UWCScholar :: Browsing by Author "Hess, Danelle"

Browsing by Author "Hess, Danelle"

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The development of design principles to guide the development of clinical reasoning in physiotherapy education
(University of the Western Cape, 2021) Hess, Danelle; Rowe, Michael
Clinical reasoning is enigmatic; however, students need to learn how to do it, educators need to be able to develop it, and experts need to explain how they do it. Health professions educators have described clinical reasoning as a skill required for health professionals. Clinical reasoning has been used synonymously with terms such as clinical judgement, critical thinking and clinical decision-making. Broadly speaking, clinical reasoning refers to the thought and decision-making processes associated with clinical practice and particularly choosing a course of action for a patient. Possible strategies for developing clinical reasoning and the use of certain learning tasks in the development of clinical reasoning in undergraduate health professions students have been highlighted. However, there are still areas of research to consider.
Do physiotherapy students employ evidence-based practice in the management of musculoskeletal disorders and sports injuries
(2013) Hess, Danelle; Frantz, Jose
Background: Musculoskeletal disorders (MSD’s) and sports injuries are commonly sustained throughout the world daily. They are dominant in many countries, with considerable cost involvement and impact on quality of life. For this reason they need to be recognised as a necessary part of general practice. MSD’s refer to a wide variety of diseases and disorders of the musculoskeletal system, such as degenerative and inflammatory conditions (arthritis), spinal and soft tissue disorders, osteoporosis and musculoskeletal injury. Managing these musculoskeletal conditions are a challenge and using the best available evidence should be the first the choice. All health professionals should have the ability to determine the best available evidence and thus strive to give their patients the best health care known to them. Evidence-based practice (EBP) is an important key in making this happen as it uses the best current evidence in the decision-making process regarding the care of patients. Literature highlights that health care professionals are expected to implement evidence-based practice (EBP); this means that newly graduated students and health care professionals alike are required to be confident in exercising this skill of EBP. When expecting EBP from students, educators need to realize that students have limited clinical experience. Therefore, they need the skills to acquire the best research evidence when applying the best treatment for patients. In introducing evidence-based practice, various research is aimed at evaluating the health professional’s attitude and behaviour towards evidence-based practice (EBP). There is limited research regarding the actual implementation of EBP in everyday practice. Aim: Therefore, the aim of the study was to determine if undergraduate physiotherapy students implement evidence-based practice in the management of musculoskeletal disorders and sports injuries. Objectives: The study had four objectives: i) To determine the most common treatment techniques used by students in the management of the conditions treated at the UWC clinic through data extraction of patient records in the clinic using a self-designed data extraction sheet, ii) To determine the knowledge and beliefs about EBP among undergraduate physiotherapy students through a survey, iii) To determine an evidence-based intervention strategy of one of the most common conditions seen through a systematic review and iv) To map the links between current practice, student beliefs and evidence-based information. vii Methodology: The study used a predominantly quantitative approach with a few open ended questions and took place at a student training Physiotherapy clinic. The first phase was a retrospective document analysis study which consisted of data extraction of patient records for the period January 2009 to December 2011. The second phase used a mixed methods approached and consisted of a questionnaire with both closed and open-ended questions. It was completed by the 2012 registered fourth year students regarding attitudes and knowledge of EBP. The third phase consisted of a systematic review to identify the evidence for interventions used to manage one of the most common conditions identified. In the final phase and discussion of this thesis triangulation of the data was used by the researcher in order to formulate a picture of whether students apply evidence-based practice by using the data extracted from the patient folders in combination with the questionnaire survey of the participants and the systematic review. Data analysis for phases one and two was done using SPSS Statistical package software to determine frequencies and descriptive statistics. Phase two also had two open ended questions and this was analysed thematically and data was coded, themes allocated and responses counted. The systematic review focused on systematic reviews of treatments for low back pain and this was narratively described. The research project received ethical clearance from the University of the Western Cape Research Grants and Study Leave Committee (project registration number: 12/3/12), and permission to conduct the survey was obtained from the Head of Department. Informed consent was obtained from all participants, they were informed of the research process at the outset of the project, and kept up-to-date at every major stage. Questionnaires for surveys were accompanied by an information sheet explaining the background and reason for conducting the survey, and students gave written, informed consent following an opportunity to clarify the study details. Results: The results showed that males were predominantly seen at the physiotherapy clinic, and that the most common complaint was pain in the neck, shoulder and lower back area. The students most common treatment choice was soft tissue mobilisation and the use of heat for all three these areas of pain. The questionnaire responses were also captured using SPSS and frequencies and descriptive statistics employed. These results showed that although students knew what EBP was it was not clear that they knew how to implement it. The systematic review assessed and established the most common treatments used in literature for the treatment of lower back pain; and pain, function and disability were viii the only outcomes considered. The only intervention that had a positive effect on the included outcomes was the use of manual therapy (spinal manipulation and mobilisation). In triangulating the data, it was shown that the students do not seem to use the same treatment choices as the literature indicates. Conclusion: The results show that there is very little link between the students choices of treatment for one of the common conditions highlighted and the current literature. It is therefore possible that although students understand the term EBP they do not show that they know how to use or implement the concept. Implications for practice: Institutions may need to be more vigilant about making provision for EBP in the curriculum as well as how it is implemented so that students can be comfortable with this practice. More randomised controlled trials and systematic reviews are necessary on physiotherapy interventions so that practice can be better informed. Finally, EBP is perhaps one way to promote a culture of life-long learning within the physiotherapy profession.
