Associate Professor Louisa Remedios Physiotherapy

Faculty of Medicine, Dentistry & Health Science The University of Melbourne

Architecture of a DPT Program: from Vision to Construction: The University of Melbourne Model 2.

Scaffolding and a couple of uniquely designed rooms

Assessment drives learning

Assessment drives learning

But poorly done – it can be a bit of a car crash!

Constructive Alignment

In every subject in the program

Subject learning

outcomes

Teaching approach

Assess To achieve

LOs

DPT Attributes as generic skills

Health professionals for a new century: Strengthening 21st century global health systems: Investing Strategically in the Health Care workforce Julio Frenk (2011)

Systematic Failures

• Mismatch of competencies to needs

• Weak teamwork

• Hospital dominance over primary care

• Weak leadership for health system

performance

Transformative learning

Level Objectives Outcome

Informative Information Skills

Experts

Formative Socialization Values

Professionals

Transformative Leadership attributes

Change agents

How do we transition our learners:

• Independent, reflective critical reasoning • for lifelong learning & tolerant to ambiguity • Responsive to the scope of the profession • Attributes of the profession and the UoM • Level 9 E (AQF)

Principles of assessment

• Assessment designed as an active learning experiences for student with emphasis on the development of physiotherapy relevant attributes

• A focus on students’ capacity to analyse and synthesise new information and concepts, rather than simply recall information previously presented

• Promotion of “habits of mind” that have to do with self-awareness, critical thinking, intellectual growth, and engagement with active learning

• Tasks that facilitate the development of students’ collaborative, organizational and time management skills

• Progressive complexity in assessment tasks across the program • Requirement to integrate knowledge from diverse subjects and

not to isolate knowledge • Qualitative and quantitative feedback on achievements of criteria

available to students

Research being lead By A/Prof Delaney

• levels of Ax found in research

• Level 1: Receive and recall information

• Level 2: Analyse given information

• Level 3: Locate and analyse information

• Level 4: Apply knowledge to experience

• Level 5 Develop knowledge from experience

- Traditional exams/OSCEs - assignments - APP for clinics - Reflection assignment for 1st

assignment & onwards - Presentations/PKs - Posters, wikis, blogs - Health needs analysis proposal - ‘solve’ a professional challenge - Setting their own learning

outcomes for their final clinic

Range of assessment approaches

Standardised instrument used nationally • Established reliability & validity • Identifies 7 domains of practice and lists 20 items considered fundamental to our profession • Scores are determined by a rating scale used with performance indicators • APP is for use in ‘core’ clinical units where student is meant to carry their own caseload

Performance indicators

Assessment of Physiotherapy Practice

Healthcare in Context Working with and Working for

the Community:

Learning about health promotion through Community Engagement

The sequence of HCC practice

HCC1

• Community engagement

• Getting to know the community

• Understanding the determinants of health

HCC2

• Community needs assessment

• Working with the community

• Identifying the wellness priorities of the community

HHC3

• Community project/health promotion

• Working for the community

• Design project to meet identified need of the community

Assessment as driving learning

HCC1 Anotated bibliogrpahy

Needs analysis plan

Needs analysis finding

Presentation

HHC2 Global reflections

Health promotion

project

Presentation

Student conference

Learning sequence

Individual learning

Small Group learning

Cohort

Learning

HCC Outcomes: Single community health promotion over 3 years

2014: • APA InMotion article: Communication with Deaf and hard of

hearing individuals • Videos for Deaf Community + Private practitioners

“Deaf Awareness for Physiotherapists”

2013: • Working with Auslan interpreters to improve communication access

for the Victorian Deaf community & • Presentation at APA conference on above

2015: • Physio student education • Poster WCPT: Health needs

analysis of VicDeaf community

‘Service learning’

A physiotherapy

experience

Pecha Kucha

06:40

Values & aspirations of community of practice

Professional community

Academic

community

Civic community

Values and attributes

• the ability and a willingness to contribute to the community

• a commitment to contribute to the resolution of health inequities locally and globally

• DPT graduates are scientifically & socially literate who will improve the healthcare of individuals & community at a local, national & international level

•

Healthcare in Context Community engagement

Community Engagement

HCC1

• ½ cohort x 2

• 9 weeks intensive

• Needs Analysis

HCC2

• Full cohort

• 16 weeks distributed

• Health promotion

Examples of communities

Rumbalara Football & Netball Club

Riding Develops Abilities

Example 1: Arabic Women’s group

Example 1: Arabic Women’s group

Example 2a: 2013

Example 2a: 2013

Example 2b: 2015

Example 2b: 2015

Finding communities

Logistics

Competing subjects

Crammed curriculum

HCC has it challenges:

Values in action

The road ahead …

Leadership and Management:

an oxymoron or

a perfect partnership

Overview

• Why this subject?

• How has the subject evolved?

• Which relationships have shaped the subject?

• What does the subject looks like?

• What do students think?

• Lessons learnt?

Why ‘Leadership & Management”?

• Why?

