Continuing
Professional Education
www.uab.ca/pd
2015-16
FRM Continuing Professional Education OVERVIEW The Faculty of Rehabilitation Medicine at the University of Alberta continues to lead the way amongst post-secondary institutions in Canada when it comes to lifelong learning for health professionals. We were the first Canadian University to offer fully online credit programs geared specifically towards working health professionals and continue to offer the widest variety of professional development opportunities in a post-secondary setting. In support of our mission to enhance quality of life and improve function of patients around the world, as well as in support of our strategic direction to provide evidence-based education and enhance clinical skills for health professionals, we are seeking opportunities to collaborate with other agencies to deliver existing programs or to develop and deliver new programs to meet the needs of the clinical community. The continuing education programs described here could be further developed and customized according to the specific needs of the potential clients (e.g. the Bridging Program or the continuing education certificate programs could be laddered into a master’s degree program).
BACKGROUND In 2010 the University of Alberta’s Faculty of Rehabilitation Medicine initiated the development of several continuing professional education programs in support of its strategic plan. Guiding principles for program development have been: •
To provide a range of offerings from 1 hour webcasts and 1 day clinical workshops to more intensive graduate level programs
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Interdisciplinary focus where applicable
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High clinical relevance
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Availability in a fully online format and accessible via a range of devices (e.g. laptop, Smartphone, tablet) where applicable
With these principles in mind the Faculty developed and now offers: •
Physical Therapy Bridging Program
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On-demand webcasts
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Two online graduate level certificate programs (pain management and stroke rehabilitation)
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An online graduate diagnostic imaging course for physical therapists
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Workshops
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Health Sciences Visiting International Program
UNIQUELY POSITIONED Graduate Level Credit the University is uniquely positioned to offer graduate level credit. The credit earned appears on participants University transcript and may be used as elective credit towards a graduate program of study by either current graduate students or by working professionals who choose to pursue graduate studies in the future. Participants completing a certificate program receive a parchment in recognition of their accomplishment from UofA’s Faculty of Graduate Studies and Research and the use of letters to designate program completion (e.g. PgCPain – Post graduate certificate in pain). Non-credit programs offer a certificate of completion signed by the Associate Dean Professional Programs and Teaching for inclusion in the clinicians’ portfolio. Access to Leaders & Innovators Being housed within a post-secondary setting facilitates access to academic and clinical leaders in research, management and education from across Canada and beyond and ensures our programs are scientifically rigorous and rely on the latest evidence based approaches in each specific content area. Interprofessional & Distance Based The online format has facilitated access to education by both rural and urban clinicians and has attracted health professionals from across Canada, the US and beyond. Registrants include physical therapists, occupational therapists, speech language pathologists, physicians, nurses, psychologists, pharmacists, social workers, recreation therapists, chiropractors, current graduate students from several institutions, and others. Broad Range of Offerings Our programs include on-demand recorded webcasts, full day clinical workshops, fully online graduate level certificate programs, stand-alone master classes, and not for credit online learning modules. Program offerings incorporate adult and interprofessional education learning strategies, and use the latest in online learning technologies. Infrastructure The faculty houses an internal IT group which allows us to develop and manage a variety of online learning opportunities and ensure ongoing IT support. Our CPE program manager ensures the programs are efficiently developed, delivered, promoted, and supported.
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CPE PROGRAM DESCRIPTIONS 1. PHYSICAL THERAPY BRIDGING PROGRAM This graduate certificate program is designed around the training standards for foreign staff competencies. This program adopts its framework from the Bridging Certificate Program for Internationally-educated Physiotherapist in Alberta which provides training for physiotherapists who are educated outside of Canada and who wish to bridge their practice to Canadian standards. This part-time program which takes 10-12 months to complete includes 2 academic courses (offered in a blended format - online + in-person labs) and 3 clinical mentorship/placement courses. The format can be customized to make it feasible for remote clients. A Brief overview of the certificate program curriculum: •
Evidence based practice
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Professional and medical ethics
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Professional Communication o
Verbal and non-verbal skills; patient interview skills; collaborative goal setting, difficult communication;
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Interprofessional collaboration and communication
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Supervision and delegation
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Use of models in critical thinking and clinical reasoning
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Planning and carrying out an assessment, interpretation or assessment findings, treatment planning and intervention; use of outcome measures to evaluate interventions
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Application of clinical reasoning and differential diagnosis skills to cases covering the scope of PT practice
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Written documentation
For internationally-educated physiotherapist in Canada, it also includes •
Written and practical exam strategies and skills
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Workplace integration o
Job search strategies, resume and cover letter writing skills, interview skills]
Program format (the terms are coined for a Canadian setting in the current curriculum but could be renamed based on the program specifics in another context): Course 1: Professional Physiotherapy Practice in Canada 1: This 14 week blended format course focuses on the development of the knowledge, skills and judgment required to deliver safe and effective PT care in the Canadian setting, clinical reasoning and professional communication.
