A telehealth curriculum: A pre-post study of physiotherapy students’ perceived knowledge, self-efficacy and intentions for future use

Authors

DOI:

https://doi.org/10.11157/fohpe.v23i3.595

Keywords:

telehealth curriculum, pre-professional training, physiotherapy, self-efficacy, intentions for future use

Abstract

Introduction: With the ever-increasing adoption of telehealth into clinical practice, the need for physiotherapists to be competent with these technologies is paramount. Given the lack of literature detailing effective approaches to prepare physiotherapists for telehealth practice, a telehealth curriculum has been designed, implemented and evaluated in an Australian physiotherapy program. This study aimed to evaluate the effect of the telehealth curriculum on the perceived knowledge, skills, self-efficacy and future intentions of physiotherapy students.

Methods: A cohort study was undertaken, with two research arms: 1) a pre- and post-test self-report survey of perceived knowledge, skills and self-efficacy against empirically derived telehealth competencies and 2) focus groups exploring effects of the curriculum on students’ perceptions of telehealth and intentions for future use. Participants undertook a telehealth curriculum, including 19 hours of online modules and 6 hours of accompanying simulations. The curriculum was specific to the practice of telehealth in physiotherapy and aimed to provide knowledge and skills about telehealth fundamentals, technology and use in practice.

Results: From an eligible 117 participants, complete and matched pre-post surveys were obtained from 72 students (61.5%) and eight of these 72 students participated in focus groups. All six telehealth competencies were significantly higher following the intervention (p < 0.001). From the focus group data, two themes were generated: perceptions of telehealth following the curriculum and feedback regarding the curriculum structure.

Conclusion: This study demonstrates positive impacts of a telehealth curriculum involving online content and simulations on physiotherapy student perceived knowledge, skills and self-efficacy aligned with telehealth competencies. The study further supports the integration of telehealth curricula in pre-professional healthcare training.

References

Ali, N. S., Carlton, K. H., & Ali, O. S. (2015). Telehealth education in nursing curricula. Nurse Eductor, 40(5), 266–269. https://doi.org/10.1097/NNE.0000000000000149

Almathami, H. K. Y., Win, K. T., & Vlahu-Gjorgievska, E. (2020). Barriers and facilitators that influence telemedicine-based, real-time, online consultation at patients' homes: Systematic literature review. Journal of Medical Internet Research, 22(2), Article 16407. https://doi.org/10.2196/16407

Archibald, M. M., Ambagtsheer, R. C., Casey, M. G., & Lawless, M. (2019). Using Zoom videoconferencing for qualitative data collection: Perceptions and experiences of researchers and participants. International Journal of Qualitative Methods, 18. https://doi.org/10.1177/1609406919874596

Arends, R., Gibson, N., Marckstadt, S., Britson, V., Nissen, M. K., & Voss, J. (2021). Enhancing the nurse practitioner curriculum to improve telehealth competency. Journal of the American Association of Nurse Practitioners, 33(5), 391–397. https://doi.org/10.1097/JXX.0000000000000303

Aungst, T. D., Lahoz, M. R., & Evans, P. J. (2017). Digital health evaluation workshop for interprofessional healthcare students. Digital Health, 3. https://doi.org/10.1177/2055207617740089

Australian Physiotherapy Association (APA). (2020). Telehealth guidelines: Response to COVID-19. https://australian.physio/sites/default/files/APATelehealthGuidelinesCOVID190420FA.pdf

Bandura, A. (1997). Self-efficacy: The exercise of control. W.H. Freeman.

Bandura, A. (2006). Guide for constructing self-efficacy scales. In F. Pajares & T. C. Urdan (Eds.), Self-efficacy beliefs of adolescents (Vol. 5, pp. 307–337). IAP.

Braun, V., & Clarke, V. (2006). Using thematic analysis in psychology. Qualitative Research in Psychology, 3(2), 77–101. https://doi.org/10.1191/1478088706qp063oa

Braun, V., & Clarke, V. (2021). One size fits all? What counts as quality practice in (reflexive) thematic analysis? Qualitative Research in Psychology, 18(3), 328–352, https://doi.org/10.1080/14780887.2020.1769238

Bulik, R. J., & Shokar, G. S. (2010). Integrating telemedicine instruction into the curriculum: Expanding student perspectives of the scope of clinical practice. Journal of Telemedicine and Telecare, 16(7), 355–358. https://doi.org/10.1258/jtt.2010.090910

Bunniss, S., & Kelly, D. R. (2010). Research paradigms in medical education research. BMC Medical Education, 44(4), 358–366. https://doi.org/10.1111/j.1365-2923.2009.03611.x

Carpenter, C., & Suto, M. (2008). Qualitative research for occupational and physical therapists: A practical guide. Wiley.

