A survey of patient education practices and perceptions of physiotherapists: a mixed methods study.

INTRODUCTION: Patient education is an integral part of physiotherapy practice. The use of patient education and the adoption of a patient-centered approach to education has not been examined in a European setting. OBJECTIVE: To explore the frequency and perceived importance of patient education practices of physiotherapists in Iceland. METHODS: A convergent mixed methods study design was utilized. A cross-sectional, web-based survey was completed by 216 physiotherapists (35.1% response rate). Transformed qualitative data played a secondary role to quantitative results measuring frequencies of use and perceived importance of a spectrum of patient education practices. RESULTS: Providing exercise and diagnostic information had the highest rated frequency and importance. Advising on social support and having the patient explain why their home exercises were important were rated lowest. A large difference was reported between frequency and importance when collaborating with patients on goal-setting. Therapists reported delivering education through discussions and physical demonstrations, while relying on visual cues and return demonstrations to evaluate education effectiveness. Patient-specific education, including preferred learning style, was not always considered. The highest-rated barriers to patient education were patient characteristics that were psychosocial in nature. Results regarding readiness for education indicated needs to assess patient motivation while managing external barriers. CONCLUSION: The results indicate that physiotherapists engage in a wide variety of patient education activities that they consider important. Barriers to patient education identified by therapists may be managed by further skill development in a collaborative patient-centered approach to patient education.

Faculty's attitudes and perceptions related to applying motivational principles to their teaching: a mixed methods study.

BACKGROUND: It is uncommon for faculty development professionals to assess faculty attitudes towards their teaching responsibilities and their perceived obstacles to teaching effectiveness. The purposes of this study were (a) to document faculty attitudes and practices related to applying motivation principles, and (b) to identify the perceived contextual factors that may shape these attitudes and practices. METHODS: A sequential explanatory mixed methods design was used. Faculty members (n = 272; 32% response rate) were surveyed about their responsibility for and application of the five motivational principles that are part of the MUSIC Model of Motivation: eMpowerment, Usefulness, Success, Interest, and Caring. Repeated measures ANOVAs and Student's t-tests were computed to detect differences. Subsequently, two focus groups of faculty members (n = 11) interpreted the survey results. We conducted a thematic analysis and used the focus group results to explain the survey results. RESULTS: Faculty rated their responsibilities for applying principles related to Usefulness, Interest, and Caring significantly higher than they did for Success and eMpowerment. Most faculty also reported that they actually applied Usefulness, Interest, and Caring strategies within the past year, whereas over half of the faculty applied Success strategies and about a third of faculty applied eMpowerment strategies. Focus group participants identified factors that affected their ability to apply eMpowerment strategies, (e.g., offering choices), including students lacking generic skills (e.g., critical thinking, problem-solving), a lack of confidence in their abilities to implement empowering strategies and meet the needs of students, passive students, and large lecture-type courses. Focus group participants cited obstacles to implementing Success strategies (e.g., providing feedback), including difficulty in providing feedback in large courses, lacking time and assistant teachers, limited knowledge of technologies, and lacking skills related to guiding effective student peer feedback. CONCLUSIONS: Faculty appear adequately prepared to implement some types of motivational strategies, but not others, in part due to contextual factors that can influence their attitudes and, ultimately, their application of these strategies. We discuss how these factors affect attitudes and application of motivational strategies and formulate suggestions based on the results.

'We have different needs': Specifying support for classroom and clinical sessional educators.

CONTEXT: Both classroom and clinical sessional educators are often overlooked in faculty development, even though they play an important role in student learning. Our aim was to contrast classroom and clinical sessional educators´ experiences of and perceived needs for connectedness, appreciation and support, in relation to their teaching quality. We then utilised these results to make suggestions for supporting these educators. METHODS: The participants (11 physical therapy sessional educators: four clinical; seven clinical, and classroom) took part in three focus groups. We based the interview guide questions on previous survey results, used a critical theory research paradigm and performed thematic analysis. RESULTS: We identified four emerging differences between physical therapy sessional educators with experience in the classroom and clinic. Classroom sessional educators needed: (a) more connectedness; (b) more appreciation; (c) more access to the learning management system, and (d) both different and similar faculty development when compared to clinical sessional educators. Differences were greater in classroom sessional educators who taught more hours. We also saw similarities in the need for feedback on teaching, orientations and communication, a better salary and clinical workplace support their role of an educator. Suggestions for context-dependent support for sessional educators were designed to address these similarities and differences. CONCLUSIONS: Talking to various types of sessional educators about their teaching needs is the first step in providing effective faculty development. Varying needs for connectedness, appreciation, pedagogy and access to the learning management system amongst physical therapy sessional educators highlighted the need for an investment in classroom educators who teach multiple hours and want to grow as health science educators. Differences between classroom and clinical sessional educators brought to the forefront the importance of individualised, contextual faculty development and administrative or departmental action that supports sessional educators. The resulting context-dependent suggestions for improvement of support of sessional educators have the potential to improve the quality of health science teaching overall.

