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Objectives:The opportunity for student self-reflection and the accuracy of that reflection are critical to the acquisition of professional competencies. The relationship between student–clinician agreement and clinical performance in physiotherapy students has not yet been investigated. The aim was to determine whether a simple measure of student–clinician agreement assessed midway during a clinical placement predicts final placement score.Participants:100 undergraduate Monash University Bachelors of Physiotherapy students and their clinical educators.Main outcome measures:Assessment of Physiotherapy Practice (APP).Method:Clinician and student ratings of student performance across all clinical placements from January 2012–June 2013 at two time-points (midway and final) were entered into a purpose-built, web-based platform, and then averaged across the number of placements undertaken. The relationship between midway student–clinician agreement (student minus clinician APP score) and final APP score (determined by the clinician) was analyzed via forward regression. Sub-group comparisons were performed investigating the stability of the relationship across placements.Results:On average, midway agreement was associated with a −0.50 (95% CI −0.67 to −0.33) unit decrease in final placement APP% score. This model was highly statistically significant (p< 0.001) but only explained 24% of the total variance (based on the adjustedr-squared statistic). This relationship was similar in early and late placements.Conclusions:Student–clinician agreement is related to clinical performance. A midway evaluation may provide an important opportunity to identify students “at risk” of poor clinical outcomes enabling timely implementation of support strategies. Further work is required to improve the predictive accuracy of the proposed model. [ABSTRACT FROM AUTHOR]

The article reports on research which was conducted to investigate whether wearing compression socks for 48 hours after marathon running improved functional recovery in runners. Researchers evaluated 33 runners after marathons. They found that the compression socks had a beneficial effect on recovery after marathons.

Background: Exercise is an effective intervention for the prevention of falls; however, some forms of exercises have been shown to be more effective than others. There is a need to identify effective and efficient methods for training health professionals in exercise prescription for falls prevention. Objective: The objective of our study was to compare two approaches for training clinicians in prescribing exercise to prevent falls. Methods: This study was a head-to-head randomized trial design. Participants were physiotherapists, occupational therapists, nurses, and exercise physiologists working in Victoria, Australia. Participants randomly assigned to one group received face-to-face traditional education using a 1-day seminar format with additional video and written support material. The other participants received Web-based delivery of the equivalent educational material over a 4-week period with remote tutor facilitation. Outcomes were measured across levels 1 to 3 of Kirkpatrick's hierarchy of educational outcomes, including attendance, adherence, satisfaction, knowledge, and self-reported change in practice. Results: Of the 166 participants initially recruited, there was gradual attrition from randomization to participation in the trial (n = 67 Web-based, n = 68 face-to-face), to completion of the educational content (n = 44 Web-based, n = 50 face-to-face), to completion of the posteducation examinations (n = 43 Web-based, n = 49 face-to-face). Participant satisfaction was not significantly different between the intervention groups: mean (SD) satisfaction with content and relevance of course material was 25.73 (5.14) in the Web-based and 26.11 (5.41) in the face-to-face group; linear regression P = .75; and mean (SD) satisfaction with course facilitation and support was 11.61 (2.00) in the Web-based and 12.08 (1.54) in the face-to-face group; linear regression P = .25. Knowledge test results were comparable between the Web-based and face-to-face groups: median (interquartile range [IQR]) for the Web-based group was 90.00 (70.89-90.67) and for the face-to-face group was 80.56 (70.67-90.00); rank sum P = .07. The median (IQR) scores for the exercise assignment were also comparable: Web-based, 78.6 (68.5-85.1), and face-to-face, 78.6 (70.8-86.9); rank sum P = .61. No significant difference was identified in Kirkpatrick's hierarchy domain change in practice: mean (SD) Web-based, 21.75 (4.40), and face-to-face, 21.88 (3.24); linear regression P = .89. Conclusion: Web-based and face-to-face approaches to the delivery of education to clinicians on the subject of exercise prescription for falls prevention produced equivalent results in all of the outcome domains. Practical considerations should arguably drive choice of delivery method, which may favor Web-based provision for its ability to overcome access issues for health professionals in regional and remote settings. Trial Registration: Australian New Zealand Clinical Trials Registry number: ACTRN12610000135011; http://www.anzctr.org.au/ACTRN12610000135011.aspx (Archived by WebCite at http://www.webcitation.org/63MicDjPV) [ABSTRACT FROM AUTHOR]

