PL-LBA-2188

K. Hurtubise^1,2, I. Gaboury², M. Phoenix¹

¹McMaster University, CanChild Centre for Childhood Disability Research, School of Rehabilitation Sciences, Hamilton, Canada, ²Université de Sherbrooke, Family Medicine and Emergency Medicine, Longueil, Canada

Background: Many children globally face limited access to pediatric physiotherapy services. Lack of access leads to negative developmental and health consequences for these children and their families. Evidence exists to show the efficacy of digital practice in improving service access, and children’s outcomes, supporting its sustained use as a service delivery option. Although the pandemic drastically increased digital service use, many pediatric physiotherapists reported adopting digital practice without prior experience and lacked training. As digital service delivery requires a change in practice behaviours, appropriate evidence-informed strategies should be used.

Purpose: To explore a) the training needs and barriers encountered by pediatric physiotherapists to sustain digital practice as a service option, and b) identify and recommend appropriate strategies for future professional development activities.

Methods: This study used an exploratory design. A 30-minute survey was distributed electronically to Canadian pediatric physiotherapists (October 2021-2022) via professional networks. Survey questions were mapped to the 14 domains of the Theoretical Domain Framework, a well-known knowledge implementation framework. Thirty-eight statements were ranked using a 9-point Likert scale (where 1= “strongly disagree” and 9= “strongly agree). Descriptive statistics were used to analyze rated responses. Analyzed survey responses were reviewed in relation to the Behaviour Change Wheel, an integrated framework of behaviour change intervention functions, from which appropriate implementation strategies were selected.

Results: Seventy-three Canadian pediatric physiotherapists completed the survey; most reported using digital practice since the onset of the pandemic (74%), with no formal training (82%). Survey responses identified 5 domains of the Theoretical Domains Framework as barriers to sustainable digital practice: Environmental contexts and resources (median= 4.20), Social/Professional Role Identity (median=4.42), Knowledge (median=4.46), Behavioural Regulation (median=4.53), Intention (median=4.60), Skills (median= 4.73). These domains aligned with the Behaviour Change Wheel of intervention strategies of education (e.g., information on the child/family outcomes), training (e.g., instruction on how to perform a digital practice session, practice conducting a session, session feedback, self-monitoring) modelling (e.g., demonstration of appropriate digital practice session, focus on past successes), environmental restructuring (e.g., creating a physical environment conducive to digital practice), enablement (e.g., providing social support, problem-solving complex cases).

Conclusions: The adoption of digital practice shows promise Our study findings highlight that pediatric physiotherapists still face many barriers to sustaining digital practice post-pandemic. These barriers reach beyond those typically addressed in training initiatives (i.e., knowledge and skills). Using a systematic approach, recommendations for appropriate strategies were identified for integration into future professional development initiatives focused on this topic.

Funding acknowledgements: The first author is supported by a Canadian Health Research Post-Doctoral Fellowship Award.

Keywords:
Digital practice
Professional development
Pediatrics

Topics:
Education: continuing professional development
Paediatrics

Did this work require ethics approval? Yes

Institution: McMaster University

Committee: Hamilton Integrated Research Ethics Board

Ethics number: 14775