Training Musculoskeletal physiotherapists in Patient-centred care informed by Acceptance and Commitment Therapy (MuPACT): a exploratory study.
Marie March1,2, Belinda Judd2, Alison Harmer2, Jillian Eyles3, Sarah Dennis2,4,5 1Physiotherapy Department, Blacktown Mt Druitt Hospitals, Western Sydney Local Health District, Blacktown, NSW, Australia2Faculty of Medicine and Health, University of Sydney, Sydney, NSW, Australia3Kolling Institute for Bone and Joint Research, Faculty of Medicine and Health, University of Sydney, St Leonards, NSW, Australia4South Western Sydney Local Health District, Liverpool, NSW, Australia5Ingham Institute for Applied Medical Research, Liverpool , NSW, Australia
Abstract
Background
Patient-centred care is essential important for high quality musculoskeletal care. However, clinicians report barriers to implementing patient-centred care including skills, beliefs about capabilities and social/professional role & identity.
The primary aim of this study was to develop and evaluate if a simulation-based educational strategy (informed by Acceptance and Commitment Therapy) improved physiotherapist knowledge and confidence in implementing patient-centred musculoskeletal care.
Methods
Acceptance and Commitment Therapy informed the content of patient-centred care skills. The Theoretical Domains Framework informed which educational approaches were used, involving a simulated patient and role play.
Repeated-measures single-group interventional pilot study. Primary outcomes: self-reported survey data at three timepoints exploring knowledge and confidence in patient-centred care. Repeated measures ANOVA was used to analyse primary outcomes. Secondary outcomes included behavioural intention, and ongoing implementation of skills learnt.
Results
Baseline data (N=17) indicate participants were relatively young (71% < 35 years old), female (67%), early career (mean experience 3.25 years), and ethnically diverse (67% identify with ethnicities other than Australian).
Participants had high baseline knowledge and no significant improvements occurred after intervention. Participant confidence significantly improved from baseline to immediately after the workshop, and at six weeks after the workshop (p<0.05 for all five outcomes).
Participants had very high behavioural intention (mean scores 6-7 where 7=strongly agree), and high agreement in three aspects of implementation (coherence 59-88%, cognitive participation 75-88% and reflexive monitoring 52-85%), with limited agreement in collective action (30-78%).
Conclusions
A simulation-based educational strategy improved physiotherapist confidence in patient-centred musculoskeletal care. Combined with high behavioural intention and high implementation outcomes, our educational strategy is likely to lead to ongoing improvements in patient-centred care for the benefit of patients, carers and physiotherapists.
Biography
Marie is a Senior Clinical and Research Physiotherapist at Blacktown Mt Druitt Hospitals, Western Sydney Local Health District, and a Clinical Lecturer at the University of Sydney. She has extensive clinical experience in orthopaedics and musculoskeletal care and is currently in a transdisciplinary clinical role in the emergency department. Marie’s research interests include optimising complex patients undergoing arthroplasty, implementing high value models of care, and psychologically-informed physiotherapy practice. Her PhD has recently been accepted at the University of Sydney exploring psychological health and recovery from knee arthroplasty. She has ~$150 000 of grant funding and six publications.