Mentorship Program in Advanced Orthopedic Manual Therapy
The Mentorship Program in Advanced Orthopedic Manual Therapy prepares physical therapists with advanced diagnostic and clinical management skills in orthopedic manual physical therapy (OMPT).
The program consists of online lessons and activities related to physical therapy examination and treatment. It involves completion of assigned lessons and readings, review of techniques, patient videos, PowerPoint lectures, quizzes, short writing assignments, clinical reasoning projects, and discussion forums with faculty and classmates.
The program also includes several hours of small group tutorial work online and in person to enable participants to practice techniques and discuss cases.
At the completion of the Clinical Mentorship in Manual Therapy (OMPT 501) students will be able to demonstrate competence in clinical skills and knowledge (patient examination, evaluation, diagnosis, establishing a prognosis, implementation of plan of care and re-examination) for patients who demonstrate musculoskeletal problems affecting the spine, shoulder and knee complexes.After completing this course, students should be able to:
- Perform targeted patient/client interview/history, taking into consideration patient goals, expectations, psychosocial factors, and functional/activity limitations for the spine complex, (upper cervical, mid/low cervical, thoracic, lumbar), shoulder and knee complexes.
- Interpret the data from the interview, plan and prioritize the physical examination, taking into consideration relevant evidence and the patient’s presentation.
- Evaluate data from the physical examination, taking into consideration the need for medical referral/consultation for red flag, yellow flag, or other non-musculoskeletal conditions.
- Establish the prognosis which considers the complexity of the patient/client’s dysfunctions, the level of optimal improvement that may be attained through intervention and the amount of time required to reach predicted levels of improvement during the course of physical therapy.
- Establish, justify and prioritize intervention goals and plan of care with predicted outcomes, time frames, and plan for discharge.
- Accurately record tests/measures, interview findings, patient goals, initial and between-visit response to intervention, using when appropriate objective tests and measures.
- Perform manual therapy interventions, exercise, and self-mobilization identified in the plan of care, using when appropriate, standardized outcome measures and relevant evidence.
- Educate patient/client, including family and other supportive personnel in the rehabilitation process and in preventive measures to preserve health and safety.
- Reassess and modify as appropriate the plan of care.
- Accurately document all elements of patient/client management, including patient consent, indications and contraindications of OMPT examination and management.
- Discharge the patient when the anticipated goals and expected outcomes have been achieved.
- Communicate effectively, accurately and efficiently to other health care providers.
- Actively engage cooperation of the patient, identifying appropriate methods, style, and level of communication with the patient to facilitate understanding of the examination, plan of care and rehabilitation process.
- Demonstrate attitudes and behaviors that will promote the provision of an optimal level of service delivery and excellence in clinical practice, as well as maintenance and promotion of ethical practice.
Program Director: Carol Jo Tichenor
Instructional Designer: Patricia Schodowski
Web Technologists: Linda Green, Steve Schoen
Faculty: Margaret Anderson, Joe Farrell, Maggie Fillmore, Allan Horwitz, Joyce Zinski, Mike Koury, Leslie Harder, Ivan Matsui, Nancy Woelffer, Steve Ryan
This course was developed from over 400 pages of printed course materials previously used in a traditional classroom setting and developed over a 30-year old postgraduate curriculum.
The major challenges were transforming such a large amount of didactic material into attractive, interactive online lessons and to create a consistent organization of materials throughout the course.
We developed the lessons systematically, relying on Bloom’s Taxonomy to provide a logical progression through the cognitive domain of concepts, application, and analysis. Content modules follow the format of reading and exploring resources (concepts), practicing new skills in both informal and formal settings (application), and beginning to develop clinical reasoning skills and best practices for achieving desired outcomes (analysis).
Our development process consisted of devising a lesson template for use by the subject matter experts (faculty) to achieve consistency in the order and level of material presented in each lesson. Each lesson went through an instructional design review to employ online instructional elements, such as interactive multimedia and collaboration opportunities.
