1 Training on wheelchair provision and use in the curricula of rehabilitation professionals
2 Agenda WHO Overview of WSTP and Integration (Chapal Khasnabis) ISWP Overview & Meeting Goals (Jon Pearlman) Integration Survey (Nicky Seymour) Integration Interviews (Paula Rushton) Integration Pilot Sites (Krithika Kandavel) Case Study 1- Univ. CES, Colombia (Maria Toro) Case Study 2 - Univ. of Montreal, Canada (Paula Rushton) Discussions
3 Meeting Goals Share outcomes of our researchShare activities related to integration Learn about steps/ways to amplify integration activities. Who are key decision makers related to curriculum Continuing education vs. core curricula Challenges/Opportunities related to funding & implementation Next steps
4 ISWP’s Overview Mission: Serve as a global resource for wheelchair service standards and provision through advocacy, training/testing, standards, evidence-based practice, innovation and a platform for information exchange Activities: Awareness & Advocacy Training Product Quality Standards Evidence-based practice
5 Increase policy adoptionWorking Groups Advocacy Increase awareness Increase policy adoption Training Testing Integration Scalable Trainings Standards Caster Failures Rolling Resistance Design Guidelines Research Data Collection Minimum Data Set Research Framework
6 Integration Goal: Increase number of trained WC service providers through training in OT/PT/O&P programs Rationale: These professionals often become WC service providers. Training materials are already available. There is a grass-root effort to add this curricula. Current exposure is not enough, even at the basic level.
7 Survey Outcome Very little exposure to WCs in core curriculaStrong desire for this training around the world Some early-adopters demonstrating success
8 Current Activities Facilitate meetings to share experiencesSupporting programs by providing tests & materials Facilitating content sharing
9 A Global Description of Wheelchair Service Education1. Cross-Sectional Survey Study 2. In-Depth Qualitative Interview Study 3. Integration Pilot Sites
10 Aim To gain an enhanced understanding of the wheelchair service education provided in educational programs of rehabilitation professionals.
11 Methodology Global survey: set of 27 questions
12 Participants 72 Establishments: 21 CountriesPhysiotherapists Occupational therapists Prosthetist orthotists Wheelchair service professionals 15
13 79% of curriculums included WC contentLRS 6 UMRS 6 HRS 31 LRS UMRS 3 HRS
14 51% are unaware that WSTP exists
15 Wheelchair service training packagesWHO Guidelines Professional service approach Service levels: Basic and Intermediate Minimum standards (40hrs) Training resources
16 Training Packages supporting the 8 StepsWHO Guidelines WSTP-b WSTP-i WSTP-m WSTP-s WC Skills Program 1. Referral ✪ ✪✪ ✪✪✪ X 2. Assessment ✪✪✪✪ 3. Prescription 4. Ordering 5. Product Prep 6. Fit 7. User Training 8. Follow-up, Maintenance/repair X Step is not mentioned in the package ✪ Awareness raising only ✪✪ Minimal attention to training this step (less than 2 hours) ✪✪✪ Moderate attention to training this step (discussion, activities) ✪✪✪✪ Extensive attention to develop knowledge and skills for this step
17 How is original material used?Duration LRS – 35 hours UMR 6 – 32 hours HRS hours Practical: 66% LMS & UMRS – practical with clients HRS – a day in a wheelchair Seating clinic Testing: 88% Majority practical Basic + Intermediate Basic Intermediate
18 How is WSTP used? Majority: Complete package (40 hours) vs partMajority: One off module vs spread across curriculum ‘We implemented the standards set by WHO with modifications to adapt to our audience.’ Basic + Intermediate Basic WSTP Comments WSTP is too much for some professions eg OTA. Applicable for other eg CBR workers, Medics and paramedics Challenges: ‘….needs more resources and training such as a different type of wheelchairs’. ‘Training done in collaboration with service providers. Availability of trainers’
19 Interest? 15 (21 %) not teaching 1 not interested – uncertain of requirements and concerned about time 14 interested in integrating wheelchair content 5 previously aware of WSTP 10 specifically interested in WSTP 5 had initiated the process towards integration Range of 1 to 35 hours available ‘Where can I view the wheelchair service training package curriculum’ ‘Maybe it would also be good if we tap the current world federation of professionals (ex. WFOT, WCPT, etc) [ ] to encourage members associations to recognize WSTP curriculum integration.’
20 Summary Recommendations Interest in integrating wheelchair trainingLarge variety in how wheelchair provision education is trained Lack of awareness of available training resources Recommendations Raise awareness of 8 steps and global resources Analyze curriculums against the 8 steps Carry out in depth interviews to explore facilitators and barriers and develop necessary resources in answer to FAQs
21 A Global Description of Wheelchair Service Education1. Cross-Sectional Survey Study 2. In-Depth Qualitative Interview Study 3. Integration Pilot Sites
22 Aim To develop an in-depth understanding of education regarding the wheelchair service provision process provided in Occupational Therapy, Physical Therapy and Prosthetics and Orthotics university programs located in low-, middle- and high-resourced settings geographically dispersed throughout the world.
