The Experts below are selected from a list of 7662 Experts worldwide ranked by ideXlab platform
Hylton B Menz - One of the best experts on this subject based on the ideXlab platform.
-
Podiatry intervention versus usual general practitioner care for symptomatic radiographic osteoarthritis of the first metatarsophalangeal joint a randomised clinical feasibility study
Arthritis Care and Research, 2021Co-Authors: Kade L Paterson, Hylton B Menz, Rana S Hinman, Ben R Metcalf, Penny K Campbell, David J Hunter, Kim L BennellAbstract:OBJECTIVE: To determine the feasibility of a clinical trial comparing a Podiatry intervention to usual general practitioner (GP) care for people with first metatarsophalangeal (MTP) joint osteoarthritis (OA). METHODS: A 2-arm, participant- and assessor-blinded, randomized feasibility study was conducted over 12 weeks. Participants were age >40 years and had pain and radiographic OA in the first MTP joint. Participants in the Podiatry group had 3 visits and received foot orthoses, exercise, manual therapy, and advice. Participants in the GP group had 1 visit and received medication advice/prescription and the same advice as the Podiatry group. Primary outcomes were measures of feasibility (recruitment, attendance, and retention rates; percentage of prescribed exercise sessions completed; orthoses wear hours/day; treatment fidelity). Secondary outcomes included self-reported pain, function, satisfaction, adherence, adverse events, and dropouts. RESULTS: A total of 236 people were screened, and 30 (13%) were included. All except 1 participant in the Podiatry group attended the required clinical visits, and retention rates were 93% (Podiatry group) and 80% (GP group). Participants completed 66% of the exercise sessions and wore orthoses for an average of 6.3 hours/day. Adherence to medication use was 5.3 on an 11-point numeric rating scale. Both treatment approaches improved pain and function by clinically important differences at 12 weeks. CONCLUSION: A clinical trial comparing a Podiatry intervention to usual GP care for people with first MTP joint OA is feasible. Given the improvements in pain and function observed, a larger appropriately powered clinical trial is warranted to evaluate the superiority of one treatment approach over the other.
-
Podiatry interventions to prevent falls in older people a systematic review and meta analysis
Age and Ageing, 2019Co-Authors: Gavin Wylie, Claire Torrens, Pauline Campbell, Helen Frost, Adam L Gordon, Hylton B Menz, Dawn A Skelton, Francis Sullivan, Miles D Witham, Jacqui MorrisAbstract:Background foot problems are independent risk factors for falls in older people. Podiatrists diagnose and treat a wide range of problems affecting the feet, ankles and lower limbs. However, the effectiveness of Podiatry interventions to prevent falls in older people is unknown. This systematic review examined Podiatry interventions for falls prevention delivered in the community and in care homes. Methods systematic review and meta-analysis. We searched multiple electronic databases with no language restrictions. Randomised or quasi-randomised-controlled trials documenting Podiatry interventions in older people (aged 60+) were included. Two reviewers independently applied selection criteria and assessed methodological quality using the Cochrane Risk of Bias tool. TiDieR guidelines guided data extraction and where suitable statistical summary data were available, we combined the selected outcome data in pooled meta-analyses. Results from 35,857 titles and 5,201 screened abstracts, nine studies involving 6,502 participants (range 40-3,727) met the inclusion criteria. Interventions were single component Podiatry (two studies), multifaceted Podiatry (three studies), or multifactorial involving other components and referral to Podiatry component (four studies). Seven studies were conducted in the community and two in care homes. Quality assessment showed overall low risk for selection bias, but unclear or high risk of detection bias in 4/9 studies. Combining falls rate data showed significant effects for multifaceted Podiatry interventions compared to usual care (falls rate ratio 0.77 [95% CI 0.61, 0.99]); and multifactorial interventions including Podiatry (falls rate ratio: 0.73 [95% CI 0.54, 0.98]). Single component Podiatry interventions demonstrated no significant effects on falls rate. Conclusions multifaceted Podiatry interventions and multifactorial interventions involving referral to Podiatry produce significant reductions in falls rate. The effect of multi-component Podiatry interventions and of Podiatry within multifactorial interventions in care homes is unknown and requires further trial data. Prospero registration number CRD42017068300.