–Graduates work in Private Practice

–Graduates not prepared for PP

–Graduates do not feel prepared for PP

– PPs not taking students into clinics

– Masters graduates => more likely to go to PP

• New program 2011 – new opportunity to meet needs of profession and of graduates

Partnerships

Business

students

Leadership

&

Management

Business

Experts

DPT

students

Links with other

subjects

Leaders in the profession

The profession

Step 1 – 2011

• The University of Melbourne capstone project

• Department of Management & Marketing

• Business consulting MGMT30012 – 5 students

– PPs perception of students preparation for PP

– barriers & incentives PPs face in offering clinical placements

– What would make students more attractive to PPs?

Data collection

• Interviews: 6 committee members of the Australian Physiotherapy Association PP interest group

• Variability in experience, specialization

• Market segment differs demographically, geographically & behaviorally

Findings

• Lack of business knowledge, skills & exposure (finance, tax, insurance …)

• Marketing skills (expanding market base)

• Insufficient levels of clinical skills/diagnostic skills/clinical reasoning

• Need to prepare students & increase exposure to PP

Why not take students and educate them in PP?

• Time and financial sacrifices to provide placement

• Negative impact on business reputation if students fail to meet consumer expectations

– Esp smaller practices or sole practitioner practices

• Insufficient support from the Unis

• placements provided for altruistic reasons

• Need to set up partnerships with PPs

What would make students more attractive?

• Financial & nonfinancial remuneration

• Freedom to select students (not likely)

• Priority for students ie should not be core placement

• Prepare students and make PP an elective

Step 2: enter the experts

• Associate Professor Pat Foley

• Department of Management and Marketing

• Faculty of Business and Economics

• Mr. Justin Steer

• STEER Healthy Business

Step 3: Learn from PP + public sector informants

• to know how to use themselves effectively in a business context – Time management

– Customer rapport

– Manage self & others (reflective practitioners)

• The tensions between making profits and delivering EBP service; attend to stakeholders and see value

• The role of health funds in legitimizing different types of health care interventions

Step 3: Learn from PP + public sector informants

• Part of new knowledge and fresh ideas

• Knowledge leaders

• Need to be innovative

• Grow customer base

• The increasing importance placed on evidence based health promotion

• Physiotherapy as more than competent technicians

• innovative scholarly practitioner who has good business awareness.

+ In practice 2025

Subject: Leadership & Management

• 12.5 credit points

• Year 3, semester 2

• Final year before employment

• Series of lectures and exercises by business expert;

• Extensive reading into literature

• Input from Justin Steer make relevance explicit for PP context

• Private practitioners as guest speakers

• Focused assessment

Content frameworks

• Model in response to PP interview

– LEAD model

• Tipping point leadership

• Leadership evolution

• Value innovation and value creation

• Entrepreneurship

Some specific business content

• Managing self to manage relationships

• Communicating with stakeholders

• The budget

– Fee structure

– Need to earn/ratio rentals

– Nature of salaries

– Legal implications of elements of budget

• Setting up a business

• Customer relationships

Private practitioner consultation

Private practitioner consultation

Business students – capstone project

Business expert analysis

Subject design

Student feedback

Student feedback on L&M

• Challenging, learning something very new. Having a different perspective on businesses, and what is needed for a business to thrive and survive

• I discovered an interest in the business world that I don’t think I would have been exposed to if it weren’t for this subject

• I loved learning about leadership and management in physiotherapy, and liked when physiotherapists from different backgrounds came in to share their experiences. I also found it very useful learning about what is entailed in running a private physiotherapy practice.

• It challenged students in different ways of thinking than we were accustomed to. The sessions that directly related to physiotherapy practice e.g. building up a client base in a private practice setting and what you should be negotiating for in a private practice job contract were the most immediately valuable.

Student comments

Finding opportunity for PP placements to supplement L&M

Core musc (outpatients)

PP in global placements (3 weeks)

PP as professional

selective

(4 weeks)

work readiness

(musc outpatients)

(4 weeks)

L&M here

Subject plan

• Give you clear structure on L&M so you can make choices on how you inhabit your L&M roles (LEADS)

• Bring in experts on L&M + leaders and managers

• Structured your reading to provide frameworks to progress you thought the subject

• Assessment tasks to drive your learning

• Choice ++++ in assessment to meet your personal needs and interests

• Good and bad news – group work assignments

The perfect leader

LEADS

Testing analysis and synthesis

Finally Exams for the DPT students

E-Health Records: To Implement, or not to

Implement… That is the question?

Social media

• Presented by the Creators and

Owners of

For Marketing and Communication in Physiotherapy

Engaging The Untapped Physiotherapy Workforce: A design thinking leadership approach

Physiotherapy Workforce

• Bbb

What is known about the Australian physiotherapy

workforce?

What factors contribute to physiotherapists

leaving the workforce?

What strategies could be implemented to improve physiotherapy retention?

Lessons learnt

• Listening to the voice of PPs

– Generous PPs – very willing to help

• Value of multiple partnerships

– Multiple insights

• Evidence based development of curriculum

• What works and what needs further attention

Thank you to all our partners in the DPT - physiotherapist from the private & public sector - students - educators

Some of our plans

Learning from constructive misalignment-

When making mistakes can improve your practice

Making the student the master in the

master class setting

Reflection and feedback

during my OSCE, what

have I learnt?

Education research

• Social media use in health professional education: an international and interdisciplinary study

• Global learning partnership: implementing the sustainable development goals

• Learning from Assessment in Indigenous Health Education

• Identifying pedagogy & teaching strategies for achieving nationally prescribed learning outcomes