Gillian Webb

Sustainable undergraduate education and professional competency

The primary purpose of Schools of Physiotherapy, and their tradition, is to develop in their students the cognitive and practical breadth required to function as competent practitioners immediately on graduation, with the capacity to continue to learn and develop. As schools within universities, they also seek to provide students with broad educational experiences, assisting them to develop generic skills such as independent learning, teamwork, responsibility towards other people, problem solving abilities and the like.

Australian physiotherapy student intake is increasing and attrition remains lower than the university average: a demographic study

QUESTIONS Have student numbers (ie, intake and attrition) changed since the introduction of graduate entry-level physiotherapy courses in Australian universities? What is the impact of any changes in student numbers on university funding? What is the impact of any changes in student numbers on the workforce? Have student characteristics (ie, gender, country of origin, background) changed? DESIGN Demographic study of 2003 graduates, 2004 student intake, and estimated 2007 student intake. PARTICIPANTS Eleven Schools of Physiotherapy in Australia. RESULTS In 2003, 836 new physiotherapists graduated, and in 2004, 1108 students commenced with the percentage of graduate-entry Masters and international students increasing. Compared to the overall average 25% attrition rate of students from university, the rate for physiotherapy students was less than 5%; the funding formula thus underestimates physiotherapy student numbers across the years of the courses. While it remains the case that in undergraduate and graduate-entry programs most physiotherapy students are female, a greater proportion of males are entering graduate-entry Masters programs than undergraduate courses. International student numbers are increasing in line with trends across the sector, but representation of Aboriginal and Torres Strait Islander students in physiotherapy courses was lower than within universities generally. CONCLUSIONS The marked overall increase in student numbers and greater retention rate in the graduate entry-level courses puts physiotherapy at a disadvantage in relation to Department of Education, Science and Training student funding. While the substantial increase in new physiotherapists may serve to ease workforce demands in the short term, significant pressure on physiotherapy academics and clinical educators was evident.

Taking stock of interprofessional learning in Australia.

Changes in health service delivery and issues of quality of care and safety are driving interprofessional practice, and interprofessional learning (IPL) is now a requirement for medical school accreditation. There is international agreement that learning outcomes frameworks are required for the objectives of IPL to be fully realised, but there is debate about the most appropriate terminology. Interprofessional skills can be gained in several ways — from formal educational frameworks, at pre‐ and post‐registration levels to work‐based training. Research activity suggests that many consider that IPL delivers much‐needed skills to health professionals, but some systematic reviews show that evidence of a link to patient outcomes is lacking. Australian efforts to develop an evidence base to support IPL have progressed, with new research drawing on recommendations of experts in the area. The focus has now shifted to curriculum development. The extent to which IPL is rolled out in Australian universities will depend on engagement and endorsement from curriculum managers and the broader faculty.

The use of the International Classification of Functioning, Disability and Health to understand the health and functioning experiences of people with chronic conditions from the person perspective: a systematic review

Abstract Purpose: This systematic review examines the literature to identify the context and extent of implementation of the International Classification of Functioning, Disability and Health (ICF) model to understand the experience of health and functioning in persons with chronic conditions from the person perspective. Method: The literature search was conducted through five electronic databases between 2001 and December 2012. Reference lists of included papers were also searched. Articles in which the ICF was used to understand the health and functioning experience of adults with chronic conditions from the person-perspective were included. Data were extracted and analysed to identify the year of publication, geographical location, health condition, context of ICF use, authors’ remarks and identified limitations of the ICF. Results: Thirty-seven qualitative and mixed-methods studies were included representing 18 countries and a range of chronic conditions. The ICF was found to be used to elicit and analyse people’s narratives, with the majority of studies reporting that the ICF provides a comprehensive analysis of experiences and needs from the person perspective. Some limitations to its use and the need to classify the “personal factors” component were reported. Conclusion: The ICF has been used to provide a comprehensive understanding of health and functioning in persons with chronic conditions from the person perspective, although there are currently relatively few studies which have used the ICF in this context. Limitations regarding its use were reported which should be considered by users of the model and during its revision process. Implications for Rehabilitation The ICF encourages a bio-psycho-social and person-centred approach to healthcare and may provide a useful tool for guiding clinical assessment and encouraging clinicians to consider the multitude of factors which impact health, which may result in more specific and individualised treatment targeted at individual needs. Using a common framework that can be understood across health disciplines may enhance interdisciplinary communication and collaboration, improving health care delivery. The ICF may be used to compare perspectives of individuals and their health professionals and to identify people’s needs that are not adequately being addressed, which may have significant implications for improving healthcare provided and overall health outcomes.

