Cardiorespiratory Physiotherapy Research Articles

A44Simulated placement preparation: physiotherapy student acceptability of a multi-level simulated placement preparation week

Practice based learning (PBL) remains a universal mandatory experience for physiotherapy students. Challenges of placement capacity were heightened by the impact of COVID 19 as well as growing demand in response to the NHS long term plan/interim people plan for growth in AHP workforce. These challenges provided opportunity to rapidly progress sustainable PBL capacity utilizing simulation as replacement and enhancement of PBL. Having established simulation as placement replacement within the Faculty of Health & Wellbeing at University of Winchester [1], the simulated placement preparation (SPP) project aimed to explore the acceptability of simulation as preparatory enhancement of PBL, delivering a week of multilevel peer assisted simulated PBL; two primary objectives of reducing demand on capacity and optimizing students’ success in PBL through preparatory simulated activities. Simulation and learning focused on the development of digital capabilities in recognition of the Topol review that reflected the requirements of NHS workforce to be digitally capable [2]. Additionally, the KNOWSBEST study [3] recommended digital capability and simulation within PBL, thus simulated activities were designed to promote core digital capabilities including training and simulation in remote consultations and presenting simulated scenarios accessed via electronic patient records. Collaborative learning in practice (CLiP) model of supervision was used to promote peer assisted learning with learning outcomes focused on communication and MDT domains of the common placement assessment form (CPAF), familiarization with digital technologies and orientation and management of scenarios in high acuity environments and enhancement of digital capabilities. The SPP week utilized mixed modality and fidelity simulated activities including ‘real play’ remote consultations, simulated patients, manikins/ventilators and virtual simulations. Students completed faculty developed questionnaires pre and post SPP relating to self-assessed communication and telehealth capability and specific clinical competence in musculoskeletal and cardiorespiratory physiotherapy. A convenience sample of students participated in focus group interviews following subsequent completion of PBL to explore their perceived impact of SPP on subsequent PBL. Thematic analysis was used to analyse focus group interviews and pre-post anaylsis conducted using repeated measures ANOVA. Results demonstrated increased capabilities in teleconsultation and appreciation of digital technologies potential. Students reported enhancement of in person and remote communication as well as clinical capabilities in high acuity environments. Students reported the SPP week as an acceptable means of replacing one week of PBL, enhancing the preparedness for clinical environments and sustainably increasing placement capacity by providing 4440 hours of simulated PBL. Authors confirm that all relevant ethical standards for research conduct and dissemination have been met. The submitting author confirms that relevant ethical approval was granted, if applicable.

A21The use of simulated learning in prequalifying physiotherapy education: a scoping review

Simulation-based learning is an increasingly popular pedagogical approach. In some areas of physiotherapy, it is better been documented, for example, cardiorespiratory physiotherapy [1]. However, its use in other physiotherapy-related settings is less clear. Therefore, the aim of this project was to review the literature on simulation-based learning in prequalifying physiotherapy education, in order to explore where studies have taken place, which physiotherapy settings it is used in and indication of its effectiveness in teaching. This study was carried out based on the scoping review methodology outlined by Arksey and O’Malley [2]. The following databases were searched: AMED, BNI, CINAHL, Embase, Emcare, HMIC, Medline and PsychInfo, using specific search terms, to find studies involving the use of simulation in a prequalifying physiotherapy setting. Returned papers were screened using inclusion and exclusion criteria by two reviewers. The database search results were recorded and managed using Rayyan™ [3]. The database search retrieved 280 papers. Following the removal of duplicates, screening titles and abstracts and then screening full-text papers, 39 papers were included. The included studies were conducted in USA ( This scoping review identified a growing body of evidence supporting simulation-based learning in prequalifying physiotherapy education. However, to date, its use in pedagogical research has tended to focus on the cardiorespiratory setting, and it has often been researched as a tool to explore or enhance interprofessional collaboration. Whilst both of these areas are of value to the profession, there is scope to explore the use of simulation-based learning in settings such as musculoskeletal teaching. Further work on its use and value in the teaching of discrete complex tasks, in addition to collaborative practice, such as team working, de-escalation and communication is also needed. Authors confirm that all relevant ethical standards for research conduct and dissemination have been met. The submitting author confirms that relevant ethical approval was granted, if applicable.