Cottrell, M. A., Hill, A. J., O’Leary, S. P., Raymer, M. E., & Russell, T. G. (2018). Patients are willing to use telehealth for the multidisciplinary management of chronic musculoskeletal conditions: A cross-sectional survey. Journal of Telemedicine and Telecare, 24(7), 445–452. https://doi.org/10.1177/1357633X17706605

Dario, A., & Simic, M. (2021). Innovative physiotherapy clinical education in response to the COVID-19 pandemic with a clinical research placement model. Journal of Physiotherapy, 67(4), 235–237. https://doi.org/10.1016/j.jphys.2021.08.008

Davies, L., Hinman, R. S., Russell, T., Lawford, B., Bennell, K., Billings, M., Cooper-Oguz, C., Finnan, K., Gallagher, S., Gilbertson, D. K., Holdworth, L., Holland, A., McAlister, J., Miles, D., & Roots, R. (2021). An international core capability framework for physiotherapists to deliver quality care via videoconferencing: A Delphi study. Journal of Physiotherapy, 67(4), 291–297. https://doi.org/10.1016/j.jphys.2021.09.001

Dopp, A. R., Mapes, A. R., Wolkowicz, N. R., McCord, C. E., & Feldner, M. T. (2021). Incorporating telehealth into health service psychology training: A mixed-method study of student perspectives. Digital Health, 7, Article 2055207620980222. https://doi.org/10.1177/2055207620980222

Edirippulige, S., & Armfield, N. (2017). Education and training to support the use of clinical telehealth: A review of the literature. Journal of Telemedicine and Telecare, 23(2), 273–282. https://doi.org/10.1177/1357633X16632968

Edirippulige, S., Brooks, P., Carati, C., Wade, V. A., Smith, A. C., Wickramasinghe, S., & Armfield, N. R. (2018). It’s important, but not important enough: eHealth as a curriculum priority in medical education in Australia. Journal of Telemedicine and Telecare, 24(10), 697–702. https://doi.org/10.1177/1357633X18793282

Fergus, A., Hartsook, K., Smith, J., Hale, M., & Kellar, D. (2021). A novel physical therapy learning experience in pediatrics via telehealth: A qualitative case analysis. Journal of Physical Therapy Education, 35(2), 159–167. https://doi.org/10.1097/JTE.0000000000000184

Forbes, R., & Mandrusiak, A. (2020). Educating students to educate patients. The Clinincal Teacher, 17(3), 244–248. https://doi.org/10.1111/tct.13036

Forbes, R., Mandrusiak, A., Smith, M., & Russell, T. (2018). Training physiotherapy students to educate patients: A randomised controlled trial. Patient Education and Counseling, 101(2), 295–303. https://doi.org/10.1016/j.pec.2017.08.009

Gonzalez-Caminal, G., Kangasperko, M., Brodin, N., Grüneberg, C., Salinas-Bueno, I., & Brader, A. G. (2021). Virtualist awareness: Use of simulation to explore competences needed in telehealth for physiotherapists. In EDULEARN21 proceedings: 13th International Conference on Education and New Learning Technologies. IATED. https://doi.org/10.21125/edulearn.2021

Hong, S. M., Olson-Kellogg, B. J., North, S. E., Davis, J. L., & Staker, J. L. (2020). Telehealth physical therapy as an innovative clinical education model with positive patient impact: A case report in the context of the COVID-19 pandemic. Journal of Physical Therapy Education, 34(4), 275–281. https://doi.org/10.1097/JTE.0000000000000163

Jaye, P., Thomas, L., & Reedy, G. (2015). “The Diamond”: A structure for simulation debrief. The Clinincal Teacher, 12(3), 171–175. https://doi.org/10.1111/tct.12300

