INNOVATION IN PHYSIOTHERAPY EDUCATION-GUIDING PRINCIPLES

Abstract: A common question in physiotherapy education is “what are the innovations in education?” To innovate, we need different ways of thinking. Innovation is the implementation of doing something different than what we regularly do, to improve services. Sometimes, innovation also includes revising if we are doing what we say we are doing. An innovative action implemented today, will be obsolete in a short time, that is why we need to be able to continuously adjust. Therefore, recipes for innovation are not recommended. This article provides three principles to guide innovation adjusted to each different higher educational institution in physiotherapy education: 1) Adjust to the (continuous) paradigm shifts in society; 2) Focus on the beneficiary and 3) Apply the theories and models underlying contemporary learning and education. Next to these principles, some practical implications to follow the guiding principles for the current needs for innovation are provided. Aspects for innovation like: student-centered learning, connectivism theory, entrusted professional activities and enlarged scope of practice are highlighted. Innovation requires reflection on what are we doing and transformation in epistemological beliefs of physiotherapy and physiotherapy education from all stakeholders. Educators will need to do their self-transformation and stimulate the shift in students and professionals in practice.

Highlights

• •

  Innovation in physiotherapy education should follow three guiding principles: 1) Adjust to the (continuous) paradigm shifts in society; 2) Focus on the beneficiary and 3) Apply the theories and models underlying contemporary learning and education.

• •

  Practical implications to follow the guiding principles for the current needs for innovation, require the application of new structures and methods in HEIs student-centered learning, connectivism theory, entrusted professional activities and enlarged scope of practice are highlighted.

• •

  Innovation requires reflection on what we are doing and transformation in epistemological beliefs of physiotherapy and physiotherapy education from all stakeholders. Educators will need to do their self-transformation and stimulate the shift in students and professionals in practice.

Introduction: Higher Education plays a fundamental role in preparing professionals for the job market. For this, educational structures and concepts are demanded to constantly update to the requirements of society, profession-oriented scientific and technological developments and of global developments (European Commission). We are experiencing times of rapid change, to which society, and thus education has to anticipate at the same pace. This leads to the need of innovation and frequently the question is “what are the innovations in education? However, these questions are usually related to methods instead of ways of thinking which is the underlying concept of innovation. In this article we will focus on Innovation in Physiotherapy Education.

Innovation is in fact, a process of experimentation, that results from co-creation instead of individual initiatives. It requires the combination of different ideas or ways of thinking, the transference of others and the capacity to act differently. To innovate, we do need enter new thinking paradigms and apply correspondent methods. Sometimes, innovation also includes revising if we are doing what we say we are doing. For example, most programmes are structured as a competency-based curriculum, which represents a way of thinking. However, what we see are fragmented modules of education and knowledge assessment. We all know about the importance of student-centered learning (another way of thinking), while most educational strategies are teacher-centered. An innovative action implemented today, will be obsolete in a short time, therefore, we need continuous adjustments.

Therefore, instead of a list of innovative strategies in physiotherapy education, this article provides three principles to guide innovation and some practical implications to follow the guiding principles for the current needs for innovation.

Guiding Principles to Innovate in Physiotherapy Education (Fig. 1)

Adjust to (continuous) paradigm shifts in society

Currently, the process of globalisation, the advances in technology, the increased mobility across countries and the current economical and social challenges, require professionals to act according to these new realities. These paradigm shifts have direct impact in how we educate current students and future professionals.

Figura 1. Practical implications to follow the guiding principles for the current needs for innovation.

From the health care perspective these changes are translated in services efficiency, increased life expectancy, access to scientific information for informed based-practice. On the other hand, we face also some challenges: aged population, increased non-communicable diseases and co-morbidities associated to aging and non-healthy habits, stress, nutrition and pollution.

From the societal perspective we have agile access to information and a growth in complexity and diversity of the living context, demanding more societal and environmental responsibility.

Therefore, we need to expand the body of knowledge to correspond to the new scope of practice and competences, adequate to the new demands:

• •

  Healthy ageing needs for a more sustainable society, entailing the community in general aiming for children, youth and adults with healthier life styles (physical activity, nutrition, environment sustainability).

• •

  Aged population with co-morbidities integrated in society and not just in clinical context, meaning citizens who wish to maintain their quality of life and functionality with co-existing health conditions, stressing the importance of the positive health concept.

