Archive for the ‘ physiotherapy ’ Category

Aligning curriculum with assessment

Our department is gearing up for it’s annual planning meeting, where we review the physiotherapy course from the past year and plan for the next one. This is also the year that our newly formed Directorate of Teaching and Learning has developed an institutional teaching and learning policy, with a strategic implementation plan over the next 5 years. As part of the development of a scholarship of teaching and learning at the university, all faculties and departments are now being asked to develop their own teaching and learning policies, aligned with the institutional one. I’ll be conducting a short workshop at the planning meeting, where we’ll look at the institutional departmental policy and flesh out the draft document I’ve been working on for the past week or so.

As part of my presentation, I’ll be showing an example of how we can align a simple assessment task with the departmental teaching and learning policy. Here’s my initial idea, feedback or comments are welcome.

Developing clinical reasoning and critical thinking

“Clinical reasoning is a process in which the therapist, interacting with the patient and significant others (e.g. family and other health-care team members), structures meaning, goals and health management strategies based on clinical data, client choices and professional judgment and knowledge (Higgs & Jones, 2000).

Clinical reasoning is difficult, if not impossible to “teach” (if anything is actually possible to teach [Game & Metcalfe, 2009]) but can be developed indirectly through careful course design. I’m trying to move my teaching from helping students to answer the simple Who, What, Where and When questions, to answering the more complex How and Why questions. Instead of memorising content, which is how most of my students prefer to study, I’m trying to help them see the value in developing a deeper understanding of the topic. To use the content as a framework around which we can use critical thinking to apply our understanding of theory, to practice. In other words, to develop clinical reasoning.

I’ve started to change the types of assignments I give to my students, to try and integrate some form of critical thinking. I’ve uploaded and shared the last assignment handout on Google Docs (unfortunately I only have the PDF…seem to have deleted to ODT version), and would love suggestions or feedback on the process. The feedback from students has been great and the quality of the work they produce has been of a very high standard. I’ve found that the feedback from the drafting process (a requirement of the assignment) really helps to give direction to the students, and although they are initially resistant to the idea (they want to submit work that is perfect), they see the value when they get their scripts back and have the opportunity to refine their arguments.

The research and evidence-based practice component is something that we’re trying to incorporate into all of our modules, but which currently is covered only superficially. Students don’t understand how to extract relevant information from academic publications, probably because they lack the specific academic literacies required in higher education. Once we establish that they need only identify the main conclusion of the study (this is at a second year undergraduate level), and use that conclusion to construct an argument, they manage just fine.

Game, A., & Metcalfe, A. (2009). Dialogue and team teaching. Higher Education Research & Development, 28(1), 45-57. doi: 10.1080/07294360802444354

Higgs, J. & Jones, M. (2000). Clinical reasoning in the health professions. In Clinical Reasoning in the Health Professions, 2nd edition (J. Higgs & M. Jones, eds), pg. 3-14

A national core physiotherapy curriculum

I had a great conversation with a colleague today, that stemmed from an ongoing discussion we’re having in our department about moving our practical assessments towards an OSCE-type format. We’ve been thinking about standardising on our assessments for a while but have never had dedicated time to work on it…not that we have any now, but we’ve finally realised that it’s important enough to make time. Besides, it’s something I’m particularly interested in as it ties in closely with my PhD research.

Piggy-backing on that conversation, we then started talking about the possibility of a standardised, national physiotherapy core curriculum, developed by lecturers from all departments in the country. We would look at the SAQA outcome levels, as well as HPCSA requirements for the profession, our shared teaching, learning and assessment practices, our content, and anything else related to producing graduates who are physiotherapists, as opposed to people who know about physiotherapy.

I’ve been told that some South African physiotherapy academics (and clinicians) are close-minded control freaks, jealously guarding their own little worlds, who would. But (mostly) I don’t believe that, and if they are, it’s only because the rest of us haven’t made the benefits of sharing clear.

So, a collaborative national core curriculum in physiotherapy is my pipe dream…anyone interested?

Giving students a voice in Physiotherapy Ethics

I’ve been going through some of the “Professional Ethics” assignments I received from our third year physiotherapy students, and wanted to share this one with you (with the students’ permission). It was written by Basil Buthelezi, and which I think really showcases the wonderful talents our students have, which we would never usually encounter because we focus so much energy on the clinical component of physiotherapy education.

The assignment was to explore the theme of Human rights in South African healthcare, using any media that the students wanted. So far, I’ve received a fictional newspaper front page (which I’m hoping to put up here as well), been directed to this blog, and now this poem by Basil. I wanted to share it because I think it illustrates the potential that students have to amaze us when we give them the opportunity to speak with their own voices. Here’s the poem by Basil Buthelezi…

Site of entertainment (voices personalising HIV / AIDS)

I’m all over,
From the person next to you,
In the neighbourhood and,
All four corners of the world.