-
cost effectiveness of a multifaceted Podiatry intervention for the prevention of falls in older people the reducing falls with orthoses and a multifaceted Podiatry intervention trial findings
Gerontology, 2018Co-Authors: Belen Corbacho, Hylton B Menz, Anthony C Redmond, Sarah Cockayne, Caroline Fairhurst, Catherine Hewitt, Kate Hicks, Sarah E Lamb, C Macintosh, Sara RodgersAbstract:Background: Falls are a major cause of morbidity among older people. Multifaceted interventions may be effective in preventing falls and related fractures. Objective: To evaluate the cost-effectiveness alongside the REducing Falls with Orthoses and a Multifaceted Podiatry intervention (REFORM) trial. Methods: REFORM was a pragmatic multicentre cohort randomised controlled trial in England and Ireland; 1,010 participants (> 65 years) were randomised to receive either a Podiatry intervention (n = 493), including foot and ankle strengthening exercises, foot orthoses, new footwear if required, and a falls prevention leaflet, or usual Podiatry treatment plus a falls prevention leaflet (n = 517). Primary outcome: incidence of falls per participant in the 12 months following randomisation. Secondary outcomes: proportion of fallers and quality of life (EQ-5D-3L) which was converted into quality-adjusted life years (QALYs) for each participant. Differences in mean costs and QALYs at 12 months were used to assess the cost-effectiveness of the intervention relative to usual care. Cost-effectiveness analyses were conducted in accordance with National Institute for Health and Clinical Excellence reference case standards, using a regression-based approach with costs expressed in GBP (2015 price). The base case analysis used an intention-to-treat approach on the imputed data set using multiple imputation. Results: There was a small, non-statistically significant reduction in the incidence rate of falls in the intervention group (adjusted incidence rate ratio 0.88, 95% CI 0.73–1.05, p = 0.16). Participants allocated to the intervention group accumulated on average marginally higher QALYs than the usual care participants (mean difference 0.0129, 95% CI –0.0050 to 0.0314). The intervention costs were on average GBP 252 more per participant compared to the usual care participants (95% CI GBP –69 to GBP 589). Incremental cost-effectiveness ratios ranged between GBP 19,494 and GBP 20,593 per QALY gained, below the conventional National Health Service cost-effectiveness thresholds of GBP 20,000 to GBP 30,000 per additional QALY. The probability that the Podiatry intervention is cost-effective at a threshold of GBP 30,000 per QALY gained was 0.65. The results were robust to sensitivity analyses. Conclusion: The benefits of the intervention justified the moderate cost. The intervention could be a cost-effective option for falls prevention when compared with usual care in the UK.
-
Podiatry intervention versus usual care to prevent falls in care homes pilot randomised controlled trial the pirfect study
BMC Geriatrics, 2017Co-Authors: Gavin Wylie, Hylton B Menz, Sarah Mcfarlane, Simon Ogston, Frank Sullivan, Brian Williams, Zoe Young, Jacqui MorrisAbstract:Abstract Background Common foot problems are independent risk factors for falls in older people. There is evidence that Podiatry can prevent falls in community-dwelling populations. The feasibility of implementing a Podiatry intervention and trial in the care home population is unknown. To inform a potential future definitive trial, we performed a pilot randomised controlled trial to assess: (i) the feasibility of a trial of a Podiatry intervention to reduce care home falls, and (ii) the potential direction and magnitude of the effect of the intervention in terms of number of falls in care home residents. Methods Informed by Medical Research Council guidance on developing and evaluating complex interventions, we conducted a single blind, pilot randomised controlled trial in six care homes in the East of Scotland. Participants were randomised to either: (i) a three month Podiatry intervention comprising core Podiatry care, foot and ankle exercises, orthoses and footwear provision or (ii) usual care. Falls-related outcomes (number of falls, time to first fall) and feasibility-related outcomes (recruitment, retention, adherence, data collection rates) were collected. Secondary outcomes included: generic health status, balance, mobility, falls efficacy, and ankle joint strength. Results 474 care home residents were screened. 43 (9.1%) participants were recruited: 23 to the intervention, 20 to control. Nine (21%) participants were lost to follow-up due to declining health or death. It was feasible to deliver the trial elements in the care home setting. 35% of participants completed the exercise programme. 48% reported using the orthoses ‘all or most of the time’. Completion rates of the outcome measures were between 93% and 100%. No adverse events were reported. At the nine month follow-up period, the intervention group per-person fall rate was 0.77 falls vs. 0.83 falls in the control group. Conclusions A Podiatry intervention to reduce falls can be delivered to care home residents within a pilot randomised controlled trial of the intervention. Although not powered to determine effectiveness, these preliminary data provide justification for a larger trial, incorporating a full process evaluation, to determine whether this intervention can significantly reduce falls in this high-risk population. Trial registration ClinicalTrials.gov identifier: NCT02178527 ; Date of registration: 17 June 2014.
