Fary Robyn E, Slater Helen, Jordan Joanne E, Gardner Peter, Chua Jason, Payne Carly, Briggs Andrew M
J Orthop Sports Phys Ther. 2017 Sep;47(9):652-663. doi: 10.2519/jospt.2017.7281.
Study Design Prospective within-subject, cross-sectional, between-group, nested qualitative designs within an implementation science framework. Background Physical therapy is recommended for rheumatoid arthritis (RA) care, yet prelicensure RA curriculum time remains limited. Objectives To determine readiness for, and success of, implementing an e-learning tool, Rheumatoid Arthritis for Physiotherapists e-Learning (RAP-eL), within the prelicensure physical therapy curriculum. Methods All physical therapy students in a 1-year cohort in 2014 had RAP-eL embedded in their curriculum. Rheumatoid Arthritis for Physiotherapists e-Learning is an online platform that delivers RA disease information with translation to clinical practice. Implementation readiness, determined by acceptability of RAP-eL to students, was evaluated using focus groups (n = 23). Implementation success was measured using quantitative data from a previously validated questionnaire, including changes in students' self-reported confidence in knowledge (out of 45) and skills (out of 40) in managing RA after 4 weeks of access to RAP-eL, retention of learning over 14 months, and differences in workforce readiness between students in the cohort who had access to RAP-eL and a historical control cohort. Results Acceptability of RAP-eL was confirmed from qualitative data, demonstrating implementation readiness. Short-term improvements were observed in RA knowledge (mean difference, 16.6; 95% confidence interval [CI]: 15.7, 17.6) and RA skills (mean difference, 14.9; 95% CI: 13.9, 15.9; n = 137). Retention was demonstrated after 14 months (P<.001; n = 62). Students in the 1-year cohort who had RAP-eL embedded in the curriculum scored significantly higher on knowledge (mean difference, 3.6; 95% CI: 1.3, 5.9) and skills (mean difference, 3.3; 95% CI: 0.9, 5.7; n = 62) compared to those without RAP-eL (n = 36). Rheumatoid Arthritis for Physiotherapists e-Learning remains embedded in the curriculum. Conclusion This study demonstrated both readiness and success of the sustainable implementation of RAP-eL within a prelicensure physical therapy curriculum. J Orthop Sports Phys Ther 2017;47(9):652-663. doi:10.2519/jospt.2017.7281.
在实施科学框架内采用前瞻性受试者内、横断面、组间、嵌套定性设计。背景：物理治疗被推荐用于类风湿关节炎（RA）的护理，但执照前RA课程时间仍然有限。目的：确定在执照前物理治疗课程中实施电子学习工具“物理治疗师类风湿关节炎电子学习（RAP-eL）”的准备情况和实施效果。方法：2014年一个为期1年的队列中的所有物理治疗专业学生的课程中都嵌入了RAP-eL。“物理治疗师类风湿关节炎电子学习”是一个在线平台，提供RA疾病信息并转化为临床实践。通过焦点小组（n = 23）评估学生对RAP-eL的可接受性来确定实施准备情况。使用先前验证的问卷中的定量数据来衡量实施效果，包括在访问RAP-eL 4周后学生自我报告的在管理RA方面的知识（满分45分）和技能（满分40分）的信心变化、14个月内的学习保留情况，以及有机会使用RAP-eL的队列学生与历史对照队列学生在劳动力准备方面的差异。结果从定性数据证实了RAP-eL的可接受性，表明具备实施准备情况。在RA知识（平均差异，16.6；95%置信区间[CI]：15.7，17.6）和RA技能（平均差异，14.9；95%CI：13.9，15.9；n = 137）方面观察到短期改善。14个月后显示出学习保留情况（P <.001；n = 62）。与未使用RAP-eL的学生（n = 36）相比，课程中嵌入RAP-eL的1年队列学生在知识（平均差异，3.6；95%CI：1.3，5.9）和技能（平均差异，3.3；95%CI：0.9，5.7；n = 62）方面得分显著更高。“物理治疗师类风湿关节炎电子学习”仍然嵌入在课程中。结论：本研究证明了在执照前物理治疗课程中可持续实施RAP-eL的准备情况和实施效果。《骨科与运动物理治疗杂志》2017年；47(9)：652 - 663。doi:10.2519/jospt.2017.7281 。