23 Methods Design: Semi-Structured Qualitative InterviewsSampling Strategy: Purposive Target Sample: OT, PT, & O&P university programs integrating (or planning) wheelchair content Resourced settings: low, medium, and high Geographically dispersed Procedure: Semi-structured interview guide Conducted through Adobe Connect Audio recorded and transcribed verbatim Data Analysis: Content analysis using Coding Analysis ToolKit program
24 Participating Sites Montreal Winnipeg Hartford Togo Sudan HondurasColombia Mostly North America (Canada [n=2] & US [n=1]) South America (Honduras) n=1 South America (Columbia) n=1 West Africa (Togo) n=1 North Africa (Sudan) n=1
25 Profession (# of students) State of Development of Wheelchair CourseDemographics Setting (Country) Education Degree Profession (# of students) State of Development of Wheelchair Course When in curriculum? LRS #1 (Togo) Diploma P&O (16) PT (20) in development P&O: 3rd yr PT: 2nd yr LRS #2 (Sudan) P&O (15) 1st time 1st yr LMRS #1 (Honduras) College Degree, not Bachelor’s FT (50-60) 2nd yr UMRS #1 (Colombia) Bachelor’s PT (15-20) 5th, 6th or 7th semester (10 semesters total) HRS #1 (Canada) Bachelor’s/Professional Master’s continuum OT (31) 2nd yr, mostly Master’s level HRS #2 Professional Master’s OT (50) established 1st & 2nd yr HRS #3 (US) Doctorate PT (40) 1st, 2nd & 3rd yr university names LRS/LMRS/UMRS/HRS = low/low-middle/upper-middle/high resourced setting; P&O = Prosthetics & Orthotics; PT = Physiotherapy; FT = Functional Therapy; OT = Occupational Therapy; yr = year.
26 Most Sites Cover All 8 Wheelchair Service Provision Process Stepsin use planned use not used Institution 1: Referral 2: Assessment 3: Prescription 4: Product Preparation 5: Funding 6: Fitting 7: User Training 8: F/U & Maintenance LRS #1 LRS #2 LMRS #1 UMRS #1 HRS #1 HRS #2 HRS #3
27 Most Sites Use WSTP-B + Supplementary Materialsin use planned use not used Institution WSTP Basic WSTP Intermediate Others LRS #1 LRS #2 Motivation products LMRS #1 Original material UMRS #1 HRS #1 Wheelchair Skills Program GF Strong Rehab Center Maintenance Program HRS #2 HRS #3
28 Most Sites Use WSTP-B + Supplementary Materialsin use planned use not used Institution WSTP Basic WSTP Intermediate Others LRS #1 LRS #2 Motivation products LMRS #1 Original material UMRS #1 HRS #1 Wheelchair Skills Program GF Strong Rehab Center Maintenance Program HRS #2 HRS #3 “For the intermediate [level of WSTP], we are trying to, but otherwise it can be more for professionals. […] We are starting [to apply for] some funds for wheelchairs for the intermediate [course], […] so that we can start that training.”
29 Most Sites Use WSTP-B + Supplementary Materialsin use planned use not used Institution WSTP Basic WSTP Intermediate Others LRS #1 LRS #2 Motivation products LMRS #1 Original material UMRS #1 HRS #1 Wheelchair Skills Program GF Strong Rehab Center Maintenance Program HRS #2 HRS #3 “No, to tell the truth, I am aware of some of the WHO materials but I didn’t know there was information on wheelchairs.”
30 Most Sites Use WSTP-B + Supplementary Materialsin use planned use not used Institution WSTP Basic WSTP Intermediate Others LRS #1 LRS #2 Motivation products LMRS #1 Original material UMRS #1 HRS #1 Wheelchair Skills Program GF Strong Rehab Center Maintenance Program HRS #2 HRS #3 “The WHO material, one of the things I used it for was the 8-steps as a way of organising and structuring the content. Much of that content was there already, but it wasn't necessarily organized or structured in that.”
31 Most Sites Use WSTP-B + Supplementary Materialsin use planned use not used Institution WSTP Basic WSTP Intermediate Others LRS #1 LRS #2 Motivation products LMRS #1 Original material UMRS #1 HRS #1 Wheelchair Skills Program GF Strong Rehab Center Maintenance Program HRS #2 HRS #3 “… we moved on to do evaluation of other components, wheelchair skills using the Wheelchair Skills Program… wheelchair confidence using an assessment called the WheelCon .” “… prescription and selection of a wheelchair and how to finance it… that information was less focused on WHO materials and more context-specific… here in the province of Quebec… a wheelchair is funded by RAMQ and there is very specific assessment form that has to be completed.”
32 All Sites Use Lecture & Practical Pedagogical Approachesin use planned use not used Institutions Duration Lectures Online Practical Methods LRS #1 40h Provide wheelchair service to actual clients: “groups of 2 students per client with total of 10 clients (1 wheelchair per client) for 20 students and 4 trainers in lab” LRS #2 Follows WSTP Course LMRS #1 TBA Lab workshops UMRS #1 32-36h HRS #1 2nd year: 3h Master’s: 45h Lab workshops, Day in a wheelchair, Presentations from representatives of different manufactures, HRS #2 28h Lab workshops, Day in a wheelchair, Boot camp on weekend (WSP) HRS #3 1st year: 7h 2nd year: 30h 3rd year: ? Lab workshops, Day in a wheelchair, Model clients, Actual home assessment, Van modification No online learning modules, but resources were available online.
33 All Sites Use Lecture & Practical Pedagogical Approachesin use planned use not used Institutions Duration Lectures Online Practical Methods LRS #1 40h Provide wheelchair service to actual clients: “groups of 2 students per client with total of 10 clients (1 wheelchair per client) for 20 students and 4 trainers in lab” LRS #2 Follows WSTP Course LMRS #1 TBA Lab workshops UMRS #1 32-36h HRS #1 2nd year: 3h Master’s: 45h Lab workshops, Day in a wheelchair, Presentations from representatives of different manufactures, HRS #2 28h Lab workshops, Day in a wheelchair, Boot camp on weekend (WSP) HRS #3 1st year: 7h 2nd year: 30h 3rd year: ? Lab workshops, Day in a wheelchair, Model clients, Actual home assessment, Van modification “The practical conducted at the school, we are inviting the clients for them. We will call the clients so that [the students] can practice in the real situation.” No online learning modules, but resources were available online.