-
finding your feet the development of a Podiatry intervention to reduce falls in care home residents
Journal of Foot and Ankle Research, 2015Co-Authors: Gavin Wylie, Hylton B Menz, Simon Ogston, Frank Sullivan, Brian Williams, Zoe Young, Roberta Littleford, Joanne Coyle, Jacqui MorrisAbstract:People who live in care homes often fall. Foot and ankle muscle weakness, sub-optimal footwear, and common foot problems such as corns and hallux valgus are known and potentially modifiable contributory factors to falls in older people. Conducting a randomised controlled trial in a care home setting to address these issues is challenging and presents a number of uncertainties that need to be addressed prior to undertaking a phase III trial. Therefore, this study used a qualitative approach to assess the feasibility and acceptability of a Podiatry falls intervention to care home residents and staff. The data acquired during this qualitative preparatory phase will inform the conduct of a subsequent exploratory randomised controlled trial of a Podiatry intervention to reduce falls in care homes.
Jacqui Morris - One of the best experts on this subject based on the ideXlab platform.
-
Podiatry interventions to prevent falls in older people a systematic review and meta analysis
Age and Ageing, 2019Co-Authors: Gavin Wylie, Claire Torrens, Pauline Campbell, Helen Frost, Adam L Gordon, Hylton B Menz, Dawn A Skelton, Francis Sullivan, Miles D Witham, Jacqui MorrisAbstract:Background foot problems are independent risk factors for falls in older people. Podiatrists diagnose and treat a wide range of problems affecting the feet, ankles and lower limbs. However, the effectiveness of Podiatry interventions to prevent falls in older people is unknown. This systematic review examined Podiatry interventions for falls prevention delivered in the community and in care homes. Methods systematic review and meta-analysis. We searched multiple electronic databases with no language restrictions. Randomised or quasi-randomised-controlled trials documenting Podiatry interventions in older people (aged 60+) were included. Two reviewers independently applied selection criteria and assessed methodological quality using the Cochrane Risk of Bias tool. TiDieR guidelines guided data extraction and where suitable statistical summary data were available, we combined the selected outcome data in pooled meta-analyses. Results from 35,857 titles and 5,201 screened abstracts, nine studies involving 6,502 participants (range 40-3,727) met the inclusion criteria. Interventions were single component Podiatry (two studies), multifaceted Podiatry (three studies), or multifactorial involving other components and referral to Podiatry component (four studies). Seven studies were conducted in the community and two in care homes. Quality assessment showed overall low risk for selection bias, but unclear or high risk of detection bias in 4/9 studies. Combining falls rate data showed significant effects for multifaceted Podiatry interventions compared to usual care (falls rate ratio 0.77 [95% CI 0.61, 0.99]); and multifactorial interventions including Podiatry (falls rate ratio: 0.73 [95% CI 0.54, 0.98]). Single component Podiatry interventions demonstrated no significant effects on falls rate. Conclusions multifaceted Podiatry interventions and multifactorial interventions involving referral to Podiatry produce significant reductions in falls rate. The effect of multi-component Podiatry interventions and of Podiatry within multifactorial interventions in care homes is unknown and requires further trial data. Prospero registration number CRD42017068300.
