Chapter 1IntroductionThe strength of physical therapy depends on research to extend its scientific basis for practice and patient healthcare, leading to intended evidence based practice, a vision advocated by the American Physical Therapy Association (APTA) 17. Medical Research is an essential element in developing clinical practice and increasing the level of patient care. Undergraduate research is defined as: ‘any teaching and learning activity in which undergraduate students are actively engaged with the research content, process or problems of their discipline’. Research is not merely pursuit of academic career rather; it also includes an aspect of learning process.Research is important for a Physiotherapist to:1) Provide effective physical therapy services.
2) Helps to make intelligent clinical decisions by promoting critical thinking. 3) Provide information for successful treatment.4) Improve patient’s health by making intelligent clinical decisions based on research findings.
5) Provide valid answer to the physiotherapist questions.6) Helps to improve health policies.It is the student’s involvement in activities that generate high-quality learning. Despite the fact that the concept of student’s engagement in research involves the elements of learning and the institutional environment, its main focus is on students. The General Medical Council has recommended that learning outcomes for all medical graduates should include research skills to permit them to study in-depth areas which are of particular interest to them and to obtain knowledge of scientific and research methods.
Medical students’ engagement in research has been associated with the competencies in the areas of communication, teamwork, time management, critical thinking, gaining experience and motivation for a research career, improving critical thinking abilities and having positive attitudes toward science and scientific methodology. Although individual studies addressing students’ engagement in research are available, a synthesis of results in this areahas not yet been undertaken. This gap in evidence motivated us to conduct a research on Attitude and perception of undergraduate Physiotherapy students towards research. Such analysis in this area ought to provide insights into the issues related to students’ involvement in research, which are otherwise not readily available. To its end, we shall be able to analyze physiotherapy students’ interest in conducting research22.Research activities by undergraduates are a powerful way of enhancing students’ basic skills and attitude necessary for future professional practice. Inquiry and an evidence-based medicine (EBM) approach are complimentary processes in that and they include ? identification of important questions,? search for the best research evidence, ? critical appraisal of the evidence and ? application of the evidence to practice.
Therefore, this study was undertaken as an investigation into this area. A good understanding of students’ research experiences allows to identify why and how research activity promotes meaningful learning. Moreover, identifying factors that affect students’ research activity can provide important practical implications to encourage research opportunities for students. This study aims to investigate: 1) students’ perceptions of research and learning through participation in undergraduate research; and 2) what factors affect the process of their engagement in undergraduate research14.
Evidence–based practice (EBP), research utilization (RU), and knowledge translation (KT) are interrelated concepts that pertain to the identification, utilization and application of knowledge from research sources to clinical practice. EBP is defined as “the integration of clinical expertise, patient values, and the best research evidence into the decision making process for patient care”16.The evidence-based practice technique consists of five steps: (i) translation of uncertainty to an answerable query; (ii) systematic retrieval of best evidence available; (iii) important appraisal of evidence for validity, scientific relevance and applicability; (iv) software of outcomes in practice; and (v) evaluation of overall performance .RU is a sub–set of EBP, which refers to “the process by which a research–based knowledge is implemented in practice”.
KT emphasizes the synthesis, dissemination, exchange and application of knowledge from research findings, and from other sources, to influence changes in practice and improve health outcomes. Research is important to advance the practice of physical therapy in order to assist physical therapists in the development of knowledge unique to their practice17.Globally, exposure of medical students to research has been on the rise. In Canada, 42% of second year medical students showed an interest in pursuing a career in research after completing mandatory electives.
Germany is also nurturing fresh minds as 28% of publications from one of its renowned institutions were authored by medical students. Developing countries spend their restricted assets in ways viewed as more important, like for academic scholarships for students. Medical training generally in Pakistan does not emphasize the importance of researchin professional practice15. Undergraduate research (UR) has become an integral part of medical education and has influenced the performance of medical practitioners, yielding positive results in the development of important skills, including critical analysis and leadership, whether or not the professional pursues an academic or research career21.Providing physiotherapy students with the opportunity to conduct research and to build evidence helps to promote clinical practice, change attitudes towards research and enhance research skills.9 As a clinical professional, the physiotherapist does not only need to obtain skills and knowledge, but he also needs to update his knowledge and regularly seek the ways of improving his treatment modalities.
10 The effectiveness of research education depends on students’ ability to use their research competencies in their future professional practice. The survey study shows that students’ intention to use research in their future professional practice and correlates highly with their perceptions and attitudes towards research, whereas research activities and research context have less of an effect. So in order to extend the functionality of the integration of research into higher education, students’ research attitudes should be considered.11 Supportive conditions for physiotherapists’ use of research analysis exist at multiple beneficial levels. Research use in physiotherapy appears to be an interactive and interpretative social process that involves a good interaction with colleagues and patients.12 The first factor we assessed was research usefulness, most of the students considered it useful and helpful.
2 The second factor regarding research anxiety and difficulty showed that students considered it more complicated and that they would perhaps make a lot of mistakes, and to half of the concepts were difficult to understand 1.The third factor was to assess self reported knowledge and behavior of students to apply research in their professional practice.The application of research in physiotherapy has been found to be associated with individual factors such as attitudes, knowledge, skills, higher levels of education. These factors are described as:1. Modi?able organizational factors like access to evidence and social control support 2. Non-modifable factors like younger age and less time in the profession. These factors have been established in cross-sectional analysis which precludes the causative inferences regarding the mechanisms by which evidence based practice can be achieved.
