Application of a contextual instructional framework in a continuing professional development training program for...

Area of Science:

• Rehabilitation Sciences
• Health Professions Education
• International Health

Background:

• Continuing professional development (CPD) is crucial for capacity building in low-resource settings.
• Physiotherapy services in low-resource countries often face challenges in professional development and training.
• Rwanda presents a specific context for implementing and evaluating CPD initiatives for physiotherapists.

Purpose of the Study:

• To describe the application of a contextual instructional framework for designing and delivering CPD courses for physiotherapists in Rwanda.
• To evaluate the effectiveness of this framework in addressing the specific needs and environmental factors of the Rwandan healthcare system.
• To provide a model for similar CPD initiatives in other low-resource countries.

Main Methods:

• A case study approach was used, detailing four project phases: proposal/needs assessment, program organization/instructional design, delivery, and evaluation.
• Contextual factors (environment, healthcare organization, rehabilitation needs, profession's status) and facilitating factors (professional associations, CPD requirements) informed instructional choices.
• Instructional content was co-developed and delivered with Rwandan instructors, incorporating practical skills, clinical reasoning, advocacy, and leadership.

Main Results:

• CPD courses reached the majority of Rwandan physiotherapists (n=168), with a balanced urban/rural distribution.
• Participants reported significant improvements in skills and perceived benefits for patient care.
• Courses were adapted for rural and urban settings, and content evolved based on identified needs, including leadership and advocacy.

Conclusions:

• Contextual factors are critical for successful CPD program design and implementation in low-resource settings.
• Facilitating factors like established professional bodies and existing project foundations significantly contribute to project success.
• The described framework and methods, emphasizing in-country collaboration and practical skills, offer valuable insights for CPD in physiotherapy and other professions in resource-limited environments.