34 All Sites Use Lecture & Practical Pedagogical Approachesin use planned use not used Institutions Duration Lectures Online Practical Methods LRS #1 40h Provide wheelchair service to actual clients: “groups of 2 students per client with total of 10 clients (1 wheelchair per client) for 20 students and 4 trainers in lab” LRS #2 Follows WSTP Course LMRS #1 TBA Lab workshops UMRS #1 32-36h HRS #1 2nd year: 3h Master’s: 45h Lab workshops, Day in a wheelchair, Presentations from representatives of different manufactures, HRS #2 28h Lab workshops, Day in a wheelchair, Boot camp on weekend (WSP) HRS #3 1st year: 7h 2nd year: 30h 3rd year: ? Lab workshops, Day in a wheelchair, Model clients, Actual home assessment, Van modification “I think for now, we are aiming to introduce the training itself, but within it, we use the WHO basic.” No online learning modules, but resources were available online.
35 All Sites Use Lecture & Practical Pedagogical Approachesin use planned use not used Institutions Duration Lectures Online Practical Methods LRS #1 40h Provide wheelchair service to actual clients: “groups of 2 students per client with total of 10 clients (1 wheelchair per client) for 20 students and 4 trainers in lab” LRS #2 Follows WSTP Course LMRS #1 TBA Lab workshops UMRS #1 32-36h HRS #1 2nd year: 3h Master’s: 45h Lab workshops, Day in a wheelchair, Presentations from representatives of different manufactures, HRS #2 28h Lab workshops, Day in a wheelchair, Boot camp on weekend (WSP) HRS #3 1st year: 7h 2nd year: 30h 3rd year: ? Lab workshops, Day in a wheelchair, Model clients, Actual home assessment, Van modification “I think that it would be most pertinent to have the first approach from the point of theoretical aspects and then to have then the practical component. The virtual aspect would complement the subject, but the subject would not be completely virtual. There would be the theoretical lectures.” No online learning modules, but resources were available online.
36 All Sites Use Lecture & Practical Pedagogical Approachesin use planned use not used Institutions Duration Lectures Online Practical Methods LRS #1 40h Provide wheelchair service to actual clients: “groups of 2 students per client with total of 10 clients (1 wheelchair per client) for 20 students and 4 trainers in lab” LRS #2 Follows WSTP Course LMRS #1 TBA Lab workshops UMRS #1 32-36h HRS #1 2nd year: 3h Master’s: 45h Lab workshops, Day in a wheelchair, Presentations from representatives of different manufactures, HRS #2 28h Lab workshops, Day in a wheelchair, Boot camp on weekend (WSP) HRS #3 1st year: 7h 2nd year: 30h 3rd year: ? Lab workshops, Day in a wheelchair, Model clients, Actual home assessment, Van modification “We developed case studies and the students were in groups of 3. And they each had a different case study with a different population, diagnosis, adults, older adults, paediatrics. The intent was for 1 student to act as the occupational therapist, 1 student to act as the wheelchair user and 1 student to act as the caregiver.” No online learning modules, but resources were available online.
37 All Sites Use Lecture & Practical Pedagogical Approachesin use planned use not used Institutions Duration Lectures Online Practical Methods LRS #1 40h Provide wheelchair service to actual clients: “groups of 2 students per client with total of 10 clients (1 wheelchair per client) for 20 students and 4 trainers in lab” LRS #2 Follows WSTP Course LMRS #1 TBA Lab workshops UMRS #1 32-36h HRS #1 2nd year: 3h Master’s: 45h Lab workshops, Day in a wheelchair, Presentations from representatives of different manufactures, HRS #2 28h Lab workshops, Day in a wheelchair, Boot camp on weekend (WSP) HRS #3 1st year: 7h 2nd year: 30h 3rd year: ? Lab workshops, Day in a wheelchair, Model clients, Actual home assessment, Van modification “I reach out if [my clinical clients] are interested in helping out with the class. Some are interested in coming to talk to the students, [… and] others are really interested [in having the students do hands-on] and they will be happy to come in as patient models.” No online learning modules, but resources were available online.
38 Most Sites Assess Knowledge Using a Written & Practical Examin use planned use not used Institutions Theoretical Written Exam Practical Exams Assignments/Projects LRS #1 practical exam: demonstration of skills LRS #2 TBD LMRS #1 practical exam UMRS #1 HRS #1 exam stations for 8 steps case studies quiz presentation HRS #2 program a wheelchair assess & train user HRS #3 participation funding letter of justification
39 Most Sites Assess Knowledge Using a Written & Practical Examin use planned use not used Institutions Theoretical Written Exam Practical Exams Assignments/Projects LRS #1 practical exam: demonstration of skills LRS #2 TBD LMRS #1 practical exam UMRS #1 HRS #1 exam stations for 8 steps case studies quiz presentation HRS #2 program a wheelchair assess & train user HRS #3 participation funding letter of justification “So there will be a practical and a theoretical session in the examination time. […] a set of questionnaires [to test competence] before we start the training and then after we finish the training. We will make our own tests. [For practical exam,] they can come pick a question there and ask them to practice in front of us, so that we can evaluate if they are able to do it, how they assist a wheelchair user to propel, up the stairs, something like that.”
40 Most Sites Assess Knowledge Using a Written & Practical Examin use planned use not used Institutions Theoretical Written Exam Practical Exams Assignments/Projects LRS #1 practical exam: demonstration of skills LRS #2 TBD LMRS #1 practical exam UMRS #1 HRS #1 exam stations for 8 steps case studies quiz presentation HRS #2 program a wheelchair assess & train user HRS #3 participation funding letter of justification “We set up wheelchairs based on their case studies [...]. according to [the students’] prescription, but we maladjusted each chair with two or three things wrong, so that they could …go through the process of the Safe and Ready Checklist to figure out what was wrong with the chair and then present it to the group.”
