Survey: Physiotherapy clinicians’ perceptions of artificial intelligence in clinical practice

We know very little about how physiotherapy clinicians think about the impact of AI-based systems on clinical practice, or how these systems will influence human relationships and professional practice. As a result, we cannot prepare for the changes that are coming to clinical practice and physiotherapy education. The aim of this study is to explore how physiotherapists currently think about the potential impact of artificial intelligence on their own clinical practice.

Earlier this year I registered a project that aims to develop a better understanding of how physiotherapists think about the impact of artificial intelligence in clinical practice. Now I’m ready to move forward with the first phase of the study, which is an online survey of physiotherapy clinicians’ perceptions of AI in professional practice. The second phase will be a series of follow up interviews with survey participants who’d like to discuss the topic in more depth.

I’d like to get as many participants as possible (obviously) so would really appreciate it if you could share the link to the survey with anyone you think might be interested. There are 12 open-ended questions split into 3 sections, with a fourth section for demographic information. Participants don’t need a detailed understanding of artificial intelligence and (I think) I’ve provided enough context to make the questionnaire simple for anyone to complete in about 20 minutes.

Here is a link to the questionnaire: https://forms.gle/HWwX4v7vXyFgMSVLA.

This project has received ethics clearance from the University of the Western Cape (project number: BM/19/3/3).

Digital literacy survey: Outcome of reliability testing

Earlier this year we started the International Ethics Project, a collaboration between physiotherapy departments from several countries who intend offering an online course in professional ethics to their undergraduate students. You can read more about the project here.

In June we started the process of developing a questionnaire that we can use to establish some baseline data on students’ levels of digital literacy. It’s taken a bit longer than expected but we’ve finally managed to complete the reliability testing of the questionnaire as part of a pilot study. Before we can begin planning the module and how it will be implemented we need to get a better understanding of how our population – drawn as they are from several countries from around the world – uses digital tools in the context of their learning practices. The results of the reliability study showed that most of the survey items had Kappa values between 0.5 – 0.6 (indicating moderate agreement); 0.7 – 0.8 (indicating strong agreement); or >0.8 (indicating almost perfect agreement). See this post on the project blog for more details on how the reliability testing was conducted.

Now that we have conducted quite a rigorous piloting of the questionnaire, we hope that this questionnaire might be useful for other health professional educators who are considering the use of digital tools in their classrooms. To this end we would like to report the results of this pilot, along with some preliminary results, at the ER-WCPT conference on 11-12 November, 2016 in Liverpool. We will therefore be submitting an abstract for the conference in the coming months.

Twitter Weekly Updates for 2012-02-20

Developing case studies for holistic clinical education

This is quite a long post. Basically I’ve been trying to situate my current research into a larger curriculum development project and this post is just a reflection of my progress so far. It’s probably going to have big gaps and be unclear in sections. I’m OK with that.

Earlier this week our department had a short workshop on developing the cases that we’re going to use next year in one of our modules. We’re going to try and use cases to develop a set of skills and attitudes that are lacking in our students. These include challenges with (text in brackets are stereotypical student perspectives):

  • Problem solving and clinical reasoning (Tell me what the answer is so that I can memorise it)
  • Critical analysis (Everything I read has the same value)
  • Empathy (The patient is an object I use to develop technical skills)
  • Communication (The use of appropriate professional terminology isn’t important)
  • Groupwork (Assessment is a zero sum game…if you score more than me it bumps me down the ranking in the class, therefore I don’t help you)
  • Knowing vs Understanding (It’s more important for me to know the answer than to understand the problem)
  • Integration of knowledge into practice (What I learn in class is separate to what I do with patients)
  • Integration of knowledge from different domains (I can’t examine a patient with a respiratory problem because I’m on an orthopaedic rotation)
  • Poor understanding of the use of technology to facilitate learning (social networks are for socialising, not learning)

I know it might seem like a bit much to think that merely moving to case-based learning is going to address all of the above, but we think it’ll help to develop these areas in which the students are struggling. The results of my ongoing PhD research project will be helping in the development of this module in the following ways:

  • The survey I began with in 2009 has given us an idea of digital literacy skills of this population, as well as some of the ways in which they learn.
  • The systematic review has helped us to understand some of the benefits and challenges of a blended approach to clinical education.
  • The Delphi study (currently in the second round) has already identified many of the difficulties that our clinicians and clinical supervisors experience in terms of developing the professional and personal attributes of capable and competent students. This study will attempt to highlight teaching strategies that could help to develop the above mentioned problems.
  • I’ve also just finished developing and testing the data capture sheet that I’ll be using for a document analysis of the curriculum in order to determine alignment.
  • Later next year I’ll be conducting an evaluation of the new module, using a variety of methods.

