Seeking Outcomes: Providing Physical Therapy Continuing Education and Mentoring in Nairobi, Kenya
Purpose: Physical therapy professional education programs are limited in scope in many developing countries.1 Continuing education is one of the main sources of access to evidence-based practice and advanced instruction for physical therapists in the United States but is of particular importance in areas where the entry-level physical therapy degree is a three-year diploma or Bachelor of Science degree.2 Collaboration between sponsoring organizations and host partners are one method of bringing Western trained physical therapists to a location to train local clinicians, with the expectation that the clinicians will use the training to provide a higher level of care to their patients.3,4 Western trained healthcare providers and faculty who participate in providing international continuing education have an opportunity to benefit from an improved cultural sensitivity and awareness, as measured on the Multicultural Sensitivity Scale.8 The purposes of this investigation are 1. to describe a collaborative international partnership between a sponsoring organization and physiotherapists in Kenya and its effects of intensive face-to face training in geriatric physical therapy on knowledge and practice of the student participants, and 2. to describe the effects of cultural sensitivity and awareness on a PT faculty member participating in provision of an international continuing education course.
Methods/Description: Kenyan physiotherapists (n=15; 11 male, 4 female) enrolled in and completed a two-week long, face-to-face continuing education course in Geriatric Physical Therapy, undergoing 80 hours of lecture and lab-based education and examination. The highest level of education for all participants was a 3-year diploma of physiotherapy, which is the only PT degree required by law in Kenya. All participants were fluent in English, and their years of experience as a physiotherapist ranged from 7-30, with the median number of years of experience being 12. All students participated in didactic geriatric physical therapy education with clinical lab practice of skills. Content areas included examination, evaluation, diagnosis, prognosis, intervention, and reevaluation of the geriatric patient/client. The instructor divided the curriculum into the following topics: theories of aging, system-based age-related changes with relevant tests and measures of vital signs, gait, posture, and balance, pharmacology, and development and progression of appropriate intervention plans. Students underwent frequent written and practical examination of skills, knowledge, and clinical reasoning. The instructor measured assessment of learning via the scores earned on 5 quizzes, 1 practical exam, 1 live patient exam, and 1 written exam. Assessment of the cultural sensitivity and awareness of the geriatric PT faculty was determined by administration of the Multicultural Sensitivity Scale (MSS) before and after the experience.
Results/Outcomes: No student had previous training in geriatric physical therapy. Seven students had completed continuing education in neurological physical therapy and in cardiopulmonary physical therapy for 2 weeks each, and all had 1-3 orthopedic manual physical therapy courses prior to this one. Despite their years of practice, each topic area in geriatrics required significant time in the classroom (up to 8 hours) due to the necessary inclusion of prerequisite information, (relevant anatomy and physiology), which was absent from their prior educational preparation. Average scores at the end of the program were high: 86% on the written final exam (78-98%), 87% on quizzes (30-100%), and 97% on live patient exam (95-100%). All participants passed the course with an over score of 91% or higher. Furthermore, each student reported having increased his or her knowledge and confidence in treating geriatric clientele (5/5 on Likert scale). Scores on the MSS were 31 before travel to Kenya and 37 after completion of the course.
Conclusions/Relevance to the conference theme: Despite the numerous challenges, there were many significant successes in designing and implementing a geriatrics curriculum in Kenya. The Kenyan physiotherapists all gained knowledge and confidence in treating geriatric patient/clients. The two-week intensive program was a profound experience in cultural awareness for the American faculty who participated. Faculty in American Entry-level Physical Therapy programs may experience improved cultural sensitivity via teaching in underdeveloped nations, and thus, bring that cultural sensitivity to their classrooms.