Implementing a Virtual Care Clinical Placement for a Physiotherapy Student in a Hospital-Based Chronic Pain Programme

2021 ◽  
pp. e20200098
Author(s):  
Ana Vrzic ◽  
Kyle Vader ◽  
Melanie Law ◽  
Jordan Miller
Keyword(s):  
Chronic Pain ◽  
Case Report ◽  
Clinical Education ◽  
Clinical Performance ◽  
Clinical Placement ◽  
Learning Goals ◽  
Clinical Instructor ◽  
Physiotherapy Student ◽  
Virtual Care ◽  
Part Time

Purpose: The aim of this case report was to determine the experiences and outcomes of implementing a part-time virtual care clinical placement for a physiotherapy student in a hospital-based chronic pain programme. Client Description: Three participants were involved in this clinical placement: an entry-level physiotherapy student, a physiotherapy clinical instructor, and an academic coordinator of clinical education from a Master of Science in Physical Therapy (MScPT) programme. Intervention:We implemented a part-time 40-hour virtual care clinical placement (10 hr/wk for 4 wk) in a publicly funded chronic pain programme at Kingston Health Sciences Centre for an MScPT student from Queen’s University in Kingston, Ontario. Measures and Outcome:The student’s performance was evaluated by the clinical instructor using learning goals and the Canadian Physiotherapy Assessment of Clinical Performance. The participants also provided reflections on their experiences in their respective roles. The student achieved the learning goals and demonstrated competency at the level required for a senior-level placement. Overall reflections on the virtual care clinical placement were positive, with a few key challenges. Implications: Novel clinical placement opportunities can help prepare physiotherapy students for emerging practice experiences. This case report provides insight into one such experience.

Project-based learning for physiotherapy clinical education quality and capacity

2020 ◽  
Author(s):  
Roma Forbes ◽  
Romany Martin
Keyword(s):  
Service Delivery ◽  
Student Learning ◽  
Clinical Education ◽  
Project Based Learning ◽  
Education Quality ◽  
Clinical Placement ◽  
Learning Needs ◽  
Clinical Placements ◽  
Physiotherapy Student ◽  
Adaptive Models

Background: Increasing, supporting and sustaining the capacity for physiotherapy student placements is a priority for universities and the physiotherapy workforce. The interruption, and in some cases, cancellation of placements as a result of Covid-19 has provided an added impetus to consider the use of flexible and adaptive models to meet student learning needs and support new and existing placement host organisations. Project-based learning provides an opportunity to supplement clinical placements through student-led activities that are mutually beneficial for student learning and service delivery needs of the host organisation. Aim: This paper outlines the pedagogical underpinnings of project-based learning and provides tangible examples of activities that have been adopted within physiotherapy host organisations to support clinical placement quality and capacity. Discussion: Clinical placement host organisations require flexible, student-centred approaches to supporting clinical placement efforts during 2020 and beyond. Project-based learning has the potential to be adapted across settings to support student learning and host organisation services and their stakeholders. Universities should aim to encourage and support partnerships between host organisations and their students to adopt, evaluate and sustain project-based learning across physiotherapy settings.

Hypertrophic Scar with Chronic Pain after Acute Herpes Zoster -A case report-

2005 ◽  
Vol 18 (2) ◽  
pp. 229 ◽  
Author(s):  
Jong Cheol Choi ◽  
Hong Beom Bae ◽  
Sung Tae Jeong ◽  
Seok Jai Kim ◽  
Seong Wook Jeong ◽  
...  
Keyword(s):  
Chronic Pain ◽  
Case Report ◽  
Herpes Zoster ◽  
Hypertrophic Scar ◽  
Acute Herpes Zoster

Physiotherapy Students’ Performance in Clinical Education: An Analysis of 1 Year of Canadian Cross-Sectional Data

2021 ◽  
pp. e20200018
Author(s):  
Sarah Wojkowski ◽  
Kathleen E. Norman ◽  
Paul Stratford ◽  
Brenda Mori
Keyword(s):  
Clinical Education ◽  
Clinical Performance ◽  
Mixed Effects ◽  
Cross Sectional ◽  
Clinical Placements ◽  
Entry Level ◽  
Typical Performance ◽  
Performance Profiles ◽  
Assessment Of Clinical Performance ◽  
Physiotherapy Students

Purpose: This research examines 1 year of cross-sectional, Canada-wide ratings from clinical instructors using the Canadian Physiotherapy Assessment of Clinical Performance (ACP) and analyzes the performance profiles of physiotherapy students’ performance ratings over the course of their entry-to-practice clinical placements. Method: Canadian physiotherapy programmes that use the ACP were invited to submit anonymized, cross-sectional data for placements completed during 2018. Descriptive analyses and summary statistics were completed. Mixed-effects modelling was used to create typical performance profiles for each evaluation criterion in the ACP. Stepwise ordered logistic regression was also completed. Results: Ten programmes contributed data on 3,290 placements. Profiles were generated for each ACP evaluative item by means of mixed-effects modelling; three profiles are presented. In all cases, the predicted typical performance by the end of 24 months of study was approximately the rating corresponding to entry level. Subtle differences among profiles were identified, including the rate at which a student may be predicted to receive a rating of “entry level.” Conclusions: This analysis identified that, in 2018, the majority of Canadian physiotherapy students were successful on clinical placements and typically achieved a rating of “entry level” on ACP items at the end of 24 months.

scholarly journals Pre-entry student clinical placement demand: can it be met?