All of the above information is being fed into the curriculum development process that we’re using to shift our teaching strategy from a top-down, didactic approach to a blended approach to teaching and learning. Development of the cases is one of the first major steps we’re taking as part of this curriculum development process. I’ll try to summarise how the cases are being developed and how they’ll be used in the module. This module is called “Applied Physiotherapy” and it’s basically where students learn about the physiotherapy management of common conditions.

In the past, these conditions were divided into systems and taught within those categories e.g. all orthopaedic conditions were covered together. The problem is that this effectively silo’s the information and students see little crossover. In fact, reality is very rarely so conveniently categorised. Patients with orthopaedic conditions may develop respiratory complications as a result of prolonged bed rest. Patients with TB often also present with peripheral neuropathy, as a result of the association of TB with HIV. So, the purpose of the cases is also to integrate different conditions to help students understand the complexity of real-world cases.

In the first term we’ll use 2 very simple cases that each run for 3 weeks. The reason that the cases are simple is that we’re also going to be introducing many new ideas that the students may have little experience with and which are important for participation in the cases e.g. computer workshops for the online environment, concept mapping, group dynamics, presentation skills, etc. The cases will increase in complexity over time as the students feel more comfortable with the process.

Each case will have an overview that highlights the main concepts, learning outcomes, teaching activities, assessment tasks and evaluation components that the case encompasses. The case will be broken up into parts, the number of which will depend on the duration and complexity of the case. After the presentation of each part, the students (in their small groups) will go through this process:

  • What do I know that will help me to solve this problem?
  • What do I think I know that I’m uncertain of?
  • What don’t I know that I need to learn more about?

These questions should help the students develop a coherent understanding of the knowledge they already have that they can build on, as well as the gaps in understanding that they need to fill before they can move on with the case. Each part will involve students allocating tasks that need to be completed before the next session and role allocation is done by each group prior to the introduction of the case. During this process, facilitators will be present within the groups in order to make sure that students have not left out important concepts e.g. precautions and contraindications of conditions.

At the next session, each member of the small groups present to each other within the small groups. The purpose of this is to consolidate what has been learned, clarify important concepts and identify how they’re going to move forward. At the end of each week each small group presents to the larger group. This gives them the opportunity to evaluate their own work in relation to the work of others, make sure that all of the major concepts are included in their case notes, as well as opportunities to learn and practice presentation skills. Students will also be expected to evaluate other groups’ work.

There will be a significant online component to the cases in the form of a social network built on WordPress and Buddypress. We will begin by providing students with appropriate sources that they can consult at each stage of the process. Over time we’ll help them develop skills in the critical analysis of sources so that they begin to identify credibility and authority and choose their own sources. They will also use the social network for collaborative groupwork, communication, and the sharing of resources.

Finally, here are some of the tasks we’re going to include as part of the cases, as well as the outcomes they’re going to measure (I’ve left out citations because this has been a long post and I’m tired, but all of these are backed by research):

  • Concept mapping – determine students’ understanding of the relationships between complex concepts
  • Poetry analysis – development of personal and professional values e.g. compassion, empathy
  • Reflective blogging – development of self-awareness, critical evaluation of their own understanding, behaviours and professional practices
  • Peer evaluation – critical analysis of own and others’ work
  • Case notes – development of documentation skills
  • Presentations – ability to choose important ideas and convey them concisely using appropriate language

This is about where we are at the moment. During the next few months we’ll refine these ideas, as well as the cases, and begin with implementation next year. During my evaluation of the module, I’ll be using the results of the student tasks listed above, as well as interviews and focus groups with students and staff. We’ll review the process in June and make changes based on the results of my, and 2 other, research projects that will be running. We want the curriculum to be responsive to student needs and so we need to build in the flexibility that this requires.

