Impact of guided self-study on learning success in undergraduate physiotherapy students in Switzerland – a feasibility study of a higher education intervention

Abstract

Background: Guided self-study (G-SS) can be used as a self-directed learning method (andragogy) or self-determined learning (heutagogy) that fosters changes in knowledge and skills in a higher physiotherapy education setting. Until now, there has been no empirical evidence for the use of G-SS in higher physiotherapy education. Furthermore, and to the best of our knowledge, no practical guidelines for G-SS exist for physiotherapy undergraduate students to foster changes in knowledge and skills. This higher education feasibility study aimed to investigate the feasibility to establish a G-SS program in a fulltime undergraduate physiotherapy degree course at the Bern University of Applied Sciences (BFH), Switzerland. In addition, the effectiveness of the G-SS was assessed on changes in knowledge and skills. Method: Fifty-one first-semester physiotherapy students volunteered from BFH. They were randomly divided into a G-SS group or control group (CG). The G-SS group received six cases. Each case was processed in an eight-day cycle. One week in advance, the clinical case (i.e. description of a patient and the symptoms) and learning goals were provided to the students electronically (day 1). The students prepared the cases in groups and were guided (e.g. via Skype) by the tutor during this preparation time (day 2 to 7). The results of the group work were presented and reflected on during a moderated plenum session (90 minutes) at day 8. The primary outcome parameters were i) exposure as the number of G-SS sessions performed over 90 minutes, ii) the responsiveness of students with a previously determined 83% willingness to participate in the G-SS program iii) program differentiation, to illustrate the difference between G-SS content and the curriculum and the total score in the objective structured clinical examination (OSCE) and written exams. Statistical analyses were conducted using an Intention-To-Treat (ITT) approach. Results: All six G-SS sessions on day 8 were performed over 90 minutes. The responsiveness of students as willing to participate in the G-SS program was 23%, clearly below the set 83%, and in terms of program differentiation, no differences were found between G-SS program and normal curriculum content. G-SS as compared to the CG scored significantly better on OSCE (p < 0.01) and on the written exam (p < 0.04). Conclusion: The results showed that this higher education G-SS program in its current form was not feasible. Slight modification of the study protocol (e.g. better time planning in the academic calendar) is needed to improve the student’s responsiveness. The adjustments to the timetable must allow the physiotherapy students to prepare the clinical cases. G-SS have the potential to promote change in knowledge and skills in undergraduate physiotherapy students when students prepare the case, present the case solutions and reflect upon their actions.