-
Podiatry intervention versus usual care to prevent falls in care homes pilot randomised controlled trial the pirfect study
BMC Geriatrics, 2017Co-Authors: Gavin Wylie, Hylton B Menz, Sarah Mcfarlane, Simon Ogston, Frank Sullivan, Brian Williams, Zoe Young, Jacqui MorrisAbstract:Abstract Background Common foot problems are independent risk factors for falls in older people. There is evidence that Podiatry can prevent falls in community-dwelling populations. The feasibility of implementing a Podiatry intervention and trial in the care home population is unknown. To inform a potential future definitive trial, we performed a pilot randomised controlled trial to assess: (i) the feasibility of a trial of a Podiatry intervention to reduce care home falls, and (ii) the potential direction and magnitude of the effect of the intervention in terms of number of falls in care home residents. Methods Informed by Medical Research Council guidance on developing and evaluating complex interventions, we conducted a single blind, pilot randomised controlled trial in six care homes in the East of Scotland. Participants were randomised to either: (i) a three month Podiatry intervention comprising core Podiatry care, foot and ankle exercises, orthoses and footwear provision or (ii) usual care. Falls-related outcomes (number of falls, time to first fall) and feasibility-related outcomes (recruitment, retention, adherence, data collection rates) were collected. Secondary outcomes included: generic health status, balance, mobility, falls efficacy, and ankle joint strength. Results 474 care home residents were screened. 43 (9.1%) participants were recruited: 23 to the intervention, 20 to control. Nine (21%) participants were lost to follow-up due to declining health or death. It was feasible to deliver the trial elements in the care home setting. 35% of participants completed the exercise programme. 48% reported using the orthoses ‘all or most of the time’. Completion rates of the outcome measures were between 93% and 100%. No adverse events were reported. At the nine month follow-up period, the intervention group per-person fall rate was 0.77 falls vs. 0.83 falls in the control group. Conclusions A Podiatry intervention to reduce falls can be delivered to care home residents within a pilot randomised controlled trial of the intervention. Although not powered to determine effectiveness, these preliminary data provide justification for a larger trial, incorporating a full process evaluation, to determine whether this intervention can significantly reduce falls in this high-risk population. Trial registration ClinicalTrials.gov identifier: NCT02178527 ; Date of registration: 17 June 2014.
-
finding your feet the development of a Podiatry intervention to reduce falls in care home residents
Journal of Foot and Ankle Research, 2015Co-Authors: Gavin Wylie, Hylton B Menz, Simon Ogston, Frank Sullivan, Brian Williams, Zoe Young, Roberta Littleford, Joanne Coyle, Jacqui MorrisAbstract:People who live in care homes often fall. Foot and ankle muscle weakness, sub-optimal footwear, and common foot problems such as corns and hallux valgus are known and potentially modifiable contributory factors to falls in older people. Conducting a randomised controlled trial in a care home setting to address these issues is challenging and presents a number of uncertainties that need to be addressed prior to undertaking a phase III trial. Therefore, this study used a qualitative approach to assess the feasibility and acceptability of a Podiatry falls intervention to care home residents and staff. The data acquired during this qualitative preparatory phase will inform the conduct of a subsequent exploratory randomised controlled trial of a Podiatry intervention to reduce falls in care homes.
