Postgraduate Diploma in Clinical Paediatric Physiotherapy

Purpose

The primary purpose of this Postgraduate Diploma in Clinical Paediatric Physiotherapy qualification would be to train and educate physiotherapists in the current knowledge and skills in different areas of paediatric care in a hospital setting, in order to enable them to deliver safe, effective and appropriate evidence-based health care practice as an independent practitioner within the multidisciplinary paediatric team.

Rationale

Children are admitted to secondary and tertiary healthcare centres for multiple reasons. Many children benefit from multi and inter-disciplinary care aimed at optimising their clinical and functional outcome and facilitating reintegration into their communities after being discharge. Some children may require intensive care in a complex environment whereby they have severe illnesses; require potent therapies to be administered and these therapies may pose severe side-effects. The equipment such as mechanical ventilation, while intended to be life-saving, can also be harmful and even lethal if used in appropriately. Health professionals working in paediatrics require particular skills in human and physical resource management and in risk assessment and management.

CIinical and research evidence consistently emphasises the importance of a well-functioning multidisciplinary team to safely navigate care through this highly complex setting. Health professionals-medical, allied health professionals and nurses-are all contributors to what is traditionally called the multidisciplinary 'team' but in effect get little training, or no training in how to function together and what is expected of them. This has led to the under-utilisation and under-recognition of the role of various health professionals in paediatric care in different settings.

In medicine, paediatric training is a specialisation. However, in ancillary disciplines such as Physiotherapy, newly qualified learners are allowed to work with children even though many undergraduate degrees only offer minimal, or no training in paediatric care. The risks of this are enormous in terms of safety and effectiveness of the care offered. The Postgraduate Diploma in Clinical Paediatric Physiotherapy would provide the necessary basis to enable safe and effective management of children in a range of conditions within a hospital setting.

Red Cross War Memorial Children's Hospital is unique in the African context in that it utilises a well-trained clinical multidisciplinary team, and together with institution, has a strong culture of research and training. Together with the Division of Physiotherapy at Groote Schuur Hospital, a unique interdepartmental programme focussing on postgraduate clinical training in the specialised field of paediatrics has been formulated.

This qualification proposes the specialised education and equipping of this multidisciplinary team of health professionals at a postgraduate level. It is believed that it is necessary to ensure that physiotherapists working with ill and disabled infants and children have sufficient theoretical, clinical and experiential knowledge and expertise. The institution and Red Cross War Memorial Children's Hospital are uniquely positioned to provide the necessary clinical training, learning opportunities and supervision required for this new group of clinical fellowships.

This qualification would fit in well with the "Third Arm" of the African Paediatric Fellowship Programme (APFP), which aims to extend the training programme to ancillary health therapists from across the African continent providing a unique resource for the African continent.

Recognition of Prior Learning (RPL)

RPL will be possible whereby specific existing knowledge and skills will be assessed in one or more of the courses, against the outcomes of the course and in line with the assessment procedures of the course.

Entry Requirements

Learners can apply for the Postgraduate Diploma in Clinical Paediatric Physiotherapy if they meet the following requirements:

• Bachelor of Science in Physiotherapy or equivalent qualification.
• The learner must be a qualified physiotherapist with some clinical experience in paediatrics.

This qualification consists of 2 compulsory modules at NQF Level 8, totalling 120 Credits.

• Clinical Management in Paediatric Physiotherapy, 90 Credits.
• Essay: Transition and Translation of Knowledge, 30 Credits.

1. Demonstrate an understanding of Basic Research Methods (including the ability to critically review and interpret scientific literature).
2. Demonstrate knowledge and understanding of normal and abnormal motor development.
3. Demonstrate an understanding of the Paediatric Hospital and Intensive care environment and the effect on the child and family.

Associate Assessment Criteria for Exit Level Outcome 1

• Information in the literature on paediatric physiotherapy is gathered, independently validated and evaluated.
• Using clinical discourse to relate understandable approaches to the holistic care of sick children is communicated.
• Own learning processes is managed in order to maintain the level of skills and knowledge attained and remain current with the latest literature on the subject.
• The clinical knowledge and skills gained throughout the training to the clinical situations of work environments is applied.
• Proper research protocols are followed.

Associate Assessment Criteria for Exit Level Outcome 2

• The spectrum of age-appropriate development and variations from typical for children from birth through adolescence is described.
• Major theories of development are identified.
• How the different developmental domains interact and influence one another at different stages of development is discussed.
• A child's typical progress in each of the behavioural domains is described and signs of abnormal development are identified.
• Specific paediatric behavioural, developmental and medical problems are diagnosed and managed using knowledge and insight about family development and family systems theory.
• Appropriate coping strategies used by children and their families to contend with illness and medical interventions, and common ineffective coping strategies, including non-compliance are recognised and differentiated.
• Standardised, validated and accurate developmental and behavioural screening instruments, plus skills in interview, exam and medical knowledge to identify patterns of atypical development is used.
• Select, perform and/or interpret appropriate clinical tests to establish a medical etiology of identified developmental and/or behavioural problems, such as.
• Demonstrate familiarity with commonly used clinical and psycho-educational testing used by specialists to evaluate and monitor children with developmental and behavioural problems.

Associate Assessment Criteria for Exit Level Outcome 3

• The functioning and interpretation of important ward and Pediatric intensive care unit (PICU) equipment is understood.
• A number of relevant paediatric medical and surgical conditions (needs to be translationally relevant to country of origin) are understood.
• The severely ill child is recognised, and appropriate course of action (referral, emergency care) is taken.
• The ill or disabled child is accurately assessed and appropriately handled.
• The role of Physiotherapy in achieving optimal patient outcomes is understood.
• The importance of a multidisciplinary team approach is understood.
• Knowledge of paediatric diseases and care and to own practice is translated.
• Techniques relevant to practice for managing ill and disabled children (acute and chronic) are applied.

Integrated Assessment

Assessment is both formative and summative. Formative assessment is built on continuous feedback on both knowledge and clinical competence. Knowledge is then applied and such application assessed in an extended essay. In addition learners are required to maintain a log-book of at least 50 procedures and/or cases. An exit examination will consist of an oral paper.