Introduction: Cost studies are increasingly popular given resource constraints. While scholars stress the context-dependent nature of cost, and the importance of theory, cost studies remain context-blind and atheoretical. However, realist economic evaluation (REE) privileges context and the testing/refinement of economic programme theory. This preliminary REE serves to test and refine economic programme theory for supervision training programmes of different durations to better inform future programme design/implementation., Methods: Our preliminary REE unpacked how short (half-day) and extended (12 week) supervision training programmes in Victoria, Australia, produced costs and outcomes. We employed mixed methods: qualitative realist and quantitative cost methods. Economically optimised programme models were developed guided by identified cost-sensitive mechanisms and contexts., Results: As part of identified context-mechanism-outcome configurations (CMOCs) for both training programmes, we found a wider diversity of positive outcomes but greater costs for the extended programme (11 outcomes; AU$3069/learner) compared with the short programme (7 outcomes; $385/learner). We identified four shared cost-sensitive mechanisms for both programmes (training duration, learner protected time, learner engagement, and facilitator competence) and one shared cost-sensitive context (learners' supervisory experience). We developed two economically optimised programme models: (1) short programme for experienced supervisors facilitated by senior educators ($406/learner); and (2) extended programme for inexperienced supervisors facilitated by junior educators ($2104/learner)., Discussion: Our initial economic programme theory was somewhat supported, refuted and refined. Results were partly consistent with previous research, but also extended it through unpacking cost-sensitive mechanisms and contexts. Although our preliminary REE fills a pressing gap in the methodology literature, conducting REE was challenging given our desire to integrate economic and realist analyses fully, and remain faithful to realist principles. Attention to training duration and experience levels of the facilitator-learner dyad may help to balance the cost and outcomes of training programmes., (© 2021 Association for the Study of Medical Education and John Wiley & Sons Ltd.)

Students on clinical placement may encounter practice that deviates from what they perceive to be evidence-based. However, queries by students about the evidence-base of their clinical educators decision-making and practice can be a challenging conversation to initiate. It is unclear how these conversations occur, and what impact engaging in these challenging conversations may have on practice, the learning experience, and the relationship with the educator. This study sought to explore clinical educators' experiences of student-initiated discussions that question the evidence-base of their clinical practice. And to identify their preferred approaches for students to initiate these conversations. Individual interviews were conducted with 23 clinical educators from five professions at three different hospitals in Victoria, Australia. Semi-structured interviewing techniques were employed to identify participants' context and experiences. Participants described student-initiated conversations about deviations from evidence-based practice as challenging encounters with potential for positive or negative impact on clinical educators, students and patients. They noted that the perceived appropriateness of the discussion could be influenced by the method utilised by students to initiate the conversation. Elements identified by clinical educators as barriers or enablers to support students to appropriately initiate conversations about clinical practice may be utilised by education and health providers to enhance opportunities for learning conversations to occur., (Copyright © 2021 Elsevier Ltd. All rights reserved.)

In health professional education, reflective practice is seen as a potential means for self-improvement from everyday clinical encounters. This study aims to examine the level of student honesty in critical reflection, and barriers and facilitators for students engaging in honest reflection. Third year physiotherapy students, completing summative reflective essays on clinical encounters using the modified Gibbs cycle, were invited to participate in an anonymous online survey. Student knowledge and beliefs about reflective practice, and disclosure of the truthfulness of their reflections, were assessed using a mixed method approach. A total of 34 students, from a maximum possible of 48 (71 %), participated in the study activities. A total of 68 % stated that they were at least 80 % truthful about their experiences. There was general student consensus that reflective practice was important for their growth as a clinician. Students questioned the belief that the reflection needed to be based on a factual experience. Reflective practice can be a valuable addition to the clinical education of health care professionals, although this value can be diminished through dishonest reflections if it is not carefully implemented. Student influences on honest reflection include; (1) the design of any assessment criteria, and (2) student knowledge and competency in applying critical reflection.