-
reflecting on the methodological challenge of recruiting older care home residents to Podiatry research
Journal of Foot and Ankle Research, 2015Co-Authors: Gavin Wylie, Hylton B Menz, Simon Ogston, Frank Sullivan, Brian Williams, Zoe Young, Roberta Littleford, Jacqui MorrisAbstract:Successful randomisd controlled trials (RCTs) require successful participant recruitment; poor recruitment leads to poor, under-powered studies, and may waste grant funds. Recruitment of older care home residents to RCTs is challenging. This is problematic for Podiatry, because older people within care home settings are high users of Podiatry services; therefore it is essential that strategies are employed to maximise recruitment to RCTs. We describe the experience of recruiting to a feasibility study of a Podiatry intervention to reduce falls in care home residents in the East of Scotland. This was the first phase of a two phase project consisting of the feasibility study to acquire data (recruitment strategy, selection of suitable outcome measures) to inform the conduct of the second phase, an exploratory RCT. Recruitment difficulties became apparent early in the study. Difficulties arose when it came to assessing whether or not potential participants fulfilled certain inclusion criteria: (1) Presence of foot pain (defined as foot pain lasting for at least a day in the last month and a positive response of “some days” or “most/every days” to at least one item on the Manchester Foot Pain and Disability Index (MFPDI)) (2) Ability to provide informed consent. The reasons for these difficulties are that (1) we discovered that in the area in which our study was conducted, the majority of care home residents receive basic NHS Podiatry care to treat any superficial lesions (i.e. pathological nails and skin callus) thus the prevalence of foot pain resulting from these lesions was lower than we had originally anticipated, and (2) the care homes that we engaged for this phase of the study had residents who were far more dependent and with much higher levels cognitive impairment than we anticipated, making obtaining informed consent difficult. Based on the existing inclusion criteria, it was deemed unlikely that we would meet our recruitment target for the subsequent exploratory randomised controlled trial (n=40).
Gavin Wylie - One of the best experts on this subject based on the ideXlab platform.
-
Podiatry interventions to prevent falls in older people a systematic review and meta analysis
Age and Ageing, 2019Co-Authors: Gavin Wylie, Claire Torrens, Pauline Campbell, Helen Frost, Adam L Gordon, Hylton B Menz, Dawn A Skelton, Francis Sullivan, Miles D Witham, Jacqui MorrisAbstract:Background foot problems are independent risk factors for falls in older people. Podiatrists diagnose and treat a wide range of problems affecting the feet, ankles and lower limbs. However, the effectiveness of Podiatry interventions to prevent falls in older people is unknown. This systematic review examined Podiatry interventions for falls prevention delivered in the community and in care homes. Methods systematic review and meta-analysis. We searched multiple electronic databases with no language restrictions. Randomised or quasi-randomised-controlled trials documenting Podiatry interventions in older people (aged 60+) were included. Two reviewers independently applied selection criteria and assessed methodological quality using the Cochrane Risk of Bias tool. TiDieR guidelines guided data extraction and where suitable statistical summary data were available, we combined the selected outcome data in pooled meta-analyses. Results from 35,857 titles and 5,201 screened abstracts, nine studies involving 6,502 participants (range 40-3,727) met the inclusion criteria. Interventions were single component Podiatry (two studies), multifaceted Podiatry (three studies), or multifactorial involving other components and referral to Podiatry component (four studies). Seven studies were conducted in the community and two in care homes. Quality assessment showed overall low risk for selection bias, but unclear or high risk of detection bias in 4/9 studies. Combining falls rate data showed significant effects for multifaceted Podiatry interventions compared to usual care (falls rate ratio 0.77 [95% CI 0.61, 0.99]); and multifactorial interventions including Podiatry (falls rate ratio: 0.73 [95% CI 0.54, 0.98]). Single component Podiatry interventions demonstrated no significant effects on falls rate. Conclusions multifaceted Podiatry interventions and multifactorial interventions involving referral to Podiatry produce significant reductions in falls rate. The effect of multi-component Podiatry interventions and of Podiatry within multifactorial interventions in care homes is unknown and requires further trial data. Prospero registration number CRD42017068300.
