This learning module will focus on interdisciplinary education, collaborative learning practices and how to use technology to create online collaborative interdisciplinary opportunities for students.

The content was created from the information discussed in the literature reviews (Len, 2020; Len, 2020; Len, 2019) completed by Dr. Len as part of her EdD coursework.  These reviews looked at trends within physical therapy education, student learning and use of technology in academia. This line of inquiry was inspired by Dr. Len's personal experiences, first as a student learning physical therapy (PT) content, followed by fifteen years of serving as a Master clinician and clinical instructor for PT students and currently as an Adjunct Faculty at New York University (NYU) Doctor of Physical Therapy program.

This learning module is meant to be an introductory course for instructors interested in exploring how to use the affordances of virtual platforms - Learning Management System to promote online collaborative learning opportunities. Interdisciplinary education will be the focus of this course with the goal to help physical therapy instructors’ structure virtual experiences that will enable participants gain insight in the roles of various rehabilitative and health allied specialists.

Learning Objectives:
*By the end of the course the Learners will be able to:

• understand the importance of collaborative learning experiences for future health care professionals
• explain the affordances that an online platform offers its participants
• demonstrate understanding of how to choose technology to support educational goals
• develop a virtual exercise for interdisciplinary educational content

Learning Outcomes:
*This learning module is most appropriate for physical therapy educators and therapists, but can be beneficial for any health care professional or administrator involved in creating collaborative learning environments.

*Course duration is 6 weeks.

*Basic understanding of physical therapy curriculum and at least 1 year experience in teaching is needed.

*Successful completion of the course includes review of all presented materials, peer engagement through submission of comments and participation in collective intelligence work through Learners updates prompted by Administrator updates. Completion of group project with rubric for self- and peer- review. Completion of one shot design post-course survey. 

Physical therapists are movement specialists whose role intertwines with many other health professions. Video demonstrates the tremendous variety of settings that physical therapy students will be expected to perform in when they become licensed professionals.

_{(American Physical Therapy Association, 2010)}

Therapists in the video mentioned 'thinking, analytical skills, problem solving skills" as requirements to ensure a PT can create an effective treatment plan for the patients with based available evidence. In addition to learning content knowledge and developing mentioned skills, PTs are expected to be advocates and innovators. 

Physical therapists are part of a rehabilitative team where each specialty is responsible to not only provide treatment which follows guidelines of their respective professions’ best practices, but also to make appropriate referrals to other team members when necessary. Understanding of each team members role is cruicial to esure a holistic treatment plan for the patients. 

In US, the model of interdisciplinary practice was first promoted in 1960s by Magraw (the Deputy Assistant Secretary for Health Manpower in Department of Health, Education, and Welfare) and was in response to division of responsibilities to various specialties within the healthcare field (Magraw, 1968).

Attachments below are the original Magraw (1968) article and a compilation of images from this article were used to create a diagraph to demonstrate Magraw's take on the transition of healthcare participants experience through history (Len, 2020).

_{Magraw, R. M. (n.d.). Interdisciplinary teamwork for medical care and health services. Components and organization. Annals of Internal Medicine, 69(4), 821–835. https://doi-org.proxy.library.nyu.edu/10.7326/0003-4819-69-4-821}

_{(A. Len, Ed., 2020)} 

Magraw's 1968 article and images highlighted the change that has occurred in health care field regrading the growing number of professionals that maybe involved the individual patients' care. Magraw's proposed healthcare model geared to achieve "a comprehensive, community-wide, program-oriented approach to care" (Lavin, 2001, p.28). The goal was to allow for multilevel healthcare but offer centralized coverage for the treatment. This 'total package" solution for the patients would also ensure collaboration and communication across specialties involved in each patient case (Magraw, 1968).

The new interdisciplinary focus posed educational considerations for allied health programs and 1960's publications note an emergence of research on the topic of interdisciplinary education (Lavin, et al., 2001).