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Course 2: Professional Physiotherapy Practice in Canada 2: This 14 week blended format course consolidates skills requires by a primary care PT in interpretation, diagnosis and application of assessment findings and treatment plans through the application of clinical decision making model(s), critical thinking and evidence-based practice. Pre-requisite: Must have successfully passed Professional Physiotherapy Practice in Canada 1. Courses 1A & 2A: Clinical Mentorship 1 & 2: These courses include 40 hours each during which the student works closely with a physiotherapist in a clinical setting. Students will progress through observation of practice and all associated activities (documentation, interprofessional communication, etc.) to independently providing care to select patient. (Must be completed with Professional Physiotherapy Practice in Canada 1 & 2.) Course 3: Clinical Placement: This 6 week full-time in-person placement (240 hours) will be offered after the academic courses are successfully completed. Hands-on clinical experience consolidates knowledge and skills enabling competence in Canadian practice and provides Canadian work experience. Prerequisite: Must demonstrate practice readiness by having passed Professional Physiotherapy Practice in Canada 1 and 2, and Clinical Mentorship 1 & 2. The Program components could be offered in a different way if there was a need for a revised format. Currently the Program is offered at 3 geographically separate sites across the province of Alberta.
2. PHYSIOTHERAPY PRACTICE IN CANADA COURSE This online course provides the Internationally Educated Physiotherapist (IEPT) with a broad overview of the practice of physiotherapy within the context of the Canadian health care system. Topics include an overview of organization of health care in Canada, the role, scope and function of physiotherapists within this system, their legal requirements, and the key competencies required to practice within Canada. Physiotherapy Practice in Canada is delivered using a distance format via e‐class (The University of Alberta’s online learning platform). The course consists of five (5) modules to be completed within eight (8) weeks. All content is delivered asynchronously meaning there is no requirement to be online at a specific class date and time. Students can complete the learning activities in a place and time of their choosing. Content is accessible twenty four (24) hours-a-day from any location with an internet connection. Each module consists of online lectures, self‐directed learning activities, a self-reflection and a quiz. Students must complete each learning activities to progress in the course. Students are fully responsible for completing learning activities and to regularly check the University of Alberta’s e‐class website for updates to online content.
3. ON-DEMAND WEBCASTS These clinically relevant, highly focused sessions are delivered by content experts in each respective area and are offered in a flexible distance-based format. Each recorded webcast consist of
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approximately 1-1.5 hours of content and can be easily purchased directly from the FRM webpage and viewed via Smartphone, tablet and laptop/desktop. Example webcasts include: Working with Deaf and Hard of Hearing Children Webcast Series This series includes four webinars about hearing loss, each focused on a different audience: General Audiences, Physicians, Speech Language Pathologists and Public School Teachers and Support Staff. The series has a pediatric emphasis but also has application to adults. Rehabilitation for Total Joint Arthroplasty Education sessions include interactive presentations of current concepts of joint arthroplasties by orthopaedic surgeons and physical therapists, bariatric issues associated with knee arthroplasties including bariatric rehabilitation. "Brain Training": Are there clinical applications? Recently, computer-based 'brain training' games based on "principles of neuroplasticity" have become widely available and are being increasingly used by individuals wanting to increase or maintain their cognitive skills. This presentation will briefly review a number of commercially-available brain training programs, and explore whether there are potential clinical applications for these programs. We will also examine the evidence base on the use of such programs with various clinical populations.
