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远程医疗电子指导在肌肉骨骼物理治疗研究生教育中的应用:一项混合方法案例研究。

Telehealth e-mentoring in postgraduate musculoskeletal physiotherapy education: A mixed methods case study.

机构信息

Centre of Precision Rehabilitation for Spinal Pain (CPR Spine), School of Sport, Exercise and Rehabiliation Sciences, University of Birmingham, Birmingham, UK.

Centre of Precision Rehabilitation for Spinal Pain (CPR Spine), School of Sport, Exercise and Rehabiliation Sciences, University of Birmingham, Birmingham, UK.

出版信息

Musculoskelet Sci Pract. 2021 Dec;56:102448. doi: 10.1016/j.msksp.2021.102448. Epub 2021 Aug 14.

Abstract

BACKGROUND

Educational standards of advanced musculoskeletal physiotherapy include mentored clinical practice. Whilst traditionally delivered face-to-face, telehealth e-mentoring affords a distinctive andragogy to facilitate mentee development.

OBJECTIVE

To understand the experiences and outcomes of stakeholders participating in musculoskeletal physiotherapy telehealth e-mentoring.

DESIGN

A case study design with sequential mixed methods (quantitative patient outcome data and qualitative interviews and a focus group) of a 20-week e-mentored telehealth physiotherapy service.

METHODS

Data collection comprised 1) Patient experiences and measures of musculoskeletal health 2) Mentee semi-structured interviews 3) Mentor focus group. Data analysis included descriptive statistics (median and IQR) and the Framework Method for qualitative and quantitative data respectively. An exploratory bidirectional approach supported data integration across all participants.

RESULTS

Participants included patients (n = 90), mentees (n = 10) and mentors (n = 6). Patients reported improvements (>MCID) in MSK-HQ and Patient Specific Functional Scale, with high scores for Consultation and Relational Empathy and Patient Enablement Instruments. Main themes were a) social learning b) advanced professional practice c) learner experience and d) limitations of telehealth for mentees, and for mentors a) preparedness b) journey of development and c) challenges. Participant data integration resulted in 4 main themes 1) energising/positive experience 2) communications skills valued 3) perceptions of telehealth 4) upskilling required.

CONCLUSIONS

Telehealth e-mentoring is a valuable alternative to face-to-face mentored physiotherapy practice to support development in advanced musculoskeletal physiotherapy practice. Findings indicate that technical and professional skills are required, high levels of communication skills were valued, there is a need for reconceptualisation of musculoskeletal physiotherapeutic interventions.

摘要

背景

高级肌肉骨骼物理治疗的教育标准包括有指导的临床实践。虽然传统上是面对面进行的,但远程医疗电子指导提供了一种独特的成人教育方法,以促进学员的发展。

目的

了解参与肌肉骨骼物理治疗远程医疗电子指导的利益相关者的经验和结果。

设计

一项案例研究设计,采用顺序混合方法(定量的肌肉骨骼健康患者结果数据和定性访谈以及焦点小组),对 20 周的远程医疗电子指导物理治疗服务进行研究。

方法

数据收集包括 1)患者的体验和肌肉骨骼健康的测量 2)学员的半结构化访谈 3)导师的焦点小组。数据分析包括描述性统计(中位数和 IQR)和分别用于定性和定量数据的框架方法。探索性双向方法支持所有参与者的数据整合。

结果

参与者包括患者(n=90)、学员(n=10)和导师(n=6)。患者报告了肌肉骨骼健康问卷和患者特定功能量表的改善(> MCID),咨询和关系同理心以及患者赋权工具的得分很高。主要主题是 a)社会学习 b)高级专业实践 c)学习者体验和 d)远程医疗对学员的限制,以及对导师的 a)准备情况 b)发展历程和 c)挑战。参与者数据的整合产生了 4 个主要主题 1)充满活力/积极的体验 2)重视沟通技巧 3)对远程医疗的看法 4)需要提高技能。

结论

远程医疗电子指导是面对面指导的肌肉骨骼物理治疗实践的一种有价值的替代方法,可支持高级肌肉骨骼物理治疗实践的发展。研究结果表明,需要技术和专业技能,重视沟通技巧,需要重新概念化肌肉骨骼物理治疗干预措施。

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