• •

  Working population with high stress levels demanding attention to emotional and mental dimensions to maintain well-being.

• •

  Globalisation and emergence of new services demanding interprofessional skills, leadership and a resilient entrepreneurial attitude with cultural and ethical competences.

• •

  Technology competences in intervention models and data management for optimization of practice.

These are just some of the more evident contemporary needs. However, educational programmes should anticipate future needs. This paradigm shift is already highlighted by David Nicholls¹ in his book “The End of Physiotherapy” and in the discussion within the World Health Organisation for health care in general, the World Confederation of Physiotherapy and many national Physiotherapy professional associations for physiotherapy specifically with impact in the new professional profiles.

The major changes relate with competences like: agility, creativity, adaptability and life-long learning within complex contexts, uncertain and emergent challenges (as environmental challenges for instance), co-creation, entrepreneurship, interprofessional collaboration and evidence informed practice¹.

Despite the existence of some new ways of thinking, the methods applied are still in the old perspective of physiotherapy needs and therefore innovation is limited.

Focus on the beneficiary

The younger generations (future professionals), the Centenialls or Generation Z, are citizens with more flexibility; higher adaptability capacities; more responsible with their tasks and mission towards others; society and environment centered; digital and technologically literate; globally connected, multi-tasking capable; autonomous and self-learners; with a noticed reduced attention window but emotionally competent². This should be seen as an opportunity for HEIs and curricular design programmes.

The concept of student-centred learning dates from the 1930s³, however, its implementation is limited. Only a small percentage of higher educational institutes (HEIs) seem to use this approach in a systematic way. What prevails is a more rigid educational structure, focused on institutional and teachers’ priorities and approaches. This is a preoccupation as it ignores the latest scientific recommendations, not offering adequate models of education and ignores the characteristics of our current students.

Apply the theories and models underlying contemporary learning and education

The world became more complex and diverse, increasing the complexity of settings where physiotherapists need to enact. This demands agility for decision-making and performance in non-linear contexts where outcomes are not predictable and standardized procedures are not always the answer⁵. The current educational models, based on pre-defined and artificial and controlled contexts are not sufficient anymore to prepare professionals for the complexity and competences needed in the 21st century. This preparation is only possible when learning occurs in real life context⁶ demanding a combination between student-centred learning and practice centered learning which characterizes the concept learning in complexity. This practice is supported by the Connectivism Theory in complement to behaviorism and constructivism⁶.

Conclusion: The recommendations provided are to be adjusted to each HEI context. Innovation requires transformation in epistemological beliefs of physiotherapy and physiotherapy education from all stakeholders. Educators will need to do their self-transformation and stimulate the shift in students and professionals in practice. Countries with this type of adjustments show to be more innovative.

This article only touches the needs and trends for innovation. Specifiers on each topic are further developed within the European Network of Physiotherapy Education (ENPHE) working groups. These groups share, benchmark and define best practices. Aspects like adjustments in assessment methods, clinical reasoning, informed based practice, applied research and the transformative learning process for educators is currently on the agenda of the network.

References

1. Nicholls D. The end of physiotherapy. Abingdon, Oxon; New York, NY: Routledge; 2018.

2. Corey S. Generation Z goes to college. Jossey-Bass; 2016.

3. Learning Liftoff. What Is Student-Centered Learning? Education, Education Issues; 2019.

4. Payton DM. Effective Teaching in Higher Education for the 21st Century Adult Learner. Walden Dissertations and Doctoral Studies Collection. Walden University; 2015.

5. Miller R, Feukeu EK. Futures Literacy: A Skill for the 21st Century. UNESCO; 2019. Available at: https://en.unesco.org/themes/futures-literacy

6. Mynbayeva A, Sadvakassova Z, Akshalova B. Pedagogy of the Twenty-First Century: Innovative Teaching Methods; 2017.

7. Huber M, Knottnerus JA, Green L, et al. How should we define health? BMJ 2011;343:d4163.

8. Trinidad J. Understanding student-centred learning in higher education: students’ and teachers’ perceptions, challenges and cognitive gaps.

9. Pembridge J, Paretti M. Characterizing capstones design teaching: A functional taxonomy. Res J Eng Educ 2019;108(2).

10. Ten Cate O. A primer on entrustable professional activities. Korean J Med Educ 2018;30(1):1–10.

Palabras clave: Innovación; Educación; Fisioterapia

Keywords:Innovation; Education; Physical Therapy Specialty