4. GRADUATE LEVEL CERTIFICATES Each Certificate Program is developed by an interdisciplinary committee of content experts in their respective field. Each course includes guest faculty who are leaders in research, management, and education nationally and internationally. These programs, which consist of three 3 credit graduate-level courses, were designed for the working clinician but can be used as elective credit for current graduate students. 100% online availability has increased uptake of the programs by clinicians working in rural settings from across Canada, the US and beyond. Each course incorporates adult and Interprofessional Education (IPE) learning strategies, and uses the latest in online learning technologies. Clinicians can register for certificate programs by completing a brief online application and submitting only their degree program transcript. The following online strategies are utilized: • • • •
Pre-recorded video lectures Discussion boards Chat forums Interactive webinars
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GRADUATE CERTIFICATE IN PAIN MANAGEMENT The aim this online interprofessional graduate-level credit program is to provide advanced education in collaborative pain management for healthcare professionals. In addition to earning graduate level credit, clinicians completing the program can use the letters PgCPain (post graduate certificate in pain) to designate program completion. Pain Certificate courses are eligible for Mainpro-C and Mainpro-M1 credits through the College of Family Physicians of Canada (CFPC). Also, certificate courses can be used towards credentialing through the Canadian Academy of Pain Management (CAPM). This Certificate provides an opportunity for practicing clinicians to learn with, from and about each other to address the multi-dimensional nature of both acute and chronic pain, with an emphasis on complex/chronic pain. Registrants completing the program will be: •
adapt and use an interprofessional approach to pain management through an understanding of the unique and shared roles and responsibilities of various professionals
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use critical thinking and evidence-based approaches to develop assessment and comprehensive management plans.
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use a bio-psycho-social clinical reasoning framework which integrates information across models in the assessment and management of pain. COURSE DESCRIPTIONS
A Certificate is granted by the University of Alberta’s Faculty of Graduate Studies and Research upon successful completion of three required graduate-level credit courses, as listed below. REHAB 535: The Nature of Pain (*3) Pain is a major factor impacting quality of life and will continue to become more so as the average lifespan increases. Understanding the multi-dimensional nature of pain and its broad impact is critical to applying best practice in its assessment and treatment. The neural pathways / mechanisms subserving normal and pathological pain will be studied in depth as well as a critical view of translating these findings to clinical practice. A range of theoretical perspectives underlying the individual’s experience of pain across the continuum from acute to complex/chronic will be presented. The role of interprofessional collaboration for comprehensive pain management will be introduced. (This course is a pre-requisite for REHAB 536 and REHAB 537.) REHAB 536: Assessment and Management of Pain (*3) Knowledge Translation: Integrating evidence into practice. Building on foundations developed in Rehab 535, this course will present models of and approaches to assessment of and treatment for common pain conditions, across the lifespan, with an emphasis on complex/chronic pain. This course will explore the etiologies of various pain conditions, the prevalence of pain, as well as ethical issues, barriers, and facilitators to comprehensive assessment and treatment. Rationale for pharmacological and non-pharmacological interventions will be reviewed. Participants will discuss best practice roles and evidence based roles and interventions for each of the health professionals involved in the collaborative interprofessional management of chronic pain. Prerequisite: REHAB 535.
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REHAB 537: Integrating and Implementing Pain Management Models (*3) This course will provide an opportunity for students to integrate and apply information presented in REHAB 535 and 536 using standardized assignments with real and/or simulated patients as a base from which to develop an evidence-based, collaborative, interprofessional, assessment and treatment of chronic pain and disability. Pre-requisite: REHAB 535, REHAB 536. The course director is Dr. Judith Hunter, Assistant Professor in the Department of Physical Therapy at the University of Alberta and University of Toronto, and the recipient of the 2013 award for Excellence in Interprofessional Pain Education from the Canadian Pain Society. Course contributors include leaders in pain research, management, and education from across Canada and beyond including but not limited to: • • • • • • • • • • • • • • • • •
