A 65-year-old woman with chronic low back pain participated in a 1-week community walking poles course. Although the participant received instruction in the standard Nordic walking method, she independently adopted a novel, modified, two-point gait pattern. Subsequently, her pain and activity tolerance using walking poles were monitored at 6 and 12 months. The participant ambulated two times the distance and reported lower ratings of perceived exertion and pain at 6-month and 12month follow-ups when walking with poles compared with walking without poles. This case highlights the potential effect of respecting patient preference within the clinical decision-making model. Doing so empowered a participant with chronic low back pain to adopt a novel, self-selected gait pattern and improve her short-term and long-term outcomes associated with chronic musculoskeletal disease.
Purpose: Using valid and reliable measures to assess curricula within health professions programs has gained significant attention in recent years. The educational environment is considered a key domain for student success. The primary aim of this study was to measure the educational environment following the addition of a flipped classroom model within a physical therapy course as measured by the Dundee Ready Education Environment Measure. Methods: A first year doctorate of physical therapy course, “Physical Agents”, was redesigned to include a flipped classroom model, incorporating 24 videos that students reviewed independently, prior to hands-on laboratory learning. Following the conclusion of the course, students (n=57) completed the Dundee Ready Education Environment Measure, a valid and reliable survey designed to measure the educational environment within health profession programs. The Dundee Ready Education Environment Measure contains 50 items, rated from 0 to 4 (5-point Likert scale, “0” strongly disagree to “4” strongly agree), assessing five domains: students’ perceptions of learning; perceptions of teachers; academic self-perception; perceptions of atmosphere; and social self-perception. Descriptive statistics included mean global score (out of 200, 151 to 200 being an excellent environment) mean domain scores, and mean item scores. Cumulative grade point average between students in the flipped classroom model (n=58) and those who previously received a traditional teaching model (n=59) for the course were also compared. Student’s t-test was utilized with significance accepted at p<0.05. Results: The mean global score (168 ± 13.3), indicated that the flipped classroom model fostered an excellent educational environment. Additionally, all mean domain scores, including students’ perceptions of learning (41.3 ± 3.9), perceptions of teachers (39.2 ± 2.9), academic self-perception (25.1 ± 2.5) perception of atmosphere (40.1 ± 4.1) and social self-perception (22.1 ± 2.9) fell into the highest rank of each subscale. Individual item analysis demonstrated 26 items (52%) were identified as especially strong areas, five items (10%) were identified as areas that could be improved, and no individual items were identified as requiring particular concern or immediate attention. Further, no significant differences were seen in cumulative course grade point average between the flipped classroom model (3.74 ± 0.44) and the traditional teaching model (3.71 ± 0.46). Conclusions: The flipped classroom model, utilizing an online learning environment, fostered an excellent educational environment for the physical therapy Physical Agents class. No difference in course grade point average between the flipped classroom model and previous traditional teaching model was seen. Further investigations examining performance on didactic and psychomotor activities within the flipped classroom model are recommended.
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