41 Most Sites Assess Knowledge Using a Written & Practical Examin use planned use not used Institutions Theoretical Written Exam Practical Exams Assignments/Projects LRS #1 practical exam: demonstration of skills LRS #2 TBD LMRS #1 practical exam UMRS #1 HRS #1 exam stations for 8 steps case studies quiz presentation HRS #2 program a wheelchair assess & train user HRS #3 participation funding letter of justification “… they will have to demonstrate that they can assess and train someone in a wheelchair.”
42 Barriers & Facilitators to Integration of Wheelchair ContentLack of wheelchair service provision services in the country Support from university directors, chairs of programs, & students Advocacy efforts large in scope Collaborations (ex: wheelchair providers; content experts / experienced instructors) Lack of equipment resources (ex: wheelchairs) Motivation (of students and professors); Flexibility of curriculum Lack of space (ex: to run labs, to store equipment) Availability of space Lack of time in curriculum Wheelchair donations & loans Location of course (ex: time-consuming transit for students) Access to materials supported by the WHO Poor Internet connection Location close to resources Lack of training for professors in use of WSTPs Positive course evaluations & research study findings Lack of support as mandatory course Availability of optional courses in curriculums Program type (ex: extension to Professional PhD)
43 Barriers & Facilitators to Integration of Wheelchair ContentLack of wheelchair service provision services in the country Support from university directors, chairs of programs, & students Advocacy efforts large in scope Collaborations (ex: wheelchair providers; content experts / experienced instructors) Lack of equipment resources (ex: wheelchairs) Motivation (of students and professors); Flexibility of curriculum Lack of space (ex: to run labs, to store equipment) Availability of space Lack of time in curriculum Wheelchair donations & loans Location of course (ex: time-consuming transit for students) Access to materials supported by the WHO Poor Internet connection Location close to resources Lack of training for professors in use of WSTPs Positive course evaluations & research study findings Lack of support as mandatory course Availability of optional courses in curriculums Program type (ex: extension to Professional PhD) “Nothing exists for wheelchair service provision within the country [...] but obviously, it is needed. […] We still advocate for social inclusion…” LRS # 2
44 Barriers & Facilitators to Integration of Wheelchair ContentLack of wheelchair service provision services in the country Support from university directors, chairs of programs, & students Advocacy efforts large in scope Collaborations (ex: wheelchair providers; content experts / experienced instructors) Lack of equipment resources (ex: wheelchairs) Motivation (of students and professors); Flexibility of curriculum Lack of space (ex: to run labs, to store equipment) Availability of space Lack of time in curriculum Wheelchair donations & loans Location of course (ex: time-consuming transit for students) Access to materials supported by the WHO Poor Internet connection Location close to resources Lack of training for professors in use of WSTPs Positive course evaluations & research study findings Lack of support as mandatory course Availability of optional courses in curriculums Program type (ex: extension to Professional PhD) “Market research needed to inform the need of the wheelchair-related course.” LMRS # 1
45 Barriers & Facilitators to Integration of Wheelchair ContentLack of wheelchair service provision services in the country Support from university directors, chairs of programs, & students Advocacy efforts large in scope Collaborations (ex: wheelchair providers; content experts / experienced instructors) Lack of equipment resources (ex: wheelchairs) Motivation (of students and professors); Flexibility of curriculum Lack of space (ex: to run labs, to store equipment) Availability of space Lack of time in curriculum Wheelchair donations & loans Location of course (ex: time-consuming transit for students) Access to materials supported by the WHO Poor Internet connection Location close to resources Lack of training for professors in use of WSTPs Positive course evaluations & research study findings Lack of support as mandatory course Availability of optional courses in curriculums Program type (ex: extension to Professional PhD) “The whole uncertainty as to when and if we receive our products…” LRS # 2 “There are literally space restraints and equipment restraints...” HRS # 1
46 Barriers & Facilitators to Integration of Wheelchair ContentLack of wheelchair service provision services in the country Support from university directors, chairs of programs, & students Advocacy efforts large in scope Collaborations (ex: wheelchair providers; content experts / experienced instructors) Lack of equipment resources (ex: wheelchairs) Motivation (of students and professors); Flexibility of curriculum Lack of space (ex: to run labs, to store equipment) Availability of space Lack of time in curriculum Wheelchair donations & loans Location of course (ex: time-consuming transit for students) Access to materials supported by the WHO Poor Internet connection Location close to resources Lack of training for professors in use of WSTPs Positive course evaluations & research study findings Lack of support as mandatory course Availability of optional courses in curriculums Program type (ex: extension to Professional PhD) “Some of our challenges are having a good place to store equipment and enough space to do all this.” HRS # 3
47 Barriers & Facilitators to Integration of Wheelchair ContentLack of wheelchair service provision services in the country Support from university directors, chairs of programs, & students Advocacy efforts large in scope Collaborations (ex: wheelchair providers; content experts / experienced instructors) Lack of equipment resources (ex: wheelchairs) Motivation (of students and professors); Flexibility of curriculum Lack of space (ex: to run labs, to store equipment) Availability of space Lack of time in curriculum Wheelchair donations & loans Location of course (ex: time-consuming transit for students) Access to materials supported by the WHO Poor Internet connection Location close to resources Lack of training for professors in use of WSTPs Positive course evaluations & research study findings Lack of support as mandatory course Availability of optional courses in curriculums Program type (ex: extension to Professional PhD) “For PT, there is a big issue to include the 40 hours in their curriculum, they still working on...” LRS # 1 “Finding the hours to do that. [Master’s OT program] is pretty full and pretty busy as are all the programs across the country. […] So that was the biggest issue in terms of advocacy to get the time.” HRS # 2
