Therapeutic Sciences, Department of Computer Science, Trier University of Applied Sciences, Trier, Germany.
Institute of Family Medicine, University of Luebeck, Luebeck, Germany.
BMC Med Educ. 2023 Jul 31;23(1):545. doi: 10.1186/s12909-023-04517-5.
Stratified models of care are valuable for addressing psychosocial factors which influence the outcome of patients with musculoskeletal disorders. Introducing such models in undergraduate training has the potential to propagate this knowledge with evidence and foster its implementation. The objective of this paper is to explore the perception and changes in the fear-avoidance beliefs of physiotherapy students participating in a developed blended learning course on stratified care.
A mixed-methods with a convenient sample of two consecutive cohorts were given a blended learning course on stratified care for patients with low back pain. The blended learning course comprised scientific rudiments and application of stratified care in clinical practice conceptualised using the KERN' 6-step approach. The exam scores, perceptions, performance on self-reflection-tests and pre- and post-scores on The Tampa Scale for Kinesiophobia for Physiotherapists' (TSK-PT) were obtained. After gaining clinical experience, participants were invited to discuss their clinical experiences and perceptions in workshops. The quantitative data was analysed explorative-descriptively. The qualitative data was analysed following an inductive coding system with constant comparisons.
Ninety-one participants consented to the evaluation (mean age = 22.9 ± 1.6 years), 66% were female. Exam scores correlated with time spent in training (r = 0.30) and scores on self-reflection-tests 1 and 2 (r = 0.40 and r = 0.41). Participants in both cohorts described the learning resources as promoting their interest in the subject (72% and 94%), up-to-date (91% and 93%) and helpful (91% and 97%). The fear-avoidance scores for participants decreased from 53.5 (± 9.96) to 40.1 (± 12.4) with a large effect size (d = 1.18). The regression model [F (2, 49) = 1151.2, p < 0.001] suggests that pre-TSK-PT and the interest of participants in the training predicted post-TSK-PT. The workshop participants (n = 62) all worked in clinical practice. Emerging from the analysis were 4 categories (evolving to maturity in practice, perceiving determinants of stratified care, strategising for implementation and adopting an outlook for future practice).
The quality of engagement in learning, training strategy and interest in the subject contributes immensely to learning outcomes. This blended learning course was successful in reducing kinesiophobia and influencing the participants' attitude towards care with the potential of being translated into long-term practice.
分层护理模式对于解决影响肌肉骨骼疾病患者预后的心理社会因素非常有价值。在本科培训中引入这种模式有可能传播这种知识，并促进其实施。本文的目的是探讨参与分层护理开发的混合学习课程的物理治疗学生对恐惧回避信念的感知和变化。
采用方便样本对两个连续队列进行混合方法研究，对他们进行了关于下腰痛患者分层护理的混合学习课程。混合学习课程包括科学基础知识和使用 KERN' 6 步方法概念化的分层护理在临床实践中的应用。获得考试成绩、感知、自我反思测试表现以及 Tampa 运动恐惧症量表对物理治疗师（TSK-PT）的前后分数。在获得临床经验后，邀请参与者在研讨会上讨论他们的临床经验和看法。对定量数据进行探索性描述性分析。对定性数据使用恒比比较的归纳编码系统进行分析。
91 名参与者同意评估（平均年龄 22.9 ± 1.6 岁），66%为女性。考试成绩与培训时间（r=0.30）和自我反思测试 1 和 2 的分数（r=0.40 和 r=0.41）相关。两个队列的参与者都描述说学习资源促进了他们对该主题的兴趣（72%和 94%）、最新（91%和 93%）和有用（91%和 97%）。参与者的恐惧回避分数从 53.5（±9.96）降至 40.1（±12.4），具有较大的效应量（d=1.18）。回归模型 [F（2,49）=1151.2，p<0.001] 表明，TSK-PT 前和参与者对培训的兴趣预测了 TSK-PT 后。62 名参加工作坊的参与者（n=62）均在临床实践中工作。从分析中出现了 4 个类别（在实践中逐渐成熟、感知分层护理的决定因素、为实施制定策略以及对未来实践的展望）。
学习参与质量、培训策略和对主题的兴趣对学习成果有很大影响。这种混合学习课程成功地降低了运动恐惧症，并影响了参与者对护理的态度，有可能转化为长期实践。
