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Diabetic foot ulcers (DFUs) impact a substantial proportion of patients with diabetes, with high recurrence rates, severe complications, and significant financial burden to health care systems. Adherence to treatment advice (e.g., limiting weight-bearing activity) is low with patients reporting dissatisfaction with the way in which advice is communicated. This study aimed to address this problem via the systematic development of a motivation communication training program. The program was designed to support diabetes-specialist podiatrists in empowering patients to actively engage with treatment. The development process followed an intervention mapping approach. Needs assessment involved observations of 24 patient-practitioner consultations within a diabetes-specialist foot clinic. This informed specification of a theory of change (self-determination theory) and relevant evidence-based communication strategies (drawing from motivational interviewing). The training program was developed iteratively with changes made following feedback from five diabetic foot health care professionals. The resulting training program, consisting of six one-hour face-to-face sessions over an 8-week period, was delivered to a further six diabetes specialist podiatrists, with five participating in post-program telephone interviews to assess acceptability. Deductive thematic analysis of interview data revealed positive aspects of the training (e.g., valuable and relevant content), ideas for improvement (e.g., online resources and context-specific video examples), the acceptability of motivation strategies, and challenges putting the strategies into practice (such as time constraints and breaking old communication habits). This study contributes to our understanding of integrating motivation principles into routine consultations and holds potential for enhancing adherence to treatment recommendations in patients living with diabetic foot ulcers.

Nursing faculty with expertise in community health are well poised to introduce nursing students to the rewarding experience of caring for vulnerable populations. Multiple partnerships have been established over the years within the central Connecticut region that have benefited both the university's nursing students and the affiliated agency, as well as the individuals served. Utilizing knowledge related to the common health issues faced by the homeless population, faculty worked with community partners to discuss needs and create a plan involving nursing students, which specifically focused on vision and foot health.

Nowadays, the problem of prevention and correction of various diseases in preschool children has become particularly relevant. This is due, first of all, the presence of a large number of preschoolers (84.9%) with different deviations in the state of health and with pathologies in the development of the musculoskeletal system in particular. The problem of studying the psychological characteristics of preschool children with orthopedic diseases seems to be quite relevant, although in contemporary scientific literature this issue has not been adequately reflected. The aim of the research is to identify the psychological characteristics of children of preschool age with a diagnosis of "flat feet" with the help of projective methods. The study was conducted among pupils of preschool educational institutions in Moscow, who are diagnosed with "flat feet" and conditionally healthy children (SWAD, WAD). The average age of the subjects was 6 years. As a result of the research, it has been found that children with a diagnosis of "flat feet", already in preschool age have certain changes in the emotional sphere, especially an increased level of anxiety and fear.

Peer mentoring schemes are increasingly visible within professional practice, and in recent years, universities have integrated mentoring across undergraduate programmes. In order to provide the appropriate support to peer mentors and contribute to the future development and success of peer-mentoring schemes, it is necessary to investigate not only the benefits afforded to mentees, but also peer mentors' perceptions of their experiences. This small-scale qualitative study was conducted with participants who were recruited from the peer-mentoring scheme across two professional undergraduate health programmes: Podiatry and Sports Therapy. Semi-structured interviews were used to explore the early experiences and expectations of being a mentor, mentorship activities, reasons and personal narratives for becoming a mentor, and the effectiveness of the training they received. Findings suggest that constructive and destructive friction exist between how mentors perceive their mentorship role and the strategies and skills they develop and use during their mentorship experiences. The study concludes with recommendations for new mentors and implementation of mentorship schemes within the widening population context of higher education.

Peer mentoring schemes are increasingly visible within professional practice, and in recent years, universities have integrated mentoring across undergraduate programmes. In order to provide the appropriate support to peer mentors and contribute to the future development and success of peer-mentoring schemes, it is necessary to investigate not only the benefits afforded to mentees, but also peer mentors' perceptions of their experiences. This small-scale qualitative study was conducted with participants who were recruited from the peer-mentoring scheme across two professional undergraduate health programmes: Podiatry and Sports Therapy. Semi-structured interviews were used to explore the early experiences and expectations of being a mentor, mentorship activities, reasons and personal narratives for becoming a mentor, and the effectiveness of the training they received. Findings suggest that constructive and destructive friction exist between how mentors perceive their mentorship role and the strategies and skills they develop and use during their mentorship experiences. The study concludes with recommendations for new mentors and implementation of mentorship schemes within the widening population context of higher education.

