Mann M1, Munzaines I2, Xiong M3, Whalen C4, Clark K5
1Johns Hopkins Bloomberg School of Public Health, International Health, Baltimore, United States, 2Humanity and Inclusion (Formerly Handicap International), Kigali, Rwanda, 3Health Volunteers Overseas, Washington, DC, United States, 4The Ohio Colleges of Medicine Government Resource Center, Columbus, United States, 5Boston Biopharma, Alpharetta, United States
Background: The Advancement of Rwandan Rehabilitation Services Project was a program implemented by Health Volunteers Overseas from March 2013 until May 2015. A key goal of the project was to improve the quality of rehabilitation services provided in Rwanda. Five comprehensive continuing professional development (CPD) courses were offered to practicing physiotherapists in Rwanda. The courses were on the following topics chosen by a Rwandan Steering Committee: (1) evaluation and treatment of orthopedic spinal problems, (2) therapeutic exercise for the extremities, (3) neurological rehabilitation, (4) pediatric rehabilitation, and (5) leadership development in physiotherapy. The courses ranged from 42 to 64 hours in length and a recurring theme in all of them was the understanding and use of International Classification of Functioning, Disability and Health (ICF) based clinical decision-making skills in patient management. Teaching methods included didactic classroom teaching, hands-on training, case study presentations, and clinic visits. The clinic visits allowed for mentoring in real life situations and promoted transfer of knowledge from the classroom to the clinical setting. Twenty-five months after the completion of the Pediatric Rehabilitation course a follow-up survey was sent to course participants.
Purpose: The purpose of the study was to evaluate long-term confidence in applying ICF-based clinical reasoning skills after a CPD course that included clinical mentoring.
Methods: An online 2-year post course follow-up survey was completed by 65% (N = 43) of the 66 participants who completed a 48 hour pediatric course that used ICF as a framework for teaching. All participants who turned in the survey had also completed a final evaluation on the last day of the course. Both instruments included questions about perceived confidence with carrying out ICF-based clinical decision making skills. Answers to these questions were compared and data analyzed in order to evaluate changes in confidence two years after completing the course. Participants were also questioned about the usefulness of clinical visits as a way to reinforce teaching.
Results: Six questions were asked regarding clinical decision-making. In five of those six questions, perceived confidence two years after the course remained at least 90% of what it was immediately after completing the course. In the remaining question, perceived confidence was 84% of what it was after the course. Ninety five percent of the respondents stated that clinical visits by the course instructors were helpful to them especially in integrating theory learned into practice.
Conclusion(s): The results indicate that two years after the course, participants still had high confidence in their abilities to perform skills gained in the training. This demonstrates a high degree of sustainable confidence in their mastery of lessons learned in the course. Furthermore it indicates that it is possible to build and maintain long-term capacity in clinical decision making knowledge and skills through CPD training.
Implications: The multi-modal methodology used in this CPD course can be used to assist in the design of future courses in other low resource settings. In particular, results point to clinical mentoring being key in assuring sustainability of skills and concepts learned.
Keywords: Clinical decision making, ICF, continuing professional development
Funding acknowledgements: Funding was made possible by support from the United States Agency for International Development (USAID) and Health Volunteers Overseas.
Purpose: The purpose of the study was to evaluate long-term confidence in applying ICF-based clinical reasoning skills after a CPD course that included clinical mentoring.
Methods: An online 2-year post course follow-up survey was completed by 65% (N = 43) of the 66 participants who completed a 48 hour pediatric course that used ICF as a framework for teaching. All participants who turned in the survey had also completed a final evaluation on the last day of the course. Both instruments included questions about perceived confidence with carrying out ICF-based clinical decision making skills. Answers to these questions were compared and data analyzed in order to evaluate changes in confidence two years after completing the course. Participants were also questioned about the usefulness of clinical visits as a way to reinforce teaching.
Results: Six questions were asked regarding clinical decision-making. In five of those six questions, perceived confidence two years after the course remained at least 90% of what it was immediately after completing the course. In the remaining question, perceived confidence was 84% of what it was after the course. Ninety five percent of the respondents stated that clinical visits by the course instructors were helpful to them especially in integrating theory learned into practice.
Conclusion(s): The results indicate that two years after the course, participants still had high confidence in their abilities to perform skills gained in the training. This demonstrates a high degree of sustainable confidence in their mastery of lessons learned in the course. Furthermore it indicates that it is possible to build and maintain long-term capacity in clinical decision making knowledge and skills through CPD training.
Implications: The multi-modal methodology used in this CPD course can be used to assist in the design of future courses in other low resource settings. In particular, results point to clinical mentoring being key in assuring sustainability of skills and concepts learned.
Keywords: Clinical decision making, ICF, continuing professional development
Funding acknowledgements: Funding was made possible by support from the United States Agency for International Development (USAID) and Health Volunteers Overseas.
Topic: Education; Education: methods of teaching & learning; Education: clinical
Ethics approval required: No
Institution: N/A
Ethics committee: N/A
Reason not required: IRB approval was not required because this work is a course evaluation, assessing long-term capacity building achieved after attendance in a continuing professional development course that utilized multi-modal teaching techniques.
All authors, affiliations and abstracts have been published as submitted.