13. The methodology, studied Population, Randomization, Statistical analysis, clinical significance and the limitations of the study has to be critically appraised before reaching the conclusion. It demands the students in the health care profession to have a qualitative interpretive description in clinical physiotherapy education. We noted three integrative themes from the analysis:1. Attempt to apply evidence-based practice2. Novices in clinical practice3. Prioritize practice experience As research practice emerged and grew, healthcare providers and new graduates were assumed to use and be confident in applying evidence based practice skills.
3 This demonstrates that teaching research methodology is inclined towards qualifying students with the skills to conduct research.4 Reflection serves as a model for life-long learning by engaging students in research studies what they learnt in a given context and how they will apply that research work in future.5 Students who had not come across any form of systematic training on research demonstrate low level of research6.The factors like interest, searching literature, writing skills, etc may influence students’ performance. More practice sessions and repeated exercises along with constructive feedback from mentors may introduce deep reflecting skills leading to more productive transformative learning in students.7 Moreover clinical instructors should influence students during clinical education, as they are the potential role models in evidence-based practice. Faculty officials should plan in more disciplined way to improve the students’ skills and knowledge and to achieve the desired positive attitude toward research activity20.
Scaria introduced the ‘four I’s’ framework, which acts as a base upon which we possibly can explain the modern-day poor interest amongst medical students in the direction of research . The boundaries highlighted in this model display a loss of initiative (exposure, experience and knowledge), impulse (time and competitiveenvironment), incentive (presentation/guide opportunities and acknowledgement) and idols (mentors and supervisors) 23,24. Actions from academic and clinical settings are also needed to improve competence in research practice among clinical instructors, and future research is needed to investigate the effect of such efforts on students’ behaviour1. Research work is mandatory before graduation from medical schools. Medical students are expected to conduct research and defend their work publicly in the final year of studies. A Doctor of Physiotherapy thesis is partial requirement for undergraduate certification. Such practice is expected to serve as a foundation for the acquisition of basic research skills. Medical students can carry out basic research but these studies are rarely published and cited.
Hence there is more encouragement for medical students to be engaged in research. Despite the conduct of research over the years, many students often do not really know where to begin once a research topic has been handed to them so there is a requirement of some efforts to endow students with basic research skills 18. The effectiveness of research training depends on students’ intention to use their abilities of their future professional exercise. This survey describes the relationships among undergraduate students’ aim to apply their studies competencies of their future professional practice and their perceptions and attitudes in the direction of research 19. Because of the significance of research, its application in health care delivery and the emphasis on evidence-based practice, the findings of this study could contribute to the development of a curriculum in physical therapy that should emphasize research and evidence-based practice in physical therapy 25 .1.2 OBJECTIVES OF STUDY:? To find the attitude and perception of Undergraduate Physiotherapy students towards research? To observe the quality of research in their education1.
3 RATIONALE: The ultimate purpose of this study is to improve knowledge and skills to practice research in health care in the students of physiotherapy, that will improve the health standards and aid to their clinical expertise.CHAPTER 4METHODOLOGY? Study design:The study design is descriptive cross sectional.? Study Setting: The study was carried out in physiotherapy and rehabilitation institutes of Liaquat University of Medical and Health Sciences Jamshoro, Isra University Hyderabad, and Peoples University of Medical and Health sciences for women Nawabshah.? Study population:Undergraduate Physiotherapy students of fourth and final year in the institutes of Physiotherapy and rehabilitation sciences of Liaquat University of Medical and Health Sciences, Isra university and Peoples University of Medical and Health sciences for women Nawabshah. ? Sample sizeThe sample size is calculated by undergraduate registered population of fourth and final year in Institute of Physiotherapy and Rehabilitation sciences LUMHS Jamshoro, Isra University Hyderabad and Peoples University Nawabshah. 197 participants are selected as sample in this study.? Sampling Technique: Simple random sampling technique was used in the study in which every individual from the population had an equal chance of being selected in the study.? Inclusion Criteria: The students of the three Universities enrolled in DPT program studying in fourth and final year having research methodology in their subjects.
? Exclusion Criteria: The students of first year, second year and third year are excluded from the study.? Data Collection: A structured survey questionnaire was to be filled by the undergraduate students who met the inclusion and exclusion criteria .The questionnaire had three components .The first factor was about the research usefulness to profession .The second part of the questionnaire was regarding the research anxiety in students and the third factor was of self-reported knowledge and behavior of students to research.? Data Analysis: Data was analyzed using statistical package for the social sciences (SPSS) version 22.0.
Results: out of 197 students approached, 94(47.7%) were students of fourth year and 103 (52.3%) were from final year .The first part of the questionnaire was to assess research usefulness for their professin.89(45.2%) students wanted research to be a part of undergraduate curriculum.
However 101(51.3%) students wanted research to be a part of their profession training .88(44.7%) students considered research useful and valuable for their profession 93(47.
2%) students agreed that the research skills will be helpful to them in future . The second part of questionnaire was to assess research anxiety among students 95(48.2%) considered it stressful to perform 82(41.6%) students felt insecure concerning the analysis of data 81(41.1%) find it difficult to understand its concept.
The third part of the questionnaire was to investigate self-reported knowledge and behavior of students about research 90(45.7%) students agreed that research is beneficial to their career 98(49.7%) students perceived that research oriented thinking plays an important role to their life 78(39.6%) students considered research important to discover new ideas. However 103 (52.3%) students considered that the findings published in journals are relevant to their clinical practice 83(42.1%) students showed that they would like to be involved in research process in future. DiscussionConclusion It is encouraging that majority of the students considered research useful for their profession and had positive attitude towards research.
Although the students considered research related to their daily life, they considered it stressful at the same time. Moreover actions from academic settings are needed to improve competence in research practice among clinical practitioners and future research is needed to investigate the effect of such efforts on students’ behaviour.