They all bow for me,
From TB to Cancer,
From strokes to the paralysed,
Beautiful or ugly,
From infants to the elderly,
Rich or poor,
White or black, “colour with no discrimination”,
But all the negativities in me.

Fair enough,
I’m tired of tears and the angry faces of stranded orphans,
Hopeless,
Harmless,
Hungry,
Homeless,
Their tears have given birth to an ocean.
Yes, my throat is dry, but I can’t drink in this ocean because it’s dirty,
All infected, the attack of vampires is in full swing,
Kill them, kill them all!!
Seize the duplication.

Dollars and dollars,
I have explored their pockets and robbed their monies,
Monies buying antiretrovirals
To keep me low, yet
The dead sentence is coming.

Graves and graves,
If they were coloured red
This world will be red, red
Red for danger
Red bloody red.

The equation is shifting,
Outplaying the moments of pleasure,
Abstain to restore the equilibrium
“Be faithful” is a song of goodwill.

If not!
Pause, before you explore the site of entertainment,
Have you worn a jacket to protect you,
To protect you from hot and juicy stuff?
I know you want to be happy down there…,
But you need a license to enjoy,
Cause I’m like a vampire waiting to attack
And destroy the essence of your life.

Basil Buthelezi (2009)

An open letter to the SASP: Opening up access to the journal

Dear SASP

I’m a young(-ish) and relatively inexperienced author who lately has had a few concerns about the direction of the South African Journal of Physiotherapy (SAJP). I’m proud of the high quality research that is being conducted in the field of rehabilitation and health sciences in South Africa, and like every other academic, researcher and author, I’m trying to make a useful contribution to the field. My concern however, is that most (if not all) of the wonderful research that’s done in this country will never be seen by anyone who is not a member of the South African Society of Physiotherapy.

After thinking about some of these issues, I thought I’d take this opportunity to write to you, in the hope that you might consider some of the benefits of moving the SAJP towards an open access model of publication. I’m sure you’re aware of the disruption taking place in the publishing industry at the moment, with content creators using what are effectively free services to bypass the traditional publication process entirely. Consider the following statement:

“Scientific publishers should be terrified that some of the world’s best scientists, people at or near their research peak, people whose time is at a premium, are spending hundreds of hours each year creating original research content for their blogs, content that in many cases would be difficult or impossible to publish in a conventional journal. What we’re seeing here is a spectacular expansion in the range of the blog medium. By comparison, the journals are standing still.” Nielson, M. (2004)

The warning signs of disruption in an industry can be seen when there is a sudden proliferation of entities offering similar services that fulfill a customer’s need. With that in mind, consider that in the last few years there has been a significant increase in the number of new journals that are open access (BioMed Central, PLoS Medicine), or established journals that are moving towards an open model of publication (Pubmed Central, British Medical Journal, Physiotherapy Canada). These and many other high profile academic journals have recognised the importance of making peer-reviewed research available for everyone in the world, and taken the step towards making it a reality. They recognise that knowledge is essentially useless unless it can be accessed by anyone who wants it, and they accept their social and educational responsibility to advance new and important ideas in a world that is desperately in need of answers to desperate problems.

Opening access to scientific research is in everyone’s best interest, as the journal increases it’s readership, authors increase their citations, and anyone interested in that particular paper gets to read it. If the role of the academic journal is to register, certify, disseminate and preserve ideas, open access seems to be the most efficient way to achieve these goals. Indeed, providing the results of research to anyone with an internet connection must be the best way to make sure that the ideas published in scientific papers are original, disseminated widely and preserved. If publishers don’t seize the opportunity to benefit from a move towards openness, they may find authors increasingly self-archiving their works, leaving traditional publishers out of the loop entirely. These tools are available, free to use and provide researchers with an alternative that would see their work being spread far more widely than if it were stuck behind a paywall.

Researchers have the most to gain by the open access movement, and may soon question the usefulness of a gated system that severely limits the reach of their scientific contributions. Any author will tell you that what they want most of all is for more people to read and cite their work. With most papers essentially invisible to most researchers, how is the status quo benefiting authors? If publishers don’t begin moving towards opening up access, they may find themselves without any relevant content, as scholars establish open repositories in which to deposit the final, peer-reviewed drafts of their work. The University of the Western Cape has recently created a Research Repository, and other institutions will surely follow, perhaps making use of the Open Archive Initiative to ensure cross-institution / international compatibility. The time is approaching when authors will ask why they should pay for access to knowledge when the cost of self-publication is essentially zero (and the cost of purchasing articles is enormous)?