A prototyping process then took place to design web page layouts and then our web technologist developed the online course in Sakai.
Ours is a hybrid course with reading material, videos, forum discussions, and knowledge checks delivered asynchronously in Sakai.
Our course also includes live “hands-on” training sessions during which students learn the hands-on skills required for physical therapy. Additionally, our course took advantage of synchronous online technology to hold monthly webinars (using WebEx) with the students during which a faculty member addressed special topics with the students. This course, in its traditional format, was taught by the entire Fellowship faculty, and that model was retained in the online delivery. Faculty members taught in teams of two with each team being assigned two-week rotations. Faculty used Sakai announcements to inform students of the “changing of the guard” and interacted with students in the discussion forums to remain present to students during their rotations. Additionally, to give students a sense of knowing the faculty, each faculty member recorded a greeting for the students, which are available, along with faculty photos, in the Faculty Bios area of the course.
Use of tools:
Announcements are used in the usual manner to post up-to-date information for the students. Because of the rotating faculty assignments, announcements were particularly useful for posting greetings to let the students know who they would be interacting with during the coming two weeks.
Syllabus. We renamed the Syllabus tool Course Information and used its categorization features to group together like documents, such as schedules and contact lists. This tool makes it easy to group relatively small amounts of information without the need for students to navigate folders.
Modules. We renamed the Melete modules Lessons. This tool allowed us to organize a large amount of information and provides easy navigation with Next and Previous links. The ability to collapse and expand modules keeps the page from being too overwhelming visually for the students.
Forums. We used forums for asynchronous discussions and for Q&A between students and faculty.
Assignments, Tests & Quizzes, and Gradebook. We used these tools to administer tests and assignments, and the faculty used these tools to grade. We found the Model Answer feature of the Assignments tool most helpful in delivering expert responses to students automatically.
Web Content tool. We used several instances of this tool to provide access to information from the navigation menu, most notably the Support & FAQs page and the Faculty Bios page.
Calendar. We made use of the calendar to keep students informed at a glance about assignments due and events they needed to participate in. Screen shots are included to show how we set up a color scheme for different types of events.
We used the Forums area both for general discussion and for graded forum discussions. Students also collaborated in groups Although our course includes collaborative group assignments, we decided not to include the Wiki or the Groups tools but instead conducted those assignments using the main discussion area and email simply because the amount of technology we used in the course was becoming overwhelming to both students and faculty.
A major innovation we included in our course, although not integrated with Sakai, were webinars held monthly (using WebEx). The webinars served as a supplement to the online lessons. One student for each webinar collected questions from the other students using a Sakai forum. That student then compiled the questions and provided them to the faculty members conducting the webinar in time for them to prepare a presentation to address the specific questions.
The asynchronous Q&A forum became so popular that we ended up locking the original forum as an “archive” and creating a new forum just to keep the number of threads manageable. Students told us they never felt isolated in the course because there was always some type of collaboration taking place.
Quantity and quality of learning materials are the cornerstone of our course. We made use of the Melete Modules add-on in Sakai to organize lessons and present structured content.
Each lesson module is designed consistently, beginning with objectives, key components, and a list of readings. Lesson content is provided on attractively designed pages that employ icons to call attention to various course components.
We chose to use Melete modules because of the ability to organize material hierarchically and because of the navigation features of Melete modules, specifically “next” and “previous” paging and built-in table of contents. We were also able to easily reorganize the lessons to keep current content at the top of the page, a feature that greatly simplified course navigation for the students.
Learning materials consist of a variety of multimedia including videos and Flash-based elements. Our course includes over 50 videos, directed by our program director and produced by Kaiser, which feature faculty members demonstrating the techniques of manual physical therapy to the students. We believe these videos, which give students the opportunity to view techniques over and over again, are a major asset of the online program over the classroom-based program. Although students do get to experience live demonstrations during hands-on lab sessions, they can use the videos to reinforce learning.
