Integrating moving and handling guidelines into practice: a case study in an educational context

Otago

School of PhysiotherapyCentre for Physiotherapy Research

Integrating moving and handling guidelines into practice: a case study in an educational context.

Ally Calder, Dr Hilda Mulligan & Sandy Ferdinand

Overview of Programme

• 4 year degree programme

• 1st 3 years largely theoretical & skills based learning.

• Final year = integration of theory & skills into practice.

Clinical Educator Role

Guide and support the clinical education of final year physiotherapy students in order to achieve autonomous decision making in the clinical environment.

Propositional Knowledge

Effective Clinical Decision Making

CONTEXT

Professional Craft

Knowledge

Personal Knowledge

CONCEPTS CUES

Donaghy & Morss (2000)

PLAN

DO

REFLECT

MODIFY

REFLECT

MODIFY

REFLECTIONIN

ACTION

THECLINICAL

ENCOUNTER

CONCEPTS CONTEXT CUES

The Case

What went wrong?

PLAN

DO

REFLECT

MODIFY

REFLECT

MODIFY

REFLECTIONIN

ACTION

THECLINICAL

ENCOUNTER

CONCEPTS CONTEXT CUES

Curriculum

Objectives: Safe moving & handling

•Demonstrate safe moving and handling of people taking into account safety, analysis of movement and use of equipment

•NZ ACC moving and handling guidelines

Curriculum

Objectives: Movement Analysis

•Identify critical components of movement.

•Analyse the implications for moving and handling

What went wrong?

PLAN

DO

REFLECT

MODIFY

REFLECT

MODIFY

REFLECTIONIN

ACTION

THECLINICAL

ENCOUNTER

CONCEPTS CONTEXT CUES

Strategies

Placed student in a highly supportive CONTEXTUAL environment.

Strategies

Revisited the CONCEPTS of:

• risk analysis using the LITEN UP approach

• analysis of movement

LITEN UP Approach

L

• Co-operate & follow instructions but this is variable• Unable to communicate• Small in size• Extensor muscle tone present on standing• Panic attacks

I• Understands the procedure for sit - stand• No physical limitation

T• Performed task numerous times before• Some lifting assistance may be needed depending on co-

operation level

E• Space for the transfer to occur is sufficient• Other patients moving around the room

Technique: Sit - Stand

Strategies

Video analysis

Strategies

Applied a MASTER – APPRENTICE model of learning.

Master – Apprentice Model

Modelling

Coaching

Scaffolding

Articulation

Reflection

Exploration

Collins et al (1989)

Outcome

Conclusion

The LITEN up approach, along with other strategies can be used strategically to assist physiotherapy students to move and handle people safely in an authentic contextual learning environment.

Otago

School of PhysiotherapyCentre for Physiotherapy Research

Questions?