Evaluation of a blended learning approach on stratified care for physiotherapy bachelor students

Abstract

Background Stratified models of care are valuable for addressing psychosocial factors which influence the outcome of patients with musculoskeletal disorders. Introducing such models in undergraduate training has the potential to propagate this knowledge with evidence and foster its implementation. The objective of this paper is to explore the perception and changes in the fear-avoidance beliefs of physiotherapy students participating in a developed blended learning course on stratified care. Methodology A mixed-methods with a convenient sample of two consecutive cohorts were given a blended learning course on stratified care for patients with low back pain. The blended learning course comprised scientific rudiments and application of stratified care in clinical practice conceptualised using the KERN’ 6-step approach. The exam scores, perceptions, performance on self-reflection-tests and pre- and post-scores on The Tampa Scale for Kinesiophobia for Physiotherapists’ (TSK-PT) were obtained. After gaining clinical experience, participants were invited to discuss their clinical experiences and perceptions in workshops. The quantitative data was analysed explorative-descriptively. The qualitative data was analysed following an inductive coding system with constant comparisons. Results Ninety-one participants consented to the evaluation (mean age = 22.9 ± 1.6 years), 66% were female. Exam scores correlated with time spent in training (r = 0.30) and scores on self-reflection-tests 1 and 2 (r = 0.40 and r = 0.41). Participants in both cohorts described the learning resources as promoting their interest in the subject (72% and 94%), up-to-date (91% and 93%) and helpful (91% and 97%). The fear-avoidance scores for participants decreased from 53.5 (± 9.96) to 40.1 (± 12.4) with a large effect size (d = 1.18). The regression model [F (2, 49) = 1151.2, p < 0.001] suggests that pre-TSK-PT and the interest of participants in the training predicted post-TSK-PT. The workshop participants (n = 62) all worked in clinical practice. Emerging from the analysis were 4 categories (evolving to maturity in practice, perceiving determinants of stratified care, strategising for implementation and adopting an outlook for future practice). Conclusion The quality of engagement in learning, training strategy and interest in the subject contributes immensely to learning outcomes. This blended learning course was successful in reducing kinesiophobia and influencing the participants’ attitude towards care with the potential of being translated into long-term practice.

Physiotherapy students' perspectives of a blended learning approach through the COVID-19 pandemic years

“…) This is supported by recent studies exploring medical skill courses (Pham et al, 2021) and physiotherapy degree programmes (Ng et al, 2021;Plummer et al, 2021;Rossettini et al, 2021), all of which had to undergo the necessary switch to online delivery through the COVID-19 pandemic. Findings from these studies indicate some early success both in students' grades and satisfaction with the online delivery format, with requests received from students to continue with online delivery after the removal of the COVID-19 restrictions (Adje et al, 2023;Pham et al, 2021;Rossettini et al, 2021;Zheng et al, 2021).…”

“…Blended learning can be taught in a variety of forms, for example implementing a "flipped classroom" approach where students complete traditional theoretical learning online at home, then apply this knowledge to problem-solving or clinical reasoning tasks in a collaborative fashion in the classroom (Ozdamli & Aşiksoy, 2016). Although most traditional health professional courses are based on a face-to-face teaching andragogy, several studies have indicated benefits of online-blended learning, such as enhanced student engagement and higher retention, even prior to the COVID-19 pandemic in a range of medical and associated professions, including physiotherapy (Adje et al, 2023;Al-Shorbaji et al, 2015;George et al, 2014;Green et al, 2018. ) This is supported by recent studies exploring medical skill courses (Pham et al, 2021) and physiotherapy degree programmes (Ng et al, 2021;Plummer et al, 2021;Rossettini et al, 2021), all of which had to undergo the necessary switch to online delivery through the COVID-19 pandemic.…”

“…Recent research suggests that while theoretical health education content is positively received by students in an online format, the acquisition of certain technique-oriented practical skills (especially for the novice learner) have failed to transition within eLearning approaches, rendering traditional face-to-face teaching methods essential (George et al, 2014;Ng et al, 2021;Plummer et al, 2021;Rossettini et al, 2021). Overall, the acceptance of eLearning has been supported as a legitimate teaching option for healthrelated courses including physiotherapy (Adje et al, 2023;Bell et al, 2022;Harvey et al, 2014;Pham et al, 2021;Plummer et al, 2021;Rossettini et al, 2021).…”

“…Previous research has explored students' perceptions of receiving online physiotherapy education for either individual courses (Adje et al, 2023;Harvey et al, 2014) or whole degree programmes during the COVID-19 pandemic (Ng et al, 2021;Plummer et al, 2021;Rossettini et al, 2021). However, no research has examined how a physiotherapy degree designed from the outset to be delivered via a blended approach (prior to and regardless of COVID-19), has been received by the student population.…”