Ms Windfeld-Lund: Senior Physiotherapist, Alfred Health, Melbourne, Australia, Mr Sturt : Allied Health Clinical Education Lead, Alfred Health, Melbourne, Australia. Ms Pham: Senior Physiotherapist, Alfred Health, Melbourne, Australia. Dr. Lannin: Professor, Department of Neuroscience, Monash University, Melbourne, Australia; and Clinical Chair (Occupational Therapy), Alfred Health, Melbourne, Australia. Dr Graco: Implementation Scientist, Institute for Breathing and Sleep, Austin Health, Melbourne, Australia.
J Contin Educ Health Prof. 2023 Apr 1;43(2):109-116. doi: 10.1097/CEH.0000000000000477. Epub 2023 Mar 28.
Continuing allied health professional (AHP) clinical education is essential to ensure high-quality patient care; however, the effectiveness of current education programs is unclear. This review aimed to determine whether AHP education programs improve the knowledge of AHPs, change their clinical practice behavior, and/or improve patient-related clinical outcome and to identify important components of these programs.
Four electronic databases were searched. Controlled clinical trials investigating the effectiveness of clinical education programs were included. Education programs were diverse, varying in design, delivery mode, and intensity. Only therapy-specific AHPs were included. Effectiveness was determined by differences in group outcomes in the domains of AHP knowledge, AHP clinical practice behavior, and patient-related clinical outcomes.
Forty-four studies were identified, of which 26 included physiotherapists only. Most control groups were waitlist, passive dissemination of information, or usual care, limiting comparisons between programs. Changes in AHP knowledge was investigated in 20 trials, with 13 showing an improvement. Thirty studies investigated changes in AHP clinical practice behavior, with half demonstrating a difference between groups. Seventeen studies investigated a patient-related clinical outcome, with five finding a difference between groups. Where improvements in outcomes were demonstrated, programs tended to incorporate self-selection and cater to the learner's contextual needs.
AHP knowledge is effectively improved through targeted education programs. To change AHP behavior and patient outcomes, it seems important to incorporate self-selection for the program and consider the learner's individual needs and contexts through mentoring, outreach visits, reflection, and incorporating patient participation in the learning.
持续的辅助医疗专业人员(AHP)临床教育对于确保高质量的患者护理至关重要;然而,目前教育计划的效果尚不清楚。本综述旨在确定 AHP 教育计划是否能提高 AHP 的知识水平、改变他们的临床实践行为、以及/或改善与患者相关的临床结果,并确定这些计划的重要组成部分。
检索了四个电子数据库。纳入了调查临床教育计划有效性的对照临床试验。教育计划多种多样,设计、交付模式和强度各不相同。仅包括特定治疗的 AHP。通过 AHP 知识、AHP 临床实践行为和与患者相关的临床结果领域的组间结果差异来确定有效性。
确定了 44 项研究,其中 26 项仅包括物理治疗师。大多数对照组为等待名单、信息被动传播或常规护理,限制了计划之间的比较。20 项研究调查了 AHP 知识的变化,其中 13 项显示出改善。30 项研究调查了 AHP 临床实践行为的变化,其中一半显示出组间差异。17 项研究调查了与患者相关的临床结果,其中 5 项发现组间存在差异。在显示出结果改善的地方,计划往往会纳入自我选择,并满足学习者的背景需求。
有针对性的教育计划可以有效地提高 AHP 的知识水平。要改变 AHP 的行为和患者的结果,似乎重要的是将自我选择纳入计划,并通过指导、外展访问、反思和将患者参与学习纳入计划来考虑学习者的个人需求和背景。