Enhancing the development of clinical reasoning in health professional students – Scoping review
(University of Western Cape, 2021) Engel-Gilbert, Ilse; Hess, Danelle
Clinical reasoning is the central aim of student health professionals’ education. However, educators still find it challenging to teach, and students still struggle to demonstrate clinical reasoning abilities. Various teaching strategies are used by educators to facilitate the development of clinical reasoning abilities, but it is unclear whether educators utilise robust theories to underpin their teaching strategies. Theories can assist with the conceptualisation, simplification and improvement of information. The aim of this study was to explore the use of theory to inform the teaching strategies which develop clinical reasoning in undergraduate health professional students.
Recommendations of behavioural facilitators for success in a physiotherapy clinical practice module: Successful students’ perspectives
(PubMed, 2020) Ennion, Liezel; Hess, Danelle
Background: Students struggle to bridge the gap between theory and application thereof in clinical settings. Exploring the behaviours of students who have been shown to be successful in the clinical practice module of physiotherapy could provide an insight into what facilitated their success. Sharing this information with other students could assist with decreasing anxiety and improving student success. Objectives: The objective of this study was to explore behaviours that facilitate student success in a physiotherapy clinical practice module from the perspective of high-achieving students. Method: Data were collected at the University of the Western Cape’s physiotherapy department in South Africa. Ten students with the highest marks in clinical practice from the 2016 and 2017 final-year cohorts were purposively selected and invited to participate in two different Nominal Group Technique (NGT) discussions. In total, 14 students consented to participate in the study. A demographic and socio-economic status questionnaire and an NGT discussion were used to collect data. Participants analysed the NGT discussion data themselves by ranking facilitators in order of priority. Results: Doing pre-block preparation, self-reflection and having a good rapport with patients as well as personal motivation and coping strategies were identified as the most important behavioural facilitators for physiotherapy students’ success in a clinical practice module.
Recommendations of behavioural facilitators for success in a physiotherapy clinical practice module: Successful students’ perspectives
(OpenJournals Publishing AOSIS (Pty) Ltd, 2020) Ennion, Liezel; Hess, Danelle
Students struggle to bridge the gap between theory and application thereof in clinical settings. Exploring the behaviours of students who have been shown to be successful in the clinical practice module of physiotherapy could provide an insight into what facilitated their success. Sharing this information with other students could assist with decreasing anxiety and improving student success.
Self-assessment of final-year undergraduate physiotherapy students’ literature-searching behaviour, self-perceived knowledge of their own critical appraisal skills and evidence-based practice beliefs
(Health and Medical Publishing Group, 2016) Hess, Danelle; Frantz, Jose M.
