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Impact of using the ICF framework as an assessment tool for students in paediatric physiotherapy: a preliminary study
1Department of Health and Rehabilitation Sciences, Faculty of Health Sciences, University of Cape Town, Observatory 7925, Cape Town, South Africa.
Insights
Physiotherapy students using the International Classification of Functioning, Disability and Health (ICF) framework demonstrated improved clinical assessments for children with neurological conditions. This holistic approach enhanced patient evaluation and intervention planning.
Area of Science:
- Pediatric physiotherapy
- Clinical assessment tools
- Rehabilitation sciences
Background:
- Physiotherapy students require effective frameworks for assessing children with complex neurological conditions.
- The International Classification of Functioning, Disability and Health (ICF) offers a standardized model for describing health and disability.
- Previous assessments by students showed variable adherence to a holistic approach.
Purpose of the Study:
- To evaluate the impact of explicitly using the International Classification of Functioning, Disability and Health (ICF) on physiotherapy students' clinical assessments of pediatric patients with neurological conditions.
- To determine if ICF-guided assessments lead to more comprehensive and function-oriented evaluations.
Main Methods:
- A retrospective audit compared assessments from physiotherapy students in 2008 (loosely ICF-based) with those from 2009 (rigorously ICF-based).
- Assessments were conducted at special needs schools providing clinical exposure for students.
- A validated scoring sheet and blind evaluation by external physiotherapists were used to analyze assessment quality.
Main Results:
- Students using the ICF framework in 2009 achieved significantly higher scores than the 2008 group (median 60 vs. 50).
- The 2009 group also received higher overall impression marks, indicating a superior assessment quality.
- ICF-based assessments incorporated more function-related information, suggesting a more holistic evaluation.
Conclusions:
- Explicitly teaching and utilizing the ICF framework enhances physiotherapy students' clinical reasoning in pediatric neurological assessments.
- The ICF approach promotes a more holistic understanding of the patient's condition within their context.
- Improved assessment quality through ICF facilitates the development of more appropriate and beneficial intervention plans for pediatric patients.
Objective:
To determine if clinical assessment of children with neurological conditions by physiotherapy students was improved through the overt use of the International Classification of Functioning, Disability and Health (ICF).
Design And Participants:
A retrospective, pragmatic audit of practice using written patient assessments completed by third-year physiotherapy students. Assessments completed by third-year students in 2008 were compared with assessments completed by third-year students in 2009. The assessment format used in 2008 was very loosely based on the ICF model, while the 2009 assessments made rigorous use of the ICF approach.
Setting:
Two schools for children with special needs to which physiotherapy students from the Department of Health and Rehabilitation Sciences, Faculty of Health Sciences, Division of Physiotherapy, University of Cape Town are sent for clinical exposure.
Method:
A score sheet was drawn up to evaluate specific criteria in each assessment, using a five-point marking scheme. The mark sheet was tested for reliability. All assessments were evaluated independently using the score sheet by two external physiotherapists who were blind to the purpose of the exercise.
Results:
There was a significant difference between the scores obtained on the score sheet for the 2008 group and the 2009 group. The 2009 group obtained a median score of 60, compared with a median score of 50 for the 2008 group (median difference between groups 9.2, 95% confidence interval 4.2 to 14.1). The overall impression mark given to the 2009 group was also higher than that given to the 2008 group, with a median difference between the groups of 5.9 (95% confidence interval 3.2 to 12.7). It would appear that the 2009 students, using the ICF framework for assessing patients, were able to include more function-related information in their assessments, resulting in a more holistic assessment.
Conclusion:
Teaching students to use the ICF framework when assessing paediatric patients encourages clinical reasoning and an improved holistic approach to identifying the patient's problems in context. This, in turn, enables the student to plan a more appropriate intervention treatment, to the patient's benefit.