COMMENT: Share your experience of learning or being treated by a healthcare team versus a sole provider. (200 words)

UPDATE: Find and share a resource that demonstrates an example of a interdiciplinary practice. (500 words)

*Comment on three peer updates (50 words each)

Additional resources can be found in each respective professional associations.

Physical Therapy Assoc. https://www.apta.org/

Occupational Therapy Assoc. https://www.aota.org/

Speech and Language Therapy Assoc. https://www.asha.org/

Nursing Assoc. https://www.nursingworld.org/ana/

Medical Assoc. https://www.ama-assn.org/

Chiropractic Assoc. https://www.acatoday.org/

Massage Assoc. https://www.amtamassage.org/

Dental Assoc. https://www.ada.org/

Despite significant technological advancements, traditional pedagogical approach is still the most commonly used in higher education. Literature (Len, 2019) supports that physical therapy students would benefit from a pedagogical approach which includes a variety of activities when learning presented content.

Research assessing learning styles of PT students demonstrates their preference for 'active/ hands on' and 'think and watch' learning style (Lowdermilk, 2017; Pei-Jung, 2013; Stander, 2019). There is also evidence that entry-level DPT students specifically are multimodal learners (Brudvig, 2019). This group would benefit from pedagogical approach which includes a variety of activities when learning presented content. Presenting information in one way only will put at disadvantage 80% of the class.

Below is a video which discusses the principals of Multimodal Learning.

_{(Principles of Multi-Modal Learning, 2015)}

Considering learner differences, preference for content delivery and assessment framework when developing a curriculum would improve and enhance educational experience. 

It is important to note that lack of consistency in using the same learning style instrument across all DPT programs to have comparable information. There is a need for further studies looking at the association between learning styles and various pedagogical approaches. As per sparse publications, students' performance does not seem to be impacted across four learning style (Pei-Jung, 2013) however, the interview confirmed 'specific characteristics of favorite and disliked courses among students with different learning styles'. There is also data demonstrating a significant but weak correlation to critical thinking skills acquisition (Brudvig, 2019). More studies are needed with valid assessment tools to make any conclusions on these associations.

What is clear from research so far is that traditional style or a single style of information delivery does not compliment PT students learning preferences (Lowdermilk, 2017; Brudvig, 2019; Stander, 2019). While students find a way to be successful in the program despite outdated information delivery, it is important to also consider students' perception and preferences for learning.

In order to address the future of PT education goals (Davis & Tschoepe, 2016), it is critical to create opportunities of learning with other discipline professionals. Physical therapy, occupational therapy, social work and nursing students have similar learning preferences (Katz & Heimann, 1991). This creates an opportunity to design lectures and experiences where students from different disciplines are learning together, mimicking the real time practices.

COMMENT: Share an idea that this material prompted. (200 words)

UPDATE: Share your most memorable educational experience as a student or instructor and which framework, modes were used (500 words)

*Comment on three peer updates. (50 words each)

Additional Resources:

Evolution of Physical Therapy Education (Len, 2019)

Learning Styles of Physical Therapy Students (Len, 2020)

Assessments in Physical Therapy Programs (Len, 2020)

"Cooperative and collaborative learning is an instructional framework in which peers work together on a learning task, with the goal of all participants benefiting from the interaction" (O'Donnell, 2005). The video below describes the cooperative and collaborative learning theory.

_{(Cooperative vs Collaborative, 2018)}

Author explains that cooperative learning is often seen in younger participants and serves as the base which allows for collaborative learning when participants mature.

Trietiak (2020) literature review points to the work of Harasim (2012) as cited by Bates (2015) These authors offer the following definition of Online Collaborative Learning (OCL):

Online collaborative learning theory provides a model of learning in which students are encouraged and supported to work together to create knowledge: to invent, to explore ways to innovate, and, by so doing, to seek the conceptual knowledge needed to solve problems rather than recite what they think is the right answer (paras 1).