48 Barriers & Facilitators to Integration of Wheelchair ContentLack of wheelchair service provision services in the country Support from university directors, chairs of programs, & students Advocacy efforts large in scope Collaborations (ex: wheelchair providers; content experts / experienced instructors) Lack of equipment resources (ex: wheelchairs) Motivation (of students and professors); Flexibility of curriculum Lack of space (ex: to run labs, to store equipment) Availability of space Lack of time in curriculum Wheelchair donations & loans Location of course (ex: time-consuming transit for students) Access to materials supported by the WHO Poor Internet connection Location close to resources Lack of training for professors in use of WSTPs Positive course evaluations & research study findings Lack of support as mandatory course Availability of optional courses in curriculums Program type (ex: extension to Professional PhD) “From a student’s perspective, it was also a challenge, as the course was located at Marie Enfant Rehabilitation Centre, which is not near the School.” HRS # 1
49 Barriers & Facilitators to Integration of Wheelchair ContentLack of wheelchair service provision services in the country Support from university directors, chairs of programs, & students Advocacy efforts large in scope Collaborations (ex: wheelchair providers; content experts / experienced instructors) Lack of equipment resources (ex: wheelchairs) Motivation (of students and professors); Flexibility of curriculum Lack of space (ex: to run labs, to store equipment) Availability of space Lack of time in curriculum Wheelchair donations & loans Location of course (ex: time-consuming transit for students) Access to materials supported by the WHO Poor Internet connection Location close to resources Lack of training for professors in use of WSTPs Positive course evaluations & research study findings Lack of support as mandatory course Availability of optional courses in curriculums Program type (ex: extension to Professional PhD) “I failed in 1 [ISWP basic competency test], because of the network connection. I did not have enough bandwidth to go through all of the questions.” “… the network connection is not very stable in the country. Sometimes, it is very good, but the next day, it is cutting out. Online components not possible because of the poor network connection.” LRS # 1
50 Barriers & Facilitators to Integration of Wheelchair ContentLack of wheelchair service provision services in the country Support from university directors, chairs of programs, & students Advocacy efforts large in scope Collaborations (ex: wheelchair providers; content experts / experienced instructors) Lack of equipment resources (ex: wheelchairs) Motivation (of students and professors); Flexibility of curriculum Lack of space (ex: to run labs, to store equipment) Availability of space Lack of time in curriculum Wheelchair donations & loans Location of course (ex: time-consuming transit for students) Access to materials supported by the WHO Poor Internet connection Location close to resources Lack of training for professors in use of WSTPs Positive course evaluations & research study findings Lack of support as mandatory course Availability of optional courses in curriculums Program type (ex: extension to Professional PhD) “I hadn’t been trained in those materials. I was learning as I went along.” HRS # 1
51 Barriers & Facilitators to Integration of Wheelchair ContentLack of wheelchair service provision services in the country Support from university directors, chairs of programs, & students Advocacy efforts large in scope Collaborations (ex: wheelchair providers; content experts / experienced instructors) Lack of equipment resources (ex: wheelchairs) Motivation (of students and professors); Flexibility of curriculum Lack of space (ex: to run labs, to store equipment) Availability of space Lack of time in curriculum Wheelchair donations & loans Location of course (ex: time-consuming transit for students) Access to materials supported by the WHO Poor Internet connection Location close to resources Lack of training for professors in use of WSTPs Positive course evaluations & research study findings Lack of support as mandatory course Availability of optional courses in curriculums Program type (ex: extension to Professional PhD) “Getting approval in general for a wheelchair-specific course […], because […] the pedagogic committee was not necessarily onboard with something so targeted.” HRS # 1
52 Barriers & Facilitators to Integration of Wheelchair ContentLack of wheelchair service provision services in the country Support from university directors, chairs of programs, & students Advocacy efforts large in scope Collaborations (ex: wheelchair providers; content experts / experienced instructors) Lack of equipment resources (ex: wheelchairs) Motivation (of students and professors); Flexibility of curriculum Lack of space (ex: to run labs, to store equipment) Availability of space Lack of time in curriculum Wheelchair donations & loans Location of course (ex: time-consuming transit for students) Access to materials supported by the WHO Poor Internet connection Location close to resources Lack of training for professors in use of WSTPs Positive course evaluations & research study findings Lack of support as mandatory course Availability of optional courses in curriculums Program type (ex: extension to Professional PhD) “My department was quite receptive; we do have a keen interest in assistive technology, so that sort of predisposed us to being open to ideas of expanding wheelchair content.” HRS # 2
53 Barriers & Facilitators to Integration of Wheelchair ContentLack of wheelchair service provision services in the country Support from university directors, chairs of programs, & students Advocacy efforts large in scope Collaborations (ex: wheelchair providers; content experts / experienced instructors) Lack of equipment resources (ex: wheelchairs) Motivation (of students and professors); Flexibility of curriculum Lack of space (ex: to run labs, to store equipment) Availability of space Lack of time in curriculum Wheelchair donations & loans Location of course (ex: time-consuming transit for students) Access to materials supported by the WHO Poor Internet connection Location close to resources Lack of training for professors in use of WSTPs Positive course evaluations & research study findings Lack of support as mandatory course Availability of optional courses in curriculums Program type (ex: extension to Professional PhD) “Collaborations with the Center Purchasing Material, which is based in Togo, covered at Centre pour personnes handicapées LRS # 1 “…collaborations with patients in clinic, Home Assessment Program, Van Modification Program, major equipment-recycling center in Connecticut.” HRS # 3
