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Cunningham S.1, Litwin B.2, Fernandez-Fernandez A.2, Canbek J.2
1Radford University, Department of Physical Therapy, Roanoke, United States, 2NOVA Southeastern, Physical Therapy, Fort Lauderdale, United States
Background: Residency training was a novel approach to allow physiotherapists with technical degrees access to specialty training and ongoing mentorship without a substantial change to educational infra- structure for physiotherapy education currently provided through the higher education institutions within the country of Kenya. The residency program was introduced in 2012 in cooperation with Kenya Medical Training College in Nairobi, Kenya and the Jackson Clinic Foundation in Virginia, United States of America. Since its inception, four residency cohorts have successfully completed the training receiving a Higher Diploma in Orthopaedic Manual Therapy.
Purpose: The purpose of this study was to explore the effect of residency program completion on the participants' professional development and clinical practice through a mixed methods research design.
Methods: Participants were physiotherapists graduating in the third and fourth cohorts of the residency program offered in Nairobi, Kenya (n=28). A non- experimental survey design was utilized for this study. The questionnaire was adapted from previously published outcomes of residency training in the United States. The survey was pilot tested with 15 residents in the first cohort of the program in September 2014 to ensure understanding and applicability of the questions. In addition to the survey, interviews were performed with the graduates to explore their experience in the residency program. The phenomenology approach was utilized to describe the results.
Results: To determine the value and influence of the residency on professional development, median values were determined for each of the 17 survey questions. Graduates of the residency program reported a positive influence of the residency program on the ability to perform a systematic clinical examination, use a logical clinical reasoning process, treat effectively to achieve projected outcomes, treat in a time efficient manner, determine the nature of the patient problem, diagnose complex patients, perform overall patient management, and utilize scientific literature to provide rationale for interventions. The qualitative interviews supported these findings with residents noting significant gains in clinical reasoning skills allowing them to perform a through assessment and design an individualized treatment plans for their patients. In addition, they reported a decrease in patient visits per diagnosis, improved referrals, and a change in clinical practice of colleagues as they provided education and mentoring to peers. Approximately half of the residents noted that their income and access to job promotion did not change as a result of the program.
Conclusion(s): The Kenyan residents reported similar improvements in professional development as residents in the United States in the areas of patient care and clinical outcomes. Continued exploration of outcomes is necessary as the residency program becomes more established.
Implications: Physiotherapists receiving residency education in developing countries may experience similar benefits in professional development as therapists in the United States providing additional motivation for the successful completion of a long-term education program. Furthermore, clinical outcomes improved with a decreased number of patient visits. This increase in efficiency may assist in meeting the physical therapy needs of the community in regions where the number of rehabilitation professionals are limited.
Funding acknowledgements: Not Applicable.
Topic: Education: continuing professional development
Ethics approval: Kenya Medical Training College Ethics and Research Committee, Institutional Review Board of Radford University, and NOVA Southeastern Institutional Review Board
All authors, affiliations and abstracts have been published as submitted.
