Fizyoterapi ve Rehabilitasyon Eğitiminde Kanıta Dayalı Uygulama Yaklaşımının Sistematik Olarak Gözden Geçirilmesi

Year 2020, Volume: 3 Issue: 1, 13 - 23, 30.01.2021

Veysel Alcan

Abstract

Fizyoterapistlerden kişilerin sağlık sonuçlarını en üst düzeye çıkarmak için araştırma kanıtlarını klinik karar verme süreçlerine dâhil etmeleri beklenmektedir. Fakat yapılan araştırmalarda bilgi ve yeterlilik düzeylerindeki eksiklik, tutum değiştirme ile ilgili sorunlar ve zaman yetersizliği gibi engellerden dolayı rutin uygulamada kanıta dayalı uygulama (KDU) yaklaşımının yeterli ölçüde kullanılmadığı rapor edilmiştir. Akademik programlar, KDU temelli fizyoterapi ve rehabilitasyon becerilerini geliştirmede ve daha sonra pratikte kullanımını desteklemede en önemli role sahiptir. Eğitim programlarının KDU temelli bilgi ve beceri stratejileri, fizyoterapideki akredite ulusal ve uluslararası kuruluşların beklentileri, sektör ve iş gücü piyasasının beklentilerini karşılayabilecek dinamik bir içeriğe sahip olmalıdır. Bu yüzden fizyoterapistlerin klinik karar verme stratejilerinde, klinik uygulamalarında hangi test ve değerlendirme ölçüm araçlarının etkin ve uygun olacağını belirlemek için KDU yaklaşımlarına yönelik yapılacak güncel literatür araştırmaları, kapsamlı değerlendirmeler ve bilgi kaynakları önem taşımaktadır. Bu çalışma, Türkiye’deki fizyoterapi ve rehabilitasyon eğitiminde KDU yaklaşımının entegrasyonunu araştırarak öğrenme hedefleri için bir değerlendirme sunmayı amaçlamıştır.

