Patient education best practice; enhancing physiotherapy students’ self-efficacy and skills

Abstract

Patient education is an important component of physiotherapy care and a required competency for entry-level practice. Despite its important role, how physiotherapists deliver patient education in practice and the specific competencies required to provide this effectively are currently unknown. Understanding how the current curriculum prepares graduates as patient educators and whether training can enhance self-efficacy and skills of physiotherapy students to perform patient education is an important step in advancing professional practice in this area.Following a review of the literature which demonstrates a gap in this research, this thesis incorporates five studies (five manuscripts) with the overall aims to 1) explore how patient education is practiced and perceived by physiotherapists; 2) determine key differences in practices and perceptions based on levels of clinical experience; 3) identify the competencies required for physiotherapists in the area of patient education; 4) investigate the patient education self-efficacy of new-graduates and the influence of previous training, and 5) determine the effect of a patient education training intervention on physiotherapy students' self-efficacy and performance.Study 1 (Manuscript 1) was a cross sectional survey of practicing physiotherapists in Australia. This study investigated the self-reported practices and perceptions of physiotherapists relating to patient education, and their perception of factors that led to their development of patient education skills. Participants (n=304) reported a broad range of educational activities and approaches in their practice, it was therefore deemed important to understand how practice and perception may differ based on levels of experience.Study 2 (Manuscript 2) compared the self-reported practices and perceptions of experienced (n=204) and novice (n=52) physiotherapists. Experienced therapists reported a greater use of educational content consistent with patient-centred practice and a greater emphasis on self-management. Experienced therapists also reported a higher frequency of explicitly evaluating the effectiveness of their education than novice physiotherapists and perceived fewer patient-related factors as barriers to effective patient education.Findings from this study inform the patient education training needs of student and novice physiotherapists.Study 3 (Manuscript 3) involved a two-round Delphi approach using expert physiotherapists (n=12) to generate and reach consensus on competencies that physiotherapists require for effective patient education. This study led to the consensus of a set of 22 competencies with a high level of expert agreement. Importantly, these competencies aided the development of a self-efficacy and performance assessment measure for the following two studies as well as contributing to further understanding patient education training needs. with simulated patients, feedback and debriefing. Specific outcome measures were developed using the competencies derived from Study 3. A step-...

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