Physiotherapy 7 - Clinical Physiotherapy, 27 credits

To start the course Physiotherapy 7 - Theme Clinical Physiotherapy, 27 credits in semester 5 all credits, up to and including semester 3 and the courses Medical Subjects 2 and Physiotherapy 6 -Theme Clinical Physiotherapy in semester 4 must be passed.

A student who has failed a placement/equivalent as a consequence of serious deficiencies in knowledge, skills or attitude, such that patient security or the patients' confidence in healthcare is at risk, qualifies for a new placement opportunity only when the individual action plan has been completed.

The course aims to develop a gradually advanced and broadened professional identity and readiness by integrating and applying physiotherapy knowledge, skills and attitudes in meeting with the patient in different rehabilitation contexts with cooperation in a multiprofessional team and other individuals relevant to the patient's rehabilitation.

Intended learning outcomes
On completion of the course, the student should be able to

• independently apply and reflect on the physiotherapy process and ICFregarding current preventive and rehabilitating actions within several physiotherapy domains and for patients in different rehabilitation contexts
• reflect on, evaluate and explain all stages of the physiotherapy process based on theoretical and practical knowledge, and assess if the patient should be referred to another care provider
• show good manual skills and awareness of patient's safety and apply knowledge of contraindications and the ability to assess the need for individual adaptation/modification and dosage of physiotherapy treatment
• apply a professional approach based on a bio-psycho-social perspective and demonstrate the ability to reflect on communication/interaction between physiotherapist and patient/relatives/other members of the team
• apply behavioural medicine principles to support the patient's ability to reflect, behavioural changes, motivation and participation in the rehabilitation process and responsibility for own health including primary and secondary preventive measures
• adapt treatment and physiotherapy measures based on knowledge of the importance of context, culture and gender in the rehabilitation process and be able to apply different physiotherapy roles such as caregiver, educationalist consultant
• suggest and test out different aids and instruct patients and caregivers in the use of these
• follow laws and ethical rules that govern health care. Demonstrate an active and reflective approach towards his/her own values, his/her own learning and need for continuous competence development

Common contents for the 4 modules of the course are

• The physiotherapy process and ICF concerning disability, functioning and contextual factors including behavioural medical aspects in rehabilitation in different rehabilitation contexts
• The role of the physiotherapist as caregiver, educationalist, consultant and team member
• Evidence-based working method (published knowledge, best practice, the patient's wishes and available resources)
• Contraindications for different examination and treatment methods
• Gender, culture, diversity, laws and regulations and ethical rules
• Physical activity in rehabilitation

Module 1: Physiotherapy rehabilitation 1, 11.5 credits
Module 2: Physiotherapy rehabilitation 2, 4 credits
Module 3: Physiotherapy rehabilitation 3, 8.5 credits
Module 4: Physiotherapy rehabilitation 4, 3 credits

Part 1: Clinical education with a focus on physiotherapy examination, assessment and treatment in rehabilitation of diseases/injuries in the musculoskeletal system with respect to:

• Movement habits and body positions, as well as behaviours and and reference to problems triggering or tending to maintain pain conditions
• principles of differential diagnoses concerning joint, muscle and nerve involvement
• Hyper- and hypomobility and their causes
• Muscle function regarding strength, endurance, coordination, muscle length and pain
• treatment with devices and orthopedic technical aids

Part 2: Patient care concerning physiotherapy examination, assessment and treatment in rehabilitation of mental disease or psychosomatic problems

This module focuses on physiotherapy examination, assessment and treatment in rehabilitation of psychosomatic problems with respect to:

• psychosomatic approach
• treatment, reflection and communication
• psychosomatic orientated examination with an emphasis on resource- and problem analysis
• psychosomatic-targeted treatment methods; body awareness, therapeutic touch, relaxation and stress management

Clinical education with a focus on physiotherapy examination, assessment and treatment in rehabilitation of diseases/injuries in the nervous system with respect to:

• motor control as a theoretical model for clinical practice
• sensorimotor control, cognitive functions and communication, condition and strength and ADL ability
• participation in the rehabilitation process
• Orthotic devices, wheelchairs and other aids

This part of the course consists largely of examinations where modules 1, 2 and 3 and earlier acquired knowledge are integrated concerning:

• different competence areas in clinical context
• evidence-based physiotherapy working method in injuries and diseases in the musculoskeletal system, the nervous system and in psychosomatic problems
• independent application of integrated knowledge, skills and attitudes on an unknown patient and reflection on own effort

Education during the course in clinical physical therapy takes place mostly in a context with patients/clients and/or with other physiotherapy activities. Theoretical knowledge and professional attitude are integrated in practical clinical experience. In parallel with the placement, learning activities occur such as; lectures, demonstrations, seminars, methodology with and without patients and assignments related to clinical activities. Reflection, clinical theoretical reasoning are included in the learning activities. The assignments are carried out individually, in groups and with peer-review. Compulsory teaching that is not examined occurs. The students will also have time to specialise in their own studies during the clinical course. The clinical placement is based on in-patient care, out-patient care, and in the home enviroment.

The clinical placement with own patients will be offered at 2 different clinics during 2 periods. The students are divided into two groups for administrative reasons, an A course and a B course. During the first period, half of the students will focus on modules 1 and 2, and the other half on module 3. After the first period, the student groups switch focus.
The course develops knowledge and skills from previous semesters and progression concerns
- the grade of independence in applying, reflecting on, explaining the different parts of the physiotherapy process from theoretical and practical knowledge
- complexity in the clinical situation
- maturity in professional attitude

The progression is clarified by the assessment instruments for clinical work that are used in period 1 and period 2. During the last weeks in the course, in module 4, the progression is further clarified in connection with examinations that set high requirements for integration of earlier knowledge and acquired in this course.

The course is examined according to the following:

Module 1:

• Oral/practical seminar with patient case descriptions. Grading scale: (Pass/Fail)
• Assessment of the student's knowledge, skills and attitude in the clinical work with patients take place continuously. Grading scale: (Pass/Fail)

Module 2:

• Oral seminars with patient case descriptions. Grading scale: (Pass/Fail)

Module 3:

• A written report concerning wheelchair adaptation for a patient from the clinical work. Grading scale: (Pass/Fail)
• The student's knowledge, skills and attitude in clinical work with patients are assessed continuously. Grading scale: (Pass/Fail)

Module 4:
Here, integrated knowledge, skills and attitude are examined from earlier modules and courses

• In clinic by the student carrying out medical history, examination and assessment of an unknown patient. The examination should be based on the physiotherapy process and ICF. The examination also includes subsequent discussion in which the student accounts for his/her assessment and reflection on his/her own work and continuous learning. Grading scale: (Pass/Fail)
• Written integrated examination. Grading scale: (Pass/Fail)
• Oral presentation in a thematic seminar concerning condition that is highlighted from different perspectives in the area of physiotherapy. Grading scale: (Pass/Fail)
• Written report/patient case description including personal reflections including giving and receiving feedback from fellow students and oral seminar with discussion of these patient cases. Grading scale: (Pass/Fail)

Compulsory attendance at the clinical training and at theoretical and practical seminars is required. Compulsory attendance (80%) at the clinical related teaching is required to pass If the objectives for clinical training are not satisfied, this must be compensated for at the regular clinical course of the following semester. Written examination, seminar sessions and patient case examination of skills and attitudes are offered once more during an on-going course. The student may take the clinical course twice and be examined six times. A supplementary seminar or written assignment is determined in consultation with the course coordinator. Take-home examination or the equivalent should be submitted according to stated date on the course web to become assessed.

To achieve a pass grade in the whole course, a pass grade on all modules is required. For modules 1, 3 and 4: in all modules a pass grade must be achieved to receive pass grade.

The examiner can with immediate impact interrupt a student's placement or the equivalent if the student shows such serious deficiencies in knowledge, skills or attitudes that patient safety or the patients' confidence in healthcare is at risk. If a clinical placement is interrupted in this way the student is deemed to have failed that element and to have used up one clinical placement opportunity.

In such cases, an individual action plan should be set up stating which activities and tests are required before the student is qualified for a new clinical placement on the course.

The course has been cancelled and was offered for the last time in the spring semester of 2016. Examination will be provided until the spring semester of 2021 for students who have not completed the course

The course evaluation will be carried out according to the guidelines established by the Board of Education and based on established evaluation routines in the course programme.