Developing a Curriculum Module to Prepare Students for Community-Based Physiotherapy Rehabilitation in South Africa

Abstract

Background and purpose With the rapid turnover and consequent demand for hospital beds and the inadequate number of physiotherapists, increasing numbers will need to work in community settings in South Africa in the future. Education of students at the University of Cape Town was required to move away from a disease-centred, hospital-based curriculum to a community-based programme in order to meet the rehabilitation needs of the majority of the disabled population in the country. The aim of this study was to identify the gaps in the undergraduate curriculum and to make the required curricular changes to ensure that, on graduation, the students would be competent and confident to work in community settings. Methods A module on community physiotherapy preceded a four-week placement in an historically disadvantaged community with no access to rehabilitation facilities. Seventy-five students provided severely disabled persons and their caregivers with rehabilitation and education programmes in their homes. The students were provided with two sessions of clinical supervision weekly. At the end of the placement they were examined on their ability to treat patients in a home environment and were also scored on their block performance over the month. Students evaluated the placement as a learning experience and the clinical supervisors kept records throughout the two years on gaps in the content of the community physiotherapy module. Findings The majority of students found the placement a valuable learning experience and suggested that it should be developed into a multi-disciplinary student rotation. The clinical supervisors identified several topics that were essential to include in the community physiotherapy module to help the students in moving from a medical model to a bio-psychosocial model in the management of their clients. Conclusion The study achieved its aim of identifying the gaps in the existing undergraduate programme that needed to be addressed in order to prepare students to be competent and confident to practise in community settings on graduation. Changes to the curriculum were done incrementally during the year and also at the beginning of each of two years. These have been in operation for the past five years. With the rapid turnover and consequent demand for hospital beds and the inadequate number of physiotherapists, increasing numbers will need to work in community settings in South Africa in the future. Education of students at the University of Cape Town was required to move away from a disease-centred, hospital-based curriculum to a community-based programme in order to meet the rehabilitation needs of the majority of the disabled population in the country. The aim of this study was to identify the gaps in the undergraduate curriculum and to make the required curricular changes to ensure that, on graduation, the students would be competent and confident to work in community settings. A module on community physiotherapy preceded a four-week placement in an historically disadvantaged community with no access to rehabilitation facilities. Seventy-five students provided severely disabled persons and their caregivers with rehabilitation and education programmes in their homes. The students were provided with two sessions of clinical supervision weekly. At the end of the placement they were examined on their ability to treat patients in a home environment and were also scored on their block performance over the month. Students evaluated the placement as a learning experience and the clinical supervisors kept records throughout the two years on gaps in the content of the community physiotherapy module. The majority of students found the placement a valuable learning experience and suggested that it should be developed into a multi-disciplinary student rotation. The clinical supervisors identified several topics that were essential to include in the community physiotherapy module to help the students in moving from a medical model to a bio-psychosocial model in the management of their clients. The study achieved its aim of identifying the gaps in the existing undergraduate programme that needed to be addressed in order to prepare students to be competent and confident to practise in community settings on graduation. Changes to the curriculum were done incrementally during the year and also at the beginning of each of two years. These have been in operation for the past five years.