Browsing by Author "Ernstzen, Dawn V."

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    Clinical practice guidelines for the management of chronic musculoskeletal pain in primary healthcare : a systematic review
    (BioMed Central, 2017-01-05) Ernstzen, Dawn V.; Louw, Quinette A.; Hillier, Susan L.
    ENGLISH SUMMARY : Background: Up-to-date, high quality, evidence-based clinical practice guidelines (CPGs) that are applicable for primary healthcare are vital to optimize services for the population with chronic musculoskeletal pain (CMSP). The study aimed to systematically identify and appraise the available evidence-based CPGs for the management of CMSP in adults presenting in primary healthcare settings. Methods: A systematic review was conducted. Twelve guideline clearinghouses and six electronic databases were searched for eligible CPGs published between the years 2000 and May 2015. CPGs meeting the inclusion criteria were appraised by three reviewers using the Appraisal of Guidelines Research and Evaluation (AGREE) II. Results: Of the 1082 records identified, 34 were eligible, and 12 CPGs were included based on the inclusion and exclusion criteria. The methodological rigor of CPG development was highly variable, and the median domain score was 66%. The median score for stakeholder involvement was 64%. The lowest median score was obtained for the domain applicability (48%). There was inconsistent use of frameworks to aggregate the level of evidence and the strength of the recommendation in the included CPGs. The scope and content of the included CPGs focussed on opioid prescription. Conclusion: Numerous CPGs that are applicable for the primary healthcare of CMSP exists, varying in their scope and methodological quality. This study highlights specific elements to enhance the development and reporting of CPGs, which may play a role in the uptake of guidelines into clinical practice. These elements include enhanced reporting of methodological aspects, the use of frameworks to enhance decision making processes, the inclusion of patient preferences and values, and the consideration of factors influencing applicability of recommendations.
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    Perceptions of physiotherapy clinical educators’ dual roles as mentors and assessors : influence on teaching–learning relationships
    (AOSIS Publishing, 2019) Meyer, Ilse S.; Louw, Alwyn; Ernstzen, Dawn V.
    Background: Central to clinical education is the teaching–learning (T-L) relationship that evolves between the clinical educator (CE) and the student. Within this T-L relationship, CEs may be expected to fulfil dual roles as mentors and assessors of students. Challenges for both parties may arise when CEs take on these different roles. Objectives: The goal of this study was to ascertain how CEs perceived the influence of their dual roles as mentors and assessors on their T-L relationships with physiotherapy students. Method: Individual interviews were semi-structured with nine CEs during this qualitative descriptive study at the Division of Physiotherapy, Faculty of Medicine and Health Sciences, Stellenbosch University. A content analysis followed to analyse the data obtained. An iterative process, aimed to understand the phenomena under study, was conducted via an interpretive approach in context. This revealed main themes that were identified and refined. Results: Clinical educators experienced challenges when their role changed from being a mentor to that of assessor. These challenges affected the learning of students, as they influenced the T-L relationship. Clinical educators experienced ambiguities regarding their dual roles and, as a result, their expectations were often not fulfilled. Conclusion: Students’ learning processes were negatively affected by the changing roles of CEs, who acted as mentors and later as assessors of clinical competence during the students’ clinical rotations. The positioning theory was offered as a framework to resolve the challenges created by the dual roles and to manage expectations between CEs and students. The T-L encounters could be enhanced if students and CEs aligned themselves to a learning-centred paradigm where the focus was on learning and where the needs of the diverse students and the expectations of CEs were balanced. Further research should explore how a workshop with role play, demonstrating to CEs in practice how to reposition themselves, would impact the relationships between both parties. Clinical implications: It is essential to ensure a positive T-L relationship between a CE and a student as this will improve the quality of learning in the clinical environment and, therefore, directly influence student’s patient management. Implementing faculty development programmes to address this, should be further explored.
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    Students' and clinical teachers' views on effective clinical education in Physiotherapy at Stellenbosch University
    (Stellenbosch : University of Stellenbosch, 2006-03) Ernstzen, Dawn V.; Bitzer, E. M.; University of Stellenbosch. Faculty of Education. Dept. of Curriculum Studies.
    Clinical education in health sciences is an important and distinct part of health care education. In clinical education situations, students learn to integrate the knowledge, skills, attitudes and values of the profession. The attainment of clinical competence is one of the main outcomes of the Clinical Physiotherapy module for physiotherapy students at Stellenbosch University (SU). In its Strategy for Teaching and Learning (2001:3), SU embraces a student-centered approach to teaching. In a student-centered approach towards teaching, the focus is on the quality and quantity of student learning. In the current changing context of higher education, all spheres of education need to be assessed to determine the meaning of student-centeredness and to establish whether it is achieved. The above-mentioned approach may lead to quality management in teaching and learning.