Abstract
Clare Delany, Elizabeth Molloy, eds., Clinical Education in the Health Professions, reviewed by Brenda Mori
Janet Carr, Roberta Shepherd, Neurological Rehabilitation: Optimizing Motor Performance, 2nd ed., reviewed by Meredith Smith
. 2015 Apr 16;67(2):215–216. doi: 10.3138/ptc.67.2.215
Physiother Can. 2015 Apr 16;67(2):215. doi: 10.3138/ptc.67.2.rev1
Edited by Dr. Clare Delany and Dr. Elizabeth Molloy, Clinical Education in the Health Professions is a well-constructed resource that recognizes the complexity of teaching and learning in the clinical environment. It provides theory, context, and examples that demonstrate why the role of the clinical educator should be “recognised and promoted as one that empowers students to be active, engaged and mature learners” (p. vii).
The book is well organized; tables and diagrams summarizing information within the text are supplemented by practical examples in a user-friendly format. Each chapter begins with theories relevant to the content in that chapter, followed by guidance on using theory in curriculum design and research, and then uses theory to drive practical examples in clinical education. The text is organized into three parts: “Examining Knowledge—Theoretical Perspectives about Knowledge Construction”; “Sharing Knowledge—Communities and Culture in Education”; and “Applying Knowledge—Teaching and Learning Practices.” Part 1 includes an important chapter on critical reflection (Delany and Molloy), which sets the tone by describing clinical educators' valuable role in fostering the development of reflective health care professionals. The authors' use of examples and discussion on modelling iterative critical reflection is key in clinical education.
Part 2 includes a chapter on inter-professional education (IPE) (Davidson, Smith, and Stone), now a focus of many health professional education programmes. Davidson and colleagues describe the history of IPE and present definitions contrasting IPE with multi-professional education in a clear, succinct, and very useful matrix on the various degrees of “inter-professionality.” This chapter also includes case examples of IPE in practice.
Part 3 includes several useful chapters; in my opinion, the chapters on clinical reasoning (chapter 7, by Ajjawi and colleagues) and on giving and receiving feedback (chapter 8, by Molloy) are particularly useful to clinical educators and administrators of clinical education, as both are challenging concepts for clinical educators. Chapter 7's description of a stage theory of expertise development and of different models of clinical reasoning, reinforced with examples, help to clarify a complex concept. In chapter 8, I found the tips and resources on how clinical education can foster clinical reasoning very pertinent, and particularly enjoyed the component on reconceptualization of feedback as well as the authors' recommendations, which I believe will inspire clinical educators to take a positive view of giving and receiving feedback and encourage them to empower students to be active, engaged, and mature learners.
Overall, Clinical Education in the Health Professions provides a comprehensive review of educational and other relevant theories, demonstrates how theory can inform curriculum design, and provides practical examples to show how readers can apply the concepts to their own clinical education practice. This is a valuable reference for any health professional involved in clinical education, and especially for those who lead and design clinical education in health professional curricula.
Physiother Can. 2015 Apr 16;67(2):215–216. doi: 10.3138/ptc.67.2.rev2
This second edition of Neurological Rehabilitation: Optimizing Motor Performance provides a practical, task-oriented approach to rehabilitation for clients with neurological conditions, emphasizing active participation by clients and providing details of exercises and training to challenge them and help them regain the strength and endurance needed for independent living. In the new edition, authors Janet Carr and Roberta Shepherd have included updated scientific evidence as well as input from colleagues whose research and clinical expertise are also in this area of practice. Neurological Rehabilitation is also innovative in discussing the need to expand rehabilitation to increase opportunities for practice by including semi-supervised groups and circuit training in addition to traditional one-to-one interventions.
The book is divided into three parts. Chapters 1–3 provide a foundation for understanding the role of neuro-rehabilitation in recovery. Chapter 1 reviews plasticity in the brain and the role of practice and challenge in brain reorganization; chapter 2 builds on this by discussing task-specific practice, the principles of motor learning, and clinical applications of these principles in neuro-rehabilitation. Chapter 3 provides an overview of measurement tools commonly used in neuro-rehabilitation.
Part 2 devotes one chapter to each of the following specific actions required for independent living: standing up and sitting down, walking, reaching and manipulation, and balancing. Each chapter describes the action and the biomechanical factors, the motor dysfunction that occurs following neurological injury, and practical methods for training, focusing on repetitive task-oriented training, functional strength training of task-related muscles, and maximizing skills with practice and variety. The information on training is applicable to patient care, but because it focuses on clients who are able to perform the action, there is less guidance for working with those who are unable to do so, or who need to work on other tasks such as getting out of bed.
Part 3 covers lesions to the motor and sensory–perceptual systems and includes detailed chapters on stroke, traumatic brain injury, Parkinson's disease, and multiple sclerosis. Each chapter discusses the pathology of the lesion or condition, resulting clinical features, training, and specific assessments. The recommended management consistently includes specific exercises and task-specific and aerobic training.
Throughout, Carr and Shepherd also provide information on supplementary methods for rehabilitation, including mental practice, orthosis, electrostimulation, and computerized aids, and discuss the evidence-based benefits of including these methods in management strategies. Photos of exercises, clients, and clinicians working with clients complement the text and are helpful for applying the information clinically.
Neurological Rehabilitation: Optimizing Motor Performance is an excellent book for a practical, task-oriented approach to neuro-rehabilitation, and I would recommend it as one of the key resources for working with clients with neurological conditions. However, additional resources may also be useful, since this book focuses on the task-oriented approach and offers little information or evidence on other approaches. Because of its rehabilitation focus, Neurological Rehabilitation will be most beneficial to physical therapy students, new graduates and experienced clinicians who work in neuro-rehabilitation, but other health care professionals and physical therapists in other settings may also find it helpful for the detailed information it provides on neurological injury and recovery. Overall, Neurological Rehabilitation balances evidence with clinical application, provides a foundation of knowledge for neuro-rehabilitation as well as methods for promoting motor learning and plasticity, and encourages readers to think about changing the delivery of therapy to enhance learning and recovery.