Patricia Solomon Sue Baptiste Editors
Innovations in Rehabilitation Sciences Education:
Preparing Leaders for the Future
Patricia Solomon Sue Baptiste Editors
Innovations
in Rehabilitation
Sciences Education:
Preparing Leaders for the Future
With 10 Figures and 22 Tables
Patricia Solomon
School of Rehabilitation Science, IAHS – Room 437,
McMaster University,
1400 Main St. W., Hamilton, Ontario L8S 1C7, Canada
Sue Baptiste
School of Rehabilitation Science, IAHS – Room 412,
McMaster University,
1400 Main St. W., Hamilton, Ontario L8S 1C7, Canada
Library of Congress Control Number: 2005921684
ISBN-10 3-540-25147-2 Springer Berlin Heidelberg New York ISBN-13 978-3-540-25147-7 Springer Berlin Heidelberg New York
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The genesis of this book arose from our educational consultations with many physio- therapy and occupational therapy colleagues around the world. In the course of pre- senting workshops that were primarily focused on problem-based learning (PBL), it became very clear to us that educators in the rehabilitation sciences were very interest- ed in other aspects of our curricula. There were questions related to our unique clini- cal faculty model, our admissions processes, how we incorporate evidence-based prac- tice throughout our programs, and the process by which we develop new models in clinical education, among many others. Physiotherapy and occupational therapy edu- cators were clearly interested in developing creative student-centered learning activ- ities within their own programs. Hence we designed this book to highlight, support, and illustrate educational innovations in the rehabilitation sciences curricula at McMaster University.
Although the Faculty of Health Sciences at McMaster University is known widely as the originator of problem-based learning (PBL), this book is not focused exclusively on this. The intent is not solely to promote PBL, but as its philosophical approach em- phasizes student-centered learning and educational process, there are numerous ex- amples and references to PBL throughout the book. Through sharing our experiences with educational innovation we hope to encourage educators to see the importance of integration of content and a self-directed student-centered learning process in devel- oping curricula for current and future practice.
We felt it was important to share the successes and challenges as well as the lessons learned along the way. In doing, so we have tried to incorporate the perspectives and methods used in both curricula. We hoped to model the interprofessional collabora- tion that we feel is core to health care education and practice. The context and culture of our Faculty is one that encourages an interprofessional approach to education, re- search, and “being”. Thus, another impetus for undertaking the development of this book has been to provide a chance for all of us, as colleagues, to explore our accom- plishments together as occupational therapists and physiotherapists. As busy academ- ics, it is all too easy to continue on the path of teaching, research, consultation, service, and administration and not pause long enough to think about the innovations in which we are continually immersed.Writing this book has provided a chance to do just that and to think anew about our challenges and accomplishments.
We also felt it was important to highlight the close collaboration that exists between the occupational therapy and physiotherapy faculty at McMaster University. Although we often approach things quite differently in our separate curricula we have learned much from each other and the debate and sharing that occurs provides a fertile envi- ronment for new and creative ideas.
Contents V
Preface
We are most fortunate to be housed in an institution that embraces risk taking and innovation in education. Part of the joy of working at McMaster University is the sense that you will be supported in your efforts to develop new ways of facilitating learning even if these are not always successful.
We are privileged to work with a group of exceptional colleagues who embrace in- novation and strive for ongoing excellence in education. Their commitment and en- thusiasm emerges through the reading of the chapters.
Patricia Solomon Sue Baptiste Hamilton, Ontario December, 2004
Preface VI
Chapter 1
Skills for the Rehabilitation Professional of the Future
Patricia Solomon, Sue Baptiste
New Skills for the Changing Practice Context . . . . 2
Self-directed and Lifelong Learning Skills . . . . 3
Evidence-based Practice Skills . . . . 4
Consultation Skills . . . . 5
Communication Skills . . . . 5
Professionalism and Ethical Decision Making . . . . 6
Barriers to Implementing Innovative Curricula . . . . 7
Conclusion . . . . 8
References . . . . 9
Chapter 2 Curriculum Development and Design Sue Baptiste, Patricia Solomon The Pedagogical Framework: Problem-based Learning . . . . 12
Approaching the Task of Curriculum Renewal . . . . 13