54 Barriers & Facilitators to Integration of Wheelchair ContentLack of wheelchair service provision services in the country Support from university directors, chairs of programs, & students Advocacy efforts large in scope Collaborations (ex: wheelchair providers; content experts / experienced instructors) Lack of equipment resources (ex: wheelchairs) Motivation (of students and professors); Flexibility of curriculum Lack of space (ex: to run labs, to store equipment) Availability of space Lack of time in curriculum Wheelchair donations & loans Location of course (ex: time-consuming transit for students) Access to materials supported by the WHO Poor Internet connection Location close to resources Lack of training for professors in use of WSTPs Positive course evaluations & research study findings Lack of support as mandatory course Availability of optional courses in curriculums Program type (ex: extension to Professional PhD) “Teachers are highly motivated. The students are also motivated, so I do not perceive that there maybe some obstacles that prevent the project to be done.” UMRS # 1 “Flexibility in place, because […] the students are taking a class on a weekend, which is unorthodox for them.” HRS # 2
55 Barriers & Facilitators to Integration of Wheelchair ContentLack of wheelchair service provision services in the country Support from university directors, chairs of programs, & students Advocacy efforts large in scope Collaborations (ex: wheelchair providers; content experts / experienced instructors) Lack of equipment resources (ex: wheelchairs) Motivation (of students and professors); Flexibility of curriculum Lack of space (ex: to run labs, to store equipment) Availability of space Lack of time in curriculum Wheelchair donations & loans Location of course (ex: time-consuming transit for students) Access to materials supported by the WHO Poor Internet connection Location close to resources Lack of training for professors in use of WSTPs Positive course evaluations & research study findings Lack of support as mandatory course Availability of optional courses in curriculums Program type (ex: extension to Professional PhD) “In my lab space, I have the Wheelchair Skills Program obstacle course set up” HRS # 1
56 Barriers & Facilitators to Integration of Wheelchair ContentLack of wheelchair service provision services in the country Support from university directors, chairs of programs, & students Advocacy efforts large in scope Collaborations (ex: wheelchair providers; content experts / experienced instructors) Lack of equipment resources (ex: wheelchairs) Motivation (of students and professors); Flexibility of curriculum Lack of space (ex: to run labs, to store equipment) Availability of space Lack of time in curriculum Wheelchair donations & loans Location of course (ex: time-consuming transit for students) Access to materials supported by the WHO Poor Internet connection Location close to resources Lack of training for professors in use of WSTPs Positive course evaluations & research study findings Lack of support as mandatory course Availability of optional courses in curriculums Program type (ex: extension to Professional PhD) “… Latter-Day Saints Church & Motivation: provide wheelchairs to actual clients…” LRS # 1 “Four donated manual wheelchairs […] and […] 6 or 7 wheelchairs […] loaned from local distributors” HRS # 1
57 Barriers & Facilitators to Integration of Wheelchair ContentLack of wheelchair service provision services in the country Support from university directors, chairs of programs, & students Advocacy efforts large in scope Collaborations (ex: wheelchair providers; content experts / experienced instructors) Lack of equipment resources (ex: wheelchairs) Motivation (of students and professors); Flexibility of curriculum Lack of space (ex: to run labs, to store equipment) Availability of space Lack of time in curriculum Wheelchair donations & loans Location of course (ex: time-consuming transit for students) Access to materials supported by the WHO Poor Internet connection Location close to resources Lack of training for professors in use of WSTPs Positive course evaluations & research study findings Lack of support as mandatory course Availability of optional courses in curriculums Program type (ex: extension to Professional PhD) “It helped that ICRC was recommending that the wheelchair service content was included to get acceptance from the National Academic Committee and that it was a [package from] WHO, […] which has the respect.” LRS # 2
58 Barriers & Facilitators to Integration of Wheelchair ContentLack of wheelchair service provision services in the country Support from university directors, chairs of programs, & students Advocacy efforts large in scope Collaborations (ex: wheelchair providers; content experts / experienced instructors) Lack of equipment resources (ex: wheelchairs) Motivation (of students and professors); Flexibility of curriculum Lack of space (ex: to run labs, to store equipment) Availability of space Lack of time in curriculum Wheelchair donations & loans Location of course (ex: time-consuming transit for students) Access to materials supported by the WHO Poor Internet connection Location close to resources Lack of training for professors in use of WSTPs Positive course evaluations & research study findings Lack of support as mandatory course Availability of optional courses in curriculums Program type (ex: extension to Professional PhD) “Located physically very near our major equipment-recycling center here […]. So I […] use their facility and their equipment during the course.” HRS # 3
59 Barriers & Facilitators to Integration of Wheelchair ContentLack of wheelchair service provision services in the country Support from university directors, chairs of programs, & students Advocacy efforts large in scope Collaborations (ex: wheelchair providers; content experts / experienced instructors) Lack of equipment resources (ex: wheelchairs) Motivation (of students and professors); Flexibility of curriculum Lack of space (ex: to run labs, to store equipment) Availability of space Lack of time in curriculum Wheelchair donations & loans Location of course (ex: time-consuming transit for students) Access to materials supported by the WHO Poor Internet connection Location close to resources Lack of training for professors in use of WSTPs Positive course evaluations & research study findings Lack of support as mandatory course Availability of optional courses in curriculums Program type (ex: extension to Professional PhD) “At course evaluation, 100% of students said, ”The course was useful for my education.” HRS # 1 “[Students’] evaluation of the boot camp was very positive and […] identifying it is a valuable thing and that it is worthwhile doing and then it is easy to advocate doing …” HRS # 2