Barry Sessle, Professor and Canada Research Chair, Faculties of Dentistry and Medicine University of Toronto Judy Watt-Watson, Professor Emerita, Executive Director, Centre for Advanced Studies in Professional Practice, Bloomberg Faculty of Nursing, University of Toronto Herta Flor, Central Institute of Mental Health; University of Heidelberg, Mannheim, Germany James L. Henry, Professor, Department of Psychiatry and Behavioural Neurosciences, Professor, Department of Anesthesia, Faculty of Health Sciences, McMaster University Michael McGillion, Assistant Professor, Chair, Scientific Program, Canadian Pain Society, University of Toronto, Lawrence S. Bloomberg Faculty of Nursing Alex Jadad, Rose Family Chair in Supportive Care Canada Research Chair in eHealth Innovation Professor, Departments of Health Policy, Management and Evaluation; Public Health Sciences; and Anesthesia, Staff Physician, Princess Margaret Hospital Bruce Dick, Associate Professor, Department of Anaesthesiology and Pain Medicine and Psychiatry, University of Alberta Ivan Silver, Vice Dean, Continuing Education and Professional Development, University of Toronto Cary Brown, Associate Professor, Department of Occupational Therapy, University of Alberta Ze’ev Seltzer, Professor of Genetics, Faculty of Dentistry and Professor of Physiology, Faculty of Medicine Pain Genomics and Phenomics Lab, University of Toronto Faculty of Dentistry Joel Katz, Professor, York University Canada Research Chair in Health Psychology Andrea D. Furlan, MD PhD, Associate Scientist, Institute for Work & Health Physiatrist, Toronto Rehabilitation Institute; Assistant Professor, Division of Physiatry, Department of Medicine, University of Toronto Carl L von Baeyer, PhD, Registered Psychologist Professor Emeritus of Psychology & Associate Member in Pediatrics, University of Saskatchewan Chris Spanswick MB, ChB, FRCA, FFPMRCA, Clinical Assistant Professor, Dept of Anaesthesia, University of Calgary; Medical Leader, Calgary Pain Program Alberta Health Services, Calgary Area Pamela Squire MD, CCFP, Assistant Clinical Professor UBC Tim V. Salomons, Ph.D., Division of Brain, Imaging and Behavior - Systems Neuroscience,Toronto Western Research Institute Mark Ware, MD, MRCP(UK), MSc, Assistant Professor in Family Medicine and Anesthesia, McGill University
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To date registrants have included family physicians, anesthesiologists, pharmacists, nurses, psychologists, occupational therapists, physiotherapists, speech-language pathologists, social workers and individuals from other health related disciplines. REGISTRANT COMMENTS "The "Nature of Pain" course was a wonderful experience. It gave me a firm foundation in cutting edge pain neurophysiology. My participation in the course has improved my ability to conceptualize the etiology of my patients' pain and the best way to treat it." - Family Physician (CFPC member) I have already recommended it to several people - physios and physicians. The quality of instruction is superb, with a perfect balance of theoretical and practical knowledge. We now have the tools to proceed, as well as the knowledge of how to stay current and connected with the latest in research. It expanded my knowledge tremendously and motivated me to continue learning about pain management. I learned to think more critically and have a greater understanding of various professional scopes of practice. The connections I made with other classmates/communities of practice are also invaluable. Any practitioner who works with chronic pain patients would benefit from the knowledge offered by this course. The depth and breadth of learning was excellent for anyone seeking to understand pain and its management. The opportunity to do this in an interdisciplinary and multidisciplinary way was an added bonus. Allowed for learning from many perspectives.
GRADUATE CERTIFICATE IN STROKE REHABILITATION This online graduate level credit certificate, initiated by the Alberta Provincial Stroke Strategy, is an inter-disciplinary stroke rehabilitation program designed to address the learning needs of rehabilitation clinicians across the continuum of care. In addition to earning graduate level credit, clinicians completing the program can use the letters PgCStokre (post graduate certificate in stroke) to designate program completion. This program provides high quality post-professional education on best-practices and evidence-based guidelines in stroke rehabilitation which will help to increase effectiveness and efficiency in helping stroke survivors to regain function and re-integrate into their home and community lives. Upon completion of the three certificate courses registrants will be able to: • • •
Identify and select strategies to access new and emerging evidence in stroke rehabilitation. Identify and apply best practices approaches to interdisciplinary assessment rationale, strategy and outcomes. Establish client-centered goals and a team-based plan to meet those goals.