Centros Especializados em Reabilitação (CER) no SUS e o impacto da pandemia de covid-19

To analyze the impact of the covid-19 pandemic on the functioning of Specialized Rehabilitation Centers (CER) in the SUS. An analysis of the variation in outpatient production of the CER was carried out based on data from the Outpatient Information System of the Unified Health System (SIA-SUS) from March 2019 to December 2021. Such results were compared with CER managers' perceptions about the impacts of the pandemic on the units, measured by a web survey applied between November 2020 and February 2021. Monthly averages of 247 procedures were calculated, organized into 18 groups, for three periods - year before the pandemic (YBP) and first (YP1) and second (YP2) years of the pandemic. Through the online form, information was collected on: operation and organization of services; post-covid-19 rehabilitation; actions to support the needs of users and professionals; strategies and challenges experienced. There was a 33.3% reduction in the total number of procedures in YP1 compared to YBP. There were no reductions in procedures performed by nurses and for ostomates. There was greater impairment for group activities, visual therapies and home visits. In YP2, there was a recovery of averages in relation to YBP in 11 groups of procedures, with an increase of 104.1% in Cardiorespiratory Physiotherapy. In the answers to the online form, 91.7% of the managers indicate structural and/or organizational changes in the CER, such as: creation of prioritization criteria for assistance; introduction of telerehabilitation; changes in the work process and; provision of professional training. Half of the CER already treated people with covid-19 sequelae, but not all of them had been trained to do so. Limitations in participation and social support for PWD were identified. There was a severe impact of the covid-19 pandemic on the CER. Added to the damming up of previous demands are those of post-covid-19 users, configuring a challenging picture. It is necessary to strengthen the Care Network for Persons with Disabilities, with expansion and greater integration of services and a more inclusive organization to overcome these challenges.

Awareness and Perception on Cardiorespiratory Physiotherapy for Covid-19 Patients among the Alumni Physiotherapists from KPJ Healthcare University College, Nilai

Introduction: In the respiratory management and physical recovery of Covid-19 cases, physical therapy may be necessary. The spectrum of cardiorespiratory physiotherapy is limited to acute provision without referral to an outpatient physiotherapy clinic for patientswith cardiorespiratory problems. In community settings, a limited number of physiotherapists practicing further restricting the scope. The objective of this research is to identify the awareness and perception of cardiorespiratory physiotherapy forCovid-19 patients among the alumni physiotherapists from KPJ Healthcare University College. Method: A cross-sectional online survey study among the alumni physiotherapists from KPJ Healthcare University College. 80 male and female alumni physiotherapists from Diploma Cohort 1 to 10 are selected as they would have at least 5 years and above working experience and is considered competent and reliable scientific evidence for this study. Sampling technique used for this research is convenience sampling better known as a non-probability sampling technique. Sample size is determined by using Slovin’s Formula. Questionnaire related to research topic is distributed via Google Docs. Descriptive statistics is done using SPSS version 26.Results: This study shows majority had good knowledge, awareness and their perceptionsfrom their own perspectives as a physiotherapist as well as an ordinary man. Conclusion:Chest physical therapy can help to improve physical health from an acute illness. In conclusion, this study was able to determine the awareness and gauge the perception of cardiorespiratory physiotherapy for Covid-19 patients among physiotherapists.

EFFECT OF PHYSIOTHERAPY TREATMENT IN THORACIC OUTLET SYNDROME

Introduction: Thoracic outlet syndrome (TOS) comprises a group of disorders that result in compression of the neuro vasculature exiting the thoracic outlet and was first described in 1956. TOS is usually subclassified into neurogenic TOS (nTOS), venous TOS (vTOS), and arterial TOS (aTOS), depending on the appropriate etiology upon presentation. It has been classified as Venous thoracic outlet syndrome and Neurogenic thoracic outlet syndrome. Causes: Sometimes, a congenital (from birth) abnormality can cause thoracic outlet syndrome, but it is more likely to occur after injury or bodybuilding. A cervical rib is an extra rib that grows from the cervical spine. Abnormal muscle or first rib formation, some people may have an extra or aberrant scalene muscle his condition is related to abnormalities of bony and soft tissue in the lower neck region. Symptoms: Patients with thoracic outlet syndrome will most likely present pain anywhere between the neck, face and occipital region or into the chest, shoulder and upper extremity and paresthesia in the upper extremity. The patient may also complain of altered or absent sensation, weakness, fatigue, a feeling of heaviness in the arm and hand. The skin can also be blotchy or discolored. A different temperature can also be observed. Management: Medical Management include Thrombolytic medications are given to dissolve blood clots. Anticoagulant medications decrease the blood’s ability to clot. Surgical Management include chest (thoracic surgery or blood vessel (vascular) surgery perform the procedure. Thoracic outlet syndrome surgery has risks of complications,such as injury to the brachial plexus. Physiotherapymanagement can decrease symptoms of pain and increase muscle strength, improve Postural correction and return to near normal function of upper limb.

