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| EDITORIAL |
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| Year : 2022 | Volume
: 4
| Issue : 2 | Page : 87-89 |
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Physiotherapy education in India – Past, present, and future
Snehal Dharmayat1, Santosh Metgud2
1 Department of Community Physiotherapy and Rehabilitation, KAHER Institute of Physiotherapy, Belagavi, Karnataka, India
2 Department of Orthopaedic Manual Therapy, KAHER Institute of Physiotherapy, Belagavi, Karnataka, India
| Date of Submission | 09-Dec-2022 |
| Date of Decision | 17-Dec-2022 |
| Date of Acceptance | 20-Dec-2022 |
| Date of Web Publication | 19-Jan-2023 |
Correspondence Address:
Dr. Snehal Dharmayat
Department of Community Physiotherapy and Rehabilitation, KAHER Institute of Physiotherapy, Belagavi, Karnataka
India
 Source of Support: None, Conflict of Interest: None
DOI: 10.4103/ijptr.ijptr_184_22
How to cite this article:
Dharmayat S, Metgud S. Physiotherapy education in India – Past, present, and future. Indian J Phys Ther Res 2022;4:87-9 |
“Education is not the learning of facts but the training of mind” - Albert Einstein.
As rightly stated by Einstein, education is training the mind to see and understand things in depth and making informed decisions based on the understanding gained.
Physiotherapy is largely a skill-based profession which deals with alleviating pain and improving functional independence/outcomes of patients suffering from various conditions, right from the neonatal to geriatric age groups. It requires an in-depth understanding of the human anatomy, physiology, the disease process, and how it affects the functioning of an individual. Physiotherapy has been in existence from ancient times, although it was not formally documented or termed as physiotherapy or physical therapy.[1],[2]
In India, formal physiotherapy education began in the early 1950s with the outbreak of Polio in India leading to the establishment of the 1st school for training physiotherapists in Mumbai with help from the World Health Organization.[1] Thereafter, there has been an exponential increase in the number of institutions providing physiotherapy education across the country. It began as a diploma course of 3 years' metamorphosing into a graduate course, presently of 4½ years duration along with 2 years of postgraduation, with some institutes also offering doctoral programs.[3]
The teaching or training methods followed in institutes across the country have largely been traditional, such as classroom teaching and hands-on and bedside clinical training, till the late 2000s when Physiotherapy education saw a change with the advent of technology in teaching and learning. An extensive use of the then novel AV aids such as MS PowerPoint and videos were used by a few tech-savvy teachers. This later percolated to almost all teachers and became a common feature with widespread use by teachers and students alike.
The teaching programs in the western countries have been using a variety of teaching methods including blended learning, problem-based learning (PBL), case-based learning (CBL), and flipped classroom for many years in their undergraduate (entry-level education) and/or the postgraduate program.[4] Self-directed learning and reflective learning have been used in medical education to enhance retention among students. Curricular changes in physiotherapy also lead to changes in teaching methods being adopted by institutes in India.[5]
With the introduction of competency-based education in medical education in 2019, there has been a shift in the teaching and assessment methods to match and evaluate the competencies specified.[6] A similar change has also occurred in Physiotherapy education with the proposal to introduce outcome-based curriculum in physiotherapy[7] which has already been implemented in some universities/institutes across the country. The COVID-19 pandemic further enhanced the change in the way education is imparted in our country, including Physiotherapy.[8],[9]
There has been a sudden and large-scale surge in the use of technology in teaching–learning following the pandemic which has been favorable in certain aspects such as information dissemination with access to technology being easily available in even rural areas of the country. The learning of certain skills such as patient evaluation, communication, and critical thinking has been largely affected, though, due to the restrictions imposed by the pandemic.[10] These skills are of core importance in a skill-based health-care profession such as Physiotherapy.
The present generation of students is the so-called “Gen Z” protégées who are impatient, easily distracted, more demanding in terms of relatability of education to their everyday lives and profession who need to be engaged differently for effective learning to occur and produce favorable outcomes in terms of quality patient care and health-care services in general.[11]
This calls for the introduction and adoption of newer/innovative methods of teaching such as simulated patients, flipped classroom, blended learning, PBL, and CBL. These are proven methods to enhance student learning as they engage students actively in the process of learning and put the onus/responsibility of the outcome on them rather than on the teacher. These methods, though appearing difficult or impossible to implement initially, are cost-effective and active strategies to facilitate student learning and fulfillment of course and program outcomes.[12]
Skill laboratories are the next best method to empower students with the necessary skills for patient care in the present-day scenario. Simulation laboratories can also serve the purpose. These methods, though expensive, require only an initial investment which can be used by generations of students with minor modifications incorporated with the changing times. Simulation and skill laboratory-based training have been proven to be effective in producing favorable learning outcomes in students in the western countries.[13],[14]
Assessment or evaluation of students is the other important component in the curriculum which needs to change and be more relevant with changes in the teaching and training methods and also to the students to facilitate the desired outcomes.
Traditional methods of evaluation have been the written examination and the practical examination which unfortunately also looks at the cognitive or knowledge/theoretical domain more than the psychomotor or skills domain, leading to students concentrating more on theory rather than practicing skills. In lieu of the outcome-based curriculum, assessment methods such as objective structured practical examination, objective structured clinical examination, workplace-based assessments such as mini-clinical evaluation exercise, directly observed practical skills, and objective structured assessment of technical skills are more pertinent methods. These methods have been documented to be effective in evaluating the intended outcome. They can also be used as teaching methods to train students in improving their skills.[15]
In order to achieve/facilitate higher-order thinking and/or critical thinking in students, methods such as the Extended Matching Items, Objective Structured Long Examination Record, Structured Viva Cards can be used. These methods provide a certain level of fairness and objectivity in the evaluation and can also be used to provide feedback to students which facilitates better learning.
Skill-based professions such as Physiotherapy need to constantly evolve with changing times in the way the skills are imparted to the students and the methods of evaluation for them to be relevant. Simulation-based training and use of simulated patients in cost-effective skill laboratories are the way forward for teaching in physiotherapy to ensure relevance to students and patients alike and also to ensure uniformity and quality of graduates.
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| 11. | Alexander J, Barcellona M, McLachlan S, Sackley C. Technology-enhanced learning in physiotherapy education: Student satisfaction and knowledge acquisition of entry-level students in the United Kingdom. Res Learn Technol 2019;27:2073. |
| 12. | Ødegaard NB, Myrhaug HT, Dahl-Michelsen T, Røe Y. Digital learning designs in physiotherapy education: A systematic review and meta-analysis. BMC Med Educ 2021;21:48. |
| 13. | Sandoval-Cuellar C, Alfonso-Mora ML, Castellanos-Garrido AL, Del Pilar Villarraga-Nieto A, Goyeneche-Ortegón RL, Acosta-Otalora ML, et al. Simulation in physiotherapy students for clinical decisions during interaction with people with low back pain: Randomised controlled trial. BMC Med Educ 2021;21:375. |
| 14. | Mori B, Carnahan H, Herold J. Use of simulation learning experiences in physical therapy entry-to-practice curricula: A systematic review. Physiother Can 2015;67:194-202. |
| 15. | Sakurai H, Kanada Y, Sugiura Y, Motoya I, Wada Y, Yamada M, et al. OSCE-based clinical skill education for physical and occupational therapists. J Phys Ther Sci 2014;26:1387-97. |
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