Background: Foot problems have been reported to be a very common health issue in adults with intellectual disabilities; foot problems in children and young people are, however, poorly understood. The aim of this study was to explore foot care needs of children and young people with intellectual and developmental disability. Methods: An exploratory, cross-sectional online survey was undertaken across a four-month period. A purposive snowball sampling approach was adopted. The survey tool was piloted before launch and comprised three sections. The first section elicited information relating to parent/caregiver status, diagnosis, secondary diagnoses and age of child/young person. The second domain explored foot care and sought to obtain information about foot problems, access to health services and existing knowledge about foot health. The third domain focussed on footwear. Ethical approval was granted from the host institution, and all participants provided electronic consent before completing the survey. Results: Data were collected from 49 parents/parental caregivers reporting on behalf of their children (mean age 7 years of age; SD 4.5 years of age). Parents reported foot problems to be very common (75%), and pes planus was the most frequent concern (51%). Twenty-four parents reported difficulties with finding shoes (48%). A mismatch between foot shape and the shoe (30%) or complications with orthotic devices (14%) within the shoe were highlighted. Conclusion: The results demonstrated that the burden of foot problems in children and young people with intellectual and developmental disabilities is considerable. The findings highlight the importance of access to foot care services for these children.

Purpose: Higher education institutions have a significant impact in preparing future generations for the creation of a sustainable society. By formulating appropriate curricula, the university can shape student personality with sustainability concerns. This study aims to present the results of a teaching approach on environmental sustainability using the photovoice methodology. A guided visit to the sewage treatment plant of A Coruña was included as a teaching activity in the "Microbiology and Parasitology" classes of the podiatry degree at University of A Coruña. The teaching objectives were to reinforce contents through observation and to introduce citizen awareness on sustainability and responsible water use in a cross-sectional manner. Design/methodology/approach: In this case study, different steps of photovoice as a qualitative participatory action methodology were developed. A total of 43 university students willingly participated with their photographs. Qualitative data were collected from the students' photovoice visit reports and a subsequent discussion group. Thematic content analysis was performed manually. Findings: This study explored the impact of an environmental sustainability teaching activity on the university student community. Six main categories emerged from the qualitative analysis: savings/waste of water, misuse of the water closet, disposing of used oil, solid waste/trash, reuse of clean water and reuse/reduction of the use of plastics. The cross-sectional findings on the needs of education and awareness of sustainability in the community and companies are presented. Originality/value: The findings provide evidence of the ability of photovoice method as a pedagogical tool to promote reflection and change in the university community and to introduce sustainability cross-sectional content in green campus curricula. This photovoice experiment is simple and feasible to implement and has a very low economic cost, as long as there are qualified educators.

A variety of medical simulators have been developed over recent years for students of all medical professions. These simulators serve to teach basic science concepts, advanced clinical skills, as well as empathy and student confidence. This study aimed to understand the students' perception of the integration of high-fidelity simulation exercises into the teaching of human physiology. Research groups were made up of both osteopathic and podiatric medical students. Data were obtained using a Likert-scale survey. Results indicated that students believed the simulation experiences were beneficial to further understanding of physiological concepts, as well as seeing these concepts in a clinical setting. Variations were noted between podiatric and osteopathic medical students' perception on how the experiences helped them develop clinical and personal confidence, and if the experience helped illustrate correlations between laboratory values and accompanying physiology. Results illustrated no differences in perception between the sexes. Although all students agreed that the experience helped with the understanding of physiology, podiatric medical students did not necessarily find value in the simulation for their development as future clinicians. We predict that differences in perception are largely based on the different curriculums of the students questioned. The present study indicated that incorporation of simulation experiences in the first year of medical school enhanced learning basic science physiology concepts and promoted the development of self-confidence as future clinicians. Incorporating simulation into the didactic coursework should be promoted in other medical schools' curricula.

