Integration of knowledge from musculoskeletal and cardiopulmonary physiotherapy using case studies

Developed by: Julia Coyle and Megan Smith
Charles Sturt University

Teaching and learning strategy:

In the 2nd year of the course students complete separate subjects in the core physiotherapy areas of musculoskeletal and cardiopulmonary physiotherapy. An example of the cross specialty teaching is in a practical/tutorial class scheduled towards the end of the session; classes in the two areas are combined and facilitated by teaching staff from both areas. Students are presented with two case studies and are then guided in the process of clinical reasoning about these cases. The client problems used in the case studies involve chest wall and thoracic spine pain, and thus reflect the overlap between these two areas of practice. The cardiopulmonary lecturer deliberately facilitates the case study in which the client's problems are primarily musculoskeletal in origin and the musculoskeletal lecturer facilitates reasoning in the case where the problems are primarily cardiopulmonary in origin.

The aim of the strategy is to encourage students to access and integrate knowledge from both clinical areas. The case studies are deliberately chosen to elicit students' assumptions about the different areas of physiotherapy practice. This process of shared facilitation challenges them to recognize how they may have segregated their knowledge and then challenges them to develop strategies that take a more holistic approach to patient care.

We feel that introducing this strategy at a 2nd year level influences students' learning as they develop further knowledge in core areas and prepares students for latter subjects that require more advanced integration of knowledge and reasoning, such as Complex case management.

In what course/subject/module/unit/program is the teaching and learning practice used?

Musculoskeletal and cardiopulmonary physiotherapy

In what year level are the students who participate in the teaching/learning strategy?

Year 2 undergraduate

Expected learning outcomes:

The expected learning outcomes are that students will have an increased awareness of their knowledge organization, enhanced skills in integrating knowledge from across areas of physiotherapy practice and greater ability to provide clients with holistic, patient centred care.

Aspects of the teaching and learning practice which make it particularly effective:

A key aspect of this strategy that increases the effectiveness is having the class facilitated by teaching staff from both clinical areas. It is this aspect that challenges students to look at their assumptions.

Evaluation:

This practice has been evaluated by "Harvard 1 minute techniques" where students give blinded feedback immediately the class finishes. In addition, exam questions that call upon students to use a more holistic approach form part of the theory exam. For example, the musculoskeletal exam may contain a question regarding an orthopaedic client who has coexisting respiratory or cardiac issues.

What were the outcomes of the evaluation?

Very promising. Students enjoy the classes, and recognise that they are pigeon-holing information that should inform their practice. The exam question responses show that, on the whole, students are approaching clinical decision making in a holistic way.

Do you have any plans to make changes to the teaching and learning practice?

Yes

Changes planned:

We aim to introduce cross specialty teaching between neurology and musculoskeletal.

Contact details

Name: Megan Smith
Address School of Community Health,
Charles Sturt University,
PO Box 789
Albury NSW 2640

URL: http://www.csu.edu.au/courses/ug/hea/phy/