This study demonstrates that a single 4-hour interprofessional education session can improve interprofessional attitudes, knowledge of other professions, and perceived-readiness of health science graduate students to work interprofessionally and to work with older adults.
Objective To investigate feasibility of recruitment, tablet use in intervention delivery, and use of self-report outcome measures and to analyze the effect of Energy Conservation plus Problem-Solving Therapy versus Health Education interventions for individuals with heart failure-associated fatigue. Methods This feasibility study was a block-randomized controlled trial involving 23 adults, blinded to their group assignment, in a rural southern area in the United States. Individuals with heart failure and fatigue received the interventions for 6 weeks through videoconferencing or telephone. Participants were taught to solve their fatiguerelated problems using energy conservation strategies and the process of Problem-Solving Therapy or educated about health-related topics. Results The recruitment rate was 23%. All participants completed the study participation according to their group assignment, except for one participant in the Energy Conservation plus Problem-Solving Therapy group. Participants primarily used the tablet (n=21) rather than the phone (n=2). Self-report errors were noted on Activity Card Sort (n=23). Reported fatigue was significantly lower for both the Energy Conservation plus Problem-Solving Therapy (p=0.03, r=0.49) and Health Education (p=0.004, r=0.64) groups. The Health Education group reported significantly lower fatigue impact (p=0.019, r=0.48). Participation was significantly different in low-physical demand leisure activities (p=0.008; r=0.55) favoring the Energy Conservation plus Problem-Solving Therapy group. Conclusion The recruitment and delivery of the interventions were feasible. Activity Card Sort may not be appropriate for this study population due to recall bias. The interventions warrant future research to reduce fatigue and decrease participation in sedentary activities (Clinical Trial Registration number: NCT03820674).
Although occupational therapy educators have historically used cases as a means to prepare students for clinical practice, there is little evidence that this instructional method actually facilitates clinical reasoning. This convergent, parallel mixed methods study examined how the use of varied case formats, built on the tenets of case-based learning, facilitated specific components of clinical reasoning, and explored how the cases contributed to readiness for professional practice. Case formats included text, video, role-playing, simulated patients, and a client. Case-based learning activities included application of models and frames of reference, conducting assessments, planning and implementing interventions, clinical documentation, and identification of reasoning used. All cases included the opportunity for instructors to provide direct and appropriate feedback, and facilitation of student reflection on their performance. The Self-Assessment of Clinical Reflection and Reasoning (SACRR) was used for quantitative data analysis and detected statistically significant changes in the use of theory and frames of reference to inform practice and in student reasoning about interventions, following case-based learning. Student surveys allowed for pragmatic qualitative analysis, and identified the themes of self-awareness, confidence, and developing competence related to readiness for fieldwork and clinical practice. Student preferences for case format and benefits of varied types of cases were identified. Case-based learning used different case formats, and contributed to the occupational therapy student transition from a clinical reasoning novice to an advanced beginner. Knowledge of this process is useful to occupational therapy educators in structuring case-based learning activities to influencing reasoning.
Date Presented 04/05/19
This quantitative study examined clinical reasoning development achieved through case-based learning during one year of an entry-level OT curriculum. Self-Assessment of Clinical Reflection and Reasoning identified statistically significant changes in clinical reasoning skills in total score and 10 individual items based on this instructional method. Results were supported by student feedback regarding the benefits of case formats that promoted reasoning and enriched the learning experience.
Primary Author and Speaker: Lynne Murphy
Additional Authors and Speakers: Jennifer Radloff
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