Effect of Soft Tissue Manual Technique and Breathing Exercises on Pulmonary Function, Chest Expansion and Functional Status in Post COVID-19 Survivors: A Quasi-experimental Study

Introduction: It is known that around one third of Coronavirus Disease-2019 (COVID-19) patients develop severe pulmonary complications and acute respiratory distress syndrome, leading to long-term impairments in Pulmonary Function Test (PFT) and physical performance. Due to deteriorating health status of the COVID-19 survivors after their recovery, rehabilitation is must. Aim: To evaluate the effect of soft tissue manual technique and breathing exercises on PFT, chest expansion and functional status in Post COVID-19 Survivors. Materials and Methods: This quasi-experimental study was carried out in the Department of Cardiorespiratory Physiotherapy, MGM hospital, Aurangabad, Maharashtra, India, from November 2021 to July 2022. Total 54 subjects diagnosed with COVID-19 who required oxygen therapy and had persistent respiratory symptoms for three weeks to six months after the infection, were included. All the subjects received one week of soft tissue manual techniques which included proprioceptive neuromuscular function, muscle energy technique for recruitment of diaphragm, muscles of respiration and the ribcage. Breathing exercises were inculcated at the end of the session to ensure relaxation of the subjects. Subjects were assessed for PFT, chest expansion and post COVID-19 Functional Status Scale (PCFS) pre and post-treatment. Data were analysed through Wilcoxon signed-rank Test. Results: Amongst total 54 subjects included, 10 (18.6%) males and 44 (81.4%) females with mean age of 29.92±11.94. After one week of intervention p-value was 0.0001 for Forced Expiratory Volume (FEV1), FEV1/Forced Vital Capacity (FVC), Peak Expiratory Flow (PEF) with mean values for FEV1 at baseline was 1.91±0.51 and post-treatment was 2.45±0.34, FVC was 2.25±0.50 before the treatment whereas it was 2.73±0.36 post-treatment with p-value of 0.002, FEV1/FVC and PEF was 83.99±12.03 and 4.36±1.78 at baseline whereas, post-treatment it was 87.76±7.29 and 5.88±0.95 respectively. The p-value of 0.0001 was also similar for chest expansion. No statistically significant difference was found in post COVID-19 functional status (p-value=0.013). Conclusion: Positive changes in the ribcage’s activation and integration with its muscles were seen in all of the study variables. Therefore, it is concluded that soft tissue manipulation techniques and breathing exercise improves functional status, thoracic expansion, in post COVID-19 survivors.

Consenso nacional sobre los contenidos de Grado en Fisioterapia cardiorrespiratoria: estudio Delphi

Background and objectivesThe curricula of the Bachelor's degree in physiotherapy must respond to the current demands of physiotherapy clients in the main areas of their professional practice and prepare physiotherapists to act in a challenging and complex context. The aim of this study is to elaborate and validate a list of knowledge (syllabus) about cardiorespiratory physiotherapy in Bachelor's degree programs. Material and methodsA digital survey conducted a three-round Delphi study between February and March 2021. A group of 14 experts in cardiorespiratory physiotherapy from all over Spain and with different professional profiles were contacted. To establish the degree of agreement in the consultation rounds, the free-marginal multirater kappa statistical index was used, requiring at least 70% of consensus. Cohen's kappa statistic (K) was used to analyze the responses’ stability. ResultsHundred percentage of responses were obtained in the three rounds of consultation conducted with the expert panel. At the end of the process, a syllabus made up of 11 thematic sections and 48 items was reached. An average of 90.64% of agreement and a stability in the responses of K=0.57 (p<0.001), which equates to moderate agreement, was achieved. ConclusionsThis syllabus validated by 14 respiratory and cardiac physiotherapy experts, determines the contents that should be part of physiotherapy in Bachelor's degree programs. This knowledge is crucial to address the rehabilitation necessities of cardiorespiratory alterations in a challenging and complex context, according to a contemporary approach of physiotherapy.

