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基于社区初级保健信托机构的物理治疗师的持续专业发展:一项调查认知、经历和结果的定性研究

Continuing Professional Development of physiotherapists based in community primary care trusts: a qualitative study investigating perceptions, experiences and outcomes.

作者信息

Gunn Hilary, Goding Lois

机构信息

School of Health Professions, Faculty of Health and Social Work, University of Plymouth, Drake Circus, Plymouth PL4 8AA, UK.

出版信息

Physiotherapy. 2009 Sep;95(3):210-5. doi: 10.1016/j.physio.2007.09.003. Epub 2007 Dec 31.

Abstract

OBJECTIVE

To provide an insight into individual physiotherapists' experiences of Continuing Professional Development (CPD), and to gain an understanding of the challenges of undertaking CPD in a geographically dispersed primary healthcare setting.

DESIGN

A qualitative phenomenological methodology using a one-to-one semi-structured interview technique to achieve an in-depth exploration of this complex area of study. Data analysis was conducted by data transcription, immersion, coding and generation of themes using a pragmatic five-step process.

PARTICIPANTS

Eleven participants were identified from a study population of physiotherapists working in two local primary care trusts following the principle of maximum variation sampling.

RESULTS

Four main themes emerged: CPD processes; motivation for undertaking CPD; enabling CPD; and outcomes of CPD. Participants felt that CPD should include a range of activities and learning behaviours. However, there was a preference for active learning styles and formal course-based learning. Engagement in reflective practice and portfolio keeping was generally poor, with participants identifying lack of skills in these areas. Factors motivating CPD engagement included a strong sense of professional obligation and wishing to provide the best possible service to patients. There was frustration over the impact of external issues including political and organisational change on CPD, and anxiety over forthcoming regulatory changes affecting physiotherapy. The study also identified issues around CPD planning and needs identification. There was evidence of change in individuals' practice and internal perceptions as outcomes of CPD, although issues around the application and maintenance of change were identified.

CONCLUSIONS

There is evidence that CPD has an effect on clinical practice in this small group of physiotherapists working in community National Health Service settings. Significantly, undertaking CPD improves confidence as well as competence, enabling individuals to form effective therapeutic relationships with patients and other members of their teams.

摘要

目的

深入了解个体物理治疗师的持续专业发展(CPD)经历,并了解在地理上分散的初级医疗保健环境中开展CPD所面临的挑战。

设计

采用定性现象学方法,运用一对一的半结构化访谈技术,对这一复杂的研究领域进行深入探索。通过数据转录、沉浸、编码以及使用务实的五步流程生成主题来进行数据分析。

参与者

从在两个当地初级医疗保健信托机构工作的物理治疗师研究人群中,按照最大差异抽样原则确定了11名参与者。

结果

出现了四个主要主题:CPD过程;开展CPD的动机;促进CPD;以及CPD的成果。参与者认为CPD应包括一系列活动和学习行为。然而,他们更倾向于主动学习方式和基于课程的正规学习。反思性实践和档案记录的参与度普遍较低,参与者指出在这些方面缺乏技能。促使参与CPD的因素包括强烈的职业责任感以及希望为患者提供尽可能好的服务。外部问题(包括政治和组织变革)对CPD的影响令人沮丧,而即将到来的影响物理治疗的监管变革也引发了焦虑。该研究还确定了围绕CPD规划和需求识别的问题。有证据表明,作为CPD的成果,个体的实践和内部认知发生了变化,尽管也发现了围绕变革应用和维持的问题。

结论

有证据表明,CPD对在社区国民医疗服务体系工作的这一小群物理治疗师的临床实践产生了影响。重要的是,开展CPD提高了信心和能力,使个体能够与患者及其团队的其他成员建立有效的治疗关系。

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