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Biomedical subjects

Barbara Richardson

Publications and source records attributed to Barbara Richardson.

7 recordsLinked to original sources
PubMed2006

Building an interprofessional curriculum framework for health: a paradigm for health function.

There is an increasing call for curricula in health care to facilitate interprofessional client-centred evidence-based decision making through a reflective and reflexive framework. This discussion paper proposes that adoption of the World Health Organisation, International Classification of Functioning, Disability and Health (ICF) as a framework for curricula of health professionals promotes the necessary paradigm shift needed to legitimise a broad evidence base as the foundation of interprofessional dialogue. Client function is seen as the product of an open system incorporating the individual, social and environmental influences on behaviour, with the role of the professional being to acknowledge the context of individual behaviour through an understanding of individual's functioning in their environment. It is concluded that client focused practice and an iterative process of clinical reasoning based on a broad evidence base that conceptualises health care as the maintenance and promotion of health across the lifespan requires a re-conceptualising of health. The emerging concept shifts the primary emphasis of health care away from post-diagnosis tertiary care towards clients who maintain a life-long independence in the community.

Curriculum↗
PubMed2006

Development pathways in learning to be a physiotherapist.

BACKGROUND AND PURPOSE: Few studies have examined the experiences of students' professional socialization in physiotherapy. This international longitudinal study aimed to study experiences of situated learning and change in a student cohort during a physiotherapy education programme. METHOD: A phenomenographic design with semi-structured interviews was carried out with a cohort of physiotherapy students from two sites, strategically selected for variation in gender, age, educational background, work experience and academic level. Interviews were carried out after each of the first five semesters in the programme by a team of researchers. Seventy-six interviews explored students' learning experiences. Analysis identified the variation in experiences seen as important to becoming a physiotherapist. RESULTS: Distinct perceptions of professional growth and progression are identified in four pathways of development: 'Reflecting on Practice'; 'Communicating with Others'; 'Performing Skills'; and 'Searching Evidence'. These pathways demonstrate qualitative differences in the focus of learning experiences and preferred learning context, and include learning in a context which supports reflection, learning as agreed by others in a context with patients and other professionals, learning physiotherapy skills in a practice context and learning formal knowledge in a context where theory can be linked with practice. CONCLUSIONS: In a cohort of students professional growth can be seen in a variety of development pathways. Each shows progress of professional growth in the 'what' as changes in experiences and the 'how' as ways of learning from them. In addition, the pattern of pathways in a cohort may change from one semester to another suggesting individuals may adopt different learning pathways throughout their education. Teaching staff are challenged to consider how they recognize a variation in development pathways in their student cohorts and how they purposefully ensure experiences to guide students through different learning pathways in socialization to become a physiotherapist.

Clinical Competence↗
PubMed2006

Physiotherapy students' professional identity on the edge of working life.

Market expectations of physiotherapists reflect changing demands of health care for client centred, community based management of chronic disease in an ageing population. This study forms a component part of a longitudinal study of students' socialization throughout their education programme examining the outcome of professional identity throughout professional socialization processes. The aim of this study was to explore characteristics of graduating physiotherapy students' professional identity before leaving the University. An interview guide, agreed between the Swedish and UK researchers, was used to focus the semi-structured interviews. The phenomenon of professional identity of 18 students was studied through their perceptions of their role, practice, vision, beliefs and scope of practice as physiotherapists. A phenomenographic approach was taken to analysis and identified three qualitatively different categories of professional identity as a physiotherapist which are described as the Empowerer, the Educator and the Treater. A variation of concepts in professional identity at graduation questions the extent to which educators consider how they guide the development of professional identities which fit the expectations of stakeholders and which are able to respond to promotion and development of the profession of physiotherapy in the changing fields of health care over future years.

Delivery of Health Care, Integrated↗
PubMed2004

Physiotherapists' pain beliefs and their influence on the management of patients with chronic low back pain.

