Research Report Abstracts - Gesundheit

WPT2011, Research Report Abstracts eS1153
Research Report Platform Presentation
Number: RR-PL-1492 Thursday 23 June 14:15
RAI: Emerald Room
OUT ON A LIMB: THE EVALUATION OF A
PHYSIOTHERAPY STUDENT CLINIC TO
IMPROVE RURAL ACCESS TO LYMPHOEDEMA
SERVICES
Smith M. 1 , Koschel A. 2 , Underhill C. 3 , Packer C. 4 ,
Mcgough J. 5
1Charles Sturt University, School of Community Health,
Albury, Australia, 2University of Melbourne, Rural Health
Academic Network, Wodonga, Australia, 3Border Medical
Oncology, Albury, Australia, 4Hume Health, Humerics,
Wodonga, Australia, 5Gateway Community Health,
Wodonga, Australia
Purpose: The purpose of this study was to evaluate the impact
of a trial of a physiotherapy student lymphoedema assessment
and referral clinic on 1. rural patients’ access to lymphoedema
services and 2. physiotherapy students’ preparation for future
practice in providing lymphoedema services.
Relevance: Lymphoedema which develops post cancer treatment
can impact dramatically on a person’s quality of life.
The ‘Out on a Limb’ project was designed to address a consistent
lack of access to public services for lymphoedema
assessment, referral and management in the Albury/Wodonga
region in rural Australia. It was hypothesised that services
may be enhanced in the short-term by establishing a university
based lymphoedema assessment clinic, and in the
long-term by providing an educational opportunity for students.
An assessment and referral only clinic was trialled
due to perceived difficulties with students providing sustained
treatment services beyond the life of the project.
Participants: 28 patients participated in the clinic. The mean
age of the patients was 59 years of age (range 41–80 years).
All participants were female and breast cancer was the predominant
form of cancer. The students who took part in the
clinic were 3rd and 4th year physiotherapy students. All students
had completed theoretical education on lymphoedema
(10 hours). A total of 34 students participated in the clinic.
Methods: Surveys were administered to participating
patients and students following their involvement in the
project. Semi-structured interviews were conducted with purposeful
samples of students and patients in order to explore
the survey findings in greater depth. Supplementary sources
of data were clinic records of patients and interviews with
clinical educators involved in the project.
Analysis: Survey data were analysed using descriptive statistics.
Data collected via interviews and focus groups were
analysed using principles of philosophical hermeneutics to
identify key themes and an overall interpretation of the outcomes
of the project.
Results: There was almost complete agreement that patients’
knowledge in the areas of their condition, how to prevent lymphoedema,
self-care management and treatment options had
improved as a result of the clinic. 75% of patients attending
the clinic received a referral to a qualified lymphoedema
practitioner via their GP with advice about accessing relevant
public health funding. Patients described inconsistent
subsequent service follow-up by GPs, needing independent
resourcefulness in accessing services, and needing different
services at different stages of their disease. The clinic raised
students’ level of knowledge across a range of areas relating
to lymphoedema increasing the capacity of the health
workforce to assess and manage people with lymphoedema.
Conclusions: This project achieved anticipated outcomes
and informed future service development but the potential
outcomes were limited by the funding available. Sustaining
a student assessment and referral clinic is difficult without
on-going funding. The enhanced regional profile of lymphoedema
led to the establishment of a health facility based
service. This approach is a valid means of improving access
to lymphoedema management for cancer patients.
Implications: This project supported that a student-led clinic
can contribute positively to service provision in rural areas.
Students’ engagement in such a clinic provides a unique
educational opportunity.
Keywords: Lymphoedema; Rural practice
Funding acknowledgements: This project was supported by
a Health Services Innovation Grant, Cancer Institute of NSW.
Ethics approval: Ethics approval was provided by Charles
Sturt University and Joint Hospitals Human Research Ethics
Committees.
Research Report Platform Presentation
Number: RR-PL-1479 Tuesday 21 June 08:45
RAI: Emerald Room
REFLECTIVE PRACTICE IN THE TRANSITION
PHASE FROM FINAL YEAR PHYSIOTHERAPY
STUDENT TO NOVICE GRADUATE:
IMPLICATIONS FOR TEACHING REFLECTIVE
PRACTICE
Smith M. 1 , Trede F. 2
1Charles Sturt University, School of Community Health,
Albury, Australia, 2Charles Sturt University, Education for
Practice Institute, North Paramatta, Australia
Purpose: This study explored physiotherapy students’ experiences
of learning reflective practice as a student and in the
transition to work as a novice graduate.
Relevance: Reflective practice is widely accepted as a
core capability of graduate physiotherapy practice. Learning
reflective practice is assumed to result in continual
improvements in the quality of graduate clinical practice.
The teaching of reflective practice in entry-level curricula
often includes engaging students in activities such as keeping
reflective journals or portfolios. The objective when teaching