Where to Begin? . . . . 14
Designing Our New Programs . . . . 16
Redevelopment Within a Problem-based Learning Culture . . . . 18
Integration of Experiential Practice Preparation Within a Problem-based Learning Framework . . . . 18
Evaluation Within a Graduate Problem-based Learning Framework . . . . 19
Conclusion . . . . 20
References . . . . 22
Contents VII
Contents
Contents VIII
Chapter 3
Strategies for Integrating Basic Sciences in Curriculum
Hallie Groves
Basic Sciences in an Integrated Curriculum: What to Learn? . . . . 24
Strategies for Integrating Basic Sciences into Innovative Curricula . . . . 25
Selecting Learning Resources . . . . 27
Facilitating the Learning of Basic Sciences . . . . 31
Special Issues for Facilitating the Learning of Anatomy . . . . 32
Evaluation of Basic Sciences Knowledge . . . . 34
Conclusion . . . . 35
References . . . . 36
Chapter 4 Developing Emerging Roles in Clinical Education Bonny Jung, Patricia Solomon, Beverley Cole Need for Innovations in Clinical Education . . . . 41
What Is the Role-emerging Placement? . . . . 42
What Are the Benefits? . . . . 43
What Are the Challenges? . . . . 44
Lessons Learned . . . . 46
Conclusion . . . . 48
Appendices References . . . . 56
Chapter 5 Evidence-based Practice for the Rehabilitation Sciences Patricia Solomon, Lori Letts Current Views of the Rehabilitation Professions . . . . 61
Strategies for Developing an Evidence-based Culture . . . . 64
Problem-based Learning . . . . 64
Problem Design . . . . 65
Formulating Questions for Self-study . . . . 65
Searching for Resources . . . . 68
Contents IX
Synthesis and Application to the Patient Problem . . . . 68
Evaluation . . . . 68
Clinical Skills Courses . . . . 69
Clinical Education . . . . 70
Specific Evidence-based Practice Courses . . . . 71
Conclusion . . . . 72
References . . . . 73
Chapter 6 Ethics E. Lynne Geddes, Margaret Brockett Ethics Education in Professional Programs . . . . 76
Incorporating Ethics into Physiotherapy and Occupational Therapy Curricula . . . . 77
Ethics Education in the Physiotherapy Program . . . . 78
Ethics Education in the Occupational Therapy Program . . . . 82
Interprofessional Collaboration . . . . 85
Lessons Learned . . . . 89
Faculty Involvement . . . . 89
Establishment of Learning Objectives . . . . 89
Maintaining and Adapting Content . . . . 89
Process and Format for Ethics Education . . . . 90
Role of the Tutor . . . . 91
Interprofessional Education . . . . 91
Student Barriers to Learning Ethics . . . . 92
Conclusions . . . . 92
References . . . . 93
Chapter 7 Interprofessional Education Penny Salvatori, Patricia Solomon Interprofessional Education in Rehabilitation Science at McMaster University . . . . 97
In the Beginning – Mohawk College to McMaster University 1980–1990 . . . . 97
The BHSc OT and BHSc PT Programs 1990–2000 . . . . 98
The MSc OT and MSc PT Programs 2000–Present . . . . 100
Contents X
Summary/Lessons Learned . . . . 106
From the Institutional Perspective . . . . 106
From the Faculty/Curriculum Planning Perspective . . . . 107
From the Student Perspective . . . . 108
A Glimpse at the Future of Interprofessional Education at McMaster University . . . . 108
References . . . . 109
Chapter 8 Curricula to Promote Community Health Julie Richardson, Lori Letts Community Health/Community Practice in the Physiotherapy Program . . . . 114
Impetus for Change . . . . 114
Assessment, Communication, and Management of Risk . . . . 116
Physiotherapy Role as Educators of Health Promotion and Disease Prevention . . . . 116
Theories that Have Driven Models of Practice for Behavior Change in the Curriculum . . . . 117
The McMaster Experience (Physiotherapy) . . . . 118
Content for Problem-based Tutorials . . . . 118
Clinical Skills Laboratories – What Are the Skills that We Are Imparting for Community Practice? . . . . 119
Resource Sessions . . . . 121
Evaluation Methods . . . . 122
Challenges with this Curriculum . . . . 123
Future Development and Research . . . . 123
The McMaster Experience (Occupational Therapy) . . . . 123
Definitions of Community and Community Health . . . . 124
Models of Occupational Therapy in the Community . . . . 125
Examples from the Occupational Therapy Program . . . . 125
Term 1: Health, Wellness, and Occupation . . . . 126
Term 2: Person, Environment, and Occupation . . . . 126
Term 3: Disability, Development, and Occupation . . . . 127
Term 4: Youth and the Development of Self . . . . 127
Term 5: Adulthood and Disability . . . . 127
Term 6: Complexities of Contemporary Practice . . . . 128
Curriculum Overview . . . . 128
Challenges Related to Community and Community Health in the Occupational Therapy Curriculum . . . . 129
Conclusion . . . . 129
References . . . . 130
Chapter 9 Developing Communication Skills Sue Baptiste, Patricia Solomon Elements of Communication Skills . . . . 136
Teaching and Evaluating Communication Skills . . . . 138
Illustrations from McMaster University . . . . 139