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• • • • • • • •
Describe and coordinate the various professional roles/relationships involved in stroke rehabilitation to improve outcome for the stroke survivor. Identify issues related to optimal timing of rehabilitation (both admissions and discharges) across the continuum of care settings. Identify evidence-based intervention strategies related to their discipline and/or interest and apply this information in a team approach within a context of the workplace. Describe the range of outcome measurement frameworks and tools. Develop an in-depth knowledge of an evidence-based topic in stroke rehabilitation through literature review, tailored mentoring, and/ or networking. Describe principles of organizational change management. Demonstrate the skills required to work collaboratively with a practice setting to implement evidence based practice in stroke rehabilitation. Develop competence in proposal writing and evaluation. Describe factors that may influence the implementation of evidence into practice (evidence, context, facilitation). COURSE DESCRIPTIONS
A Certificate is granted upon successful completion of three required graduate-level credit courses, as listed below. REHAB 540: Stroke Rehabilitation: Best Practice and Critical Review of the Evidence (*3) This course focuses on current knowledge of best practice in the area of stroke, and provides students with critical appraisal skills that will sustain and further the acquisition of best practice information and principles in stroke rehabilitation. This evidence and best practice is explored in the context of the stroke survivor, caregivers and rehabilitation professionals with students having an opportunity to apply learning to specific professional areas of interest. REHAB 541: The Stroke Survivor: Assessment and Rehabilitation across the Continuum of Care (*3) The goal of this course is to integrate and apply advanced knowledge from REHAB 540 into clinical practice. Using a discovery learning/case study approach, students will conduct an evidence-based review of the literature and work as an interdisciplinary team to apply best practice information to a variety of care contexts. Students will work collaboratively on case studies that offer practical opportunities to apply assessment and treatment principles. Additionally, the course will explore team functioning and dynamics within and across the various stroke rehabilitation settings with students having an opportunity to apply learning to specific professional areas of practice. Prerequisite: REHAB 540. REHAB 542: Advancing Practice in Stroke Rehabilitation (*3) The goal of this course is to develop a proposal that could be implemented into a work environment that incorporates advanced/best practices in stroke rehabilitation. Students will choose a project based on the knowledge gained in the previous courses and on needs that they identify within a practice setting. Students will gain knowledge and experience in organizational change management while working collaboratively with a host site. Students will gain skills in the area they choose for their proposal through tailored mentoring. The mentor will facilitate the process of moving evidence into practice by providing content expertise in implementation of best practice in stroke rehabilitation in a clinical setting. Additionally, this process is expected to provide students with valuable professional contacts. Prerequisite: REHAB 541.
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Course instructors include Dr. Theresa Green, assistant professor in the Faculty of Nursing at the University of Calgary, Dr. Marilyn MacKay-Lyons, associate professor in the School of Physical Therapy at Dalhousie University, Alberta Health Services expert stroke clinician Margaret Grant, and Michael Suddes Calgary Stroke Program manager. Course contributors include but are not limited to: • • • • • • • • • • • • • • • •
Joy McDermid, School of Rehabilitation Science, McMaster University Eddy Lang, Senior Researcher & Associate Professor Emergency Medicine, Alberta Health Services Jennifer Yost, Faculty of Nursing, McMaster University Nancy Mayo, Division of Clinical Epidemiology, McGill University Cheryl Hubley-Kozey, School of Physiotherapy, Dalhousie University Andrew Mente, Department of Clinical Epidemiology & Biostatistics, McMaster University Gail Eskes, Department of Psychiatry, Dalhousie University Jill Hayden, Faculty of Medicine, Dalhousie University Marilyn McDonald, School of Nursing, Dalhousie University Michael Suddes, Manager Calgary Stroke Program, Alberta Health Services Grace Warner, School of Occupational Therapy, Dalhousie University Patrice Lindsay, Department of Health Policy, Management and Evaluation Faculty of Medicine, University of Toronto Sean Dukelow, University of Calgary & Hotchkiss Brain Institute Jill Cameron, Occupational Science and Occupational Therapy, University of Toronto Sarah Blanton, Emory University School of Medicine, Department of Rehabilitation Medicine Dale Strasser, Emory University School of Medicine, Department of Rehabilitation Medicine
To date registrants have included nurses, occupational therapists, physiotherapists, speech-language pathologists and individuals from other health related disciplines. Stroke Certificate courses are eligible for Mainpro-C and Mainpro-M1 credits through the College of Family Physicians of Canada (CFPC). REGISTRANT COMMENTS What I liked most was the variety of modules and the up-to -date review of best practices. I really enjoyed the interaction with the guest lecturers because I was able to ask specific clinical questions to the experts! Very practical learning content, excellent inter professional learning. Very pertinent to the interprofessional care of the stroke patient and their families. I feel better prepared to see stroke patients, given the background knowledge I learned and the research I was able to read as a result of this course. What I liked most was the interaction between participants in the online discussions and case studies. Great to learn what is working (or not) for people in the rehab field across the country. "The Online learning format allowed me to take this course. I really liked that interaction of the other therapists.”
