Creating transformational learning experiences for 21st century healthcare students through preclinical skills training at a South African university.

BACKGROUND: Creating an inclusive interprofessional teaching and learning community can enhance student engagement and ultimately develop essential graduate attributes (GA) (also known as generic, transferable, core, soft, work-ready or nontechnical skills). The early practical development of GA within a diverse space is essential in health profession education, as students experience the transition to clinical training as challenging. AIM: This paper describes the conceptualization and implementation of an inclusive interprofessional curriculum focused on GA development in the preclinical years. METHODS: A phased multimethod research design was applied. Phase 1 focused on the conceptualization of a preclinical GA development curriculum through a consensus-seeking process among all staff in the School of Health and Rehabilitation Sciences (N = 36). Subsequently, in Phase 2, quantitative and qualitative data were gathered from participating first-year students (N = 135) as an early curricular implementation review. Descriptive statistical analyses for quantitative and thematic analyses for qualitative data were performed. RESULTS: During Phase 1, five themes were identified (Ethics, Professionalism, General principles for interventions, Organizations and institutions, Management) informing preclinical curriculum development. Forty-one first-year students (30%) participated in Phase 2. The majority of participants (87%) indicated that they had a positive learning experience during Phase 2. Students expressed that engagement was encouraged (83%) within a space of mutual respect (83%), with interprofessional groups assisting in building "a trusting environment and a supportive one". Students indicated they "liked that it [module] wasn't just about one topic", as it concretized that "there is more to being a healthcare professional that just treating people". CONCLUSION: GA development provides an invaluable opportunity for interprofessional engagement. Creating a diverse and inclusive curricular space through multimodal and interprofessional training, GA training was transformed to be more practical and future-focused, creating a positive learning experience. Future research should focus on the longer-term impact of this practical, preclinical GA development during the transition of these students into the clinical training space.

Becoming comfortable with the uncomfortable: The tale of adaptability.

Background: With the ever-changing healthcare environment and impact of the coronavirus disease 2019 (COVID-19) pandemic on tertiary education, healthcare students need to constantly adapt their approach to learning, clinical practice and well-being. Adaptive performance is therefore vital. Objectives: To investigate the adaptive performance of final year physiotherapy students at the University of the Free State. Method: A quantitative descriptive study was performed. All consenting final year undergraduate physiotherapy students registered at the University of the Free State in 2021 were approached for inclusion. The short 55-item I-ADAPT measurement was distributed electronically to all possible participants. Results: The response rate was 28.5% (n = 8). Descriptive statistics, namely frequencies and percentages for categorical data and medians and percentages for numerical data were calculated. The dimensions related to handling work stress (50%), uncertainty (62.2%) and creativity (64.0%) scored the lowest. Emotional response to stress (62.5%) and frustration in response to unpredictable situations (62.5%) was reported. Conclusion: Uncertainty and unpredictability are inevitable for healthcare students. Stress management and emotional intelligence development are advised for inclusion in undergraduate physiotherapy programmes. Clinical implications: A need for curricular evaluation to ensure students are equipped with stress management and emotional intelligence skills is proposed.

Chronic Ankle Instability and Associated Self-Reported Function in South African Professional Ballet Dancers.

INTRODUCTION: Ankle sprains are the most common acute injury among dancers and may result in the development of chronic ankle instability (CAI). Chronic ankle instability is characterized by recurrent ankle sprains, incidents of the ankle "giving way," and sensations of instability and has been reported to negatively impact functioning and psychosocial status. The large number of ankle sprains in addition to contextual factors relating to professional dancing, suggests that CAI may be a significant problem in professional ballet dancers. This study aimed to determine the prevalence of CAI and describe the ankle injury history and level of self-reported function in South African ballet dancers. METHODS: This descriptive, cross-sectional study included all professional ballet dancers employed by three professional South African ballet companies (n = 65). The Identification of Functional Ankle Instability Questionnaire (IdFAI), Foot and Ankle Ability Measure (FAAM), Dance Functional Outcome Survey (DFOS), and a researcher-developed injury history questionnaire were completed by consenting participants. Descriptive statistics were calculated. RESULTS: A CAI prevalence of 73.3% CI [55.6%, 85.8%] was calculated among 30 participants. Twenty-five (83.3%) participants reported sustaining at least one significant ankle sprain with 88% (n = 22) indicating dance related activities as the cause. Dancers with CAI demonstrated a tendency to have less control over their ankles giving way and tended to take longer to recover from their ankles giving way than those dancers not affected. Eight participants (36.4%) with CAI were identified as having a significant level of disability on the FAAM activities of daily living (ADL) subscale and six participants (27.3%) on the sport subscale. Participants with CAI had a median total score of 83.5; IQR [80 - 90] on the DFOS. CONCLUSION: The self-reported function of South African professional ballet dancers is not severely affected, however, the high prevalence of CAI and reported symptoms is concerning. Education on CAI symptoms, prevention, and evidence-based management is recommended.