The use of the international classification of functioning, disability and health (ICF) in indigenous healthcare: a systematic literature review

IntroductionThe International Classification of Functioning, Disability and Health (ICF) was endorsed by the World Health Organisation (WHO) in 2001 to obtain a comprehensive perspective of health and functioning of individuals and groups. Health disparities exist between Indigenous and non-Indigenous Australians and there is a need to understand the health experiences of Indigenous communities from Indigenous Australian’s perspectives in order to develop and implement culturally appropriate and effective intervention strategies to improve Indigenous health. This systematic review examines the literature to identify the extent and context of use of the ICF in Indigenous healthcare, to provide the foundation on which to consider its potential use for understanding the health experiences of Indigenous communities from their perspective.MethodsThe search was conducted between May and June 2012 of five scientific and medical electronic databases: MEDLINE, Web of Science, CINAHL, Academic Search Complete and PsychInfo and six Indigenous-specific databases: AIATSIS, APAIS-health, ATSI-health, health and society, MAIS-ATSIS and RURAL. Reference lists of included papers were also searched. Articles which applied the ICF within an Indigenous context were selected. Quantitative and qualitative data were extracted and analysed by two independent reviewers. Agreement was reached by consensus.ResultsFive articles met the inclusion criteria however two of the articles were not exclusively in an Indigenous context. One article applied the ICF in the context of understanding the health experience and priorities of Indigenous people and a second study had a similar focus but used the revised version of the International Classification of Impairments, Disability and Handicap (ICIDH-2), the predecessor to the ICF. Four of the five papers involved Indigenous Australians, and one of the paper’s participants were Indigenous (First Nation) Canadians.ConclusionLiterature referring to the use of the ICF with Indigenous populations is limited. The ICF has the potential to help understand the health and functioning experience of Indigenous persons from their perspective. Further research is required to determine if the ICF is a culturally appropriate tool and whether it is able to capture the Indigenous health experience or whether modification of the framework is necessary for use with this population.RésuméIntroductionLa Classification Internationale du Fonctionnement, de l’Incapacité et de la Santé (ICF) a été apprové par l’Organisation Mondiale de la Santé (OMS) en 2001 pour obtenir une perspective complète de la santé et du fonctionnement des individus et des groupes. Des disparités de santé existent entre les Australiens indigènes et non-indigènes et il y a un grand besoin de comprendre les états de santé des communautés indigènes vus de leur propre perspective afin de développer et mettre en application des stratégies d’intervention culturellement appropriées et efficaces pour améliorer leur santé. Cette révision systématique vérifie toute documentation pour identifier l’ampleur et le contexte de l’utilisation de l’ICF dans les soins des Indigènes permettant ainsi de considérer son utilisation potentielle pour comprendre les expériences de santé des communautés indigènes vues de leur propre perspective.MéthodesLa recherche a été accomplie entre mai et novembre 2012 à partir de cinq bases de données électroniques scientifiques et médicales: MEDLINE, Web of Science, CINAHL, Academic Search Complete, PsychInfo et six bases de données spécifiquement indigènes: AIATSIS, APAIS-health, ATSI-health, health and society, MAIS-ATSIS et RURAL. Les listes de références des documents inclus ont été également examinées. Les articles qui s’appliquaient à l’ICF dans le contexte indigène ont été sélectionnés. Des données quantitatives et qualitatives ont été extraites et analysées par deux critiques indépendants et les désaccords ont été résolus par consensus.RésultatsCinq articles ont bien répondu aux critères d’inclusion, bien que deux des articles n’aient pas fait exclusivement partie d’un contexte indigène. L’un des articles a appliqué l’ICF pour comprendre les expériences et les priorités de santé des Indigènes et une deuxième étude a fait de même mais a employé une nouvelle version de la Classification Internationale de l’ Infirmité, l’Incapacité et le Handicap (ICIDH-2), le prédécesseur de l’ICF. Tous les documents concernaient les Indigènes australiens à l’exception d’un dont les participants étaient des Indigènes (Premières Nations) canadiens.ConclusionLa documentation se rapportant à l’utilisation de l’ICF avec des populations indigènes est limitée. L’ICF a le potentiel d’aider à comprendre les expériences de santé et le fonctionnement des Indigènes vus de leur propre perspective. Davantage de recherche est essentielle pour déterminer si l’ICF est culturellement appropriée et peut capturer les expériences de santé des Indigènes ou si une modification de cadre est nécessaire pour son utilisation avec cette population.