2015 ◽  
Vol 39 (5) ◽  
pp. 577 ◽  
Author(s):  
Liza-Jane McBride ◽  
Cate Fitzgerald ◽  
Laura Morrison ◽  
Julie Hulcombe
Keyword(s):  
Public Health ◽  
Health Services ◽  
Clinical Education ◽  
Allied Health ◽  
Clinical Placement ◽  
Full Time ◽  
Public Health Services ◽  
Workload Management ◽  
Clinical Placements ◽  
Quality Review

Objectives The Clinical Education Workload Management Initiative (the Initiative) is a unique, multiprofessional, jurisdiction-wide approach and reform process enshrined within an industrial agreement. The Initiative enabled significant investment in allied health clinical education across Queensland public health services to address the workload associated with providing pre-entry clinical placements. This paper describes the outcomes of a quality review activity to measure the impact of the Initiative on placement capacity and workload management for five allied health professions. Data related to several key factors impacting on placement supply and demand in addition to qualitative perspectives from workforce surveys are reported. Methods Data from a range of quality review actions including collated placement activity data, and workforce and student cohort statistics were appraised. Stakeholder perspectives reported in surveys were analysed for emerging themes. Results Placement offers showed an upward trend in the context of increased university program and student numbers and in contrast with a downward trend in full-time equivalent (FTE) staff numbers. Initiative-funded positions were identified as a major factor in individual practitioners taking more students, and staff and managers valued the Initiative-funded positions’ support before and during placements, in the coordination of placements, and in building partnerships with universities. Conclusions The Initiative enabled a co-ordinated response to meeting placement demand and enhanced collaborations between the health and education sectors. Sustaining pre-entry student placement provision remains a challenge for the future. What is known about the topic? The literature clearly identifies factors impacting on increasing demand for clinical placements and a range of strategies to increase clinical placement capacity. However, reported initiatives have mostly been ad hoc or reactive responses, often isolated within services or professions. What does this paper add? This paper describes implementation of a clinical placement capacity building initiative within public sector health services developed from a unique opportunity to provide funding through an industrial agreement. The Initiative aimed to address the workload associated with clinical education of pre-entry students and new graduates. What are the implications for practitioners? This paper demonstrates that systematic commitment to, and funding of, clinical education across a jurisdiction’s public health services is able to increase placement capacity, even when staffing numbers are in decline.

scholarly journals Early surgical correction of cervical disc herniation might avoid complications associated with opioid-based pain management: A case report

2019 ◽  
Vol 10 ◽  
pp. 69 ◽  
Author(s):  
Ramsis Ghaly ◽  
Ana Pleasca ◽  
Kenneth D. Candido ◽  
Nebojsa Nick Knezevic
Keyword(s):  
Chronic Pain ◽  
Case Report ◽  
Pain Management ◽  
Disc Herniation ◽  
Life Support ◽  
Hospital Admissions ◽  
Surgical Intervention ◽  
Surgical Correction ◽  
Cervical Disc Herniation ◽  
Cervical Disc

Background: Opioids are considered an effective method for acute and chronic pain management, but they are not suitable for all cases and should be used in carefully selected patients. In the past several decades, their use has come under intense scrutiny due to significant deviations from the classically described applicability of opioids in cancer-related pain. Case Description: A 34-year-old female with a 6-year history of worsening neck pain and suboccipital headaches was managed medically including the use of oral muscle relaxants, steroids, gabapentin, and opioid-based medications as well as interventional pain procedures that provided only temporary pain relief. She made repeated ER visits and had multiple hospital admissions for pain control, during which times she was placed on patient-controlled analgesia with IV hydromorphone administration. During the most recent admission for an acute exacerbation of chronic pain, she was found by her mother to be unresponsive and not breathing. A code blue was called and cardiopulmonary resuscitation per an advanced cardiac life support algorithm was conducted. The patient was successfully resuscitated and was discharged from the hospital in satisfactory condition. This incident was reported as an “allergic reaction” to hydromorphone. After consultation with a neurosurgeon, the patient underwent a definitive surgical intervention consisting of a C5–6 anterior cervical discectomy and fusion using an interbody spacer and anterior instrumentation. Within 6 weeks, she reported significant decreases in her pain, stopped using the pain medication, and was able to return to her normal lifestyle. Conclusions: The present case report is an example of long-term pain management with multiple medications, including opioid use and performing interventional pain procedures, while avoiding early surgical correction of cervical disc herniation. This resulted in years of suffering with pain and serious morbidity from opioid overdosing. Surgical intervention was definitive in terms of ultimately improving her pain and reducing her reliance on opioid analgesics.

