Introduction:Severe brain injuries can leave people in prolonged disorder of consciousness resulting in multifaceted medical, nursing, and rehabilitative needs that can be challenging for even the most experienced multidisciplinary team. The complexities of care, communication with families, and best interest decision-making about medical interventions means there is a need for ongoing training in clinical, social, ethical, and legal aspects.Methods:Using a combination of group discussions, interviews, and questionnaires with learners, this article reports an evaluation of designing and delivering an interprofessional, online work-based course to health care professionals caring for prolonged disorder of consciousness patients.Results:There were challenges for staff uptake because of COVID-19, but engaging with it increased knowledge in defining and diagnosing patients' conditions, understanding multidisciplinary team roles, communicating with families, and navigating legal and ethical issues. Course participation also enhanced critical and reflective thinking skills, provided a sense of connection to other professionals, and generated plans to improve service provision.Discussion:Online learning that enables health care professionals to engage at their own pace and also come together as an interprofessional community can provide invaluable continuing professional development and help to enhance joined up, holistic patient care. However, achieving this requires significant investment in creating research-led, multimedia, learning materials, and courses that include synchronous and asynchronous delivery to combine flexible study with the opportunity for peer networks to form. It also depends on a commitment from organizations to support staff online continuing professional development.
Background Rates of mortality following critical illness are continually improving. With this comes an increasing need to focus on these patients outcomes following dis- charge from the intensive care unit (ICU). Historically, bed rest was prescribed for these patients. However, in recent years research recognised the adverse effects of prolonged immobility on multiple body systems, particularly its potential impact upon longer- term quality of life. In 2009, the National Institute of Clinical Excellence (NICE) recognised the potential clinical and economical gains associated with early physical rehabilitation. Evidence-based guidelines have been published to recommend rehabilitation starts as early as clinically possible. However, currently there is significant variation in the provision of rehabilitation across ICU sites. Opportunities are available for Cardiff University BSc Physiotherapy students to undertake clinical placement within the ICU setting, presenting a unique opportunity to explore the experiences of those students during the rehabilitation of critically ill patients, across multiple Welsh ICU sites. Additionally, this data can be utilised to assess current rehabilitation practice across ICU sites and inform the ongoing development of the undergraduate respiratory curriculum. Research question What are final year physiotherapy students’ experiences of early mobilisation and rehabilitation for critically ill patients during practice education? Methodology Qualitative, interpretive methodology was used to collect data via two focus groups with a total of seven Cardiff University final year physiotherapy students. Ethical approval was granted in July 2017 by the Cardiff University School of Healthcare Sciences Ethics Committee. Thematic analysis was utilised to analyse the data devising themes and sub themes ready for discussion. Results Four main themes were identified (1) Role of the physiotherapist in ICU, (2) Teamwork, (3) Barriers and (4) Evidence-based practice. Conclusion At present there is a limited literature base supporting early mobilisation and rehabilitation within ICU. As such this novel research fills a gap in the literature base by exploring final year physiotherapy undergraduate experiences of working within ICU. The findings identify students feeling overwhelmed during their ICU placements and reporting an overwhelming sense of reliance on their clinical educators. Additionally, they demonstrate a lack of knowledge surrounding the available evidence-base for practice in this area. These findings can also be utilised to explore the current provision of rehabilitation across Welsh ICU sites and to inform the ongoing development of the undergraduate teaching curriculum to ensure both students feel adequately supported, and newly qualified physiotherapists are confident and competent whilst practicing within the ICU.
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