Jones, A., & Sheppard, L. (2011). Self-efficacy and clinical performance: A physiotherapy example. Advances in Physiotherapy, 13(2), 79–83. https://doi.org/10.3109/14038196.2011.565072

Jones, A., & Sheppard, L. (2012). Developing a measurement tool for assessing physiotherapy students' self-efficacy: A pilot study. Assessment and Evaluation in Higher Education, 37(3), 369–377. https://doi.org/10.1080/02602938.2010.534765

Kirkland, E. B., DuBose-Morris, R., & Duckett, A. (2019). Telehealth for the internal medicine resident: A 3-year longitudinal curriculum. Journal of Telemedicine and Telecare, 27(9), 599–605. https://doi.org/10.1177/1357633X19896683

Likert, R. (1932). A technique for the measurement of attitudes. Archives of Psychology, 22(140), 5–55.

Mahabamunuge, J., Farmer, L., Pessolano, J., & Lakhi, N. (2021). Implementation and assessment of a novel telehealth education curriculum for undergraduate medical students. Journal of Advances in Medical Education & Professionalism, 9(3), 127–135. https://doi.org/10.30476/jamp.2021.89447.1375

Malterud, K., Siersma, V. D., & Guassora, A. D. (2016). Sample size in qualitative interview studies: Guided by information power. Qualitative Health Research, 26(13), 1753–1760. https://doi.org/10.1177/1049732315617444

Martin, R., Mandrusiak, A., Lu, A., & Forbes, D. R. (2021). New-graduate physiotherapists’ training needs and readiness for telehealth. Physiotherapy Theory and Practice. Advance online publication. https://doi.org/10.1080/09593985.2021.1955423

Pathipati, A. S., Azad, T. D., & Jethwani, K. (2016). Telemedical education: Training digital natives in telemedicine. Journal of Medical Internet Research, 18(7), Article e193. https://doi.org/10.2196/jmir.5534

Pote, H., Rees, A., Holloway-Biddle, C., & Griffith, E. (2021). Workforce challenges in digital health implementation: How are clinical psychology training programmes developing digital competences? Digital Health, 7, 1–11. https://doi.org/10.1177/2055207620985396

Randall, K., Steinheider, B., Isaacson, M., Shortridge, A., Byrd, S., Ciro, C., Ross, H., & Loving, G. (2016). Measuring knowledge, acceptance, and perceptions of telehealth in an interprofessional curriculum for student nurse practitioners, occupational therapists, and physical therapists. Journal of Interactive Learning Research, 27(4), 339–353.

Robbins, S. B., Lauver, K., Le, H., Davis, D., Langley, R., & Carlstrom, A. (2004). Do psychosocial and study skill factors predict college outcomes? A meta-analysis. Psychological Bulletin Journal, 130(2), 261–288. https://doi.org/10.1037/0033-2909.130.2.261

Ross, J., Stevenson, F., Lau, R., & Murray, E. (2016). Factors that influence the implementation of e-health: A systematic review of systematic reviews (an update). Implementation Science, 11(1), Article 146. https:doi.org/10.1186/s13012-016-0510-7

Theoret, C., & Ming, X. (2020). Our education, our concerns: The impact on medical student education of COVID‐19. BMC Medical Education, 54(7), 591–592. https://doi.org/10.1111/medu.14181

Varpio, L., Ajjawi, R., Monrouxe, L. V., O'Brien, B. C., & Rees, C. E. (2017). Shedding the cobra effect: Problematising thematic emergence, triangulation, saturation and member checking. BMC Medical Education, 51(1), 40–50. https://doi.org/10.1111/medu.13124

Wade, V. B. P., & Stocks, N. M. P. (2016). The use of telehealth to reduce inequalities in cardiovascular outcomes in Australia and New Zealand: A critical review. Heart, Lung and Circulation, 26(4), 331–337. https://doi.org/10.1016/j.hlc.2016.10.013

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Published

2022-09-30

How to Cite

Martin, R., Mandrusiak, A., Lang, R., Forbes, R., & Russell, T. (2022). A telehealth curriculum: A pre-post study of physiotherapy students’ perceived knowledge, self-efficacy and intentions for future use. Focus on Health Professional Education: A Multi-Professional Journal, 23(3), 56–72. https://doi.org/10.11157/fohpe.v23i3.595

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