scholarly journals Two-year clinical performance of cast post and core self-adhesive cementation

RSBO ◽  
2018 ◽  
Vol 1 (4) ◽  
pp. 229
Author(s):  
Igor Alessando Gontarski ◽  
Marcos Cezar Pomini ◽  
Sthelen Nayara Cenci ◽  
Giovana Mongruel Gomes ◽  
Lidia Olga Bach Pinheiro ◽  
...  
Keyword(s):  
Case Report ◽  
Clinical Performance ◽  
Resin Cement ◽  
Tissue Loss ◽  
Endodontically Treated Teeth ◽  
Cement Interface ◽  
One Step ◽  
Adhesive Cementation ◽  
Core Self ◽  
Tooth Tissue

Introduction and Objective: Endodontically treated teeth commonly present extensive tissue loss, requiring the use intraradicular posts, which provide retention for a coronal rehabilitation. Cast post and cores (CPCs) have been traditionally used in cases of marked tooth tissue loss. Case report: This case report describes two cast post and cores and subsequent rehabilitation by metal ceramic crowns. The patient was followed-up at intervals of 12 and 24 months after the rehabilitation. The posts were cemented within the root canal with self-adhesive resin cement, in a way that guarantees a perfect sealing of the root and remains stable in the oral environment. Conclusion: Self-adhesive cements are a one-step material capable of providing additional chemical adhesion to the metal, creating a monoblock, quality not found in conventional resin cements, where the adhesion occurs only in the dentin-cement interface.

Combined Paresthesia and Subperception Spinal Cord Stimulator Therapy for Management of Persistent Pain After Spinal Fusion Surgery for Congenital Scoliosis

2021 ◽  
pp. 33-36
Author(s):  
James C. Burns
Keyword(s):  
Spinal Cord ◽  
Chronic Pain ◽  
Back Pain ◽  
Case Report ◽  
Spinal Fusion ◽  
Congenital Scoliosis ◽  
Low Back ◽  
Spinal Cord Stimulator ◽  
Fusion Surgery ◽  
Spinal Fusion Surgery

Background: A significant number of patients who undergo spinal fusion surgery are managed in chronic pain clinics for low back pain or what is commonly described as failed back surgery syndrome (FBSS). There are a multitude of reasons for chronic long standing back pain after surgery, and the etiology is often multifactorial involving both preoperative and postoperative risk factors. In patients with scoliosis, it has been shown that fusion with Harrington rods extending into the lumbar region is associated with increases in postoperative back pain, especially with fusions to the L4-L5 region. Spinal cord stimulation (SCS) is a recognized treatment for this condition after repeat surgery or when conservative treatments have failed. Case Report: This case report describes the use of SCS with combination therapy in the management of severe low back pain after thoracolumbar fusion with Harrington rods in a patient with congenital scoliosis. After a failed trial of conservative medical management, a spinal cord stimulator capable of delivering combination traditional paresthesia with subperception and burst stimulation was placed. Regarding the choice of SCS therapy, there is a vast array of choices including traditional paresthesia, paresthesia-free, subperception, microburst, or combination treatment. The latter is capable of delivering multiple therapies over time designed to provide more thorough and longer-lasting relief. Conclusion: Simultaneous traditional paresthesia and subperception waveform therapy might offer superior pain relief in comparison to therapies utilizing a sing=le waveform. Further studies are needed to evaluate the use of combination over traditional SCS therapy for the treatment of axial back pain secondary to FBSS. Key words: Chronic pain, combination therapy, congenital scoliosis, neuromodulation, spinal cord stimulator, spinal fusion

Dorsal root ganglion stimulation lead fractures: potential mechanisms and ways to avoid

2021 ◽  
Vol 14 (5) ◽  
pp. e241353
Author(s):  
Gaurav Chauhan ◽  
Brandon I Roth ◽  
Nagy Mekhail
Keyword(s):  
Spinal Cord ◽  
Chronic Pain ◽  
Case Report ◽  
Dorsal Root Ganglion ◽  
Dorsal Root ◽  
Unusual Case ◽  
Pain Syndrome ◽  
Structural Instability ◽  
Probable Mechanism ◽  
Lead Fracture

Dorsal root ganglion stimulation (DRGS) therapy is a rapidly emerging tool being used by pain physicians in the treatment of chronic pain. Complex regional pain syndrome (CRPS), a debilitating disease whose mechanism is still has yet to be fully elucidated, is a common pathology targeted by DRGS therapy, often better results than traditional spinal cord stimulation. DRGS therapy, however, is not bereft of complications. Lead migration and fracture are two examples in particular that are among the most common of these complications. The authors report an unusual case of lost efficacy due to lead fractures in patients with CRPS treated with DRGS. The case report narrates identification, management and probable mechanism of DRGS lead fracture. The structural instability of DRGS leads can yield distressing symptoms at any point during the therapy, and physicians should be cognisant of the complications of DRGS therapy.

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