Purpose: Situated and experiential learning methodologies are largely underresearched in relation to student experience and satisfaction. The purpose of this paper is to illuminate the perspectives of students studying on a BSc (Hons) Podiatry degree programme to establish perceptions of their experience in practice. Design/methodology/approach: Using an interpretivist methodological framework, Free Association Narrative Interviewing was used to provide an insight into the perceived impact that experiential learning in clinical placements had on undergraduate podiatry students. Findings: Students perceived that what could not be taught but what could be experienced, contributed much to the confidence that students had gained during their training and which they anticipated would be further developed during the initial years of their training in practice, particularly in the context of the NHS. Research limitations/implications: This is a study from which it is acknowledged that within the underpinning research design and methodology there is no scope for generalisability. Practical implications: The study highlights an appreciation for the implication and recognition of "tacit" knowledge, currently recognised in medical curricula as an asset which can aid a move towards higher order critical thinking skills. Social implications: Student acknowledgement of the need for emphasis on "soft skills" can be posited, in the context of this small-scale study as an appreciation for affective domain learning in the context of podiatric academic and clinical curricula. Originality/value: Limited information from the extant literature is available in relation to the illumination of podiatry student placement experiences, so this research contributes to an effectively underresearched field.

Historically, mixed arrangements have been in place between educational institutions and podiatrist registration bodies to evaluate the capacity of courses to adequately prepare new graduates for clinical practice. The national scheme for the registration of health practitioners introduced in 2010, followed by a national system for accreditation of respective courses, has however seen significant legislative and policy change to requirements for evidencing effectiveness of podiatry courses. In addition, there has been a local and international change in emphasis by stakeholders in higher education, government, professional regulation, quality assurance and employment, towards measureable, explicit student learning outcomes. Curricula initiatives at La Trobe University, including large scale systematic review and redesign of all courses commencing in 2005 within the Faculty of Health Sciences, and a subsequent university wide 'Design for Learning' project (La Trobe University, 2009), provided a timely platform for podiatry staff to respond to critical emerging imperatives for increased program transparency and accountability.

The first four levels of Bloom's taxonomy were used to create quiz questions designed to assess student learning of the gross anatomy, histology, and physiology of the gastrointestinal (GI) system. Information on GI histology and physiology was presented to separate samples of medical, dental, and podiatry students in computer based tutorials where the information from the two disciplines was presented either separately or in an integrated fashion. All students were taught GI gross anatomy prior to this study by course faculty as part of the required curriculum of their respective program. Student responses to the quiz questions were analyzed to assess both the validity of Bloom's cumulative hierarchy and the effectiveness of an integrated curriculum. No statistically significant differences were found between quiz scores from students who received the integrated tutorial and from those who received the separate tutorials. Multiple regression analyses provided partial support for a cumulative hierarchy where scores on the lower levels of Bloom's taxonomy predicted scores on higher levels. Notably, in the majority of regression analyses, the comprehension score was the key foundational predictor for application and analysis scores. This study supports the suggestion that educators increase the number of comprehension level questions, even at the expense of knowledge level questions, in course assessments both to evaluate lower order cognitive skills and also as a predictor of success on questions requiring application and analysis levels of the higher order cognitive skills of Bloom's taxonomy.

This paper draws on the experiences of students from two vastly different disciplines to both explore the theoretical background supporting the use of multimedia resources to teach practical skills and provide a qualitative evaluation of student perceptions and experiences of using bespoke resources. Within ceramics and podiatry, practical skills are traditionally taught via an apprenticeship model within small groups. We explore the practical and pedagogic benefits of developing bespoke multimedia resources to teach practical skills, identifying common themes from these disparate discipline areas. Student focus groups revealed that, practically, the opportunity for repeated viewing at convenient times promoted less reliance on lecturers and better preparation prior to practical demonstrations. Pedagogically, time for reflection and sense making underpinned an increase in confidence which in turn led to increased creativity. The student voice was also used to identify recommendations and challenges driving future change.

