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利用远程学习教授临床医生手动轮椅技能:一项具有培训前后比较的队列研究。

Using remote learning to teach clinicians manual wheelchair skills: a cohort study with pre- vs post-training comparisons.

机构信息

Department of Physical Medicine and Rehabilitation, University of Pittsburgh, Pittsburgh, PA, USA.

Department of Bioengineering, University of Pittsburgh, Pittsburgh, PA, USA.

出版信息

Disabil Rehabil Assist Technol. 2022 Oct;17(7):752-759. doi: 10.1080/17483107.2020.1804633. Epub 2020 Aug 18.

Abstract

PURPOSE

To test the hypothesis that remote learning to teach clinicians manual wheelchair skills is efficacious.

MATERIALS AND METHODS

A convenience sample of therapists (physical and occupational) and students were enrolled in pairs in a cohort study with pre- versus post-training comparisons. The intervention was a hybrid of self-study and hands-on practice paired with remote feedback for ten intermediate and advanced manual wheelchair skills. Participants practiced with self-selected frequency and duration, uploading a session log and video(s) to an online platform. A remote trainer provided asynchronous feedback prior to the next practice session. Capacity and confidence in completing the ten skills were evaluated using the Wheelchair Skills Test Questionnaire (WST-Q). Knowledge of wheelchair skills training and motor learning was assessed using a 62-item Knowledge Test. Secondary outcome measures included skill achievement, as confirmed by submitted video recordings, and participant feedback about the training.

RESULTS

Across 41participants, scores were higher at follow-up compared to baseline for WST-Q capacity (73.9 ± 19.1 vs 16.8 ± 15.6,  < 0.001), WST-Q confidence (80.1 ± 12.2 vs 47.6 ± 18.2,  = 0.003) and knowledge (70.8 ± 7.5 vs 67.0 ± 5.4,  = 0.004).

CONCLUSIONS

Remote learning can increase wheelchair skills capacity and confidence as well as knowledge about such training and assessment. This model should be further investigated as a delivery method for training rehabilitation professionals.

CLINICAL TRIAL REGISTRATION NUMBER

NCT01807728.Implications for rehabilitationWheelchair skills training is one of the 8 steps of wheelchair provision as outlined by the World Health Organization.Wheelchair skills are not a core part of most clinical curriculums and many clinicians cite a lack of resources and uncertainty on how to implement wheelchair skills training into practice as major barriers to providing such training.Remote learning offers the benefits of structured wheelchair skills training with expert feedback on an individual's own schedule that is not afforded by one-day "bootcamp"-type courses or on-the-job training, which are how many clinicians currently learn wheelchair skills.In a sample of physical and occupational therapists and students, remote learning was effective at increasing capacity and confidence to perform manual wheelchair skills as well as knowledge of wheelchair training.

摘要

目的

检验远程学习教授临床医生手动轮椅技能是否有效的假设。

材料和方法

本研究采用队列研究的便利样本,将治疗师(物理治疗师和作业治疗师)和学生配对,进行预-后训练比较。干预措施是自我学习和实践相结合,辅以远程反馈,针对 10 项中级和高级手动轮椅技能进行。参与者根据自己的频率和时长进行练习,将练习记录和视频上传到在线平台。远程培训师在下一次练习前提供异步反馈。使用轮椅技能测试问卷(WST-Q)评估完成 10 项技能的能力和信心。使用 62 项知识测试评估轮椅技能培训和运动学习知识。次要结果测量包括技能掌握情况,通过提交的视频记录确认,以及参与者对培训的反馈。

结果

在 41 名参与者中,与基线相比,WST-Q 能力(73.9±19.1 对 16.8±15.6,  <0.001)、WST-Q 信心(80.1±12.2 对 47.6±18.2,  =0.003)和知识(70.8±7.5 对 67.0±5.4,  =0.004)评分在随访时更高。

结论

远程学习可以提高轮椅技能能力和信心,以及对这种培训和评估的了解。这种模式应该作为培训康复专业人员的一种交付方法进行进一步研究。

临床试验注册号

NCT01807728。

对康复的影响

世界卫生组织概述的轮椅提供的 8 个步骤之一是轮椅技能培训。

轮椅技能不是大多数临床课程的核心部分,许多临床医生表示,缺乏资源和不确定如何将轮椅技能培训纳入实践是他们提供此类培训的主要障碍。

远程学习提供了结构化的轮椅技能培训的好处,并在个人自己的时间内提供专家反馈,这是一天“训练营”式课程或在职培训无法提供的,而这些是许多临床医生目前学习轮椅技能的方式。

在一组物理治疗师和作业治疗师和学生中,远程学习在提高手动轮椅技能的能力和信心方面以及对轮椅培训知识的掌握方面都非常有效。

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