Emerging technologies and student information technology literacy are enabling new methods of teaching and learning for clinical skill performance. Facilitating experiential practice and reflection on performance through student self-video, and exposure to peer benchmarks, may promote greater levels of skill competency. This study examines the impact of student self-video on the attainment of clinical skills. A total of 60 Physiotherapy students (100%) consented to participate in the randomised controlled trial. One group (50%) was taught a complex clinical skill with regular practical tutoring, whilst the other group (50%) supplemented the tutoring with a self-video task aimed at promoting reflection on performance. Student skill performance was measured in an objective structured clinical examination (OSCE). Students also completed an anonymous questionnaire, which explored their perception of their learning experiences. Students received significantly higher scores in the OSCE when the examined clinical skill had been supplemented with a self-video of performance task (P = 0.048). Descriptive analysis of the questionnaires relating to student perceptions on the teaching methods identified that the self-video of performance task utilised contributed to improvement in their clinical performance and their confidence for future clinical practice. Students identified a number of aspects of the submission process that contributed to this perception of educational value. The novel results of this study demonstrate that greater clinical skill competency is achieved when traditional tutoring methods are supplemented with student self-video of performance tasks. Additional benefits included the ability of staff and students to monitor longitudinal performance, and an increase in feedback opportunities.

Effective education of practical skills can alter clinician behaviour, positively influence patient outcomes, and reduce the risk of patient harm. This study compares the efficacy of two innovative practical skill teaching methods, against a traditional teaching method. Year three pre-clinical physiotherapy students consented to participate in a randomised controlled trial, with concealed allocation and blinded participants and outcome assessment. Each of the three randomly allocated groups were exposed to a different practical skills teaching method (traditional, pre-recorded video tutorial or student self-video) for two specific practical skills during the semester. Clinical performance was assessed using an objective structured clinical examination (OSCE). The students were also administered a questionnaire to gain the participants level of satisfaction with the teaching method, and their perceptions of the teaching methods educational value. There were no significant differences in clinical performance between the three practical skill teaching methods as measured in the OSCE, or for student ratings of satisfaction. A significant difference existed between the methods for the student ratings of perceived educational value, with the teaching approaches of pre-recorded video tutorial and student self-video being rated higher than 'traditional' live tutoring. Alternative teaching methods to traditional live tutoring can produce equivalent learning outcomes when applied to the practical skill development of undergraduate health professional students. The use of alternative practical skill teaching methods may allow for greater flexibility for both staff and infrastructure resource allocation.

This pilot study explored the feasibility of and user satisfaction with an Internet User's Guide (IUG) to assist patients in sourcing relevant, valid information about osteoarthritis on the Internet. Twelve people with osteoarthritis participated in focus groups that involved searching the Internet for information relating to their condition with the aid of the IUG. Participants were asked to perform an initial search of the Internet for information on osteoarthritis, followed by a second search with the aid of the IUG. User satisfaction with the IUG and subsequent online searches was obtained during and following the Internet simulations. A total of 92% of all participants had previously used the Internet to search for health information in the past. However, only a third used the Internet to further source information on their condition. Prior to using the IUG, participants cited efficiently searching the Internet for relevant and credible information as the primary obstacle in their continued use of the Internet. All participants reported that the use of the IUG increased their ability to source quality online medical information. The provision of an IUG may support and increase user awareness about searching for relevant, quality medical information on the Internet. Further quantitative and qualitative research is required to identify how best to empower consumers who wish to use the Internet as a medical resource.