The use of Information and Communication Technology to support South African physiotherapy students

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This is the first conference presentation I ever gave. It was in 2008 at the South African Association of Health Educators (SAAHE) conference at Stellenbosch University.

I came across it just now and thought I'd put it up here, just for the sake of being complete.

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  • Today I'll be presenting the results of a study recently submitted for my Masters thesis that determined the use of information and communication technology as a means of providing support to physiotherapy students in South Africa.
  • A review of the background against which the study took place showed that... In 2002 it was estimated that within 3 years there would be about 1 billion people online worldwide. In SA, we have seen this trend grow, particularly with the adoption of broadband Internet connections. These high speed access points have ushered in the rise of social networking, online consumer forums and multimedia on demand services that show how South Africans are embracing this technology on a large scale. Internationally, this shift towards digital environments has been even more prolific, with most organisations and even individuals having an online presence. In the UK, the CSP has a website which provides its members with advice on clinical guidelines, effective professional practice, opportunities related to Continuing Professional Development and which serves to inform physiotherapists of the state of the profession. In contrast, in South Africa, the website of the SASP has only a limited amount of content for physiotherapists and physiotherapy students but at the same time, acknowledges that supporting its members is both necessary and important. The problem is that although there is a significant worldwide shift towards the use of digital technology in education and healthcare, little evidence could be found on its use to support South African physiotherapy students.
  • This problem led to the formation of the research Aim and Objectives. The aim of the study was: “ To investigate the use of ICT at South African universities as a means of providing support to physiotherapy students, as well as the experiences and perceptions of these students pertaining to the use of ICT as a means of seeking and receiving support ”. The objectives developed to achieve this aim include: 1. Determining what ICT facilities are available to physiotherapy students in South Africa, as well as the reasons for its use. 2. To determine physiotherapy students' experiences and perceptions of ICT as a means of seeking and receiving support, as well as to identify how students are currently being supported. 3. Finally, to determine if physiotherapy students are adequately prepared to use ICT to access support after graduating, as well as noting any differences between those who use ICT for support, and those who do not.
  • A review of the literature began by defining ICT as anything that deals with the use of computers and computer software to convert, store, protect, process, transmit and retrieve information. Organisations such as the WHO and the UN childrens fund support the idea of using technology to solve problems in education and healthcare, as well as discussing the many benefits of using ICT in these fields. In this country, the government has endorsed the idea of “socially acceptable technology”, particularly in the fields of education and healthcare. In other words, it supports the idea that the use of technology to solve problems is viable as long as it emphasises, and not replaces, the human element.
  • The literature review was then refined to specifically identify the benefits of the use of ICT in the fields of education and healthcare. The predominant themes that emerged included demonstrating that... E-learning, or the use of ICT to supplement the learning process has many advantages, including ensuring coursework accessibility, promoting active student engagement with content and enhancing problem-based learning, as well as improving information gathering skills. It was shown that in just a few years time, ICT will have significant role to play in healthcare, with an estimated 30% of a doctors time spent using computers. The questions is: are students adequately prepared to function in this environment? ICT was also shown to improve the opportunities for CPD by facilitating the transfer of training materials to remote areas and for enhancing communication between colleagues. In addition to this, several studies have shown that while most physiotherapists and physiotherapy students support the concept of EBP in principle, many found it hard to implement, mainly due to a lack of access to literature and isolation in terms of peer support. Furthermore, remote areas have long suffered with the problem of recruitment and retention of healthcare professionals due to geographical and professional isolation. ICT has been shown to be a feasible means of reducing isolation by providing both professional and social support through enhanced methods of communication. Finally, it was shown that ICT has allowed students and new graduates working in remote areas to be supervised by more experienced clinicians. The current system has new graduates supported telephonically, which limits what can be recorded for later review. New graduates were also identified to be unsatisfied with the levels of support they had received.
  • Challenges facing the widespread adoption of ICT in SA that were highlighted, included: 1. The argument that using ICT to solve problems in any aspect of society will increase the “digital divide” i.e. the gap between those with access to technology and those without. 2. In addition, large, rural parts of SA are without a fixed line telephone network, which is the basic infrastructure of the Internet. Having said this however, SA has the most advanced communications infrastructure on the continent. 3. Another challenge to be overcome is the high cost of equipment, training and access. However, it was also shown that these costs can be reduced and often are not prohibitive. 4. Poor ICT literacy was another factor identified, and included not only healthcare professionals, but also support staff, who would be expected to use the technology. 5. Finally, a lack of technical skills in terms of hardware maintenance, was noted. However, this could be overcome within a short period with appropriate training.