After reading through this post, I think that what I’m saying is that this forms a basic outline of how we’re defining “blended learning” for this particular module. If you’ve managed to make it this far and can see any gaping holes, I’d love to hear your suggestions on how we can improve our approach.

Twitter Weekly Updates for 2011-10-24

  • Daily Papert http://t.co/IzTvBxZk. What is the role of the teacher in society? #
  • Nudity, Pets, Babies, and Other Adventures in Synchronous Online Learning http://t.co/pRyPVvzU #
  • If you are a clinician who supervises or teaches healthcare students, please consider completing my survey at http://t.co/x1MXf3AJ #
  • The hierarchical structure of an ePortfolio http://t.co/65gIpn5Y. If your e-portfolio is structured hierarchically, you’re doing it wrong #
  • @mpascoe if they don’t perceive that the class has value, then it doesn’t, at least not for them. Forced attendance won’t change that #
  • Don’t offer students grades in return for attendance in your classes. Just be interesting #
  • @suhaifa hey Su, it was a great day to be out and about. Glad that you and @jacquesmillard could make it #

Summary of PhD progress

I’m writing this after having read Christina’s post on her thoughts on the PhD process, and following a few of her links to other PhD students who are blogging their own progress. As I’m going through a little slump at the moment, I thought it might be useful to write a short post on where I’m at right now, to review what I’ve done so far.

A few weeks ago I spent 3 days on a writing workshop with colleagues in my department who are also registered for their PhD’s (there are 4 of us), where I worked on my systematic review (see the proposal). I managed to trim the original 103 articles that I gathered during my first, second and third search rounds, to about 60. Then I went through those 60 with a more critical eye, removing what wasn’t appropriate. Finally I narrowed the list down to 20 articles that we eventually conducted independent critical reviews on, and came to consensus with my supervisor, where we finally agreed on 7 articles that matched my inclusion criteria. The article is now ready to be written up, although I’m uncertain of the format. The outcome of the systematic review will be a peer-reviewed publication that identifies some of the ways in which blended learning has been applied in clinical education, and which will inform the development of my own module (one of the later objectives).

My fourth year research group has just finished capturing the data they gathered from a survey we drew up together, where they looked at the role of social networks to facilitate reflective learning. This survey forms part of my first objective, as well as the first component of my SAFRI project (which will later include focus group interviews with staff members, and an additional survey of the students). Immediately after conducting the survey, I have also held workshops with 2 classes so far, to facilitate the process of working within the network, and will be completing workshops with the last 2 classes in the next few weeks. Tomorrow the group will submit an outline of the first few sections of a draft article, and I’ll be presenting some tentative results at the SAAHE conference next week (see the abstract).

I’ve also recently finished a first draft of an article based on a small, wiki-based project I ran in our department last year (you can still comment on it). Strictly speaking it’s unrelated to my PhD as it doesn’t fit into the proposal, but is still work in a related field. Finally, I gave a presentation on PLE’s to the Centre for Teaching and Learning at Stellenbosch University. Again, PLE’s are not explicitly addressed in my PhD proposal, but as I’m leaning more and more towards that concept as having great potential in reflective learning, I think it might ultimately end up playing an important part in the project.

Now that I look back at my progress over the past 6 months, maybe a short break is in order…?

Test-retest reliability analysis

A few thoughts on conducting test-retest reliability analysis on questionnaires, based on my own recent experiences;
– DO pay attention to your coding sheet before doing the test, it will influence your questionnaire design
– DO make sure you pilot your questionnaire for ambiguity and understanding before doing the test, it may not be essential but it is logical
– DO capture the data yourself, it will give you insight and a deeper appreciation of the process
– DO make sure you have a way to uniquely identify each questionnaire, and simple codes are better than complex ones
– DO make sure you ask participants to uniquely identify each form they complete, but make sure to preserve anonymity

– DO NOT rely on handwriting recognition to achieve the last point if you forgot to do it, it will waste your time and take you into a valley of despair
– DO NOT rush the process, you will make mistakes if you do