Practices and views of wheelchair service providers regarding wheelchair-skills training for clients and their caregivers: a global online survey

Kirby, R. Lee; Smith, Cher; Parker, Kim; Theriault, Christopher John; Sandila, Navjot

doi:10.1080/17483107.2021.1989505

Cited by 11 publications

(6 citation statements)

References 22 publications

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“…Individual programs clearly address this content area differently in terms of time explicitly dedicated to wheelchair service provision. Despite evidence suggesting that occupational therapists are more likely to provide [ 39 ], and be knowledgeable in, wheelchair service provision than other professions [ 40 ], there is clearly room for improvement and greater uniformity in their professional education as suggested by D’Innocenzo [ 41 ]. While national accreditation processes require programs to ensure competency across the professional roles defined in the Profile of Practice [ 42 ], they do not explicate content-specific requirements [ 43 ].…”

Section: Discussionmentioning

confidence: 99%

“…A recent survey among OTs practicing in one Canadian province reported one third felt their professional education inadequately prepared them to provide training to clients and caregivers [ 31 ] while a qualitative study among rehabilitation clinicians in the American Midwest reported very limited education on such training was provided before entering practice [ 44 ]. Over 30% of wheelchair service providers in a global survey felt unprepared to deliver wheelchair skills training and 24% reported inadequate professional training as a barrier to offering this service component [ 39 ]. Collectively, this suggests the User Training step merits further attention in entry-to-practice programs.…”

Section: Discussionmentioning

confidence: 99%

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Wheelchair service provision education in Canadian occupational therapy programs

2022

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Occupational therapists in Canada play a central role in wheelchair service provision. Inadequate entry-to-practice professional education has been identified as a major concern in the delivery of wheelchair related services. The goal of this study was to describe the current education provided in Canadian occupational therapy programs and to map this content against the recommended WHO 8-step wheelchair service provision process. The study used a descriptive cross-sectional online survey design. Educators were recruited from accredited occupational therapy programs in Canada. Participants completed a short sociodemographic questionnaire and a survey with 97 closed- and open-ended questions regarding the wheelchair service provision education provided in their curriculum. Survey data was then mapped according to the WHO 8-step wheelchair service provision process. Twenty-nine educators from all Canadian occupational therapy programs (n = 14) were enrolled. Most participants (55.2%) were full-time faculty members that had been teaching in occupational therapy programs for an average time of 10.9 years. All programs covered at least 4 of the WHO recommended steps, but only 5 programs covered all steps. Assessment and Prescription steps were covered in every program while the Referral & Appointment, Funding & Ordering, Fitting and User Training steps were covered in most programs. The pedagogic approach, the amount of time dedicated to wheelchair-related content, and the type of evaluation used varied greatly between programs. This study is the first to provide a detailed description of wheelchair service provision education across all Canadian occupational therapy programs according to the WHO 8 steps and provides a foundation for collaborative efforts to promote best practice in entry-to-practice professional education.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Wheelchair service provision education in Canadian occupational therapy programs

2022

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“…Most of this content is not covered by the WHO Basic Package, but it is in the WSP manuals and training resources that are freely available online. We placed particular emphasis on increasing the pool of User training questions, as recent evidence reveals that 1) few professionals provide wheelchair skills training to their clients and caregivers [ 36 ] and 2) rehabilitation professionals receive limited to no training on wheelchair skills [ 35 , 37 ], despite the fact that such training has been found to be highly effective [ 38 , 39 ]. We hope that increasing the pool of this sub-domain draws attention to educators, trainers, and trainees on the importance of wheelchair skills training as part of the wheelchair service delivery process.…”

Section: Discussionmentioning

confidence: 99%

Psychometric properties of the International Society of Wheelchair Professionals’ basic manual wheelchair-service-provision knowledge Test Version 1 and development of Version 2

