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Journal of Advances in Medical Education and Professionalism، جلد ۹، شماره ۳، صفحات ۱۴۴-۱۵۳

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عنوان انگلیسی Postgraduate Physiotherapy Training in a Quandary - Ramifications of Corona virus pandemic Lockdown: A Survey-based Study
چکیده انگلیسی مقاله Introduction: Coronavirus disease-2019 (COVID-19) has disrupted clinical services and postgraduate training across the world. Hence, this survey was conducted to understand the impact of pandemic on Physiotherapy post-graduate (PG) education.Methods: It was a cross-sectional, observational study. A total of 254 Physiotherapy PG trainees were recruited through snowball sampling from Physiotherapy colleges across the state of Maharashtra. A 34-item structured questionnaire was developed, based on available literature, to evaluate the impact of COVID-19 pandemic on four domains: academic training, clinical training, research activities, and concerns faced by a PG trainee. The face validity of this questionnaire was assessed by six academicians and their suggestions were examined. Subsequently, it was pilotedon five PG trainees before administering it to the participants. The validated questionnaire was then circulated via various social media platforms and personal contacts using Google form. Descriptive statistics were summarized as frequencies/percentages. McNemar’s test was used to determine the differences on a dichotomous dependent variable between the two related groups using SPSS software.Results: Overall 131 trainees provided complete responses. Although 85% (n=111) of them claimed they attended PG teaching activities through online mode, almost 67% (n=101) disagreed tohave achieved their learning objectives. A vast majority (91%,n=119) of them felt that their specialty related practical training was severely affected, and 98% (n=129) reported that reduced caseload had impacted their clinical learning. Also, 70% (n=54) of final year PGs had difficulty in recruiting new participants for their dissertation. Spread of infections to family (98%), commuting inpublic transport (98%), uncertainty about exam dates (91%), and competency development in specialty areas (96%) were some of their concerns.Conclusion: COVID-19 pandemic had impacted various domains of Physiotherapy PG program such as academic, clinical and research areas. Regulatory authorities should take serious consideration and devise strategies to overcome it.
کلیدواژه‌های انگلیسی مقاله COVID-19, Education, Pandemic, Survey, IntroductionCorona virus disease 2019 (COVID-19), caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), is a newly emergent virus first recognized in Wuhan, China, in December 2019. Rapid worldwide spread of COVID-19 prompted the World Health Organization (WHO) to declare it as &,lsquo pandemic&,rsquo on 11th of March 2020 ( 1,, 2,). In the wake of COVID-19 affecting India, Maharashtra was declared as the worst affected state, accounting for one third of all cases in the country ( 3,).Like most of the governments across the world, Indian government imposed a total lockdown from 25th March 2020 along with re-enforcing social distancing and infection control guidelines to curb the pandemic ( 4,). India had observed four phases of nationwide lockdown, which was extended up to 31 May 2020 ( 5,). As a result, all regular health care services in the hospitals, nursing homes and clinics were closed and elective surgeries deferred, except for the emergency services ( 6,). Universities and all other educational organizations across the world, including India, reacted quickly to this crisis by announcing immediate closure. Thus, from mid-March 2020 onwards UG and PG training of students from health sciences courses came to a halt. Social distancing, in response to the pandemic, led to the complete transition of academic teaching from classroom and clinical interactions to virtual sessions conducted online ( 7,). Moreover, the assessment and evaluation of students were also done in online settings. All these could possibly cause an unprecedented impact on medical education as seen in previous studies in India ( 4,, 8,).In recent times, researchers worldwide have studied the impact of COVID-19 on postgraduate education and training across varied specialties in medical residents from endoscopy, ophthalmology, orthopedics, to cardiothoracic specialty ( 6,, 9,- 12,). Their findings reflected a profound blow on their education and training due to the closing of non-emergency hospitals, cancellation of elective surgeries and social distancing norms. Besides, the trainee&,rsquo s psychological state has also been proven to be affected as observed by increased burnout, anxiety and stress reported in endoscopy trainees ( 9,). A recent study done by Kapasia et al. (2020) in UG &,amp PG learners of West Bengal, India, revealed major disruption of their academic activities due to COVID 19 lockdown ( 4,). Upadhaya et al.&,rsquo s study on the impact of COVID on orthopedic trainees in northern India has recommended measures to be taken by government and educational organizations to mitigate its long-term impact and ensure implementation of satisfactory mechanisms to overcome it ( 11,).Since physiotherapy (PT) is a direct contact practice, PG trainees require hands-on clinical practice and consistent patient interaction for prolonged duration to develop technical skills for effective patient care. PG program is directed towards rendering competency in specialty clinical skills to promote professional development. It encompasses various specialties like musculoskeletal PT, Neuro PT, Cardiopulmonary PT, Community PT, and Sports PT. Along with this, it consists of rigorous two years of research work inclusive of preparation of synopsis, recruitment of study participants, and undertaking of the study intervention protocols. This necessitates a steady inflow of patients/participants in the hospital set-up. Recent studies conducted on trainees of various medical specialties during the COVID era have shown a disruption in their training and education program ( 9,- 14,), but none has been reported on Physiotherapy students. Looking at the present scenario and the global footprint, COVID-19 does not seem to go away any time soon. Therefore, the present study was an attempt to assess the impact of the COVID-19 related pandemic on post-graduate teaching and learning.MethodsA