Learning and education

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.

The Impact of a Physiotherapist in the Role of Clinical Matron within a Stroke Service

To explore the impact of putting senior clinicians at the bedside with clinical expertise in their speciality to improve quality of patient care. This role was introduced at Hampshire Hospitals Foundation Trust (HHFT) in 2016, whilst mainly undertaken by senior nurses, 2 physiotherapists and an occupational therapist have also undertaken the role. This presentation explores the impact of physiotherapists undertaking such roles.

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.

Rheumatology Triage and Assessment by Advanced Practitioner Physiotherapists

In May 2016 rheumatology referrals were outstripping service capacity, leading to increasing waiting times for new patients. Following a review of new patient referrals the team identified that a significant proportion of referrals, though being appropriately referred to rheumatology, were for non-inflammatory conditions. Recognising the changing landscape of the NHS and the emphasis to look at different ways of working we put forward a proposal to pilot a rheumatology advanced practitioner physiotherapist (APP) with the following aims: -

  • Improve the triage process
  • Streamline the pathway for new patients with non-inflammatory conditions
  • Reduce waiting times

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.  

Physiotherapy assistants in the musculoskeletal outpatients setting

Physiotherapy assistants accounted for approximately 20% of the physiotherapy workforce across Stoke on Trent Community Health Services. Although their job descriptions clearly stated that the post was primarily clinical, their role depended heavily on the qualified physiotherapists and how they utilised the clinical skills of physiotherapy assistants. As a result in some clinics/clinical areas physiotherapy assistants had a predominant clinical role whereas in others they fulfilled what was primarily an administrative role. This latter trend led to physiotherapy assistants not being able to utilise their clinical skills and to job dissatisfaction as well as disparity in the clinical service provided to patients of equal clinical needs.

UEA & Norwich City: A partnership approach

The poster provides an overview of the partnership established between the UEA and Norwich City over the past 5 years. It outlines the way that the MSc pre-registration physiotherapy students develop their research dissertation topics through a collaborative approach with physiotherapists at the Norwich City football club academy. It identifies the research questions investigated by current and previous Masters students. The final section demonstrates the benefits of using research to inform practice in the elite professional football academy setting and the value of making explicit links between research, education and practice. It does this through the narrative of the physiotherapists, students and academic staff themselves.

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.

Working with complex persistent pain

To describe the role of an Advanced Physiotherapy Practitioner (APP) working within a multidisciplinary team with people with complex persistent pain in acute hospital, outpatient and community settings.

To describe relevant physiotherapy skills required in these settings

To describe the clinical outcomes of the service

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