  • In terms of the methodology used, the study design was a cross-sectional, descriptive survey, which was both quantitative and qualitative in nature, and was implemented in 6 of the 8 physiotherapy departments in SA. The sample included all undergraduate physiotherapy students at these 6 universities who completed and returned questionnaires. No exclusions were made. As no validated, reliable instrument was obtained, a self-developed questionnaire was used. A pilot study and focus group were used to refine the instrument in terms of improving validity and reliability. Methods implemented to maximise response rate included using stamped, self-addressed envelopes, cover letters and reminders, as well as offering an incentive to participate. Data were coded using the OpenOffice spreadsheet application and statistical analysis performed using SPSS. Ethical clearance to perform the study was obtained from the UWC Higher Degrees Committee, as well as permission from the head of each physiotherapy department that participated. Consent was implied by completing and returning the questionnaire and anonymity was ensured by not collecting personally identifiable data.
  • Looking at the results in terms of the demographics of the sample showed that, in terms of the response rate by university, UWC (in orange) and the US (in green) had the highest response rates. The response rate in total was almost 50% and, in general, we can see that physiotherapy is still a profession dominated by white females. In terms of age, almost 90% of respondents were aged 18-22 years, which was within the expectations of a normal age distribution for undergraduate students. It was also found that there was a strong association between the university a student attends and the racial demographic of that university, although some universities did have greater variation in terms of race and gender, than others.
  • The results obtained in terms of the use of ICT at the various universities showed that, while all students had access to ICT on campus, not all were aware of it. In terms of the frequency of use, approximately 40% of students use ICT daily on campus, while 35% more use it at least weekly. The results obtained indicated a strong association between the university attended and the activites performed online by those students. In other words, students at some universities were more confident and used ICT more frequently than at others. High levels of confidence were reported among respondents for tasks such as email, word processing, online search and printing. However, low levels of confidence were reported for tasks such as using ICT for professional development, research, and online forum discussion. This was illustrated by the fact that only 23% of students used ICT to seek advice or guidance, and only 43% used it for academic development.
  • Finally, the results pertaining to students' experiences and perceptions using ICT for support revealed that students who had had access to ICT at home and high school were more likely to use ICT at university, or at home for course-related work. A strong association was identified between race and ICT access in various settings. Results showed that Black and Indian students had the least access to ICT prior to attending university, while White students had had more. In addition, it was found that students were more likely to seek support from those most suited to provide it. In other words, they would obtain clinical and educational support more often from lecturers and supervisors, while obtaining emotional and social support from friends and family. Face-to-face contact was identified as having accounted for more than 90% of the method by which students obtained support, in contrast with only 25% using email for this purpose. Finally, most students reported being satisfied with the level of support they were receiving while at university.
  • When discussing these results in the light of the literature, the following key points should be highlighted. Most students view ICT as a means of accessing information, rather than obtaining support. In fact, the least common use of ICT by students was to seek support or guidance. This is in contrast with the literature, which identified ICT as offering a significant advantage in this regard. Even though ICT was shown consistently throughout the literature to enhance communication, SA physiotherapy students fail to use it in this way, at least in terms of their studies. This, despite the fact that 87% of students believed that ICT would make communication easier, as well as reporting a high level of confidence in the use of email to communicate. In terms of the support systems available, both the preferred method and those providing it may be appropriate at undergraduate level, but are unlikely to be present in the work environment. Students are also unlikely to approach their peers for support, which has implications when functioning as part of a MDT. With the move towards EBP in healthcare, it is of significant concern that research was highlighted as the area in which more than a third of students were least confident.
  • In conclusion, ICT has been shown to be a feasible means of providing support to physiotherapy students, both internationally and in South Africa. While students reported having the skills to use ICT to seek support and to enhance their studies, they do not apply these skills. There is still inequality in access to ICT prior to attending university, which was shown to have implications for its use at university. A recommendation that emerged from this study was that physiotherapy departments should consider developing and implementing a comprehensive ICT strategy, that should focus on the use of ICT to facilitate communication between students and lecturers. It should enable students to implement their skills to enhance the learning process, particularly with regards research and EBP.
  • The use of Information and Communication Technology to support South African physiotherapy students