BACKGROUND. Health professionals and new graduates alike are expected to be efficient in applying evidence-based practice. Research and evidencebased practice skills are taught in the research modules at university, but it is not clear whether students translate those skills into clinical practice. OBJECTIVE. To determine the self-assessment literature-searching behaviour, self-perceived knowledge of critical appraisal skills and evidence-based practice beliefs of final-year undergraduate physiotherapy students at a university in South Africa. METHODS. This study used a quantitative approach, with a small qualitative component. A convenience sample of the final-year undergraduate physiotherapy students (N=36) registered for the 2012 academic year was approached to participate in the study. Data were collected using an existing questionnaire. RESULTS. The study yielded a 75% response rate. With regard to literature-searching skills, 30% searched for literature more than once a week, 52% searched only for specific information and most had access to literature. Students received their information from journal articles (85%), the internet and databases. They were slightly confident when it came to literature appraisal and believed that evidence-based practice was essential to their practice (96%), but expressed a need for more training (59%). Their understanding of the evidence-based practice concept was limited because they based their treatment choices on content and other role-models, and related their choices to their previous patient experiences. CONCLUSION. Students believed that evidence-based practice was vital, yet their understanding of the concept was restricted when compared with the literature and they expressed a need for further training.
Student and clinical educator perspectives of clinical reasoning
(University of Western Cape, 2021) Hendricks, Jacqueline; Hess, Danelle
Clinical reasoning describes the thinking and decision-making process behind one’s actions. Effective clinical reasoning should result in appropriate decision-making that leads to better clinical outcomes for the patient. The successful transfer of basic sciences – in other words, clinical knowledge – helps students develop clinical reasoning. However there are challenges translating academic theory into practical situations. Clinical educators play an important role in improving the development of clinical reasoning and identifying difficulties. Aim: To explore student and clinical educator perspectives of clinical reasoning in the Physiotherapy Department of the University of the Western Cape.
Student and staff perceptions and experiences of the introduction of Objective Structured Practical Examinations: a pilot study
(Health and Medical Publishing Group, 2013) Frantz, Jose M.; Rowe, Michael; Hess, Danelle; Rhoda, Anthea; Sauls, Hess; Wegner, Liezel
Background. The Objective Structured Practical Examination (OSPE) is widely recognised as one of the more objective methods of assessing practical skills in healthcare programmes, including undergraduate physiotherapy curricula. Objectives. To obtain feedback from both students and staff who were involved in the introduction of an OSPE in 2011, in order to refine and standardise the format throughout the curriculum. Methods. A qualitative research design was used. Data were gathered through a questionnaire with semi-structured open-ended items and focus group discussion. Participants were all third-year undergraduate physiotherapy students (N=47) and all staff members (N=10) in the 2011 academic year who were exposed to the OSPE format or were involved in the first OSPE. Results. The main concerns raised by both students and staff were: (i) pressure due to time constraints and how this might affect student performance; and (ii) the question of objectivity during the assessment. However, their initial concerns changed as they experienced the OSPE in a more positive manner owing to the structure and objectivity of the process of implementing the OSPE. Conclusion. While both students and staff reported positive experiences, the challenges that emerged provided valuable insight in terms of refining the OSPE format in this undergraduate physiotherapy department.
Understanding the learning styles of undergraduate physiotherapy students
(2014) Hess, Danelle; Frantz, Jose M.
Background: Undergraduate students at universities have different learning styles. To perform optimally, both they and their educators should be made aware of their preferred learning styles and problem-solving abilities. Students have different backgrounds, strengths, weaknesses, interests, ambitions, levels of motivation and approaches to studying and educators should therefore aim to become more aware of the diverse approaches to learning. Objective: To identify the various learning styles and problem-solving abilities of physiotherapy students at the University of the Western Cape, South Africa. Methods: Undergraduate physiotherapy students (N=246) who were registered for the 2012 academic year participated in the study. Three valid and reliable questionnaires, including the Index of Learning Styles (ILS), the Problem-Solving Style Questionnaire (PSSQ) and the Learning Style Questionnaire (LSQ), were used. Responses were analysed statistically to establish the association between learning styles and problem-solving ability. Results: A response rate of 72% was reported (n=177). For first-, second-, third- and fourth-year students the response rates were 65/85 (76%), 53/67 (79%), 31/58 (53%) and 28/36 (78%), respectively. Forty-five (25%) participants were male, 124 (70%) were female and 8 (0.04%) did not indicate their gender. The prominent learning styles were feeling (PSSQ), kinaesthetic (LSQ) and visual-verbal (ILS). Males were prone to using the kinaesthetic learning style and females to a more visual learning style. The feeling group constituted 47% of the sample (39% males and 43% females). Conclusion. The majority of students seem to learn by doing, although facts are important to them. It therefore might be important to first teach physiotherapy students concepts and then assist them to apply these in practice.

Browsing by Author "Hess, Danelle"

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