60 Barriers & Facilitators to Integration of Wheelchair ContentLack of wheelchair service provision services in the country Support from university directors, chairs of programs, & students Advocacy efforts large in scope Collaborations (ex: wheelchair providers; content experts / experienced instructors) Lack of equipment resources (ex: wheelchairs) Motivation (of students and professors); Flexibility of curriculum Lack of space (ex: to run labs, to store equipment) Availability of space Lack of time in curriculum Wheelchair donations & loans Location of course (ex: time-consuming transit for students) Access to materials supported by the WHO Poor Internet connection Location close to resources Lack of training for professors in use of WSTPs Positive course evaluations & research study findings Lack of support as mandatory course Availability of optional courses in curriculums Program type (ex: extension to Professional PhD) “The electives courses have that advantage, theoretical and practical components.” UMRS # 1
61 Barriers & Facilitators to Integration of Wheelchair ContentLack of wheelchair service provision services in the country Support from university directors, chairs of programs, & students Advocacy efforts large in scope Collaborations (ex: wheelchair providers; content experts / experienced instructors) Lack of equipment resources (ex: wheelchairs) Motivation (of students and professors); Flexibility of curriculum Lack of space (ex: to run labs, to store equipment) Availability of space Lack of time in curriculum Wheelchair donations & loans Location of course (ex: time-consuming transit for students) Access to materials supported by the WHO Poor Internet connection Location close to resources Lack of training for professors in use of WSTPs Positive course evaluations & research study findings Lack of support as mandatory course Availability of optional courses in curriculums Program type (ex: extension to Professional PhD) “…when it was Master’s program, it was a little over 2 years, almost 2 and a half years. Then it changed over a few years ago to a doctoral level program, which in the US now, that is now the minimum required degree for licensure for physical therapist in the US. … that gives a lot of opportunity to add a lot of things that you might not otherwise have. HRS # 3
62 A Global Description of Wheelchair Service Education1. Cross-Sectional Survey Study 2. In-Depth Qualitative Interview Study 3. Integration Pilot Sites
63 Integration Pilot Sites - PurposeInclude/enhance wheelchair content in educational programs Use globally available resources as appropriate The purpose of the integration pilot sites project is to encourage and support the educational institutions to include or enhance wheelchair content in their courses and to use globally available resources as appropriate.
64 Integration Pilot Sites - Methods14 potentials partners worldwide. Based on readiness to integrate new content, methodology or ISWP tests. Joint meetings held monthly since August 2016. ‘Integration toolkit’ in development for educational institutions. Resources Current offerings: ISWP Wheelchair Service Provision Basic test ( 6 languages) Hybrid course (2 languages) Through various networks and conferences, the group identified 14 potential partner institutions, from various parts of the world and representing the varied rehabilitation professions. Institutions were identified based on readiness to integrate new content, methodology or testing mechanism available through ISWP. and these will continue into the first half of 2017 until each institution has implemented and evaluated planned activities. Through this process, ISWP will gather and develop resources, approaches, case studies and example curricula which can be included in an ‘integration toolkit’ for future use by other educational institutions.
65 Integration Pilot SitesWinnipeg Montreal Hartford Nashville Nepal India Chiang Mai Sudan Laos Togo Cambodia Colombia Bangkok Brazil
66
67 Knowledge Sharing - ResourcesPresentations Online modules screenshots of the modules - into slides - lab sessions resources - content and experience sharing, resourcec sharing ppt, online modules
68 Organization / Training InstitutionDemographics Setting Country Organization / Training Institution What is/was piloted? Low income Togo L’Ecole Nationale des Auxiliaires Médicaux (ENAM) Included the training curriculum wheelchair for basic service training for P&O third year students. Lower-middle income Sudan International Committee of the Red Cross(ICRC) Pilot WSTP – Basic as a modules for the ongoing CAT II Diploma Course Cambodia Cambodian PT Association The WSTP– Basic and Intermediate is integrated into the Bachelor of PT India Indian Spinal Injuries Centre In-progress Laos Faculty of Medical Technology, Vientiane TBD Upper-middle income Thailand Mahidol University Tentative plan for national conference about wheelchairs in 2017. Chiang Mai University Training 3rd year students on WSTP – Basic as a part of ADL course for 6-8 hours per semester Brazil Federal University of São Paulo (UNIFESP) Colombia Universidad CES, Medellin ISWP Basic wheelchair service provision test in Spanish. One faculty received ToT basic training. Basic cushion fabrication session for 5th sem PT students. Creation of Professional study group which meets once a month. High income Canada University of Montreal Incorporated materials from WSTP – Basic and Intermediate. Also supplementing the WSTP materials with the evidence-based Wheelchair Skills Program. Developing online modules for wheelchair skills testing/training classes University of Manitoba Structured exiting and new course material using the WHO 8-step framework. Integrated some of the content/materials from the WHO WSTP Basic and Intermediate packages. USA University of Hartford Belmont University university names
69 Learnings and ObservationsImportance of ISWP support. Looking forward to the development of the ‘Integration toolkit’. Knowledge sharing – 4 meetings held until now. Sharing of course materials
70 Learnings and ObservationsA much needed initiative, for the sake of continuity, continued consultations with ISWP for the wheelchair curriculum. Importance of ISWP support. Looking forward to the development of the ‘Integration toolkit’. Knowledge sharing – 4 meetings held until now. Sharing of course materials It has been very importance to us to have ISWP support (basic test, online materials, feedback and experience from other
71 Learnings and ObservationsImportance of ISWP support. Looking forward to the development of the ‘Integration toolkit’. Knowledge sharing – 4 meetings held until now. Sharing of course materials It is great if ISWP discuss at the High Level meeting and finalize what are the recommended topics for WSTP-b and WSTP-I; including teaching hours, class practical hours and clinical placement hours to integrate to the school of physiotherapy.