An Update on Cardiorespiratory Physiotherapy during Mechanical Ventilation.

Physiotherapists are integral members of the multidisciplinary team managing critically ill adult patients. However, the scope and role of physiotherapists vary widely internationally, with physiotherapists in some countries moving away from providing early and proactive respiratory care in the intensive care unit (ICU) and focusing more on early mobilization and rehabilitation. This article provides an update of cardiorespiratory physiotherapy for patients receiving mechanical ventilation in ICU. Common and some more novel assessment tools and treatment options are described, along with the mechanisms of action of the treatment options and the evidence and physiology underpinning them. The aim is not only to summarize the current state of cardiorespiratory physiotherapy but also to provide information that will also hopefully help support clinicians to deliver personalized and optimal patient care, based on the patient's unique needs and guided by accurate interpretation of assessment findings and the current evidence. Cardiorespiratory physiotherapy plays an essential role in optimizing secretion clearance, gas exchange, lung recruitment, and aiding with weaning from mechanical ventilation in ICU. The physiotherapists' skill set and scope is likely to be further optimized and utilized in the future as the evidence base continues to grow and they get more and more integrated into the ICU multidisciplinary team, leading to improved short- and long-term patient outcomes.

CPCR is on its way... to a great future, hopefully!

In 2021, the Brazilian Association of Cardiorespiratory Physiotherapy and Physiotherapy in Critical Care (ASSOBRAFIR) launched its new scientific journal called CPCR (Cardiorespiratory Physiotherapy, Critical Care and Rehabilitation). A dedicated group of chief and associate editors was assembled, and the journal is now boldly “up and running” towards a solid future. In its first year of life, CPCR has published 12 articles: 8 articles of original research, 2 short communications, 1 systematic review and 1 state-of-the-art review. The themes of the original articles covered a vast array of topics, including:

166 Sequential Simulation as Replacement for Standard 4-Week Practice-Based Learning (PBL) for First-Year Undergraduate Physiotherapy Students

Practice-based learning (PBL) via clinical placement is a core part of a physiotherapy degree with the Chartered Society of Physiotherapy (CSP) requiring completion of 1000 placement hours. The COVID-19 pandemic resulted in cancellation of placements on top of an already saturated geographical placement provision in certain regions with many Higher Education Institutes (HEI) reporting a backlog of placements. Inability to meet requisite placement hours impacts on student progression, reducing the flow of physiotherapists into the workforce at a time when Allied Heath Professions (AHP) growth has been planned. The CSP and Health and Care Professions Council (HCPC) have both encouraged HEIs to be innovative in placement provision in response. Simulation is widely utilized in healthcare training but remains an emerging concept in terms of placement replacement The aim was to develop a fully simulated placement that replicated the learning objectives achievable through standard PBL.Development of a novel placement model to deliver a fully simulated placement as replacement for a standard 4-week clinical placement scheduled for 15 (20% cohort) first-year physiotherapy students.The placement was split across clinical specialities within cardiorespiratory and musculoskeletal physiotherapy. Key objectives were set weekly: week 1, focussing on communication/patient-centred care (scaffolded across subsequent 4 weeks); week 2, focussing on assessment, patient management and clinical reasoning; week 3, consolidation of clinical reasoning; week 4, case presentation. Sequential simulation was utilized to best replicate clinical practice, following simulated patients from pre-admission/injury, through to admission, deterioration, rehabilitation and long-term management. This approach enabled learners to experience a full patient journey, unachievable through standard placement timelines. Simulation using a mixed approach to facilitation and PEARLS debrief, handover tasks, multi-disciplinary team meetings, discharge planning and smaller vignette scenarios to develop specific clinical skills were simulated utilizing actor role players, high-fidelity manikins and peer enhanced e-learning. The placement modelled a CLiP (collaborative learning in practice) delivery, an approach promoted across standard placements by HEE, with students autonomously setting objectives, utilizing across level learning, recording of daily learning logs, reflections and peer assessments. Pre- and post-placement data have been gathered exploring the students’ experiences, expectations, and attitudes towards simulated placement, competence and confidence in both communication and clinical skills using focus group interviews and questionnaires.