Our course includes 53 Melete lesson modules, more than 50 demonstration videos, and 25 PowerPoint presentations in Flash format.
Knowledge checks are delivered to students in three forms: tests, forum discussions, and written assignments. All are administered in Sakai.
Tests are auto-scored with immediate feedback delivered to students on completion.
Assignments are graded by faculty members and returned to students, who then receive access to an expert response via the Model Answer feature in Sakai.
Discussions take place in the Forums area; faculty monitor discussions and participate as necessary, and then they grade the forums.
There was some question among faculty as to how well the online lessons would prepare students for their hands-on lab sessions. However, after the first lab session, supervising faculty reported that students were more prepared than students from the previous traditional classes. The conclusion was that the graded knowledge checks administered online held students accountable for completing the course readings and other lesson materials before coming to lab.
Additionally, as previously mentioned, students were able to watch the demonstration videos multiple times to prepare for lab.
In an attachment, we have included the cumulative scored learning outcomes of the Mentorship Programs from 2008 and 2009 (two each year), with the second 2009 Mentorship being the online course submitted for your consideration. It is clear that the scores have remained stable during the four sessions analyzed. Scores are expected to fall in the 80-90% range for every category, and the 2009 Online Mentorship was no exception.
We believe the look and feel of our course is one of its strongest points. We used the Melete modules to provide a hierarchical organization of content. Because of the large amount of content, we organized the lessons by week so that students could easily keep track of the workload.
Lesson pages use a consistent font and color scheme.We worked with our Sakai host (Longsight) to develop a style sheet that contains fonts and line spacing suitable for maximum readability online. We rely on style sheets for formatting so that content is accessible to screen readers, and we include alternate text on all images (including “ “ when appropriate).
Our Flash PowerPoint presentations are not narrated, so scripts or captioning are not required.
Improvements we plan to make in the future are closed captioning of our videos and narration of our Flash presentations.
Learners in our program receive pre-course training via a live WebEx meeting, during which they are both shown and guided through the areas of the course they’ll need to interact with.
Students are provided with a Sakai Quick Reference Guide developed by the instructional designer, which is specific to our implementation of Sakai.
Technical support is available from our web technologist both by phone and by email. Average resolution time for problems is less than 24 hours.
Faculty also receives the same excellent level of support and training from our technical and instructional design team.
In the past, most of our students had to quit their jobs to take part in the Mentorship program. Students were expected to move, if necessary, to the Bay Area in Northern California because all classes were taught in traditional classroom format. Our online program makes it possible for students to remain employed and to live at home, traveling to the Kaiser facility for a weekend of hands-on training only every six weeks.
Students expressed high satisfaction with the program, and when surveyed, the majority of students told us they were not sure they would have been able to take the program if it was not offered online.
Developing the course materials in Sakai contributed to building greater consistency in faculty teaching and, therefore, a more integrated learning experience for students. Faculty members expressed high satisfaction with the learning materials delivered in Sakai.
The online course delivery also allowed us to offer the course to a wider audience by creating a subset of content we called the “Advanced Skills Program.” In that course, students were enrolled to take the online content only without the hands-on aspects of the full mentorship program. That not only gives opportunities to more students, but it allows for a wider range of collaboration in Sakai.
We believe that our use of the Melete modules, possibly beyond their initial intent, is the major innovation in our course. Everything students need to complete a lesson is provided in the weekly modules, so jumping around the course is kept to a minimum. The user interface for the Melete modules is attractive and friendly, eliminating the folder organization found in the Resources tool. We used “empty” modules as headings to visually break up the content, and we used the Dates feature to further clarify groups of content. Additionally, each week, we reorganized the modules to keep the most current content at the top of the page for the students.
| Attachment | Size |
|---|---|
| OMPT501_Learning_Outcomes.doc | 31 KB |
| OMPT501_screenshots.doc | 1001 KB |
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