Objective: Little research exists on diabetes self-care management (DSCM) in Arab populations. We examined the contribution of health belief constructs, socioeconomic position (SEP) and clinical factors (glycated haemoglobin [HbA1C] level, type of diabetes treatments, and receiving professional guidance) to DSCM among Arab patients in East Jerusalem with type 2 diabetes. Method: Using a structured questionnaire, we conducted face-to-face interviews with a random sample of 230 patients with type 2 diabetes in a large diabetes clinic. DSCM included engagement in any of the following in the last week: physical activity, consumption of low-fat and low-sugar diet, self-monitoring of blood glucose, medication uptake and foot care. We obtained HbA1C levels from the clinic's patient registry. We used linear regression to examine the contribution of health beliefs, SEP and clinical factors to explaining DSCM. Results: Adherence to DSCM was low. Most patients (84.8%) were physically inactive, 64.3% did not consume a low-fat or low-sugar diet (46.5%) and 51% did not self-monitor blood glucose. However, medication adherence (95.7%) and foot care were high (77.4%). About 71% of participants had high HbA1C (>7.0%). In the multivariate analysis, total DSCM scores were higher among patients with low financial barriers, high perception of the benefits of DSCM and higher self-efficacy. Patients using oral medication (vs insulin) had significantly lower DSCM scores. Conclusion: Among Arab patients with diabetes, more interventions are needed to encourage DSCM, specifically in areas of lifestyle (diet and physical activity). Patients' financial barriers, benefits of DSCM and patient self-efficacy should be emphasised.

The benefits of mentoring in the health sector have received a great deal of attention from health management researchers. Much of this research has concentrated on doctors and nurses at pre-qualification or early career stages in their professional lives working in large organizations. Little attention has been paid to the needs of podiatrists who are often employed in multiple part time or casual roles in public sector clinics or private practices. Many podiatrists rely on a professional association to provide a mentor and continuing professional development. This study uses semi-structured interviews with mentors and mentees and template analysis, to explore three dimensions of mentoring; career, psychosocial and clinical, of podiatrists who are members of a professional association. The implications for practice, theory and further research on podiatrists and other allied health professions are discussed.

There is a need for an assessment tool for evaluating the effectiveness of active learning strategies such as problem-based learning in promoting deep learning and clinical reasoning skills within the dual environments of didactic and clinical settings in health professions education. The Active Learning in Health Professions Scale (ALPHS) instrument captures three elements of active learning: activities that have elements of novel access to information, observing or participating in experiences focused on learning, and reflective practices about the learning process. In order to assess the criterion-related validity of the ALHPS, a Structural Regression Model was created in which the latent variable of Active Learning was placed as a predictor of graduating seniors' critical thinking. The strong psychometric properties of the ALHPS instrument indicate that it is possible to reliably assess students' perceptions of the frequency with which they experience active learning pedagogy within doctoral health professions education, and that such strategies are predictive directly of academic engagement and indirectly of increases in students' critical thinking skills.

Clinical educators play an important role in the development of clinical skills during health care undergraduates' practice placements. The supportiveness of the learning environment and the attitude of the clinical educator towards student development are considered to be important factors that impact upon practice placement experience, although these influences are multi-factorial. This pilot study is the first phase of an action research project exploring practice placements in podiatry. The aim of this pilot study is to develop a scale to measure podiatrists' capacity to engage in clinical education using criteria considered to contribute to overall clinical educator capability. An online survey consisting of 74 questions was developed and clinical educators from the podiatry services of 25 English National Health Service (NHS) Trusts were targeted. There was a 66 per cent response rate to the survey. Item-total correlations were calculated and nine subscales identified, all with Cronbach's alpha coefficients above 0.7. The scale can be used to explore the factors that influence podiatrists' capacity to engage with clinical education. It may also be utilised in the recognition and prediction of other potential variables that influence clinical educators' capacity to undertake the role. This may therefore be used to identify support and training requirements. The scale could be adapted for application to other health care professions.

There is a need to maximise rural clinical fieldwork placement to build health workforce capacity. This study investigated allied health professionals' (AHPs) experience of supervising students as part of work-integrated learning in public and private rural health settings. An anonymous postal questionnaire with 30 questions was used to collect quantitative and qualitative data about the barriers and enablers that AHPs encounter when supervising students in their clinical setting. A total of 113 public and private AHPs from Southwest Victoria, Australia, returned the questionnaire. The AHPs were trained in the disciplines of occupational therapy, physiotherapy, speech pathology, dietetics, podiatry or psychology. The majority of respondents (75%) had previously supervised students. Most respondents had only provided fieldwork education in the public sector. Allied health professionals working in public and private sectors had positive experiences with clinical fieldwork education and often had increased job satisfaction while supervising students. They experienced similar enablers to involvement in clinical fieldwork education programs, however the barriers they encountered were different. The findings highlight the differing issues between rural public and private settings that need to be addressed for successful clinical fieldwork education and work-integrated learning. Strategies to address the identified barriers need to be specific to the work conditions of each setting. (Contains 7 tables, 5 figures, and 1 note.)

