Good Practice in Australian Physiotherapy Education

At the University of Newcastle, Occupational Therapy students participate in a largely Problem Based Learning program Physiotherapy students study under a program that includes foundation study of relevant scientific and behavioural disciplines and the study of specific physiotherapeutic management of conditions. In each area eg neurological, musculoskeletal, study includes many selected case-based discussions which develop clinical reasoning skills through use of true cases backed up by video resources.
Preparation for this joint tutorial session involved development of a scenario for a patient undergoing rehabilitation following stroke. Both groups of students worked with common derived learning goals that included exploration of pathology, impairments, assessment, goal setting and appropriate interventions related to the patient.
 
OT and PT students addressed the learning goals from their own professional perspective. Students in pairs groups developed information related to one of the learning goal areas. The lecturers ensured that all aspects of the learning goals were covered.
In the joint two hour session, 12 OT students joined with 13 PT students .They presented their topic using illustrative OHP sheets and a one page handout for five minutes and answered questions. The presentation included demonstration of assessment tools/ methods and intervention techniques where appropriate.
 
Discussion was facilitated by the lecturers, one from each discipline, to consider the decision making, the specific roles of the therapists and any differing philosophies of management. Students then considered how these roles might overlap and how best they could collaborate to manage this patient.
Later feedback from physiotherapy students suggested that they found that the session was valuable in gaining insight into the role and philosophy of the occupational therapist in the neurological area and further knowledge about stroke patient management.
 
It is planned to continue to run this tutorial and attempt to develop other joint sessions with other health professionals where appropriate. Student learning and valuing of other health professionals only occurs through first hand experience. These shared learning experiences, followed up by shared clinical experiences in later years are vital to develop co-operative graduate practice among health professionals.

Students attend a tutorial session related to the issues surrounding caring for patients with end stage disease in adults and children. This is a joint session between Cardiopulmonary and Neurological Physiotherapy courses. The focus is mainly on end stage neuromuscular and/or respiratory disease.
Physiotherapists are frequently confronted with these situations and students are generally unprepared when it comes to dealing clinically with the complexities of managing the patient with end stage / terminal disease. It was determined that a tutorial session examining the role of the physiotherapist, clinical decision making and the emotional aspects of end stage disease was necessary.
 
Students are provided in advance with short case studies of patients with end stage neurological, neuromuscular and respiratory disease. These are case studies in which the tutors have been personally involved. Questions are provided for each case study which direct the students toward exploring and reflecting on:

• The effects of end stage disease on body systems and function
• The role of the physiotherapist in treating patients with end stage disease
• Clinical decision making and clinical reasoning in treatment planning for those with end stage disease
• The effects on the patient and family of terminal / end stage disease
• Their own emotional response and concerns related to caring for such patients.
   

The tutorial session activities include general discussion and identification of the student's issues and concerns related to the physiotherapy management of patients with terminal / end stage disease. Times when students have actually come into contact with end stage patients are identified.
 
The case studies are presented and discussed. Specific physiotherapeutic management clinical reasoning, treatment plans and techniques for the patients concerned are explored. Time is then spent discussing the effect of terminal / end stage disease on the patient's family, carers and involved health care workers. Students are encouraged to reflect on their own emotional response and concerns. Practical strategies for dealing with the emotional aspects of treating patients with terminal / end stage disease are identified and discussed.

The DVD resource "Introduction to the Management of Spinal Patients" was created as part of a 4th year student elective project in conjunction with the Victorian Spinal Cord Service- Austin Hospital (VSCS). Preclinical students attend a site visit to the Service as a compulsory component of PTY31NEU, where they receive a tutorial and then perform supervised assessments of clients with spinal cord injury. A 4th year elective project was designed where a student on clinical placement at VSCS developed an educational video to precede the 3rd year students' site visit. The content of the video was reviewed both by the clinicians on site and myself prior to filming and editing to ensure that the aims and objectives of the production were compatible with the needs of the both parties and would be consistent with the content of the curriculum. This video was incorporated into the PTY31NEU curriculum in semester 1, 2004.