Department of Rehabilitation Science and Health Technology, Oslo Metropolitan University, Postboks 4, St. Olavs Plass, Oslo, 0130, Norway.
BMC Med Educ. 2022 Dec 7;22(1):843. doi: 10.1186/s12909-022-03916-4.
In March 2020, campuses at Norwegian academic institutions were closed due to the COVID-19 pandemic. All in-person teaching had to be replaced by digital alternatives. The closure also affected clinical placements in physiotherapy programs, which in some cases had to be replaced by online alternatives without patient contact. The aim of this study is to evaluate the benefits and challenges of using digital pedagogies to accomplish the learning outcomes of clinical placements.
Forty-four final-year physiotherapy students at Oslo Metropolitan University had their clinical placement substituted by an online alternative centered around two main educational activities conducted online in small groups: 1) clinical case seminars and 2) digital lectures followed by webinars where students discussed and solved tasks related to the lectures. Additionally, as a part of this alternative placement, students had to conduct a physiotherapy assessment of a family member/housemate and summarize the findings in an anonymized medical record. At the end of the placement, all students wrote a short essay reflecting on their learning process. Students' written reflections were anonymized and subjected to a qualitative analysis.
Forty-three out of 44 participating students completed their essays. Although students expressed disappointment in missing out on clinical placement, they were surprised by how much learning the online alternative provided. The most valued activities were clinical case seminars where clinical cases previously experienced by the students were discussed. The seminars appeared to facilitate students' engagement in professional discussions and to enhance their clinical reasoning skills. Seminars also seemed to strengthen students' belief in their own and their fellow students' capabilities. Group discussions focusing on topics related to digital lectures were also appreciated. Interestingly, the activity that most closely mimicked a clinical setting - physiotherapy assessment of family member/housemate - was rarely mentioned in the students' essays. As expected, students most regret not meeting real patients and missing out on the new clinical experiences such encounters would provide.
Despite lack of direct patient contact, students in physiotherapy education evaluated that an online alternative placement was highly clinically relevant. Peer-to-peer discussions of clinical cases appeared to be especially valued. The fact that students themselves had to take the main responsibility for preparing the seminars and leading the discussions was an important pedagogical aspect of the online alternative. The findings indicate that in learning of clinical skills, physiotherapy students take benefit of autonomous, student-centered interventions. Further research should investigate how digital technology-enhanced learning can be used to improve quality of ordinary clinical placement, in physiotherapy- and health education.
2020 年 3 月，由于 COVID-19 大流行，挪威学术机构的校园关闭。所有面授教学都必须由数字替代品代替。停课还影响了理疗课程的临床实习，在某些情况下，这些实习不得不被没有病人接触的在线替代品所取代。本研究的目的是评估使用数字教学法来完成临床实习学习成果的益处和挑战。
奥斯陆都市大学的 44 名理疗专业四年级学生的临床实习被在线替代，该替代以两项主要的在线小组教育活动为中心：1）临床病例研讨会和 2）数字讲座，之后是网络研讨会，学生在会上讨论并解决与讲座相关的任务。此外，作为替代实习的一部分，学生必须对家庭成员/室友进行理疗评估，并将发现总结在匿名医疗记录中。实习结束时，所有学生都写了一篇短文，反思他们的学习过程。学生的书面反思被匿名化，并进行了定性分析。
44 名参与学生中有 43 名完成了他们的论文。尽管学生们对错过临床实习感到失望，但他们对在线替代方案提供的学习感到惊讶。最有价值的活动是临床病例研讨会，在研讨会上讨论了学生之前经历过的临床病例。这些研讨会似乎促进了学生参与专业讨论，并提高了他们的临床推理技能。研讨会还似乎增强了学生对自己和同学能力的信心。以与数字讲座相关的主题为重点的小组讨论也受到赞赏。有趣的是，最接近临床环境的活动 - 对家庭成员/室友进行理疗评估 - 在学生的论文中很少被提及。正如预期的那样，学生们最遗憾的是没有遇到真正的病人，错过了这样的遭遇会提供的新的临床经验。
尽管缺乏直接的病人接触，理疗教育的学生评估在线替代实习具有高度的临床相关性。对临床病例的同伴讨论似乎特别有价值。学生自己必须承担准备研讨会和领导讨论的主要责任，这是在线替代方案的一个重要教学方面。研究结果表明，在临床技能学习中，物理治疗学生受益于自主、以学生为中心的干预措施。进一步的研究应该调查如何利用数字技术增强学习来提高物理治疗和健康教育中普通临床实习的质量。