Although there has been growing interest in problem-based learning (PBL) by professional entry-level therapy educators, its effectiveness is as yet unclear. Existing overviews of the field do not provide high-quality evidence in terms of the effectiveness or otherwise of PBL in professional therapy education. The purposes of this article is to systematically review the current literature on PBL and determine its effectiveness when compared to other didactic approaches in physiotherapy, occupational therapy, speech-language therapy, dietetics, podiatry, orthoptics, and therapeutic radiography entry-level education. Eight databases were searched for controlled evaluation studies investigating the effectiveness of PBL in the seven therapy professions. Four competencies were analyzed: students' knowledge, performance, approaches to learning, and satisfaction. Data were extracted and risk of bias assessed by independent reviewers. One scoring system was used to assess the quality of the studies and another to determine the level of evidence for each competency. The search yielded 3885 articles, of which six met the inclusion criteria after full-text review; three in physiotherapy and one each in occupational therapy, dietetics, and podiatry. Three of the six studies were categorized as high quality. No study measured all four competencies. When compared to other didactic approaches, there is no evidence that PBL has a more positive effect on students' knowledge, performance, and satisfaction levels and limited evidence that it improves students' approaches to learning. Currently available literature revealed no convincing evidence that PBL is more effective than traditional didactic education for entry-level therapy professions.

Medical education in the United States and Canada continues to evolve. However, many of the changes in pedagogy are being made without appropriate evaluation. Here, we attempt to evaluate the effectiveness of lecture capture technology as a learning tool in Podiatric medical education. In this pilot project, student performance in an inaugural lecture capture-supported biochemistry course was compared to that in the previous academic year. To examine the impact of online lecture podcasts on student performance a within-subjects design was implemented, a two way ANCOVA with repeated measures. The use of lecture capture-supported pedagogy resulted in significantly higher student test scores, than achieved historically using traditional pedagogy. The overall course performance using this lecture capture-supported pedagogy was almost 6% higher than in the previous year. Non-native English language speakers benefitted more significantly from the lecture capture-supported pedagogy than native English language speakers, since their performance improved by 10.0 points. Given that underrepresented minority (URM) students, whose native language is not English, makes up a growing proportion of medical school matriculates, these observations support the use of lecture capture technology in other courses. Furthermore, this technology may also be used as part of an academic enrichment plan to improve performance on the American Podiatric Medical Licensing Examination, reduce the attrition of URM students and potentially address the predicted minority physician shortage in 2020. (Contains 1 figure and 3 tables.)

Students enrolled in the Optometry program at the University of Manchester are required to take a functional anatomy course during the first year of their studies. Low mean scores in the written examination of this unit for the past two academic years energized staff to rethink the teaching format. Interactive sessions lasting 20 minutes each were introduced during the two hour lecture sessions. In these sessions students reinforced their anatomical knowledge learned in lectures, through playing games such as anatomy bingo and solving anatomical anagrams. In addition, five e-learning modules were also introduced for students to complete in their own time. A pre- and postcourse questionnaire were distributed to obtain student views on their expectations of the course and interactive sessions. Comparisons were made between written examination results from 2008 to 2009 to written examination results from the previous five academic years to see if the interactive sessions and e-learning modules had any impact on student knowledge. In addition, comparisons were made between student performances on the functional anatomy course with their performance in all of the other assessments taken by the students during their first year of study. Analysis of the questionnaires showed that student's expectations of the course were fulfilled and the interactive sessions were well received by the majority. There was a significant increase (P less than or equal to 0.01) in the mean examination score in 2008-2009 after introduction of the interactive sessions and e-learning modules compared with scores in previous years. The introduction of interactive sessions has increased student enjoyment of the module and along with the e-learning modules have had a positive impact on student examination results. (Contains 2 tables and 4 figures.)

An educational program on geriatric foot care was completed by 59 nurse practitioners, 12 physicians' assistants, and 1 physician. The 3 1/2 day program included interactive sessions, observation, and hands-on patient care. Posttest results and 6-month follow-up showed significant knowledge increases and incorporation of learning into practice. (SK)