-
Podiatry intervention versus usual care to prevent falls in care homes pilot randomised controlled trial the pirfect study
BMC Geriatrics, 2017Co-Authors: Gavin Wylie, Hylton B Menz, Sarah Mcfarlane, Simon Ogston, Frank Sullivan, Brian Williams, Zoe Young, Jacqui MorrisAbstract:Abstract Background Common foot problems are independent risk factors for falls in older people. There is evidence that Podiatry can prevent falls in community-dwelling populations. The feasibility of implementing a Podiatry intervention and trial in the care home population is unknown. To inform a potential future definitive trial, we performed a pilot randomised controlled trial to assess: (i) the feasibility of a trial of a Podiatry intervention to reduce care home falls, and (ii) the potential direction and magnitude of the effect of the intervention in terms of number of falls in care home residents. Methods Informed by Medical Research Council guidance on developing and evaluating complex interventions, we conducted a single blind, pilot randomised controlled trial in six care homes in the East of Scotland. Participants were randomised to either: (i) a three month Podiatry intervention comprising core Podiatry care, foot and ankle exercises, orthoses and footwear provision or (ii) usual care. Falls-related outcomes (number of falls, time to first fall) and feasibility-related outcomes (recruitment, retention, adherence, data collection rates) were collected. Secondary outcomes included: generic health status, balance, mobility, falls efficacy, and ankle joint strength. Results 474 care home residents were screened. 43 (9.1%) participants were recruited: 23 to the intervention, 20 to control. Nine (21%) participants were lost to follow-up due to declining health or death. It was feasible to deliver the trial elements in the care home setting. 35% of participants completed the exercise programme. 48% reported using the orthoses ‘all or most of the time’. Completion rates of the outcome measures were between 93% and 100%. No adverse events were reported. At the nine month follow-up period, the intervention group per-person fall rate was 0.77 falls vs. 0.83 falls in the control group. Conclusions A Podiatry intervention to reduce falls can be delivered to care home residents within a pilot randomised controlled trial of the intervention. Although not powered to determine effectiveness, these preliminary data provide justification for a larger trial, incorporating a full process evaluation, to determine whether this intervention can significantly reduce falls in this high-risk population. Trial registration ClinicalTrials.gov identifier: NCT02178527 ; Date of registration: 17 June 2014.
-
finding your feet the development of a Podiatry intervention to reduce falls in care home residents
Journal of Foot and Ankle Research, 2015Co-Authors: Gavin Wylie, Hylton B Menz, Simon Ogston, Frank Sullivan, Brian Williams, Zoe Young, Roberta Littleford, Joanne Coyle, Jacqui MorrisAbstract:People who live in care homes often fall. Foot and ankle muscle weakness, sub-optimal footwear, and common foot problems such as corns and hallux valgus are known and potentially modifiable contributory factors to falls in older people. Conducting a randomised controlled trial in a care home setting to address these issues is challenging and presents a number of uncertainties that need to be addressed prior to undertaking a phase III trial. Therefore, this study used a qualitative approach to assess the feasibility and acceptability of a Podiatry falls intervention to care home residents and staff. The data acquired during this qualitative preparatory phase will inform the conduct of a subsequent exploratory randomised controlled trial of a Podiatry intervention to reduce falls in care homes.
-
reflecting on the methodological challenge of recruiting older care home residents to Podiatry research
Journal of Foot and Ankle Research, 2015Co-Authors: Gavin Wylie, Hylton B Menz, Simon Ogston, Frank Sullivan, Brian Williams, Zoe Young, Roberta Littleford, Jacqui MorrisAbstract:Successful randomisd controlled trials (RCTs) require successful participant recruitment; poor recruitment leads to poor, under-powered studies, and may waste grant funds. Recruitment of older care home residents to RCTs is challenging. This is problematic for Podiatry, because older people within care home settings are high users of Podiatry services; therefore it is essential that strategies are employed to maximise recruitment to RCTs. We describe the experience of recruiting to a feasibility study of a Podiatry intervention to reduce falls in care home residents in the East of Scotland. This was the first phase of a two phase project consisting of the feasibility study to acquire data (recruitment strategy, selection of suitable outcome measures) to inform the conduct of the second phase, an exploratory RCT. Recruitment difficulties became apparent early in the study. Difficulties arose when it came to assessing whether or not potential participants fulfilled certain inclusion criteria: (1) Presence of foot pain (defined as foot pain lasting for at least a day in the last month and a positive response of “some days” or “most/every days” to at least one item on the Manchester Foot Pain and Disability Index (MFPDI)) (2) Ability to provide informed consent. The reasons for these difficulties are that (1) we discovered that in the area in which our study was conducted, the majority of care home residents receive basic NHS Podiatry care to treat any superficial lesions (i.e. pathological nails and skin callus) thus the prevalence of foot pain resulting from these lesions was lower than we had originally anticipated, and (2) the care homes that we engaged for this phase of the study had residents who were far more dependent and with much higher levels cognitive impairment than we anticipated, making obtaining informed consent difficult. Based on the existing inclusion criteria, it was deemed unlikely that we would meet our recruitment target for the subsequent exploratory randomised controlled trial (n=40).