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“The content was relevant and my knowledge base on the subject has improved which will translate into practice.” “The course was interesting and provided a very solid introduction to developing critical appraisal skills. The format allowed me to research a topic of particular interest while introducing other interesting clinical topics. The course was very well organized and the instructors genuinely cared about our learning.”
5. GRADUATE DIAGNOSTIC IMAGING COURSE This online stand alone graduate course provides participants with the knowledge, skills, and abilities to effectively utilize diagnostic imaging in the management of selected conditions seen by physical therapists. The curriculum emphasizes patient safety and a physiotherapist’s accountability to ensure effective and appropriate utilization of diagnostic imaging, and facilitate timely access to diagnostic imaging. Curriculum includes, but is not be limited to: • • • • • • • •
Understanding diagnostic imaging technology Patient safety issues and risks when ordering diagnostic imaging Criteria for ordering diagnostic imaging Ethics of the use of diagnostic imaging in physiotherapy practice Using search patterns to understand images Understanding content and relevance of an imaging report Integration of diagnostic imaging findings into practice Understanding cost and utilization issues associated with diagnostic imaging procedures
COURSE DESCRIPTION REHAB 570: Diagnostic Imaging in Physical Therapy Practice This course is intended to provide students with an overview of diagnostic imaging and how it can be effectively utilized for conditions that are commonly seen in physical therapy practice. Case management strategies, clinical guidelines for ordering and utilizing ionizing and non ionizing imaging modalities, issues of patient safety and risk, and integration of imaging information into physical therapy care will be included. Course instructors are Dr. Jackie Whittaker PT, BScPT, PhD and Hilary Reese PT BScPT MClSc (Teaching Assistant).
6. HEALTH SCIENCES VISITING INTERNATIONAL PROGRAM (HSVIP) The HSVIP is intended to further health science graduate and clinical training in Canada, as well as professional development for health-care practitioners. This program is suited to University students who wish to enrich their understanding of the health sciences. It is also suited to practitioners and clinicians who want to enhance their skills and knowledge to better serve patients and clients in their home country. Tailored to meet the specific needs of international students the HSVIP provides a blend of education via face to face lectures, hands on activity via clinical assessment, and clinical observation at a variety of host private and public clinical sites. Students are exposed to a wide variety of clinical areas including
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the roles of the rehabilitation team and best practices in rehabilitation within the context of the Canadian health care system. Example content areas include: · · · · · · ·
Chronic Pain Management Spinal Cord Injury Stroke Rehabilitation Head Injury Swallowing Disorders Assistive Technologies Assessment and Management of MSK conditions
Clinical observation site visits may include: · Glen Sather Sports Medicine Clinic specializing in the assessment, diagnosis, treatment, and rehabilitation of orthopedic and sports related injury. · Glenrose Rehabilitation Hospital, the largest free standing comprehensive tertiary rehabilitation center in North America (observation in amputee, stroke, head injury units, overview of advanced rehabilitation technologies). · Health Science Research Commons to participate in a series of simulation scenarios in a variety of environments (critical care room with high fidelity manikins, smart condo, specialized bariatric care suite). · Private Health Clinics offering chronic pain management programs and medication management.
7. WORKSHOPS The faculty hosts several workshops included the Glen Sather Sports Medicine Clinic’s annual David C Reid Conference and the Annual Karin Greaves Memorial Education Seminar with focuses on rehabilitation after knee, shoulder, hip, ankle arthroplasty. Approximately 2-3 additional workshops are offered in addition to the two annual events. Faculty hosted workshops regularly draw 80-120 clinicians and are often available for online viewing to increase clinician participation in both urban and rural areas from across Canada and beyond.
8. UPCOMING • • •
Certificate in Sexual Health (fall 2016) Certificate in Shoulder Rehabilitation (in development) Online non-credit learning modules o swallowing disorders o medication course for physical therapists o wheelchair seating & measurement o pediatric pain course
Note: There are eligibility criteria (e.g. English Language Proficiency level, General Study Skills) that should be met by applicants for admission to the programs.
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