et al. 2023

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Introduction Valid and reliable scores from measurement tools to test competency in basic manual wheelchair-service-provision are needed to promote good practice and support capacity building. The International Society of Wheelchair Professionals’ (ISWP) Basic Test Version 1 in English, launched in 2015, is the most frequently used outcome measure tool to test basic manual wheelchair-service-provision knowledge and is part of an international certification process. Despite the wide acceptance and use of the test, its psychometric properties have not yet been established. The objectives of this study were 1) to evaluate the test’s psychometric properties, 2) to develop the test’s Version 2, and 3) to evaluate the content validity of the new version. Methods For Objective 1, methods from the Classical Test Theory were used to obtain items’ difficulty, item discrimination index and domains’ reliability. For Objective 2, a team of experts in wheelchair service delivery and education conducted a systematic qualitative review of the questions’ text and answers and updated them using evidence-based guidelines. For Objective 3, an external team reviewed the clarity, relevance and domain allocation of the developed items using a 4-point Likert scale. Descriptive statistics were used to describe and characterize the results for each objective. Item-content (I-CVI) and Scale-content (S-CVI) validity indexes were calculated to compute content validity. Results For Objective 1, all domains in the test were below the threshold for acceptable internal consistency reliability; 80% of the total test pool (116 items from the total pool of 145) did not meet the thresholds for item difficulty and index of discrimination suggested in the literature. Of the items in the Test, 78% could be responded to intuitively and 66% did not distinguish between test-takers who were knowledgeable in the content area and those who were not. For Objective 2, experts found concerns such as items being grouped in the wrong domain, being repeated, not using person-first language, and using terms inconsistently. Thirty-four (23.4%) items were dropped and 111 (76.5%) were updated. In addition, 61 new items were developed. Members re-categorized the items and proposed a new classification of subdomains. For Objective 3, good agreement between subject-matter experts was found; the S-CVI calculated using the I-CVIs related to item clarity was 84% while using the I-CVIs related to item relevance was 98%. Only 7 items (4.1%) were deemed to be in the wrong domain and 4 items (2.3%) were considered irrelevant and dropped. Conclusion The psychometric evidence in support of ISWP Basic Test Version 1 in English is suboptimal. A new set of items developed by experts in the field has shown excellent content validity. Ongoing assessments will be needed as ISWP Basic Test Version 2 is implemented and monitored.

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“…Clinician surveys should be distributed more broadly, to which online surveys lend themselves. 37 Even more importantly, the hypothesized outcomes due to the use of residual limb support (for instance, those related to the prevention of knee contractures, edema control, and comfort) need to be confirmed by a randomized controlled trial with adequate follow-up and documentation of possible adverse aspects (such as cost, falls, and negative effects on transfers and wheelchair-related function). What is needed in the literature are a series of such randomized controlled trials specifically focusing on the safety and effectiveness of residual limb supports and meta-analyses of these trials (e.g., in the form of a Cochrane review that are at the top of the “evidence pyramid”).…”

Section: Discussionmentioning

confidence: 99%

Residual limb support devices on wheelchairs for people with transtibial amputations: A scoping review and survey of rehabilitation professionals in Nova Scotia

Parker

MacDonald

Henley

et al. 2022

Prosthetics &Amp; Orthotics International

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Purpose:To determine what research evidence exists for the use of residual limb supports (RLSs) for people with transtibial amputations and to describe clinicians' use of such supports in Nova Scotia.Methods:Scoping review of published and gray literature using Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews as a guide and an anonymous online and paper-based clinician survey.Results:We identified 22 publications meeting criteria for review. Seventeen (77%) of the publications were practice guidelines or systematic reviews about care of people with lower-limb amputations, 4 (18%) involved research about the design of stump supports, and 1 (5%) researched the use of supports. Generally, the use of RLSs was recommended (e.g., to prevent contractures, control edema, and to provide comfort), but many authors acknowledged that the evidence was weak, and additional evidence in support of these treatment goals could not be found. We received 44 survey responses from health care professionals involved with the care of people with transtibial amputations in Nova Scotia. Of the 43 health care professionals who responded to the question “…what percent of patients/clients with transtibial amputations do you estimate receive stump supports…,” the mean (standard deviation) was 86.1% (21.1). The most common reasons for recommending a stump support were to prevent knee contracture (38 [86.4%]), and to prevent swelling (13 [29.5%]).Conclusions:Most clinicians who provide services to people with amputations in Nova Scotia believe that RLSs have benefits such as the prevention of contractures, the reduction of edema, and improved patient comfort. However, there is little high-quality research evidence to support their use. There is a need to perform the necessary research or to modify practice guidelines.

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Practices and views of wheelchair service providers regarding wheelchair-skills training for clients and their caregivers: a global online survey

Cited by 11 publications

References 22 publications

Wheelchair service provision education in Canadian occupational therapy programs

Wheelchair service provision education in Canadian occupational therapy programs

Psychometric properties of the International Society of Wheelchair Professionals’ basic manual wheelchair-service-provision knowledge Test Version 1 and development of Version 2

Residual limb support devices on wheelchairs for people with transtibial amputations: A scoping review and survey of rehabilitation professionals in Nova Scotia

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