Peter A Lazzarini - One of the best experts on this subject based on the ideXlab platform.
-
evaluating the impact of high risk foot training on undergraduate Podiatry students
Journal of Foot and Ankle Research, 2013Co-Authors: Lloyd Reed, Damien Clark, Ewan M Kinnear, Peter A LazzariniAbstract:Background Diabetes is the leading cause of high risk foot (HRF) complications, admissions and lower limb amputation. Best practice training of podiatrists is known to have a beneficial impact on such outcomes; however, there has been a paucity of studies into undergraduate diabetes Podiatry training. The primary aim of this paper was to investigate the changes in final year Podiatry students’ confidence, knowledge and clinical practice in the management of HRF complications.
-
evaluating the impact of high risk foot training on undergraduate Podiatry students
Faculty of Health; Institute of Health and Biomedical Innovation, 2013Co-Authors: Lloyd Reed, Damien Clark, Ewan M Kinnear, Peter A LazzariniAbstract:Background Diabetes is the leading cause of high risk foot (HRF) complications, admissions and lower limb amputation. Best practice training of podiatrists is known to have a beneficial impact on such outcomes; however, there has been a paucity of studies into undergraduate diabetes Podiatry training. The primary aim of this paper was to investigate the changes in final year Podiatry students’ confidence, knowledge and clinical practice in the management of HRF complications. Methods This was a prospective longitudinal study of final year Podiatry students (n=25) at the Queensland University of Technology. All participants throughout 2011 undertook an intervention of a series of “hands on” HRF workshops, on-campus clinics and external clinical rotations. Outcome measures included customised confidence and knowledge surveys in HRF management across four time points. A timed simulated case scenario was used to evaluate changes in clinical practice at two time points. Friedman and Wilcoxon Signed Rank Tests were used to calculate differences between time points Results Overall improvements between the first and last time points were demonstrated in 20/21 confidence items (p<0.001), 12/27 clinical practice items (p<0.05) and 3/12 knowledge items (p<0.001). Although 8/12 knowledge items recorded high baseline scores of over 80%. Conclusions Overall, it appears student confidence and clinical practice improved with the introduction of designated HRF activities, whilst knowledge remained high. This suggests “hands on” practice and not didactic lectures improve students’ clinical confidence and practice. Results from the 2012 student cohort will also be presented at this conference.
Lloyd Reed - One of the best experts on this subject based on the ideXlab platform.
-
a qualitative evaluation of scalpel skill teaching of Podiatry students
Journal of Foot and Ankle Research, 2017Co-Authors: Ryan S Causby, Michelle N Mcdonnell, Lloyd Reed, Caroline Fryer, Susan HillierAbstract:Degrees in health disciplines need a balance of theoretical knowledge and sufficient clinical practice to meet registration requirements, in particular those requiring specialist skills such as the use of scalpels and other small instruments, such as Podiatry. However, despite this requirement there is a scarcity of literature and research to inform teaching of these particular manual clinical skills. Therefore, the aims of this study were to determine the current approaches being used to teach manual skills, in particular scalpel skills, in university Podiatry programs in Australia and New Zealand, and to explore what issues, challenges and innovations exist. A qualitative study, consisting of semi-structured interviews with staff at eight university Podiatry programs in Australia and New Zealand was undertaken to determine how these skills are taught and evaluated, and how poor performers are managed. A conventional content analysis technique was used to analyse and code interview data, with the resultant categories reported. Approaches to teaching manual clinical skills, in particular scalpel skills, appear to be consistent between university programs in Australia and New Zealand in utilising didactic-style content, demonstration, physical practice on inanimate objects and real skin, and often the use of supplementary audio-visual material. The main reported differences between programs were in methods and processes of practice, with controversy regarding the use of inanimate objects versus real skin for practice. Despite a lack of research and literature surrounding this topic, the approach to teaching is relatively consistent between programs with greatest disparity being the structure and duration of practice. Key issues for teaching staff in teaching manual skills were students’ clinical exposure, motivation, levels of anxiety and dexterity.