Constructing active casual self-regulated learners from novice cardio-respiratory physiotherapy students

Purpose: 21st Century Cardio-Respiratory Physiotherapy (CRP) profession requires graduates to deal with ubiquitous and complex problems in their workplaces. CRP modules in undergraduate studies often incorporate massive summative assignments based on conventional lectures. For the past two decades, educators are urged to use active learning strategies to produce agile students of the modern era. Pedagogy recommends the use of active learning strategies to enhance students higher-order skills, engagement and self-efficacy. This concept is supported by three main learning theories- Constructivism, Cognitivism and Behaviorism. To date, there is no clear consensus on the choice of active learning strategies that targets the enhancement of student's self-efficacy, a skill that directly links to their employability. Hence, the aim of this study was to implement and examine the impact of “team-based learning” (TBL), an active collaborative learning strategy for a respiratory key note lecture – Chronic Obstructive Pulmonary Disease (COPD) in year two physiotherapy undergraduate program.

P0689 / #1947: ENHANCING POSTGRADUATE SKILLS IN PAEDIATRIC CRITICAL CARE PHYSIOTHERAPY VIA SIMULATION-BASED EDUCATION: A COLLABORATIVE APPROACH

AIMS & OBJECTIVES: Cardiorespiratory physiotherapy within the paediatric critical care unit requires specialist knowledge and postgraduate training to ensure safety and clinical competency. Within the United Kingdom, simulationbased education (SBE) is primarily used for treatment skills and updates for cardiorespiratory on-call physiotherapists (Gough et al, 2013). The availability and accessibility of high-fidelity resources and specialist education is variable. A collaboration between Great Ormond Street Hospital and the Royal Brompton Hospital, London, was established with the aim of providing a comprehensive SBE course to paediatric physiotherapists nationally. There are currently no other paediatric SBE programmes within the region. METHODS: During May 2018, 2 courses were run with a combination of pre-simulation lectures, simulation scenarios and peer group discussion. Following an international peer review from Queensland Children's Hospital and anonymised candidate feedback (N=23), the course content was divided into 2 separate study days (October 2018 and May 2019). This allowed targeted, specific SBE to both a critical care group and a high dependency care group of paediatric physiotherapists. RESULTS: 15 candidates attended the SBE paediatric critical care (N=8) and high dependency care (N=7) courses. Of the 14 anonymised electronic feedback responses, 96.5% rated the 4 simulation scenarios as extremely useful or very useful. Feedback themes were collated to guide future course content. CONCLUSIONS: The targeted SBE programme for paediatric critical care physiotherapists demonstrated improved confidence in managing highly complex scenarios alongside an opportunity for shared peer learning and reflective practice. In the current COVID-19 pandemic, the course is being modified for teaching via a virtual platform.

Cardiorespiratory Physiotherapy, Critical Care and Rehabilitation (CPCR) journal: a new source of scientific knowledge for physiotherapy clinicians and researchers

Despite being a young profession, physiotherapy has established its role in most developed countries worldwide. The increasing number of randomised clinical trials and systematic reviews testing the impact of different physiotherapy interventions supports much of this achievement. This large volume of publications is exemplified in the Physiotherapy Evidence Database (PEDro), which has indexed more than 48,500 trials, reviews and evaluation guidelines for physiotherapy interventions by September 20201 . This provides strong grounds to put evidence-based physiotherapy into practice. The use of scientific knowledge has contributed largely to the advance of physiotherapy, both showing the effectiveness of novel and classic practices, as well as suggesting that certain procedures do not contribute to or even harm the patients’ physical or functional condition

Embedding a Culture of Active Learning in Cardiorespiratory Physiotherapy Education - Hybrid Team- Based Learning (H-TBL)

In recent years, team-based (TBL) gained popularity as a student-centred active collaborative strategy in healthcare education. This paper reports the design, implementation, and impact of a hybrid team-based learning (H-TBL) for one respiratory lecture in year two undergraduate physiotherapy programs in 2019. A retrospective study was conducted on a cohort of 136, year two, undergraduate physiotherapy students using H-TBL design (COPD1 & 2 sessions) for one respiratory lecture topic. Student engagement was evaluated based on their engagement for pre-class work, attendance to classroom session, and submission of formative creative assignment. Student’s performance on formative creative task was evaluated using the rubric on student's reflection. Student perceptions were assessed based on the student's feedback using Mentimeter, a polling software. 109/ 136 (80%) students attended the COPD 2 session. 90/109 (82%) students engaged in COPD 1 (web-based) and tRAT in COPD 2 session. Received feedback and formative creative assignment submission from 54/109 (50%) and 67/90 (74%) respectively post COPD 2 session. This study confirms that H-TBL enhances student's active engagement, creativity, and equilibration of their subject knowledge. Future randomized studies are mandated to explore the validity and specificity of H-TBL in physiotherapy curriculum to evaluate the long-term student engagement and academic performance.

