Click to edit Master title style - University of Oklahoma ...

Click to edit Master title style - University of Oklahoma ...

LECTURE SERIES ON BALANCE AND POSTURAL CONTROL IN INFANTS AND CHILDREN PREPARED FOR 2ND YEAR DOCTOR OF PHYSICAL THERAPY STUDENTS Nana Safoah Twum-Ampofo PT, MPH July 2017 [email protected] Outline Description of target audiences Description of objectives Summary of content of lecture series Instructional methodologies/Teaching

strategies used Feedback Methods of Assessment Target Audience for content of lecture series Doctor of Physical Therapy (DPT) 2nd Year students DPT program is a post-baccalaureate degree study requiring 3 years to complete. Knowledge on fundamentals of human movement and neuroscience. Experienced a few weeks of clinical internship before beginning the second year of the program. Target Audience for dissemination Individuals interested in developing similar content for similar audience Working professionals

Adjunct professors Faculty members Useful teaching and feedback strategies, and assessment methods Lecture Series Objectives Describe and contrast in writing, the systems theory and the reflex/hierarchical theory of motor and postural control development. Identify characteristics of postural control development as well as the ages for typical milestone development. Understand the complex organization of postural control and the contributions of the musculoskeletal and the central nervous system to the development and maintenance of steady-state, reactive and anticipatory postural control.

Differentiate between infants and children with and without postural control dysfunction. Analyze the clinical implications of ICF (International Classification of Function, Disability and Health) in the clinical management of postural impairments in infants and children. Determine appropriate clinical tests and measurements for assessing balance and posture and design evidence based intervention programs for postural control in the pediatric population. Categorization of objectives within the revised Taxonomy framework (Krathwohl, 2002) THE COGNITIVE PROCESS DIMENSION THE KNOWLEDGE DIMENSION 1. Remember A.Factual Knowledge B. Conceptual Knowledge C. Procedural Knowledge D. Metacognitive Knowledge

2. Understand 3. Apply 4. Analyze Objective 1 Objective 2 Objective 3 5. Evaluate 6. Create Objective 4 Objective 4 Objective 5

Objective 6 Objective 6 Objective 6 Objective 5 Objective 6 Components of Lecture Series 2 lectures 2 laboratory sessions 1 group presentation and 1 comprehensive quiz Summary of Lecture series content

Review of Terms: Center of mass, center of pressure, base of support, postural sway Purpose of postural control: Postural orientation and Postural stability Components of the Postural control System: Interaction between Task, the Individual and the Environment Contributions of the musculoskeletal system and the Central Nervous system Summary of Lecture series content Development of Postural control: emergence of head and trunk control, Transition from independent sitting and

standing Mechanisms to control postural sway in sitting, standing and early walking: Exploratory and performatory Steady state control, Reactive/Compensatory Postural adjustments and Proactive/Anticipatory Postural adjustments Summary of Lecture Series Clinical tools and measurements for postural control in the pediatric population (representing all components of the WHO-ICF: Interventions for postural control dysfunction in infants and children. Saether et al, 2013, Field & Livingstone, 2013; Shumway-cook & Woollacott, 2012) Instructional Methodologies

Lectures Minimal text Flow diagrams Tables and figures Videos 60 sec podcast Case scenarios eliciting discussions Essential to maintain interest of learners who typically have short attention spans Mellie, 2008 Instructional Methodologies (cont.) Laboratory Sessions Participation in activities

that augment understanding of concepts Practicing performance of tests and measurements Discussion of case scenarios Reflection on material learned during lectures Dunst & Trivette, 2012 Instructional Methodologies (cont) Small group work facilitates the development of Higher Order Skills Group processing: Group reflection and feedback geared towards improvement on output

Positive Independence:: awareness of how success depends on effective collaboration Interpersonal and small group skills: communication , trust, leadership, decision making and conflict resolution. Johnson & Johnson, 1999 Higher Order Skills

Face-to-face supportive interaction: Learning and providing feedback Individual and group accountability: importance of each individuals contribution to achieving the group goal Feedback Essential to bridge the gap between current understanding and desired or expected understanding based on the goals set.

Questions that would foster self-assessment including self-error detection and self-monitoring skills include: What do you think was not accounted for in your assessment of the video you just saw? How do you think the group presentation went? What other way can you describe and perform the balance test for this child? In another context (describe context) how do you think this assessment will differ? What do others think about student xs answer/approach? (Hattie & Timpley, 2007). Types of feedback Directive feedback: informs the learner of what requires correction. Facilitative feedback: provision of comments and suggestions to facilitate recipients in their own revision. Immediate and regular feedback as objectives are the same

for all learners. Bi-directional evaluative feedback: Solicit feedback on teaching strategies employed. Ask for suggestions to improve delivery on areas learners struggled with Archer, 2010; Ramani & Krackov, 2012 Assessment methods Small group presentations Well defined objectives for group work and desired outcomes of tasks- provide a rubric. Both group and individual grades to facilitate individual accountability and avoid free-rider effects. Each individual assigned a task eg. of roles summarizer, researcher, checker, troubleshooter etc Johnson &Johnson, 1994;1999 Assessment methods

Comprehensive Quiz Questions with multiple choice answers, Fill-in questions and Questions requiring short written answers Example of rubric based on objectives Levels of Achievement Objectives 5 3 1 Describe and contrast in writing, the systems theory and the reflex/hierarchical theory of motor and postural

control development. Thorough and complete description of theories and at least 5 distinguishing features with all references appropriately cited Partial description of theories and less than 5 distinguishing features with less than adequate references New Roman Incomplete description of theories and less than 3 distinguishing features with insufficient references cited Discuss the complex

organization of postural control and the contributions of the musculoskeletal and the central nervous system to the development and maintenance of steadystate, reactive and anticipatory postural control Written discussion shows excellent understanding of the organization of postural control and describes clearly contributions of systems involved Written discussion shows a generally good understanding of the organization of postural control and describes

clearly contributions of systems involved Written discussion shows poor understanding of the organization of postural control and describes clearly contributions of systems involved References Archer, J. (2010). State of the science in health professional education: Effective feedback. Medical Education, 44, 101-108. Ende, J. (1983). Feedback in clinical medical education. Journal of the American Medical Association, 250(6), 777-781. Hattie, J. and Timperley, H. (2007). The power of feedback. Review of Educational Research, 77, 81-112.

Mellis, C.M. (2008). Optimizing training: what clinicians have to offer and how to deliver it. Paediatric Respiratory Reviews, 9: 105-113. Ramani, S. and Krackov, S. (2012). Twelve tips for giving feedback effectively in the clinical environment. Medical Teacher, 34, 787-791. References Johnson, D. W. and Johnson, R. T. (1994) Joining together: group theory and group skills. Prentice Hall. ISBN: 0205158463. Johnson, D. W. and Johnson, R. T. (1999) Learning together and alone: cooperative, competitive, and individualistic learning. Allyn and Bacon. ISBN: 0205287719. Field, D., & Livingstone, R. (2013). Clinical tools that measure sitting posture, seated postural control or functional abilities in children with motor impairments: a systematic review. Clinical rehabilitation, 27(11), 994-1004. Saether, R., Helbostad, J. L., Riphagen, I. I., & Vik, T. (2013). Clinical tools to assess balance in children and adults with cerebral palsy: a systematic review.

Developmental Medicine & Child Neurology, 55(11), 988-999. Shumway-Cook, A. & Woollacott, M. (2016). Motor Control: Translating Research into Clinical Practice (5th ed.). Philadelphia: Lippincott Williams & Wilkins

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