Education & learning

Evaluation of treatments and outcomes, red flags and signs and symptoms for cervicogenic headache in a musculoskeletal setting

Current evidence advocates physiotherapy treatment, for the management of cervicogenic headaches (CGH). A reasoned assessment and clear knowledge of red flags is essential.

An MSK physiotherapy team from southern England received training sessions for CGH. Topics included assessment, evidence based treatment, clinical reasoning and red flags. Physiotherapists completed a questionnaire on headache red flags and signs and symptoms, preceding and following training.

10 patient cases were examined, exploring treatments, against current best practice, after training. Effectiveness was evaluated using patient outcomes before and after intervention. The purpose/objectives of this study was to:-

  • Evaluate participant's knowledge of red flag and signs and symptoms of CGH headache, preceding and following training.
  • Examine treatments used by participants for 10 CGH patient cases, against current best practice after training.
  • Review patient treatment outcomes, of the 10 CGH patient cases after training.

Learning needs analysis of spinal specialist triage practitioners

The South East London and Kent Regional Spinal Network (RSN) aims to provide evidenced-based pathways for management of musculoskeletal spinal conditions from first point of contact through to tertiary care. From 1st April 2018 all non-emergency referrals to secondary care (Pain and Spinal Surgery) must be referred by Spinal Specialist Triage Practitioners (SSTP). GP referrals will not be accepted. This aligns with the National Back Pain Pathway (NBPP) and NICE CG59 guidelines towards improving spinal care, equity of services and commissioning of spine care across the region. SSTPs, predominantly physiotherapists by background, are multidisciplinary (e.g. osteopaths, nurses) and work in primary or secondary care or in interface services run by NHS and Any Qualified Providers (AQP).

There have been calls for the development of a regional training programme and in the long-term, a nationally recognised qualification, to support SSTPs and promote excellent patient care. Current provision of training is fragmented and learning needs unknown. A learning needs analysis is required to allow for development of future training and development.

There are no validated learning needs questionnaires suitable for the specific purpose therefore a comprehensive tool was required.

Admissions interviews and diversity in Physiotherapy cohorts

Recent scandals relating to care failings within the NHS have led the UK government to recommend that providers examine the recruitment methods for healthcare professional education programmes and initiate better screening of those entering the professions (Francis, 2013). The School of Healthcare Sciences at Cardiff University has committed to interviewing all applicants prior to enrolment and have instigated a multiple mini-interview (MMI) structure to do so.

In MMIs candidates have many opportunities to make a first impression, meeting different assessors at each station, suggesting the process is fairer and more consistent when compared to traditional panel interviews (Eva et al, 2004). However, if MMIs are designed to select for specific attributes and personalities, do they result in a homogenous student population and thus reduce the diversity of experiences, thoughts and behaviours within? Is the process which is thought to be 'fair' actually fraught with bias?

This project aimed to investigate bias within the MMI structure for Physiotherapy recruitment at Cardiff University. It considers the design and scoring of interview stations and their inclusivity, through the monitoring of performance at each station by applicants with differing characteristics.  

Assessing the impact of training on patient experience

Increased customer satisfaction is associated with reduced complaints, a positive business reputation and often financial return. Within the clinical setting it has more importantly been shown to have a direct correlation with improved clinical outcomes. The therapeutic relationship is one area that can impact on a patients overall experience and their engagement in treatment. This relationship can be improved by making sure that the patients expectations and perceptions are not only acknowledged but clearly understood. A number of physiotherapists identify that they struggle with changing mind-sets of their patients or find that they are unprepared for having those difficult conversations. Supporting physiotherapists to have effective communication skills, the ability to listen and engage and have awareness of the impact of verbal and non verbal cues is essential in improving the patient experience. Training was required to address the gap in skill and knowledge.

Transnational collaborative digital learning project

Physiotherapy programmes must prepare graduates to live and work in a globally interconnected society. Internationalised learning experiences have the potential to break down ethnocentric worldviews by exposing students to analysis and critique of practice from different cultural perspectives. Such experiences may enable transformative learning by developing the student's ability to shift perspective and reflect critically on how disciplinary practice can change with the social context. Opportunities to study abroad can only be offered to a minority of students. In contrast, digital technology such as discussion forums and video conferencing provide an inclusive platform to make international experiences available to all students on a programme. The aim of this educational project was to engage physiotherapy students in a transnational collaborative group task in order to increase awareness of different international perspectives on clinical practice and healthcare provision and facilitate reflection on their local context.

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