Document Type : Original Article

Authors

Abstract

BACKGROUND: The objective was to evaluate an innovative physical medicine and
rehabilitation (PMR) course for undergraduate students of Tehran University of Medical Sciences
and their attitude and knowledge change following course participation.
MATERIALS AND METHODS: Ninety‑one medical students filled the knowledge, attitude, and
satisfaction forms pre‑ and postintervention. Nineteen medical students, two faculty physiatrists, two
residents, two physical therapists, and two occupational therapists participated in the focus groups.
RESULTS: We found significant attitude improvements. They declared the usefulness of PMR
course for undergraduate. Moreover, they agreed that physiatrists could be first choice for refer of
musculoskeletal patients and they preferred PMR as future career after course experience. Also,
they preferred to refer musculoskeletal patients including carpal tunnel syndrome, frozen shoulder,
nonspecific low back pain after course participation. We found a good relationship between attitude
and practice scores (r = 0.543, P = 0.000); in fact, students’ attitude would strongly predict their
practice through a model involving age, satisfaction, and exam scores (R2 = 0.356, B = 0.35 [0.06],
and P = 0.000).
CONCLUSION: We found that internship training course might be an effective method of teaching
PMR. Improving attitude toward the field of PMR and patient referral practice, career choice and
disability perceptions of undergraduates is concluded in this study. Investigation of the advantages
of such courses in larger studies with longer follow‑up time‑points is highly recommend.

Keywords

1. GBD 2015 Disease and Injury Incidence and Prevalence
Collaborators. Global, regional, and national incidence,
prevalence, and years lived with disability for 310 diseases and
injuries, 1990‑2015: A systematic analysis for the Global Burden
of Disease Study 2015. Lancet 2016;388:1545‑602.
2. Wittry SA, Lam NY, McNalley T. The value of rehabilitation
medicine for patients receiving palliative care. Am J Hosp Palliat
Care 2018;35:889‑96.
3. Mayer RS, Shah A, DeLateur BJ, Durso SC. Proposal for a required
advanced clerkship in chronic disease and disability for medical
students. Am J Phys Med Rehabil 2008;87:162‑7.
4. DeLisa JA, Leonard JA Jr., Smith BS, Kirshblum S. Common
questions asked by medical students about physiatry. Brief report.
Am J Phys Med Rehabil 1995;74:145‑54.
5. Esselman P, Berbrayer D, Friedly J, Granger C, Mayer RS. Chronic
care education in medical school: A focus on functional health
and quality of life. Am J Phys Med Rehabil 2009;88:798‑804.
6. Dietz V, Ward N. Oxford textbook of neurorehabilitation. Oxford
University Press, USA; 2015.
7. Satchidanand N, Gunukula SK, Lam WY, McGuigan D,
New I, Symons AB, et al. Attitudes of healthcare students
and professionals toward patients with physical disability:
A systematic review. Am J Phys Med Rehabil 2012;91:533‑45.
8. Laskowski ER, Moutvic M, Smith J, Newcomer‑Aney K,
Showalter CJ. Integration of physical medicine and rehabilitation
into a medical school curriculum: Musculoskeletal evaluation and
rehabilitation. Am J Phys Med Rehabil 2000;79:551‑7.
9. Leipzig RM, Hyer K, Ek K, Wallenstein S, Vezina ML,
Fairchild S, et al. Attitudes toward working on interdisciplinary
healthcare teams: A comparison by discipline. J Am Geriatr Soc
2002;50:1141‑8.
10. Bloch RM, Blake DJ, Fiedler IG. Integration of physical medicine
and rehabilitation into the undergraduate medical curriculum.
Am J Phys Med Rehabil 1996;75:242‑3.
11. Stock‑Schröer B, HuberR, Joos S, Klose P. Evaluation of the current
status of rehabilitation, physical medicine and naturopathy
education 10 years after the reform of the medical licensure act‑A
nationwide survey of German medical universities. GMS J Med
Educ 2017;34:Doc3.
12. Katz R, Sutin J, Keen M, Betts H. A one‑week rotation in physical
medicine and rehabilitation. Acad Med 1987;62:769‑71.
13. Kirshblum SC, DeLisa JA, Campagnolo DI. Mandatory clerkship
in physical medicine and rehabilitation: Effect on medical
students’ knowledge of physiatry. Arch Phys Med Rehabil
1998;79:10‑3.
14. Gutenbrunner C, Schiller J, Schwarze M, Fischer V, Paulmann V,
Haller H, et al. Hannover model for the implementation of physical and rehabilitation medicine teaching in undergraduate
medical training. J Rehabil Med 2010;42:206‑13.
15. McKenna C, Farber NJ, Eschbach KS, Collier VU. Primary care
practitioners’ understanding of physiatric practice: Effects on
intention to refer. Arch Phys Med Rehabil 2005;86:881‑8.
16. Gibbs A. Focus groups. Soc Res Update 1997;19:1‑8.
17. Odebiyi DO, Omotunde AO, Aiyejusunle CB, Olalekan TA.
Knowledge and perception of physiotherapy by final year
medical students of a Nigerian university. Nig Q J Hosp Med
2008;18:156‑61.
18. Roberts E, Shamus E. Increasing medical students’ understanding
of the role of occupational therapists. JInterprof Care 2015;29:522‑4.
19. Cromes G. Physical medicine preference among undergraduate
medical‑students‑some implications for teaching. Paper presented
at: Arch phys Med Rehabil 1979;60:549.
20. Chyatte SB, Slater SB. Medical student training in rehabilitation
and career choice selection. Arch Phys Med Rehabil 1971;52:306‑10.
21. Lehmann JF. Rehabilitation medicine: Past, present and future.
Arch Phys Med Rehabil 1982;63:291‑7.
22. Abramson S, Stein J. Medical student referral patterns for
musculoskeletal disorders. Am J Phys Med Rehabil 1998;77:235‑42.
23. LeeK, SheppardL. An investigation into medical students’ knowledge
and perception of physiotherapy services. Aust J Physiother
1998;44:239‑45.
24. DeitchCJ, GutmanSA, Factor S. Medical residents’ education about
occupational therapy: Implications for referral. Am J Occup Ther
1994;48:1014‑21.
25. Silva DM, Clark SD, Raymond G. California physicians’
professional image of physical therapists. Physical Therapy
1981;61:1152‑7.
26. Doshi D, Jiandani M, Gadgil R, Shetty N. Physiotherapy
awareness in medical and non medical population: A social media
survey. Int J Physiother Res 2017;5:1971‑5.
27. Anieto EM, Ativie R, Okafor CJ, et al. Knowledge and perception
of physiotherapy among clinical students in various health care
disciplines of a Nigerian college of medicine and health sciences.
Indian J Physiother Occup Ther 2019;13:3.
28. Alotaibi NM, Manee FS, Murphy LJ, Rassafiani M. Knowledge
about and attitudes of interdisciplinary team members toward
occupational therapy practice: Implications and future directions.
Med Princ Pract 2019;28:158‑66.