    1. 1. <ul><ul><li>The use of </li></ul></ul><ul><ul><li>information and communication technology </li></ul></ul><ul><ul><li>to support </li></ul></ul><ul><ul><li>physiotherapy students </li></ul></ul><ul><ul><li>M. Rowe and Professor P. Struthers </li></ul></ul><ul><ul><li>Department of Physiotherapy </li></ul></ul><ul><ul><li>University of the Western Cape </li></ul></ul>
    2. 2. Background <ul><li>Estimated 1 billion people online in 2005 </li></ul><ul><li>Social networking, consumer-related online forum discussion and multimedia on demand </li></ul><ul><li>The CSP (UK) uses ICT to provide support to its memb ers (clinical guidelines, professional practice, CPD, general information) </li></ul><ul><li>In contrast, the SASP website lacks depth and breadth of content, while acknowledging the importance of support </li></ul><ul><li>Problem – little evidence found on the use of ICT to support physiotherapy students in SA </li></ul>
    3. 3. Aim and Objectives <ul><li>Aim: </li></ul><ul><ul><ul><li>To investigate the use of ICT at South African universities to provide support to physiotherapy students and the experiences and perceptions of those students pertaining to the use of ICT as a means of seeking and receiving support. </li></ul></ul></ul><ul><li>Objectives: </li></ul><ul><ul><ul><li>1. What ICT facilities available; </li></ul></ul></ul><ul><ul><ul><li>2. What ICT being used for; </li></ul></ul></ul><ul><ul><ul><li>3. Experiences and perceptions of ICT; </li></ul></ul></ul><ul><ul><ul><li>4. How students currently being supported; </li></ul></ul></ul><ul><ul><ul><li>5. Adequately prepared to access support post-graduation; </li></ul></ul></ul><ul><ul><ul><li>6. What differences exist? </li></ul></ul></ul>
    4. 4. Literature review <ul><li>Definition: the use of computers and computer software to manipulate information </li></ul><ul><li>WHO, UNICEF discuss the benefits of ICT in healthcare and education </li></ul><ul><li>South African government's policy on ICT in healthcare and education </li></ul><ul><li>“ Socially acceptable technology” </li></ul>
    5. 5. Literature review (cont.) <ul><li>Benefits of ICT in healthcare </li></ul><ul><ul><li>Education and training (e-learning) </li></ul></ul><ul><ul><li>Continuing professional development (CPD) </li></ul></ul><ul><ul><li>Evidence-based practice (EBP) </li></ul></ul><ul><ul><li>Geographical and professional isolation </li></ul></ul><ul><ul><li>Student support </li></ul></ul>
    6. 6. Literature review (cont.) <ul><li>Challenges facing ICT adoption </li></ul><ul><ul><li>“Digital divide” </li></ul></ul><ul><ul><li>Poorly developed infrastructure </li></ul></ul><ul><ul><li>High costs involved </li></ul></ul><ul><ul><li>Poor ICT literacy </li></ul></ul><ul><ul><li>Lack of technical skills </li></ul></ul>
    7. 7. Methodology <ul><li>Study design : cross-sectional, descriptive survey </li></ul><ul><li>Setting : physiotherapy departments of 6 universities offering the physiotherapy degree </li></ul><ul><li>Sample : all undergraduate physiotherapy students </li></ul><ul><li>Instrument design : self-developed questionnaire </li></ul><ul><li>Response rate maximised </li></ul><ul><li>Data analysis : OpenOffice spreadsheet and SPSS </li></ul><ul><li>Ethical clearance obtained </li></ul>
    8. 8. Results <ul><li>Demographics </li></ul><ul><li>Response rate 47.8% </li></ul><ul><li>Female: 82% </li></ul><ul><li>White: 41% </li></ul><ul><li>Age: 18 - 22 (87%) </li></ul><ul><li>Strong association between university attended and race </li></ul>
    9. 9. Results (cont.) <ul><li>Use of ICT at university </li></ul><ul><li>All students had access to computers and the Internet at university </li></ul><ul><li>Frequency: almost 40% use ICT daily, 35% use weekly </li></ul><ul><li>There was a strong association between race and university attended, and use of ICT </li></ul><ul><li>High levels of confidence for printing, email and online search </li></ul><ul><li>Low levels of confidence for CPD, research, forum discussion </li></ul>
    10. 10. Results (cont.) <ul><li>Experiences and perceptions of ICT for support: </li></ul><ul><ul><li>Students who had access to ICT at home and at high school were more likely to have used ICT at university </li></ul></ul><ul><ul><li>Most respondents agreed that ICT has a positive role to play in supporting students ( > 70%) </li></ul></ul><ul><ul><li>Students more likely to seek support from those most suited to provide it </li></ul></ul><ul><ul><li>Methods: face-to-face (95%), email (25%) </li></ul></ul><ul><ul><li>Most students were satisfied with current levels of support ( > 80%). </li></ul></ul>
    11. 11. Discussion <ul><li>View ICT as a means of accessing information, rather than obtaining support </li></ul><ul><li>ICT consistently shown to enhance communication, yet students fail to use it for this purpose </li></ul><ul><li>Students current support systems are not likely to be present post-graduation </li></ul><ul><li>Reduced levels of confidence using ICT for research </li></ul>
    12. 12. Conclusion <ul><li>ICT has been shown to be a feasible means of supporting physiotherapy students </li></ul><ul><li>Students have the skills to use ICT to seek support and to enhance their studies, but do not apply them </li></ul><ul><li>Inequality in access still present </li></ul><ul><li>Physiotherapy departments should consider developing and implementing of a comprehensive ICT strategy </li></ul>
    13. 13. Thank you

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