Teaching in the Field of Learning Disabilities

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Teaching in the Field of Learning
Disabilities

• Physiotherapy

Presented by Clare Cheney MCSP Physiotherapist
Stroud CLDT 22.10.08 at New Friends Hall
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A Rare Breed

• 30,000 registered physiotherapists
• Less than 300 members of ACPPLD
• 10 of physiotherapy students have a Learning
  Disability placement
• Assoc. of Chartered Physiotherapists for People
  with Learning Disabilities

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PHYSIOTHERAPY TRAINING

• BSc(Hons) Physiotherapy
• Accredited by Chartered Society Of
  Physiotherapy (CSP) and Health Professions
  Council (HPC)
• The programme leads to both an academic
  qualification and a license to practice,
  entitling the graduate to apply for full
  membership of CSP and HPC

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Programme Structure

• 3 years
• 1st year mostly uni based but concludes with a
  clinical placement
• 2nd 3rd year consist of alternate periods at
  uni and clinical placement
• Core subjects musculo-skeletal, respiratory,
  neurological

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Clinical Placement

• Supported by a clinical educator
• Facilitate integration of theory into practice
  with expectation also of developing new knowledge
  and skills
• 1000 hours required for qualification
• 6 placements of 5 weeks each (37 ½ hrs a week)
• Not specialism specific

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Objectives on Placement

• Student Objectives
• each has expected learning outcomes
• also set specialism specific objectives
• student also has personal goals and outcomes that
  they carry over from previous placements

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Learning Outcomes First placement year3

• Demonstrate systematic and fluent assessment
  procedures for a range of clinical
  presentations
• Apply, evaluate and modify appropriate
  physiotherapeutic skills
• Demonstrate a knowledge of research findings in
  relation to the treatment of presenting
  conditions
• Demonstrate further development in skills of
  reflective practice
• Demonstrate skills in the management and
  prioritisation of workload within the parameters
  of the available resources
• Demonstrate an awareness of the roles of the
  multidisciplinary team

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My Objective

• That the student feel they have learnt
  something, enjoyed their time with us and have a
  positive experience of working with people with
  LD.

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Students personal goals and outcomes

• May include
• Mobility assessment
• Advice and guidelines
• Assessment of muscle tone
• Ability to handle a person with severe physical
  disability
• Communication with person with a learning
  disability
• Prioritisation of waiting list

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Assessment on placement

• Continuous Practice Assessments (CPA)
  Communication, Professionalism/Learning
  Behaviour, Clinical Reasoning, Practical Skills,
  Organisation
• Professional Practise Oral Assessment (PP0A)
• Observation of clinical practice involving
  assessment and examination, followed by
  questioning.
• Midway Final appraisal
• Clinical educators comments and advice for
  future development

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Junior Physiotherapists

• Qualified, registered (HPC)
• Rotational band 5 posts
• 6 months each
• PCT rotation - in and out patient settings at 2
  local community hospitals, LD and paediatrics
• PCT recruits

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Juniors may

• Not have had an LD placement as students
• Not have had any previous experience with a
  person with LD
• No community experience
• Low/no expectations
• Have just qualified

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Perceptorship scheme

• Aim of a rotational physiotherapist is to learn
  and develop through experience and support from
  colleagues, to deliver a high quality and
  efficient physiotherapy service in Glos PCT
• Scheme aims to fully support the newly qualified
  physiotherapist in their development.

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Scheme

• Initial induction early on in rotation
• Discussion with perceptor re core objectives of
  the rotation and set personal objectives
• Half way review to reflect on practice and have
  feedback on performance and progress
• Watched assessments (at least 2)
• End of rotation appraisal to discuss objectives
  and identify ongoing learniing needs.
• End of rotation comments written by perceptor
  and perceptee. Copy of this to lead physio at PCT
  

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Core objectives of Learning Disabilities Rotation

• To complete an initial assessment and feedback
  to MDT
• Assess a client referred with mobility problems,
  formulate a plan for the client and feedback to
  a client and carer in a format that is understood
• To increase knowledge of postural management,
  biomechanics and equipment that that is available
• To carry out a postural management assessment or
  review with OT, complete an action and postural
  management plan.
• To expand knowledge of Cerebral Palsy in
  adulthood, understanding the complications and
  effects of CP burnout
• To assess a client for hydrotherapy, formulate
  and implement a plan
• To carry out a joint assessment with the
  orthotist

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• Core objectives of Learning Disabilities Rotation
• Shadow perceptor initially
• May complete follow up work
• When perceptee is competent and confident picks
  up their own caseload and courses of treatment
  with a client on perceptors caseload
• Joint working eg hydrotherapy
• Supervision needs to available not only formally
  but on an ad hoc basis

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Benefits to the perceptor

• Links with local practioners
• Updates knowledge outside specialty
• Challenges practice
• Satisfaction of seeing the student/junior
  develop, gain skills and knowledge

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Benefits to the perceptee

• Gain experience and confidence working with
  people who have LD
• Knowledge of our service
• Value the opportunity to develop skills in
  hydrotherapy, postural management and orthotics
• Experience multidisciplinary working

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All of which benefit the service and service users
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My Objective

• That the junior feels they have learnt
  something, enjoyed their time with us and have a
  positive experience of working with people with
  LD.

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Perceptor/Clinical Educator needs to be able to

• Delegate, be very flexible, be available
• Be comfortable with having practice challenged,
  be able to justify
• Share (desk, computer, clients and carers)
• Prioritise, manage increased demands, increased
  supervision

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Clinical Educators, Perceptors, Perceptees and
Students need

• Support of their team (including admin staff)
  to provide a working environment that is
  welcoming and comfortable to enable student to
  gain confidence and experience.
• Awareness and recognition that the student has
  objectives to meet and a limited time to do this.
• Managers to be aware of increased demands on
  clinical educator/perceptor.

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My own route

• Basic grade physiotherapist Stroud General
  Hospital working in out patients, the gym, on the
  wards and maternity.
• Senior 2 post Gloucester Royal hospital in
  Elderly Care
• Senior 2 then Senior 1 Cashes Green Hospital in
  Elderly Care
• Career break
• Senior 2 post in Community Paediatrics
• Senior 1 post in Community Paediatrics
• Senior 1 secondment in Adult Learning Disability
• Senior 1 post / Band 7 in Adult Learning
  Disability