The following diagram is Bates' (2015) Online Collaborative Learning model which demonstrates the role of the instructor/teacher as the facilitator/moderator in this student-centered learning experience

_{(Bates, 2015)}

Some of the recommendations to improve online collaborative learning experience recommended by Scager et al. (2016) as cited by Trietiak (2020) include:

• small group size (3-5 students)
• group composition (diverse perspectives, if mixed abilities - equal participation)
• nature of the task (complex just right challenge)
• social interaction (discussing, debating, explaining ideas

Designing a curriculum that ensures that Doctor of Physical Therapy (DPT) students are prepared for the future of working as part of the interdisciplinary team has been explored since the 1960s. Physical therapy students' understanding of their role and the role that other specialists have in the rehabilitation process is imperative to becoming effective advocates for their patients. Interdisciplinary collaborative experiences as part of students' learning would offer an opportunity to learn and practice all mentioned skills. Two approaches from literature are highlighted below.

Multidisciplinary Educational Model

Lary et al. (1997) developed a three-phase multidisciplinary education model utilizing concepts of problem-based learning (PBL):

• Phase I introduced discipline specific information, team concepts, and PBL concepts.
• Phase II involved students working in multidisciplinary teams solving a simulated patient case in the PBL format.
• Phase III consisted of students working in small groups and on real patients, performing an extraoral/intraoral and periodontal examination, a problem oriented physical examination, and a neuromuscular assessment. (p. 63-69)

Diagram below demonstrates the difference between the traditional approach and problem-based learning (PBL) approach to learning.

_{(Problem Based Learning, 2009)}

Traditional approach focuses on challenging memorization skills of students and then learn how to apply these concepts during hands on field experience. In PBL the focus is on identifying pertinent information that is needed to solve presented problem.

Lary et. al (1997) found that all of participants (student dental hygienist, student physical therapist, student physician assistant) reported positive results. Phase II and Phase III was specifically effective in delivering multidisciplinary material, student reported enhanced problem solving and improvement with group work.

The drawback of utilizing PBL is that it requires significant cross departmental coordination to bring students together for the in-person experience. Feasibility for this type of program to be ongoing would require resource and staff allocation so that students can be supported during the experience and ensure patients' safety. The use of patient simulations or standardized electronic patients has emerged. The use of technology to allow for ongoing communication of the students across departments on cases maybe a good avenue to explore.

Community Based Program Model

Lough et al. (1996) and Edwards and Smith (1998) promoted the use of community-based programs as clinical models for interdisciplinary health professional education.

Nilsen (2006) examined the theory and success of community-based programs and concluded that while the programs are meant to target a specific geographical area and develop a plan making certain assumptions, areas actually are heterogeneous and have a weak sense of community. Program development does not yield sufficient reach and programs do not function at an optimum level, thus demonstrating effectiveness becomes difficult.

COMMENT: Discuss benefits to collaborative learning within academic or healthcare setting. (200 words)

UPDATE: Share an own experience or summarize a peer reviewed article on the use of collaborative learning framework in the healthcare education. (500 words)

*Comment on three peer updates (50 words each)

Technology affordances offer new possibilities on how we can deliver interdisciplinary content. We reached a point where are no longer confined to a single geographical location to teach students about collaboration, or the requirement to engage them all at a specific time of day in order to promote interdisciplinary collaborative learning. In the video below, Dr. Cope discusses 7 affordance technology offers us. 

_{(cope, B., 2014)}

The use of technology such as online collaborative tools and learning management system create opportunities for interdisciplinary learning work. For example, through engaging in a problem-based activity with peers from allied health professions, students would have an opportunity to learn about roles of other specialists and gain skills of how to collaboratively work on a treatment plan as part of interdisciplinary team. It is also imperative to develop ways to enhance our students learning experience, address learner difference and prepare all health students for interdisciplinary practice. Scager (2016) reported that using Learning Management Systems in interdisciplinary education allows for participants to have diverse perspectives (specialties) and tackle complex tasks (ie electronic patient) as a group through discussion, debating and explanation of ideas.