Guidelines for the Evaluation of Cardiorespiratory Physiotherapy in Stroke Patients.

Evaluation of stroke patients is prioritized over therapeutic interventions to restore cardiorespiratory capacity. This study aimed to develop a clinically applicable guideline to evaluate cardiorespiratory physiotherapy in stroke patients based on a literature review and a modified Delphi survey. The literature search included 13,498 articles in PubMed, EMBASE, CINAHL, and Cochrane Library electronic databases. We surveyed previous articles between January 2010 and June 2019. After the option elimination process, a total of 27 documents were selected and analyzed (draft: 18, modified Delphi survey: 9). The results of this research are roughly divided into two categories. First, 31 draft items were extracted, and a modified Delphi survey questionnaire was created from a literature review. Second, an expert was asked to make two modified Delphi surveys and to modify, delete, and supplement the entries in the statistical analysis at each level to finalize the steps to 20 items. The guidelines developed in this study reflect the selective use of cardiorespiratory physiotherapy evaluation methods in the clinical setting, based on the health status of individual patients. Moreover, the guidelines may help physiotherapists make informed decisions based on expert knowledge, thereby playing a crucial role in the patient-centered treatment planning process.

Cardiorespiratory physiotherapy for mechanically ventilated children following cardiac surgery: a prospective observational service evaluation

Cardiorespiratory physiotherapy for mechanically ventilated children following cardiac surgery: a prospective observational service evaluation

Advancing Cardiorespiratory Physiotherapy Practice in a Developing Country: Surveying and Benchmarking.

Management of noncommunicable diseases requires the adoption of multidisciplinary interventions that targets the modification of risk factors. Cardiovascular and respiratory diseases are amongst the four main killers of noncommunicable diseases. Physiotherapists specializing in cardiorespiratory physiotherapy are in a critical position in the management of health behaviors associated with noncommunicable diseases. However, the current context of health service in Jordan does not provide sufficient support and recognition for the delivery of specialized physiotherapy services. Objectives. The primary aim of this study was to describe cardiorespiratory physiotherapy service in Jordan. The secondary aims of this study were to: (i) Identify benchmarks from international contexts and guidelines for the delivery of cardiorespiratory physiotherapy service. (ii) Identify gaps and areas for development in the current delivery of cardiorespiratory physiotherapy service. Methods. This two phase study included a survey and a conceptual review with benchmarking. Following ethics approval, a cross sectional survey of physiotherapists practicing in Jordan was conducted. In phase 1, a survey was developed to describe the relevant dimensions of cardiorespiratory physiotherapy service. In phase 2 a conceptual review of the literature was performed to identify domains of service delivery and criteria required for optimal delivery of cardiorespiratory physiotherapy service. In the discussion we integrated the results of the survey within the benchmarks that emerged from the conceptual review of literature in order to identify gaps and areas for development in the current delivery of cardiorespiratory physiotherapy service. Results. Phase 1: Data emerging from the survey suggests that Physiotherapists in Jordan lack training and autonomy, preventing them from acquiring advanced roles particularly cardiorespiratory physiotherapy that requires specialised knowledge and skills. The current delivery of the service is limited to acute interventions, and is based on limited, unstructured referral from physicians depriving the patients from the service. The context of health service in Jordan does not provide sufficient recognition for physiotherapy; neither does it support the delivery of multidisciplinary interventions by appropriate regulations and policies. Phase 2: The following three domains emerged from the literature and were used for describing cardiorespiratory physiotherapy in Jordan: people, scope of practice, and context of practice. Conclusion. Advancing practice requires developing competencies relevant to cardiorespiratory physiotherapy particularly diagnosis, health promotion, and prevention. It is recommended that health authorities should develop regulations and policies that promote the recognition and integration of physiotherapists in the healthcare system, as well as facilitating the implementation of patient centred, multidisciplinary interventions.