Needs, motivations, and identification with teaching: a comparative study of temporary part-time and tenure-track health science faculty in Iceland.

BACKGROUND: About 70% of teachers who instruct healthcare students are considered sessional (adjunct/temporary part-time) faculty and receive limited instruction in pedagogy. Sessional faculty may feel isolated and struggle with their teacher identity, and are often assumed to vary in their commitment, motivation, and ability to teach. However, research on teaching identity, motivations, and needs of sessional faculty is lacking. The aim of this study was to compare similarities and differences between sessional and tenure-track faculty across a health science school to guide faculty development for sessional faculty. METHODS: We developed an online needs assessment survey, based on informal interviews and literature reviews. Seventy-eight tenure-track faculty and 160 sessional faculty completed the survey (37, 25% response rate, respectively). We used validated scales to assess intrinsic motivation, identified regulated motivation, and identification with teaching, as well as developed scales (perceived connectedness, motivated by appreciation to try new teaching method) and single items. All scales demonstrated good internal consistency. We compared sessional and tenure-track faculty using t-tests/chi-square values. RESULTS: We found similarities between sessional and tenure-track faculty in intrinsic motivation, identified regulated motivation, and identification with teaching. However, sessional faculty perceived less department connectedness and were more motivated to improve instruction if shown appreciation for trying new teaching methods. Sessional faculty agreed more that they desired pedagogy instruction before starting to teach and that teachers should invest energy in improving their teaching. Admitting to less participation in activities to enhance teaching in the last year, sessional faculty were more interested in digital formats of faculty development. CONCLUSION: Our comparison suggested that sessional faculty value being a teacher as part of their self, similar to tenured faculty, but desired more appreciation for efforts to improve and perceived less connectedness to their university department than tenured faculty. They also preferred digital formats for pedagogy to improve accessibility, prior to and throughout their teaching career to support their development as teachers. Using this information as a guide, we provide suggestions for faculty development for sessional faculty. Supporting sessional faculty in the health sciences should improve the quality of teaching and positively affect student learning.

Factors predicting identity as educators and openness to improve: an exploratory study.

CONTEXT: Researchers suggest that teachers' work environment affects their sense of connectedness and appreciation, which affects their educator identity. However, sessional (also known as adjunct, clinical, contingent and non-tenured) faculty members may struggle with their educator identity. The purpose of this exploratory study was to examine the extent to which perceived connectedness and received appreciation predicted identity as a medical (health care science) educator and openness to improve in tenure-track and sessional faculty members. METHODS: We utilised an 'identification with teaching' scale to measure medical educator identity. We developed scales to measure perceived connectedness to university department, openness to improve teaching, and appreciation as a motivation to try a new teaching method. We then hypothesised a path model between these constructs. We surveyed faculty members at a health sciences school and performed confirmatory factor analyses and structural equation modelling using data from a sample of 73 tenure-track and 146 sessional faculty members to explore support for the hypothesised model. RESULTS: Connectedness and appreciation predicted identity as a medical educator and openness to improve in different ways for sessional and tenure-track faculty members. For tenure-track faculty members, appreciation predicted medical educator identity and openness to improve, whereas a sense of connectedness trended towards predicting an openness to improve. For sessional faculty members, connectedness to their department predicted their identity as a medical educator, which acted as a mediator to predict an openness to improve. DISCUSSION: Our data supported the hypothesised model, but the sessional and tenure-track faculty models differed in strength and focus. We explore reasons for these differences based on the working environment of each teacher type. We suggest that the two models partially explain the transformation from 'a clinician who teaches' to a medical educator. Finally, we make suggestions for how identity as a medical educator and openness to improve may be encouraged in both types of teachers.