PURPOSE: Little is known about physiotherapists' pain beliefs and whether they influence behavior within therapeutic encounters with patients. This qualitative study explored physiotherapists' pain beliefs with the purpose of highlighting the nature of their beliefs and the role they played within their management of chronic low back pain. METHODS: Six physiotherapists were purposefully sampled along with 12 of their patients with chronic low back pain (two patients each). A qualitative exploration of physiotherapists' pain beliefs within the context of a clinical situation was carried out using semistructured interviews and observations at designated stages throughout therapeutic encounters with their patients. The data were prepared and analyzed according to a grounded theory approach. RESULTS: The themes that emerged from the data indicated that the pain beliefs of physiotherapists in this study were determined by a number of perspectives including their beliefs regarding the development of craft knowledge needed to manage chronic low back pain, beliefs regarding the clinical characteristics of patients with chronic low back pain they considered to be "good" to treat and the challenge of patients who were "difficult" to treat, and pain beliefs within the therapeutic encounter. A tentative theory was developed which proposed that the physiotherapists' biomedically oriented pain beliefs influenced their clinical reasoning processes including the explanations given to the patients. CONCLUSIONS: The findings suggest that in order to maximize the rehabilitation potential of patients with chronic low back pain, physiotherapists need to be aware that their pain beliefs may influence their management of these patients.

Adult↗
PubMed2004

Variation in prostate specific antigen results from 2 different assay platforms: clinical impact on 2304 patients undergoing prostate cancer screening.

PURPOSE: Urologists must contend with fluctuating prostate specific antigen (PSA) results from different assay platforms when deciding whether prostate biopsy is indicated. The contribution of cross-platform variation to these fluctuations is not well understood. To address this question we performed a cross-sectional study comparing 2 popular PSA assays during prostate cancer screening. MATERIALS AND METHODS: The Baylor College of Medicine Prostate Cancer Screening Program is a community outreach program providing free screening to Houston residents. From September 18th to 23, 2000, 2,304 patients underwent digital rectal examination and parallel serum PSA assay by the Hybritech Access (Beckman Coulter, Inc., Chaska, Minnesota) and Centaur (Bayer Diagnostics, Tarrytown, New York) systems. The Wilcoxon signed ranks test was used to compare results. RESULTS: Median PSA was low for the 2 assays (Centaur 0.99 ng/ml and Access 1.09 ng/ml) and Access results were significantly higher (1.23 times) than those obtained with Centaur (p <0.001). Frozen serum from 50 patients with PSA greater than 2.5 were then re-assayed using a third methodology (third Generation Immulite, Diagnostic Products Corp., Los Angeles, California). These data were consistent with Centaur results and significantly lower than Access results (p <0.001). Using a cutoff of PSA greater than 4.0 ng/ml 55 of the 288 patients (19%) with PSA greater than 2.5 ng/ml on the 2 platforms would have been candidates for prostate biopsy based on Access but not on Centaur data. CONCLUSIONS: In a large screening population the Access system measured consistently higher PSA than the Centaur system. These findings provide a basis for interpreting PSA results obtained from 2 commonly used clinical assays.

Adult↗
PubMed2003

Developing a virtual interdisciplinary research community in higher education.

As multidisciplinary collaboration in both clinical and research settings is becoming a key aspect of contemporary health care, strategies to enhance interprofessional interaction in postgraduate research programmes can offer important experiences to facilitate ongoing interprofessional relationships. This paper provides a retrospective appraisal of a strategy which used computer-mediated communication to develop a virtual community network, known as'health_voice' accessed through a web page. The rationale for developing the network is presented, and the process of designing and establishing the web-site through an action research approach is described The outcome of the strategy is reviewed with regard to the relationships between the real' and 'virtual' community. Reflections on the developmental process contextualise the initiative within a concept of a community-of-practice. It is acknowledged that the use of a virtual arena for communication within a research community involves a cultural change in the dynamics of higher degree teaching and learning. Future plans to further embed the virtual environment within a postgraduate research culture are given.

Cooperative Behavior↗