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确定澳大利亚公立三级医疗环境中通过远程医疗提供物理治疗的能力框架和培训要求:一项多方法研究。

Determining a capability framework and training requirements to support provision of physiotherapy via telehealth in an Australian public tertiary health setting: a multi-methods study.

作者信息

Cottrell Michelle, Featherston Sarah, Pateman Kelsey

机构信息

Physiotherapy Department, Royal Brisbane and Women's Hospital, Herston, Australia.

School of Health and Rehabilitation Sciences, University of Queensland, St Lucia, Australia.

出版信息

Physiother Theory Pract. 2025 May 14:1-11. doi: 10.1080/09593985.2025.2498690.

Abstract

BACKGROUND

Inadequate clinician training and support is a primary challenge to physiotherapists' adopting telehealth. Training must be underpinned by relevant capability frameworks and co-developed to meet the needs and preferences of the existing physiotherapy workforce.

OBJECTIVE

Establish a capability framework for delivery of care via telehealth and understand training requirements to achieve competency specifically for the publicly funded physiotherapy workforce.

METHODS

Sequential multi-methods study design. Phase 1: Physiotherapists with telehealth experience participated in a 2-round e-Delphi process to establish consensus on core capability framework domains (Round 1,  = 29; Round 2,  = 26). Phase 2: Physiotherapists ( = 35) subsequently rated their current knowledge and confidence for each capability item. Phase 3: Participatory focus groups, involving physiotherapists ( = 37) from six facilities, identified theoretical and practical domains most relevant to local contexts via thematic analysis.

RESULTS

Fifty-three capability items were produced across eight domains (Compliance, Patient privacy and confidentiality, Patient safety, Technology Skills, Telehealth Delivery, Assessment and Diagnosis, Care Planning and Management, Access and Equity). Knowledge and confidence were ranked lowest within the Technology Skills domain (% respondents reporting high levels of confidence = 28.6%-42.9%), and highest in Telehealth Delivery (% respondents reporting high levels of confidence = 54.2% -80%). Focus groups identified technology skills, risk management (patient safety) and superuser support as priority areas for training.

CONCLUSION

Physiotherapists identified additional local training competencies to compliment the 53-item capability framework. Adopting a sequential multi-methods and participatory approach successfully produced a training package framework suitable for implementation in a public outpatient setting.

摘要

背景

临床医生培训和支持不足是物理治疗师采用远程医疗的主要挑战。培训必须以相关能力框架为基础,并共同开发以满足现有物理治疗人员的需求和偏好。

目的

建立通过远程医疗提供护理的能力框架,并了解专门针对公共资助的物理治疗人员实现胜任力的培训要求。

方法

采用顺序多方法研究设计。第1阶段:有远程医疗经验的物理治疗师参与两轮电子德尔菲法,以就核心能力框架领域达成共识(第1轮,n = 29;第2轮,n = 26)。第2阶段:物理治疗师(n = 35)随后对每个能力项目的当前知识和信心进行评分。第3阶段:参与性焦点小组,由来自六个机构的物理治疗师(n = 37)组成,通过主题分析确定与当地情况最相关的理论和实践领域。

结果

在八个领域(合规性、患者隐私和保密性、患者安全、技术技能、远程医疗服务、评估和诊断、护理计划和管理、可及性和平等性)产生了53项能力项目。技术技能领域的知识和信心排名最低(报告高度信心的受访者比例 = 28.6%-42.9%),而远程医疗服务领域的知识和信心排名最高(报告高度信心的受访者比例 = 54.2%-80%)。焦点小组确定技术技能、风险管理(患者安全)和超级用户支持是培训的优先领域。

结论

物理治疗师确定了额外的本地培训能力,以补充53项能力框架。采用顺序多方法和参与性方法成功制定了一个适合在公共门诊环境中实施的培训包框架。

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