Keywords

fizyoterapi ve rehabilitasyon, kanıta dayalı uygulama, eğitim, müfredat

References

• [1] Kunduracılar Z, Akbaş E, Büyükuysal C, Biçki D, Erdem EU. Fizyoterapi ve Rehabilitasyon Bolumu Öğrencilerinde Mesleki Farkındalığın Değerlendirilmesi. Yükseköğretim ve Bilim Dergisi. 2012;2:186-192
• [2] Sackett DL, Richardson WS, Rosenberg W, Haynes RB. Evidence-based Medicine: How to Practice and Teach EBM. Edinburgh: Churchill Livingstone; 2000.
• [3] World Conferation for Physical Therapy (WCPT) 2020. Erişim adresi: http://www.wcpt.org. Son erişim: 03.05.2020
• [4] American Occupational Therapy Association. Occupational therapy code of ethics. American Journal of Occupational Therapy. 2005;59:639–642.
• [5] Burgers JS, Grol R, Klazinga NS, Mäkelä M, Zaat J, AGREE Collaboration. Towards evidence-based clinical practice: an international survey of 18 clinical guideline programs. Int J Qual Health Care. 2003; 15(1):31-45.
• [6] World Confederation for Physical Therapy policy statement on description of physical therapy. Erişim adresi: http://wcpt.org/policy/ps-descriptionPT. son erişim: 03.05.2020
• [7] Ross EC, Anderson EZ. The evolution of a physical therapy research curriculum: Integrating evidence-based practice and clinical decision-making. J Phys Ther Educ. 2004;18: 52-57.
• [8] Pollock A, Legg L, Langhorne P et al Barriers to achieving evidence-based stroke rehabilitation. Clinical Rehabilitation 2000;14:611–617.
• [9] Bekkering T, Engers AJ, Wensing M et al Development of an implementation strategy for physiotherapy guidelines on low back pain. Australian Journal of Physiotherapy 2003;49:208–214
• [10] Stevenson K, Lewis M, Hay E. Do physiotherapists’ attitudes towards evidence-based practice change as a result of an evidence-based educational programme. J Eval Clin Pract 2004;10:207-217
• [11] Oxman A, Flottorp S 1998 An overview of strategies to promote implementation of evidence based health care. In: Silagy C, Haines A (eds) Evidence based practice in primary care. BMJ Books, London
• [12] Agarwal R, Kalita J, Misra UK. Barriers to evidence-based medicine practice in South Asia and possible solutions. Neurol Asia 2008;13:87-94.
• [13] Duncan EAS, Murray J. The barriers and facilitators to routine outcome measurement by allied health professionals in practice: a systematic review. BMC Health Serv Res. 2012;12:96
• [14] Salls J, Dolhi C, Silverman L, Hansen M. (). The use of evidence-based practice by occupational therapists. Occupational Therapy in Health Care. 2009;23:134-145
• [15] Tse S, Blackwood K, Penman M. From rhetoric to reality: Use of randomized controlled trials in evidence-based occupational therapy. Australian Journal of Occupational Therapy.2000;47:181–185. [16] Gibson B, Martin D. Qualitative research and evidencebased physiotherapy practice. Physiotherapy. 2003;89:350–358
• [17] Copeland JM, Taylor WJ, Dean SG. Factors influencing the use of outcome measures for patients with low back pain: a survey of New Zealand physical therapists. Phys Ther. 2008;88:1492–1505.
• [18] Pattison KM, Brooks D, Cameron JI, Salbach NM. Factors influencing physical Therapists’ use of standardized measures of walking capacity Poststroke across the care continuum. Phys Ther. 2015;95:1507–1517.
• [19] Jette DU, Bacon K, Batty C, Carlson M, Ferland A, Hemingway RD, Hill JC, Ogilvie L, Volk D. Evidence-based practice: beliefs, attitudes, knowledge, and behaviors of physical therapists. Phys Ther. 2003;83:786–805.
• [20] Al-Muqiren TN, Al-Eisa ES, Alghadir AH, Anwer S. implementation and use of standardized outcome measures by physical therapists in Saudi Arabia: barriers, facilitators and perceptions. BMC Health Serv Res. 2017;17:748
• [21] Yüksek Öğretim Kurumu (YÖK) Program Atlası. Erişim adresi: https://yokatlas.yok.gov.tr/ . son erişim: 03.05.2020
• [22] The Statistical Office of The European Union (Eurostat). Erişim adresi: (https://ec.europa.eu/eurostat/statistics-explained/index.php/Healthcare_personnel_statistics_-_dentists,_pharmacists_and_physiotherapists) son erişim: 03.05.2020
• [23] Fizyoterapi ve Rehabilitasyon Çekirdek Eğitim Programı. 2016. Erişim adresi: https://www.yok.gov.tr/Documents/Kurumsal/egitim_ogretim_dairesi/Ulusal-cekirdek-egitimi-programlari/fizyotreapi_cekirdek_egitim_programi.pdf son erişim: 25.04.2020
• [24] Mikhail C, Korner-Bitensky N, Rossignol M, Dumas J. Physical therapists’ use of interventions with high evidence of effectiveness in the management of a hypothetical typical patient with acute low back pain Phys Ther. 2005;85:1151-1167.
• [25] Bello A. Utilizing research findings in physiotherapy: a call for gap bridging Niger Postgrad Med J. 2011;18/19:54-58
• [26] Guide to Physical Therapist Practice . Rev 2nd ed. Alexandria, VA : American Physical Therapy Association; 2003
• [27] Gürses HN, Alemdaroğlu İ, Tanrıverdi M. Türkiye’de Fizyoterapi Ve Rehabilitasyon Fakülte Bölümü/Yüksekokullarının İncelenmesi ve Müfredat Analizi. Türk Fizyoterapi ve Rehabilitasyon Dergisi 2014;25:16-27.
• [28] Long BK, McEvoy MP, Lewis LK, Williams MT, Olds TS. Entry-Level Evidenced-Based Training in Physiotherapy Students: Does it Change Knowledge, Attitudes, and Behaviours? A longitudinal Study. The Internet J Allied Health Sci Practice. 2011;9 (3).
• [29] Stube JE, Jedlicka JS: The acquisition and integration of evidence-based practice concepts by occupational therapy students. Am J Occup Ther. 2007;61:53-61.
• [30] Olsen NR, Bradley P, Lomborg K, Nortvedt MW. Evidence based practice in clinical physiotherapy education: A qualitative interpretive description. BMC Med Educ 2013;13:52.
• [31] Schilling K, Wiecha J, Polineni D, Khalil S: An interactive web-based curriculum on evidence-based medicine: design and effectiveness. Fam Med. 2006;38:126-132.
• [32] Pruskil S, Burgwinkel P, Georg W, Keil T, Kiessling C: Medical students’ attitudes towards science and involvement in research activities: a comparative study with students from a reformed and a traditional curriculum. Medical teacher. 2009;31; e254-259.
• [33] Shepard KF, Hack LM, Gwyer J, Jensen GM: Describing Expert Practice in Physical Therapy. Qual Health Res. 1999;9;746-758.
• [34] Agarwal R, Kalita J, Misra UK. Barriers to evidence-based medicine practice in South Asia and possible solutions. Neurol Asia 2008;13:87-94.
• [35] Ohman A, Solomon P, Finch E: Career Choice and Professional Preferences in a Group of Canadian Physiotherapy Students. Adv Physiother. 2002;4:16-22.
• [36] Sabus C. The Effects of Modeling Evidence-Based Practice During the Clinical Internship. J Phys Ther Educ. 2008;22:74-84.
• [37] Laitinen-Vaananen S, Talvitie U, Luukka MR: Clinical supervision as an interaction between the clinical educator and the student. Physiother Theory Pract. 2007;23:95-103.
• [38] Stube JE, Jedlicka JS. The acquisition and integration of evidence-based practice concepts by occupational therapy students. Am J Occup Ther. 2007;61:53-61.