Communication in Indigenous healthcare: extending the discourse into the physiotherapy domain

Considering the high mortality andmorbidity associated with chronic conditions amongst Indige-nous communities, it is essential to provide Indigenous Austra-lians access to equitable healthcare. Physiotherapists are wellpositioned to play an important role in preventing and managingmany health conditions that are prevalent amongst IndigenousAustralians.TheAustralianPhysiotherapyAssociation(APA)hasaPosition Statement on Indigenous Health

Educating Australian physiotherapists: striving for excellence in sport and exercise medicine

Physiotherapists play a major role in sports medicine delivery and research in Australia, a country renowned for its sporting achievements and sporting culture. Sports medicine in this country is a relatively young specialty which has undergone rapid development particularly since the 1956 Melbourne Olympic Games. Educating physiotherapists in sports and exercise begins in undergraduate training where a large proportion of the physiotherapy course focuses on theoretical knowledge and practical skills in the neuromusculoskeletal area. After graduation, further sports physiotherapy experience can be gained through formal postgraduate university qualifications or a variety of professional development activities. The first formal education programme for students in the area of physiotherapy began in Australia at the University of Melbourne in the early 1900s. Initially, registration to practice physiotherapy in Australia was licensed under the Massage Registration Board and the Massage Act. In the 1970s, under the auspices of the Physiotherapy Registration Board, physiotherapists in Australia were granted primary contact practitioner status. This was a first in the world for physiotherapy. The responsibility associated with primary practitioner status had a profound effect on undergraduate education requiring an emphasis on differential diagnosis by way of clinical reasoning and clinical decision making. In Australia in the year 2000, seven universities offer physiotherapy undergraduate programmes with about 650 students in total graduating each year. Two more programmes have started and will have graduates in the near future. A further university has advertised for a new chair of physiotherapy, and other universities are considering establishing programmes. This is a clear demonstration of the popularity of physiotherapy as a choice of career for Australian students. In particular, many students are interested in the area of sports physiotherapy. The programmes are very competitive to enter and the students entering the programmes come from the top 2–5% of secondary school leavers. There …

A review of the literature to inform the development of a new model of global placement: the Global Learning Partnership

Primary Objective: To review literature to guide the design and implementation of an international and inter-professional ‘Global Learning Partnership’ (GLP). The aim of the GLP model is to create a shared learning opportunity between academics and students from Universitas 21 network with invited partner universities to address United Nations Sustainable Development Goal needs. Design: Two literature reviews were conducted to inform and refine the design of the GLP model to support the acquisition of the desired learning opportunities. One literature review explored the efficacy of international field placements on developing cultural competence in medical and health science students. The second examined common elements of education programs and collaborative projects designed to facilitate inter-professional learning in students of medicine and allied health sciences. Results: The literature reviews demonstrated that cultural awareness and cultural knowledge are enhanced through participation in cultural immersion programs. Secondly that inter-professional education assists in the development of collaborative practice competencies. However, there were few examples of inter-professional collaborations that included students and academics from the host countries as members of the collaborative learning model. Conclusion: The design of the GLP model was informed and supported by the two literature reviews in the objective to develop a project around the fundamental concepts of engagement and sharing across universities and cultural contexts. Rigour has been applied to the design process to ensure the GLP model may build capacity through education, while capitalising on strengths of existing global health placements and inter-professional education. The inclusion of host-country students and academics in this international learning exchange is believed to be key to equitable opportunity and capacity building.

Health professional workforce education in the Asia Pacific

Objective To design and implement an international and interprofessional Global Learning Partnership Model, which involves shared learning between academics and students from Universitas 21 network with other universities with United Nations Millennium Development Goal needs. Design Two literature reviews were conducted to inform ethical aspects and curriculum design of the GLP model. Feedback from conference presentations and consultation with experts in education and public health has been incorporated to inform the current iteration of the GLP model. Intervention The pilot group of 25 students from U21 universities and Kathmandu University, representing six health disciplines will meet in Nepal in April 2016 for a shared learning experience, including a one week university based workshop and three week community based experience. Outcome measures A multi-phase, mixed method design was selected for the evaluation of the GLP model, utilising a combination of focus groups and questionnaires to evaluate the efficacy of the placement through student experience and learning outcomes in cultural competency, UN SDG knowledge, community engagement and health promotion skills. Results The literature review demonstrated that cultural awareness and cultural knowledge were improved through participation in cultural immersion programs that incorporated preparatory workshops and clinical experiences. Data will be gathered in April 2006 and the results of the evaluation will be published in the future. Conclusions The GLP model proposes a project around the fundamental concept of engagement and sharing between students and academics across universities and cultural contexts to build capacity through education, while capitalising on strengths of existing global health placements. Further the inclusion of host-country students and academics in this learning exchange will promote the establishment of an international and interprofessional network for ongoing health promotion. Significance for public health The Global Learning Partnership model aims to contribute to the capacity building of a health workforce that is capable of working effectively in cross cultural and interprofessional health care teams. A shared public health focused global placement has the potential to catalyse collaborative relationships between educational institutions in the Asia Pacific region.