ABSTRACT
Keywords: Telehealth;Health-coaching;Behaviour change Purpose: COVID-19 has changed the face of healthcare, including student placement provision in the UK and internationally. There is a national placement capacity crisis. The Coventry University telehealth coaching clinic provided second year BSc Physiotherapy students with a placement on the University site. Telehealth enables students to work with clients to achieve their physical activity goals at a time when University staff working at home may need more well-being support. To our knowledge, on-site telehealth clinics are being used at one other UK University. Methods: Using problem-based learning, ten students used a ‘telehealth trigger scenario’ and worked collaboratively to brainstorm and search the evidence for key concepts. Students were facilitated by visiting tutors and clinical educators to replicate a practice placement. Students led the development of infrastructure (booking system, IT support), governance (record keeping, GDPR compliance, informed consent) and teamworking (weekly strategy meetings). Students modified the ‘improving health: changing health behaviour’ NHS health trainer handbook to use as an assessment tool, focussing on physical activity (removing eating, smoking and drinking habits). We evaluated the clinic using mixed methods: (i) placement capacity statistics, (ii) student satisfaction survey, (iii) student performance (pass/fail rate), (iv) client satisfaction survey, (v) student's experience (themes extracted from team debrief sessions). Results: Students saw a total of 15 clients, and 12 of those received a follow up appointment. (i) Placement capacity: 29 of the 120 second year BSc Physiotherapy students could not be placed during March–April 2021. Ten (35%) of these students were placed on the telehealth clinic. (ii) Student satisfaction survey: of 10 respondents, 90% agreed they gained new and transferable skills, 90% agreed they felt part of a community with staff and students, 40% agreed the placement was organised and running smoothly. (iii) Student performance: at the halfway evaluation, 100% of students had passed. (iv) Client satisfaction: of seven respondents, 85% were satisfied with the service, 100% agreed it was easy to schedule appointments at convenient times. (v) Student experience: key themes were learning achieved (development of clinical knowledge and skills, quality assurance skills, and emotional intelligence) and limitations of the placement (time constraints, limited learning opportunities). Conclusion(s): The Coventry University telehealth clinic is an innovative and high-quality service, which is appropriate to be managed by second- and third-year BSc physiotherapy students. However, there is room for improvements such as increasing structure and organisation of the clinic, which can be done by addressing feedback. Impact: Currently, 44 students do not have placements for May 2021, but 45% of these students will be placed by scaling up the telehealth clinic to take 20 students. This could reduce the current predictions that 50% of Coventry University Physiotherapy students will graduate late (due to sub-optimal placement hours), by at least one-third. Telehealth Students can gain new skills in organisation, administration, management, governance and communication (in virtual environments) that will impact confidence and ability to execute audits and service delivery projects after graduation. The telehealth service could be scaled up to include psychology, occupational therapy and dietetics students. Funding acknowledgements: No external funding was received.
ABSTRACT
The increased use of heparin during the current COVID-19 pandemic has highlighted the risk of a rare but potentially serious complication of heparin therapy, viz. heparin-induced thrombocytopenia (HIT). This is a short review on the pharmacology of heparin and its derivatives, and the pathophysiology of HIT. Guidance on laboratory testing for and clinical management of HIT is presented in accordance with international guidelines. There are important similarities and differences between HIT and the new entity of vaccine-induced immune thrombotic thrombocytopenia, also known as thrombosis with thrombocytopenia syndrome, which clinicians need to be aware of.