In March 2020, COVID-19 restrictions prompted services delivered by student-led clinics in the university sector to transition to telehealth. This provided a unique opportunity to explore the challenges and opportunities faced by clinical educators when supervising students to deliver telehealth.Semi-structured interviews were conducted with allied health clinical educators who supervised students on clinical placement who were required to provide services via telehealth. Clinical educators across the disciplines of audiology, occupational therapy, physiotherapy, and speech pathology were asked to reflect on their experiences and perceptions of the rapid transition to a telehealth model for student clinical placements. A content analysis approach was used to analyse qualitative data.From the perspective of clinical educators, student-led telehealth services can effectively meet client needs while achieving student learning outcomes. This study highlights many opportunities for student learning via telehealth in the clinical education environment and the role of the clinical educator in the learning experience.
Introduction: This study explores allied health students’ experience with and perceptions of telerehabilitation prior to and following the rapid transition of university clinical placements to telerehabilitation due to COVID-19. Methods: Semi-structured interviews were conducted with allied health students who had completed a clinical placement (between March and September 2020) at the University of Queensland that was rapidly transitioned to telerehabilitation due to COVID-19. Students were asked to report on their pre-conceptions, lived experience and post placement reflections of delivering consultations via telerehabilitation rather than in-person. Qualitative data were analysed using thematic content analysis. Results: 18 students (72% female, 20 to 31 years of age) from speech pathology (39%), physiotherapy (39%), occupational therapy (11%) and audiology (11%) conducted telerehabilitation consultations. Reflections on preconceptions of telerehabilitation nested under four themes: clinical effectiveness, interacting/communicating via telerehabilitation, technology and anticipation about a telerehabilitation placement. Experiences during placement clustered under similar topics of clinical effectiveness, interacting/communicating, practical aspects and technology. Reflections upon completion of placements related to experience in a global pandemic, benefits of combining technology and telerehabilitation, convenience, future use and knowledge, skills, and confidence with telerehabilitation. Conclusion: Despite initial concerns, students were able to rapidly transition to telerehabilitation and effectively deliver quality care, modify techniques, and achieve positive client outcomes. Student skills, knowledge and confidence improved with rapid exposure through learning “on the go”, and many indicated willingness to continue to use telerehabilitation in the future.
Amyotrophic lateral sclerosis damages proteostasis, affecting spinal and upper motor neurons earlier than a subset of cranial motor neurons. To aid disease understanding, we exposed induced cranial and spinal motor neurons (iCrMNs and iSpMNs) to proteotoxic stress, under which iCrMNs showed superior survival, quantifying the transcriptome and proteome for >8,200 genes at 0, 12, and 36 h. Two-thirds of the proteome showed cell-type differences. iSpMN-enriched proteins related to DNA/RNA metabolism, and iCrMN-enriched proteins acted in the endoplasmic reticulum (ER)/ER chaperone complex, tRNA aminoacylation, mitochondria, and the plasma/synaptic membrane, suggesting that iCrMNs expressed higher levels of proteins supporting proteostasis and neuronal function. When investigating the increased proteasome levels in iCrMNs, we showed that the activity of the 26S proteasome, but not of the 20S proteasome, was higher in iCrMNs than in iSpMNs, even after a stress-induced decrease. We identified Ublcp1 as an iCrMN-specific regulator of the nuclear 26S activity.
Clinical placements in 2020 have been significantly impacted by the COVID-19 global pandemic. Ensuring that effective clinical placement opportunities continue during this time remains the priority of the Clinical Education Managers Australia and New Zealand (CEMANZ). Supporting educators to assess student competency when service delivery models are altered to embrace telehealth services, has been integral to achieving this. Telehealth has been widely adopted to maintain services and contact with patients during the pandemic. Physiotherapy clinical educators voiced concern about the applicability of the Assessment of Physiotherapy Practice (APP) tool in this emerging learning environment and sought guidance from University Clinical Education Managers. This paper describes representative consensus across Universities regarding use of the Assessment of Physiotherapy Practice (APP) tool and the development of adapted APP performance indicators for use in telehealth. Clinical educators can use these adapted performance indicators to guide assessment of student competency for students completing placements in a telehealth setting.