72 Learnings and ObservationsImportance of ISWP support. Looking forward to the development of the ‘Integration toolkit’. Knowledge sharing – 4 meetings held until now. Sharing of course materials Learning from the experiences of others who are integrating is helping. Participants were encouraged to initiate exchange and ideas during the online meetings
73 Learnings and ObservationsImportance of ISWP support. Looking forward to the development of the ‘Integration toolkit’. Knowledge sharing – 4 meetings held until now. Sharing of course materials There was a strong focus on encouraging participants share materials (from their courses) on a shared online drive
74 Case Studies Universidad CES - ColombiaUniversity of Montreal - Canada
75 Integration efforts department of physical therapy and school of medicine CESParticipated in ToT training: 1 basic and 1 M/S Mar 2017 Jul 2016 Basic test last year PT students
76 ISWP basic test as diagnostic tool38 attended and 36 finished Average % total score 57,4 ± 7,8 (75% needed to pass)
77 Problematic topics
78 Integration in CES Dept. of PT & MedicineHybrid training with ICRC AND interprofessional ICF and WC AND Stakeholders meeting Participated in ToT training: 1 basic and 1 M/S Interview head of PT undergraduate Mar Jul Sep Oct Feb 2017 2016 Hybrid basic training: 1 PT, 1 Eng, 1 PM&R trainers 2 PT instructors participated Procured tools and donated WCs Basic test last year PT students Pilot: ICF and basic WC provision (20 hrs)
79 2017 National PT Conference ad.
80 Case Studies Universidad CES - ColombiaUniversity of Montreal - Canada
81 < 12 hours Case Study - MontrealWheelchair Content in Various Courses - Pre 2016 (mandatory courses) Content Delivery Topics in Gerontology: Positioning Lecture & Lab (3h) Mobility and Transfer Laboratory Lab & Group Discussion (3h) ‘Day in a Manual Wheelchair’ Mobility Aids Lecture (20 min), Lab (55 min) & Discussion (15 min) Anthropometric Measures Lecture (20 min), Case Study (10 min), Lab (45 min) & Discussion (15 min) Technical Aids: Tilt in Space Therapeutic Surfaces, Cushions Lecture (20 min), Case Study + Lab (50 min) & Case Study Discussion (20 min) < 12 hours Describe my learning process as part of being part of the ISWP … pilot sites projet
82 1 class (3-4 hours) per week for 15 weeksCase Study - Montreal Ergothérapie et l’utilisation du fauteuil roulant (optional course) Content Delivery Evaluation WSTP basic & intermediate packages 3 credit course (45 hours) 1 class (3-4 hours) per week for 15 weeks Lecture Lab Online modules Presentations Mid-term Participation Final exam - Written - Practical Wheelchair Skills Program Other pertinent assessments (e.g., WheelCon, LSA, WhOM) & interventions (WheelSeeU) ** culturally sensitive Describe my learning process as part of being part of the ISWP … pilot sites projet
83 Case Study - Montreal Pre-PostErgothérapie et l’utilisation du fauteuil roulant Describe my learning process as part of being part of the ISWP … pilot sites projet
84 Student Perspectives (n=31)‘The model [WHO 8-step Wheelchair Service Provision Process] used for teaching the course aided in comprehension of the material.’ ‘We liked having the WHO WSTP materials.’ ‘All students should need to take this course.’ ‘We suggest having a course earlier (in 2nd year)… an intensive week long course or a full day, so that every student has a base [of wheelchair knowledge].
85 Meeting Goals Share outcomes of our researchShare activities related to integration Learn about steps/ways to amplify integration activities. Who are key decision makers related to curriculum Continuing education vs. core curricula Challenges/Opportunities related to funding & implementation Joint position paper about integration goals
86 Accelerating integration activitiesWho are key decision makers related to curriculum? what steps to take for integration?
87 Decision Makers re CurriculaOT Promote package through our network (92 national associations), and directly to educational programs (>800) that WFOT approves. Share survey information related to uptake of WSTP. WFOT will share case studies to raise awareness through e-newsletter, online. Endorsement of WSTP/ISWP materials. Provide online modules through their lms (moodle) WFOT congress could include this topic (addl symposium). Online OTION forum related to WC training. Position statement on AT in their curriculum to clarify that WCs. Global survey on AT to include WC. ISPRM -Endorsement of WHO Materials -After endorsement– promoting materials at conferences. idenitfy next steps for each organization
88 Decision Makers re CurriculaWCPT Already promote wstp on their website. WCPT only accredits small # of programs (most done by national bodies). About 10 per year. WCPT does have their own standards. Could more actively promote WSTP. Will ’support’ WSTP materials. Survey O&P (only 40% are O&P trained) Awareness (ISWP/MOU, promotion at congress) already happening. ISWP used short-course awareness approach; they have team and could do short course collaboration through their network (so continuing ed) Makes perfect sense to have as part of curriculum (Carson); all core resources and tools are available. ISPO to endorse; allows changes to curriculum, but competencies the same. WC topic is in new guidelines to be published in Capetown. Continuing education; add to list of short course. Engage in industry ToT is critical to build. Future congress to include leads of all professional organizations to continue discussion. ISWP? Develop survey about scope of practice in field for all organizations to reach out. (use WFOT survey?) Setup consortiums in certain countries (South Africa & Brazil already working together as an example) WHO - Work to brand wstp with logos from all endorsing organizations. idenitfy next steps for each organization
89 Core curriculum vs. Continuing EdTrade-offs? Next steps for each: identify next steps for each organization
90 Moving Forward Joint Position Paper describing commitment to WC services training Standard materials, including eLearning Advocacy Strategy idenitfy next steps for each organization
91 Challenges/Opportunitiesidenitfy next steps for each organization