Health sciences educator's simulation debriefing practice needs: A mixed methods study.

BACKGROUND: Simulation debriefing influences learning from healthcare simulation activities. Health sciences educators must be competent in conducting simulation debriefing for healthcare students. A structured faculty development intervention for health sciences educators must be informed by educator needs to enhance its utility. This paper describes the needs of health sciences educators regarding simulation debriefing at a faculty of health sciences. MATERIALS AND METHODS: A parallel convergent mixed methods study design was applied on a selected population of 30 health sciences educators at the University (x) who integrate immersive simulation for first- to final-year students in their undergraduate programs. The Objective Structured Assessment of Debriefing tool underpinned observations which informed the quantitative strand of the study, while semi-structured interviews were conducted as part of the qualitative strand. Descriptive statistics and thematic analysis were used to analyze the data. RESULTS: Health sciences educators struggled to establish the learning environment for simulation (median 1), facilitate learning (median 3), and evaluate their debriefing activities. However, they were able to apply an appropriate approach toward simulation (median 4). They identified the need to be educated on the fundamentals of simulation-based education. CONCLUSION: A continuing professional development program must be developed aimed at transforming approaches toward facilitating learning, explaining the fundamentals of simulation-based education, modeling of best-practices related to debriefing, and applying appropriate strategies for evaluating debriefing activities.

Exercise interventions used along the continuum of cancer care: A scoping review protocol.

Background: Cancer is one of the leading causes of death worldwide. Exercise is crucial for ameliorating the burden associated with cancer and its management. A broad review of exercise interventions for cancer patients is not available. Objective: Our study aims to review the documented exercise interventions prescribed for adult cancer patients aimed at ameliorating cancer-related and cancer treatment-induced symptoms in patients along the continuum of care. Methods: A three-step search strategy will be used, the research question was developed; the first step in the research process was identified and the search strategy was developed using the Participants-Concept-Context framework. English language publications from 15 electronic databases from 2011 to 2021 will be searched. The Joanna Briggs Institute methodology for scoping reviews will be to guide the review and the Preferred Reporting Items for Systematic reviews and Meta-Analyses extension for scoping reviews will be used for the report. The search strategy incorporated terms relevant to the research question. The reference lists of articles included in the review will be screened for additional papers. Searched articles will be screened to determine their eligibility for inclusion and a pretested data extraction form will be used to chart the extracted evidence. Results: This article presents a protocol for a scoping review on exercise interventions to affect symptoms in cancer patients from diagnosis to end-of-life care. Conclusion: A broad review of exercise interventions for cancer management in adult patients will elucidate the characteristics and context of exercises used along the cancer care continuum. Clinical implications: Exercise interventions used as part of cancer management will be mapped out to provide an overview of such exercise interventions. This could enhance knowledge among exercise oncology experts regarding exercise interventions for different cancer patient populations.

The PIER framework for healthcare simulation integration in undergraduate physiotherapy education.

BACKGROUND: The need for healthcare curricula renewal to facilitate a continuum in education from classrooms to diverse healthcare settings is undeniable. Simulation has been recognized as an educational strategy to address healthcare education challenges, with limited reporting on the integration of simulation-based learning experiences in physiotherapy education. The study aimed to describe the finalisation of a framework for integration of healthcare simulation in an undergraduate physiotherapy program. METHODS: A qualitative descriptive research design was utilized. Five South African experts in the fields of healthcare simulation and/or physiotherapy education contributed to the finalization of the framework during a consensus meeting. Content analysis was employed and credibility was ensured through double coding. RESULTS: Structural coding yielded five themes- Planning, Implementation, Program Evaluation, Program Revision and Framework. The five themes consisted of fifteen categories, two sub-categories and 44 codes. The planning theme was most robust with seven categories. The Planning, Implementation, Evaluation, Revision (PIER) framework was developed and finalized by expert participants. following the consensus meeting. CONCLUSION: Needs analyses when planning and incorporating simulation is essential. Collaboration through resource and knowledge sharing is vital in developing a responsive curriculum integrating simulation. Furthermore, facilitator and student preparation are paramount in ensuring active engagement in simulated-based learning experiences. The interconnectedness of all framework elements and integration phases, as well as the implied importance of competent facilitators and prepared students is crucial and highlights careful consideration to be given to these aspects. The PIER framework is generic in nature and represents the continuous process of simulation integration for any healthcare program.