Video, Audiotapes, and Standardized Patients in Simulated Interviews and Practice Interactions . . . . 139
Self-assessment and Self-awareness . . . . 140
Peer Tutoring to Promote Communication Skills . . . . 141
The Written Word . . . . 143
The Presented Word . . . . 144
Conclusion . . . . 144
References . . . . 145
Chapter 10 Developing Community Partnerships Patricia Solomon, Sue Baptiste Description of Clinical Faculty Positions . . . . 148
Why Establish a Unfunded Clinical Faculty Stream? . . . . 149
Other Community–University Initiatives . . . . 152
Joint Research and Evidence-based Practice Initiatives . . . . 152
Emerging Roles Fieldwork Placements . . . . 152
Development of Client Education Packages . . . . 153
Challenges and Strategies . . . . 153
Conclusion . . . . 155
References . . . . 155
Contents XI
Chapter 11
Evidence-based Admissions in Rehabilitation Science
Penny Salvatori
A Theoretical Framework for Student Selection . . . . 158
Phase One . . . . 158
Phase Two . . . . 158
Phase Three . . . . 160
Phase Four . . . . 160
Pre-admission Academic Grades . . . . 160
Autobiographical Submission . . . . 163
Personal Interview . . . . 166
Lessons Learned . . . . 170
Conclusions . . . . 171
References . . . . 172
Chapter 12 Educational Preparation for Rural and Remote Practice: The Northern Studies Stream Jennifer Cano, Elaine Foster-Seargeant The Northern Studies Stream Program . . . . 176
The Context of Northern, Rural, and Remote Practice . . . . 177
What is Rural? . . . . 177
What Do You Need to Practice in a Rural Area? . . . . 178
Recruitment and Retention . . . . 178
Generalist as Specialist . . . . 179
First Nations’ Health Care Concerns as Part of Rural Practice . . . . 179
Educational Initiatives for Northern, Remote, and Rural Practice . . . . 181
Rural Fieldwork Experience . . . . 182
Strategies for Coping with Isolation . . . . 182
Sociocultural and Rural Practice Education . . . . 182
The Northern Studies Stream as a Comprehensive Program . . . . 182
Native Healthcare Education . . . . 184
Outcomes . . . . 187
Readiness for Practice Survey Results . . . . 187
Recruitment Outcomes . . . . 187
Retention Outcomes . . . . 188
Contents XII
Conclusion . . . . 188
References . . . . 189
Chapter 13 A Program Logic Model: A Specific Approach to Curriculum and Program Evaluation Sue Baptiste, Lori Letts External Context and Expectations for Accountability . . . . 192
Internal Demands and Expectations . . . . 193
Faculty Evaluation . . . . 193
Support for Fiscal Resources . . . . 193
Student Assessment/Evaluation . . . . 193
Course Evaluation . . . . 194
Evaluation Elements . . . . 195
Evaluation Processes in Place at McMaster University . . . . 196
Use of the Program Logic Model Approach . . . . 197
Understanding the Basic Structure . . . . 197
Developing the Model . . . . 198
Next Steps . . . . 202
Conclusion . . . . 202
References . . . . 203
Subject Index . . . . 205
Contents XIII
Contents XV
Directory of Contributors
Sue Baptiste
(e-mail: baptiste@mcmaster.ca)
School of Rehabilitation Science, IAHS – Room 412, McMaster University, 1400 Main St. W., Hamilton, Ontario L8S 1C7, Canada
Margaret Brockett
(e-mail: brocketm@mcmaster.ca)
School of Rehabilitation Science, IAHS – Room 403, McMaster University, 1400 Main St. W., Hamilton, Ontario L8S 1C7, Canada
Jennifer Cano
(e-mail: canoj@mcmaster.ca)
Health Sciences North, Lakehead University, 955 Oliver Road, Thunder Bay, Ontario, P7B 5E1, Canada
Beverley Cole
(e-mail: colebe@mcmaster.ca)
School of Rehabilitation Science, IAHS – Room 428, McMaster University, 1400 Main St. W., Hamilton, Ontario L8S 1C7, Canada
Elaine Foster-Seargeant (e-mail: fostere@mcmaster.ca)
Health Sciences North, Lakehead University, 955 Oliver Road, Thunder Bay, Ontario, P7B 5E1, Canada
E. Lynne Geddes
(e-mail: geddesl@mcmaster.ca)
School of Rehabilitation Science, IAHS – Room 438, McMaster University, 1400 Main St. W., Hamilton, Ontario L8S 1C7, Canada
Hallie Groves
(e-mail: grovesh@mcmaster.ca)
Health Sciences Centre, 1R4, McMaster University, 1200 Main St. W., Hamilton, Ontario L8N 3Z5, Canada
List of Contributors XVI
Bonny Jung
(e-mail: jungb@mcmaster.ca)
School of Rehabilitation Science, IAHS – Room 427, McMaster University, 1400 Main St. W., Hamilton, Ontario L8S 1C7, Canada
Lori Letts
(e-mail: lettsl@mcmaster.ca)
School of Rehabilitation Science, IAHS – Room 436, McMaster University, 1400 Main St. W., Hamilton, Ontario L8S 1C7, Canada
Julie Richardson
(e-mail: jrichard@mcmaster.ca)
School of Rehabilitation Science, IAHS – Room 443, McMaster University, 1400 Main St. W., Hamilton, Ontario L8S 1C7, Canada
Penny Salvatori
(e-mail: salvator@mcmaster.ca)
School of Rehabilitation Science, IAHS – Room 420, McMaster University, 1400 Main St. W., Hamilton, Ontario L8S 1C7, Canada
Patricia Solomon
(e-mail: solomon@mcmaster.ca)
School of Rehabilitation Science, IAHS – Room 437, McMaster University, 1400 Main St. W., Hamilton, Ontario L8S 1C7, Canada