On the periphery of the publication problem, there are also calls for copyright law as it relates to academic publication be revised, and that this “rebellion” should be led by academics in higher education. In addition, some have argued that the entire system of scientific publication is broken, with powerful academic journals and publishers actually hindering the progress of science. In the end though, innovation will happen, with or without the participation of academic journal publishers, and opening up access to peer-reviewed research could be the first step. Creative Commons licensing provides authors and publishers with less restrictive options with which to release content, and is increasingly being embraced by the academic community.

I see this disruption of the publication industry as an opportunity for the SASP to lead the way forward as an example for other academic journals, both locally and internationally. You have the chance to be among the first to offer the collective knowledge of South African physiotherapists to the world, and play an important part in the development and upliftment of our shared communities of practice.

I hope that the ideas outlined in this letter provide enough background for you to consider opening up access to the SAJP. I look forward to your response.

Kind regards,
Michael Rowe

PS. See the following links for additional information on the topic:

Third year ethics assignment

I just wanted to send out a quick post to highlight the great work that one of my third year students has done as part of her ethics assignment.  The idea was to discuss the topic of human rights in South African healthcare using any method that the students wanted to.  I’m getting some great feedback from them, which is pretty exciting considering that students almost never want to discuss their assignments.

Here’s the link: http://laurenharwin.wordpress.com/

If you like the idea, please consider posting a comment or two on her blog, as she is trying to generate a conversation around the topic.

My CV in Wordle

As an experiment, I put my CV (which hasn’t been updated in a while) through Wordle to see what I’d get.  As you can see below, the word cloud it created isn’t reflective of my main areas of interest (i.e. technology in education).  I’m going to spend some time updating the content and then put it through Wordle again to see what the  new cloud looks like.

CV - Wordle original

International collaborative undergraduate student project

I’ve recently been invited to participate in a collaborative undergraduate physiotherapy project, hosted at Physiopaedia, for 2010. It will involve students from several countries and continents, and our students will be the only ones from a developing country, which should make for an interesting comparison of the final products at the end.

Following the conclusion of the project, participants will be surveyed and the results published. You can check out the project details here, my profile page here, and the project leader here.

Proposal presentation

In our department, we’re required to present our research proposals for comment before submission to Higher Degrees.  This allows the group to give feedback before final corrections in the hope that the proposal is accepted without having to make major revisions.

I’ve just shared my proposal presentation that I gave a few days ago on Slideshare.  The feedback I received, although mainly editorial, means that the structure of this presentation is not the same as it will be in the final submission e.g. the Method has received another step in the process.

Would love any feedback.

Results of a reflective blogging assignment in physiotherapy ethics

Earlier this year I gave my 4th year Ethics class an assignment in which they were required engage in a reflective exercise that not only encouraged interaction with others, but allowed them to see that their own perceptions of the world were different to others’.

Reflection has been shown to be a significant factor in developing clinical and ethical reasoning skills, so the initial requirement was to read two articles and then post a short reflection on each. Other students would then comment on your reflections and you would have to respond to that comment, hopefully having considered your colleagues comment. The learning objectives of the assignment were to:

  • Understand some of the ethical problems inherent in the South African healthcare system
  • Be able to discuss some types of ethical dilemmas in healthcare, even if they are not directly related to physiotherapy
  • Understand the role of reflection in your professional development, especially in the clinical and ethical reasoning process
  • Have participated in an online, networked conversation with your peers
  • Acknowledge the differing perspectives of others who may experience the world in different ways
  • Understand some of the advantages and disadvantages of using new technologies in healthcare education

I set up a WordPress blog on my own server because I wanted the students to have full control over their data (and it was surprisingly difficult to get access to a university server), created an author account for each student and then gave a tutorial on blogging and the blogging environment. The 47 students then had about a month to complete the assignment before the blog was closed to everyone.

Here are some quick stats:

  • 94 posts (2 each)
  • 222 comments (some students made more than the 3 that were required)
  • 109 tags (the main ones being MDR-TB, Apartheid and Torture)
  • 3983 pageviews (pretty impressive for 47 students)

While the initial results seem to be favorable, I have to say that anyone who assumes that all students in higher education are tech-savvy, needs to rethink that idea. One of the biggest challenges I had was trying to get students to understand what a blog is. And I don’t mean the deeper meaning of what blogging is, I mean the concept of a website that they could edit. Forget about RSS feeds and blogging software clients. The notion of digital natives does not apply here, and if the use of technology in education is going to move forward (in this country, at least), this is one major challenge that’ll have to be overcome.

You can download the content of the blogging tutorial here (2.4 MB ppt). I’ll be opening up the blog to the public once I’ve graded them, and will be presenting the results of an evaluation at the SAAHE conference in July.