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This article was migrated. The article was marked as recommended. In response to restrictions on learner placements in clinical environments during the COVID-19 pandemic the authors developed a tool, 'The Virtual Check-In', for clinical clerks in the University of Calgary Longitudinal Integrated Clerkship. These learners, who had been pulled from their rural and remote communities because of the pandemic, used the tool to continue to develop their clinical skills while working with their preceptors and patients online. This paper describes the rapid development of the tool using Kern's principles for curriculum development and implementation, the format and uses of the final tool, and its potential use in other contexts.
RESUMO
PURPOSE: Objective was to evaluate the outcome of a standardized heavy load eccentric training program in adults with chronic painful Achilles tendinopathy, and the presence of increased Colour Doppler activity in diseased and non-diseased adults. The hypothesis was that patient satisfaction would fall within the range of average satisfaction present in the literature (60 to 90%). METHODS: Twenty patients were instructed on a training program based on the Alfredson protocol of straight leg followed by bent knee heel drops and raises. Patient satisfaction was recorded as the primary outcome. Secondary outcomes included the VISA-A and Tegner scales. Twenty one subjects without present or history of lower extremity pain and seven patients presenting at the clinic but without Achilles tendinopathy were included as controls. RESULTS: Patient satisfaction was significantly lower when compared to the literature as two patients reported that they were satisfied with the treatment while the remaining 15 reported that they were unsatisfied. Three patients were excluded from the analysis as they were unable to complete the exercises. Increased Colour Doppler activity was present in only one participant without the disease and in all patients with the disease at the end of the study (increased Colour Doppler activity was present in 40% of patients with the disease at the beginning of the study). CONCLUSION: Although some patients' symptoms improved over time, eccentric training did not satisfy patient expectations of improvement following treatment despite compliance with the home based program. Although it is a mainstay of treatment, other options, which are both efficacious and effective, need to be provided for patients who prefer a conservative and relatively non-invasive treatment option from the start.
