Mdn 50.0, P25, P75 35.5, 65.9) to prior to first clinical experience (Mdn 65.5, P25, P75 57.3, 72.5) and after the first clinical experience (Mdn 67.3, P25, P75, 58.9, 73.2) to the end of classroom instruction (Mdn 78.6, P25, P75, 72.0, 84.1). Significant increases on the EBPIS (p < 0.01) were only seen from after the first year of training (Mdn 15, P25, P75, 10.0, 22.5) to end of the first clinical experience (Mdn 21.5, P25, P75 12.0, 32.0). CONCLUSIONS: EBP confidence increased significantly after classroom instruction but remained the same after clinical experiences and at one year post graduation. EBP behavior significantly increased only after the first clinical experience and remained the same through graduation. Confidence and behavior scores were higher than were previously reported in practicing professionals. Ongoing assessment of EBP confidence and behavior may help instructors build appropriate curricula to achieve their outlined EBP objectives.

Excellence in Pediatric Physical Therapy Education: Recommendations and Action Items.

PURPOSE: This special communication identifies evidence-based recommendations and offers action items to facilitate the uptake of new knowledge from the National Study of Excellence in Pediatric Physical Therapy Education (NSE-Peds). SUMMARY OF KEY POINTS: The NSE-Peds identified a conceptual framework consisting of 4 key dimensions and associated elements that dynamically interact to prepare future physical therapists to meet the needs of society. The conceptual framework serves as the Knowledge Creation component of the knowledge to action (KTA) framework, but translation into practice requires the Action Cycle, the second component of the KTA framework. Recommendations and action items provide tangible products derived from the NSE-Peds conceptual framework for application in the Action Cycle. CONCLUSIONS: Using the KTA framework, implementation of the recommendations at the level of the individual, program, and organization should enhance pediatric physical therapy education and ultimately physical therapy care provided to children and families.

Comparing Domain-Specific Self-Efficacy in Pediatric Physical Therapy Education Across Classroom-Based, Online, and Hybrid Curriculum Designs.

PURPOSE: To describe the pediatric curriculum across 3 years when different instructional designs were used, quantify change in self-efficacy (SE) after completing the curriculum, and define relationships between pediatric experience, SE, and interest in future pediatric practice. METHODS: Students (N = 137) were included over 3 consecutive years. Instructional design varied across cohorts: classroom-based (n = 48), online (n = 44), and hybrid (n = 45). Pediatric content hours were analyzed. Measures were the Pediatric Communication and Handling Self-Efficacy Scale, pediatric experience, and interest in future pediatric practice. RESULTS: Pediatric content hours met published recommendations. Significant growth in SE occurred for all cohorts, with no significant differences in SE scores based on instructional design. Experience and interest in pediatrics were significantly related to communication SE. CONCLUSIONS: The pediatric physical therapy curriculum delivered via classroom-based, online, or hybrid instruction can be effective in promoting pediatric-specific growth in student SE. Remote pediatric experiential learning is a feasible option for physical therapy programs with limited direct contact with children. What this adds to the evidence : When pediatric curricula meet recommended total hours of instruction, regardless of instructional method or amount of direct laboratory time with real children, pediatric-specific student SE increases. This supports the use of alternative approaches for experiential learning activities in programs with limited access and availability for direct in-person child interactions. Programs may expand integrated clinical experiences (ICE) opportunities to include telehealth when in-person ICE is limited due to distance or availability in nearby clinical settings. Online learning activities (asynchronous or synchronous) may be viable options for laboratory activities when live child volunteers are limited or unavailable. Use of multiple methods of instruction (classroom-based, online, or hybrid) can be beneficial in covering pediatric physical therapy content and improving SE. This evidence can help programs expand their options for exposing student physical therapists to pediatric practice.

The Smart Class Teaching Module for Rehabilitation Medicine English Education in China.

BACKGROUND Learning medical English is particularly challenging for non-native English-speaking medical students. The Smart Class teaching module is a new online teaching module for rehabilitation-related medical English, the efficacy of which has yet to be established in the literature. Gender differences should also not be ignored in our study, taking into account the proven performance differences between males and females in language learning. MATERIAL AND METHODS First-year physiotherapy students in Grade 2018 and Grade 2019 at Guangzhou Medical University were recruited to participate in this study. Grade 2019, as the experimental group, completed the Smart Class teaching module, while Grade 2018, as the control group, completed the Traditional Class teaching module. The efficacy of both modules was assessed objectively using the students' medical English exam scores and subjectively using the students' responses to a questionnaire. RESULTS In total, 242 questionnaires were distributed, and 210 valid questionnaires were returned, of which 119 were from the Smart Class teaching module group and 91 were from the Traditional Class teaching module group. There was no statistically significant difference between the medical English exam scores of the 2 groups (P=0.324). However, the subjective assessment revealed that the students experienced a significantly greater burden from the workload in the Smart Class teaching module group (P<0.001). CONCLUSIONS We found both the Smart Class teaching module and the Traditional Class teaching module achieved similar teaching outcomes. Therefore, the former represents a viable alternative teaching option for situations where traditional class teaching is not possible.

Performance-based assessment during clinical placement: Cross-sectional investigation of a training workshop for practice educators.

Performance-based assessment evaluates a health professional student's performance as they integrate their knowledge and skills into clinical practice. Performance-based assessment grades, however, are reported to be highly variable due to the complexity of decision-making in the clinical environment. The aim of this study was to evaluate the impact of a training workshop based on frame-of-reference principles on grading of student performance by physiotherapy practice educators. This was a prospective cross-sectional study which used a single group pre-test, post-test design. Fifty-three practice educators rated two video vignettes depicting a poor and very good student performance, using a subsection of a physiotherapy performance-based assessment tool before and after training. Overall, results showed that participants amended their scores on approximately half of all scoring occasions following training, with the majority decreasing the scores awarded. This impacted positively on scoring for the poor performance video, bringing scores more in line with the true score. This study provides evidence of the benefit of a training workshop to influence decision-making in performance-based assessment as part of a wider education program for practice educators.