-
A qualitative evaluation of scalpel skill teaching of Podiatry students
BMC, 2017Co-Authors: Ryan S Causby, Michelle N Mcdonnell, Lloyd Reed, Caroline E Fryer, Susan L HillierAbstract:Abstract Background Degrees in health disciplines need a balance of theoretical knowledge and sufficient clinical practice to meet registration requirements, in particular those requiring specialist skills such as the use of scalpels and other small instruments, such as Podiatry. However, despite this requirement there is a scarcity of literature and research to inform teaching of these particular manual clinical skills. Therefore, the aims of this study were to determine the current approaches being used to teach manual skills, in particular scalpel skills, in university Podiatry programs in Australia and New Zealand, and to explore what issues, challenges and innovations exist. Methods A qualitative study, consisting of semi-structured interviews with staff at eight university Podiatry programs in Australia and New Zealand was undertaken to determine how these skills are taught and evaluated, and how poor performers are managed. A conventional content analysis technique was used to analyse and code interview data, with the resultant categories reported. Results Approaches to teaching manual clinical skills, in particular scalpel skills, appear to be consistent between university programs in Australia and New Zealand in utilising didactic-style content, demonstration, physical practice on inanimate objects and real skin, and often the use of supplementary audio-visual material. The main reported differences between programs were in methods and processes of practice, with controversy regarding the use of inanimate objects versus real skin for practice. Conclusions Despite a lack of research and literature surrounding this topic, the approach to teaching is relatively consistent between programs with greatest disparity being the structure and duration of practice. Key issues for teaching staff in teaching manual skills were students’ clinical exposure, motivation, levels of anxiety and dexterity
-
evaluating the impact of high risk foot training on undergraduate Podiatry students
Journal of Foot and Ankle Research, 2013Co-Authors: Lloyd Reed, Damien Clark, Ewan M Kinnear, Peter A LazzariniAbstract:Background Diabetes is the leading cause of high risk foot (HRF) complications, admissions and lower limb amputation. Best practice training of podiatrists is known to have a beneficial impact on such outcomes; however, there has been a paucity of studies into undergraduate diabetes Podiatry training. The primary aim of this paper was to investigate the changes in final year Podiatry students’ confidence, knowledge and clinical practice in the management of HRF complications.
-
evaluating the impact of high risk foot training on undergraduate Podiatry students
Faculty of Health; Institute of Health and Biomedical Innovation, 2013Co-Authors: Lloyd Reed, Damien Clark, Ewan M Kinnear, Peter A LazzariniAbstract:Background Diabetes is the leading cause of high risk foot (HRF) complications, admissions and lower limb amputation. Best practice training of podiatrists is known to have a beneficial impact on such outcomes; however, there has been a paucity of studies into undergraduate diabetes Podiatry training. The primary aim of this paper was to investigate the changes in final year Podiatry students’ confidence, knowledge and clinical practice in the management of HRF complications. Methods This was a prospective longitudinal study of final year Podiatry students (n=25) at the Queensland University of Technology. All participants throughout 2011 undertook an intervention of a series of “hands on” HRF workshops, on-campus clinics and external clinical rotations. Outcome measures included customised confidence and knowledge surveys in HRF management across four time points. A timed simulated case scenario was used to evaluate changes in clinical practice at two time points. Friedman and Wilcoxon Signed Rank Tests were used to calculate differences between time points Results Overall improvements between the first and last time points were demonstrated in 20/21 confidence items (p<0.001), 12/27 clinical practice items (p<0.05) and 3/12 knowledge items (p<0.001). Although 8/12 knowledge items recorded high baseline scores of over 80%. Conclusions Overall, it appears student confidence and clinical practice improved with the introduction of designated HRF activities, whilst knowledge remained high. This suggests “hands on” practice and not didactic lectures improve students’ clinical confidence and practice. Results from the 2012 student cohort will also be presented at this conference.