Influence of Cardiorespiratory Clinical Placements on the Specialty Interest of Physiotherapy Students.

Clinical placements are an important part of health students’ training. Whilst much value is placed on the clinical environment as a place to learn, there is a paucity of direct evidence about its effectiveness. The aim of this study was to compare the competence, importance, and interest in cardiorespiratory physiotherapy of students before and after one month of clinical practice. A pre- and post-placement questionnaire about students’ interest in different physiotherapy subspecialties was used. The students with a cardiorespiratory clinical placement showed a significant change in their perception about the importance of the cardiorespiratory specialty (0.348 ± 1.01; p < 0.001), while no significant change was observed in the students without cardiorespiratory placement (−0.014 ± 0.825; p = 0.883). The presence or absence of clinical placements seems to have a definitive impact on students’ choice of a specialty. This implies the need for developing a set of clinical placements in all the subareas of physiotherapy in order to give undergraduate students the opportunity to make a better decision.

Exploring the experiences of final-year BSc (Hons) physiotherapy students’ that influence views on future career specialisation in cardiorespiratory physiotherapy

Purpose: There is widespread concern for the uptake and retention of cardiorespiratory physiotherapy (CRPT) specialists, with a lack of interest in specialising reported amongst final-year students in Canada, United Kingdom (UK), Australia, and New Zealand. Although the literature on this topic is limited, the reasons reported include limited clinical experiences whilst at university, alongside fears and anxieties that exist amongst undergraduates in relation to the requirements of qualified responsibilities, for example on-call working. In nurturing and promoting the specialism therefore, more understanding of the experiences of students prior to qualification that influence their views of pursuing CRPT is needed. The study aimed to explore final-year BSc (Hons) physiotherapy students’ experiences of CRPT that influence their views on future specialisation within the field. Methods: A qualitative method using a focus group with six participants from one final-year BSc (Hons) university cohort, selected using purposive sampling was conducted, underpinned by an interpretive approach. The interview guide was developed from a literature review. Verbatim transcription and thematic analysis was employed alongside analyst triangulation and reflexivity. Results: Four themes were identified: (1) Influential figures (Clinical-educator, CRPT clinical team and CRPT university lecturers), (2) Learning and teaching practices, (3) Care-giving challenges and (4) Factors external to CRPT; further sub-themes were presented. Quotations were used to corroborate the themes. Conclusion(s): This work demonstrates that there is considerable potential at pre-registration level to influence student views of pursuing CRPT as a career path. Increasing practical teaching sessions and acknowledging the acute CRPT environment, alongside discussions around care-giving challenges at university are identified as ways that may better prepare students for practice-education. Encountering passionate role models and experiencing a supportive environment during practice-education also increase student interest levels in CRPT alongside a practice-education environment that is supportive and conducive to learning. Ultimately, the study found that student interest in pursuing CRPT as a career path is multifactorial, and although the study demonstrates that the decision will be made during qualified rotations, opportunities provided at pre-registration level can favourably contribute towards future career specialisation. This study provides insight from one university cohort and whilst a reflexive approach, triangulation and a clear audit trail enhance trustworthiness of this work, there are limits to the transferability of findings. All participants had completed a cardiorespiratory placement and different findings may have been found if this experience had not been provided. Further work on this important topic, particularly focusing on the factors influencing the decision making process for career specialisation amongst newly qualified physiotherapists, is required to promote opportunities for cardiorespiratory workforce development. Implications: These findings are pertinent to all stakeholders to the cardiorespiratory specialty concerned with growing workforce capacity and is also useful in informing teaching practices within the university that the study took place, and may be useful to other institutions with similar student and programme characteristics.

Exploring employability skills development in the context of undergraduate level cardiorespiratory physiotherapy: student views

Purpose: It is important that undergraduates are adequately prepared during university to transition to the roles and responsibilities required of them post-qualification - employability skills development therefore becomes an important emphasis. Limited literature is available that has explored employability skills development within cardiorespiratory physiotherapy. The need for the views of key stakeholders to an undergraduate programme, as to employability skills development in the context of this specialty, is pertinent given the concerns identified in the literature regarding recruitment and retention to the specialty. This is in addition to the drivers on all universities for their graduates to secure employment.