Background

Educational standards of advanced musculoskeletal physiotherapy include mentored clinical practice. Whilst traditionally delivered face-to-face, telehealth e-mentoring affords a distinctive andragogy to facilitate mentee development.

Objective

To understand the experiences and outcomes of stakeholders participating in musculoskeletal physiotherapy telehealth e-mentoring.

Design

A case study design with sequential mixed methods (quantitative patient outcome data and qualitative interviews and a focus group) of a 20-week e-mentored telehealth physiotherapy service.

Methods

Data collection comprised 1) Patient experiences and measures of musculoskeletal health 2) Mentee semi-structured interviews 3) Mentor focus group. Data analysis included descriptive statistics (median and IQR) and the Framework Method for qualitative and quantitative data respectively. An exploratory bidirectional approach supported data integration across all participants.

Results

Participants included patients (n = 90), mentees (n = 10) and mentors (n = 6). Patients reported improvements (>MCID) in MSK-HQ and Patient Specific Functional Scale, with high scores for Consultation and Relational Empathy and Patient Enablement Instruments. Main themes were a) social learning b) advanced professional practice c) learner experience and d) limitations of telehealth for mentees, and for mentors a) preparedness b) journey of development and c) challenges. Participant data integration resulted in 4 main themes 1) energising/positive experience 2) communications skills valued 3) perceptions of telehealth 4) upskilling required.

Conclusions

Telehealth e-mentoring is a valuable alternative to face-to-face mentored physiotherapy practice to support development in advanced musculoskeletal physiotherapy practice. Findings indicate that technical and professional skills are required, high levels of communication skills were valued, there is a need for reconceptualisation of musculoskeletal physiotherapeutic interventions.

中文翻译：

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研究生肌肉骨骼物理治疗教育中的远程医疗电子指导：混合方法案例研究

背景

高级肌肉骨骼物理治疗的教育标准包括指导临床实践。虽然传统上是面对面提供，但远程医疗电子指导提供了一种独特的教养方式，以促进受指导者的发展。

客观的

了解参与肌肉骨骼物理治疗远程医疗电子指导的利益相关者的经验和结果。

设计

使用连续混合方法（定量患者结果数据和定性访谈和焦点小组）的 20 周电子指导远程医疗理疗服务的案例研究设计。

方法

数据收集包括 1) 患者经历和肌肉骨骼健康测量 2) 学员半结构化访谈 3) 导师焦点小组。数据分析分别包括描述性统计（中位数和 IQR）以及定性和定量数据的框架方法。探索性双向方法支持所有参与者的数据集成。

结果

参与者包括患者 (n = 90)、学员 (n = 10) 和导师 (n = 6)。患者报告 MSK-HQ 和患者特定功能量表的改善 (>MCID)，在咨询和关系移情和患者支持工具方面得分较高。主要主题是 a) 社会学习 b) 高级专业实践 c) 学习者经验和 d) 远程医疗对学员和导师的局限性 a) 准备 b) 发展历程和 c) 挑战。参与者数据集成产生了 4 个主要主题 1) 激励/积极体验 2) 重视沟通技巧 3) 对远程医疗的看法 4) 需要提升技能。

结论

远程医疗电子指导是面对面指导物理治疗实践的宝贵替代方案，可支持高级肌肉骨骼物理治疗实践的发展。调查结果表明，需要技术和专业技能，重视高水平的沟通技巧，需要重新定义肌肉骨骼物理治疗干预措施。