cross-sectional, observational study was carried out using a 34-item self-reported questionnaire exclusively designed for Indian population. Its content element was drawn from previous studies conducted in different medical specialties across the world ( 9,- 12,). Overall, there were 254 Physiotherapy PG students recruited using snowball sampling from colleges affiliated to government university as well as deemed universities across the state of Maharashtra. The indigenous questionnaire was designed by the consensus of two authors having expertise in Physiotherapy education and training. It focused on the four domains of a PG training namely impact on academic training, clinical training, research activities, and concerns faced by a PG trainee. Responses were scored through a five-point Likert scale ranging from strongly agree to strongly disagree for most of the items, whereas few required dichotomous responses. The face validity of the questionnaire was assessed by two senior academicians with an academic experience of more than 14 years who were experts in the field of PG training. It was assessed in successive stages by requesting individual experts to evaluate the content relevance and simplicity of individual items and the entire set of items (questionnaire) as a tool followed by the iterative loops of consensus panel revisions. The consensus panel consisting of four academicians were requested to identify the lacuna in the questionnaire with regards to the location of the items, grammatical structure, and correct scaling. Few questions of the tool were then reframed, deleted, added, and modified considering their suggestions. Additional space was provided for them to give feedback and fill in deficient areas, if any.The developed questionnaire was then piloted on five PG trainees belonging to different training levels to check for clarity and comprehension of the questions. Few items in the questionnaire were again modified based on their feedback, and the questionnaire was finalized to be used for the survey.This cross-sectional online survey-based study was conducted from October 10, 2020 to October 15, 2020. The purpose of the study, the time required to complete it and permission to withdraw if deemed unsuitable was mentioned in the google form before the start of the survey questionnaire. A successful return of completed survey was considered as consent by the participant. The questionnaire was uploaded on Google form and the generated link was circulated amongst the participants. One representative from each institute was identified who served as the contact point. They were personally approached to explain the purpose of the study and discuss the workflow. These contact points (participants) were requested to forward the questionnaire links to their batchmates/peers through their common class e-mail ID and WhatsApp groups. Follow up and reminders to submit the filled questionnaires was ensured by personally contacting these representatives (contact points) after 24 hours. This way the authors aimed to target two hundred and fifty-four participants largely recruited using exponential non-discriminative snowball sampling technique. A second reminder was given to submit the completed questionnaire after a span of 48 hours. Submission of partially completed questionnaire was not accepted for analysis. The survey was closed on the 15th of October at 10 pm. No financial or other incentives were provided for participation. The responses submitted were checked for Duplication, and then were pooled, analyzed and summarized.Statistical AnalysisSPSS (Statistical Package for the Social Sciences) version 21 (IBM Corp) was used for statistical analysis. All categorical variables were summarized as frequencies/ percentages. Participant&,rsquo s age group was expressed as mean and standard deviation. For items with a five&,#8208 point Likert scale and a positive response set, the &,ldquo strongly agree&,rdquo and &,ldquo agree&,rdquo categories were combined, as were the &,ldquo neutral,&,rdquo &,ldquo strongly disagree,&,rdquo and &,ldquo disagree&,rdquo categories, so that responses fell into 1 of 2 categories, &,ldquo agree&,rdquo or &,ldquo disagree.&,rdquo Likewise, for items with a negative response set, the &,ldquo neutral&,rdquo category was combined with the &,ldquo agree&,rdquo and &,ldquo strongly agree&,rdquo categories. Response frequencies for the survey questions were thus determined and displayed in graphical formats. The&,nbsp McNemar&,rsquo s test&,nbsp was&,nbsp used to&,nbsp determine if there were differences on a dichotomous dependent variable between the two related groups. Participant&,rsquo s response before lockdown was considered as pre-test, and during lockdown as post-test. We considered p&,lt 0.05 as statistically significant.Ethical ConsiderationThe study was commenced after approval from Institutional Review Board of MGM&,rsquo s College of Physiotherapy, Maharashtra, India with ethical code MGM/COP/IRRC/141/2020 dated 5th October 2020. The work was carried out in accordance with the Declaration of Helsinki alongside guaranteeing the anonymity of the participants.ResultsParticipants&,rsquo CharacteristicsIn total, 149 respondents (out of 254) participated in this survey (response rate being 59%). After excluding incomplete (n=15) and duplicate (n=3) responses, 131 completed questionnaires were analyzed. Demographic details of the study participants are presented in Table 1,.CharacteristicsFrequency in Percentage(n)Gender Male 10(13)Female90(118)Mean Age (S.D) in years 24.98(0.73)Admission year 201710(13)201830(40)201960(78)Batch I MPT41(54)II MPT59(77)PG Specialization Musculoskeletal PT40(52)Community PT21(27)Cardiovascular &,amp Respiratory PT21(27)Neuro PT12(17)Sports PT5(7)Pediatrics PT1(1)University MUHS89(117)Deemed11(14)SD, Standard Deviation, MPT, Master of Physiotherapy, PG, Post Graduation, PT, Physiotherapy.

نویسندگان مقاله SHAILESH GARDAS |
Department of Neurophysiotherapy, Mahatma Gandhi Missions College of Physiotherapy, Navi Mumbai, India

SHRUTI NAIR |
Department of Cardiovascular and Respiratory Physiotherapy, MGM College of Physiotherapy, Navi Mumbai, India

POTHIRAJ PITCHAI |
Department of Community Physiotherapy, MGM College of Physiotherapy, Navi Mumbai, India

VRUSHALI PANHALE |
Department of Musculoskeletal Physiotherapy, MGM College of Physiotherapy, Navi Mumbai, India


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