Now that we understand the value of technology it is important to discuss online platforms may face some barriers. The cost of technology, access to internet and support required for software are a few already mentioned in literature as a deterrent to incorporate these platforms in education. Tarun (2019) and Appavoo et al. (2019) as cited by Trietiak (2020) list "lack of features which influence usability... inability to customize certain tools to meet participants needs... (as well as) coordination challenges when faced with professional and family-related commitments" are additional barriers that facilitator should consider when choosing a collaborative tool to enhance student learning.

COMMENT: Discuss benefits to using technology within academic or healthcare setting. (200 words)

UPDATE: Share and summarize a peer reviewed article or own experience using technology for collaboration in the healthcare or academic setting. (500 words)

*Comment on three peer updates. (50 words each)

Online platforms remove barriers that face to face interactions require -- travel to a single location, participants' availability at a specific time, and space requirements. Having said that, affordability and usability concerns have been raised in literature when implementing technology for education purposes.

Keeping in mind both benefits and barriers of technology, we should remember that these tools alone do not support academic success and there must be purposeful pedagogy to support meaningful learning. When faced with the option to incorporate technology into the classroom Huges (2018) encourages to reflect on the following questions:

• Does the use of technology make the activity more efficient?
• Does the use of technology enhance something already done in the classroom?
• Does the use of technology allow something to be done that is not otherwise possible? (p. 299)

Len, A (2020) literature review revealed that there is a significant gap in literature assessing the use of LMS to create interdisciplinary experiences for physical therapy students.

Technology is here to assist with developing or customizing the platform where physical therapy students can learn alongside other allied professions. Online collaborative opportunities allow for development of skills required for working as part of interdisciplinary team. These valuable skills emerge through engaging students in collaborative learning opportunities such as discussion of electronic patients even without traditional lecturing of what each specialty does.

Update 6 demonstrates the use of MS Teams where a single private channel is dedicated as an electronic patient’s case. Members of the channel include students and professionals including: occupational, physical and speech therapy field. Within the channel students create multimodal updates in response to a prompt and licenses therapists offer feedback on the posts along with peers. Below is an image from the channel.

_{(Len, 2020)}

Students are able to attach slides, images, links to videos and explain their clinical reasoning in response to each prompt. Replies are grouped for each prompt allowing to concurrent work in each update.

Below is a video which offers an overview of MS teams and specifically the use of channels function. 

_{(Microsoft, 2019)}

Technological advances afford extraordinary opportunity we have never had before for collaborative learning across generations of therapists, across countries and across disciplines. It is imperative that allied health education focuses its future work on how our Health Professions Education Vision can be supported and enhanced with technology.

GROUP WORK:

1) Group project- Case development: Choose an learning management system or an application. Set up an electronic patient case with input from each discipline. *See example in Update 6.

2) Applied work: Share the case with another group and guide them through critical reasoning when creating a treatment plan for your case on the platform. 

*Rubric below will guide you through self-review  during case development portion of this work and peer-review process during applied work portion. 

Rubric: Case development

Additional Resource:

Len, A (2020) Update: MS Teams adapting it to Tele-therapy

(n.d.)

Below is a series of images from MS Teams where the electronic patient’s case was posted. Developed electronic case asks a team to form of a comprehensive treatment plan.

Each 'new conversation' function opened up a prompt for a collaborative activity and students used 'reply' function to post their findings, thoughts, updates using pictures, writing, research articles, etc.

Prompt 1: Patient: 54 months old girl with Dx of Autism. Please post an update discussing Autism diagnosis.

Students created slides which included interdisciplinary content in relation to the Autism diagnosis.

(Len, 2020)

Slides retrieved from student archived work from NM Interventions Course (2018)

Prompt 2: Discuss Examination and Assessment Tools appropriate for this Patient as they relate to your discipline.

Students created slides which in relation to the Examination of a Child with Autism. Additional links to videos were added by each discipline to demonstrate the process.

(Len, 2020)

Slides retrieved from student archived work from NM Interventions Course (2018)

(Len, 2020)

Slides retrieved from student archived work from NM Interventions Course (2018)

(Len, 2020)