Wheelchair Service Provision Course - Evaluation Report

Summary

Wheelchair Man Sitting.jpg
In September/October 2018 Physiopedia and the International Committee of the Red Cross (ICRC) successfully delivered the Wheelchair Service Provision Massive Open Online Courses (Wheelchair MOOC) via the Physioplus online learning platform. This programme of four courses and optional written assignment were based on the “Guidelines on the provision of manual wheelchairs in less-resourced settings” developed by the World Health Organisation (WHO). In collaboration with Humanity & Inclusion (HI) a French version of the programme of courses was delivered concurrently.


Course Type - Open, Online

Course Coordinators - Rachael Lowe, Barbara Rau, Martin Jacobs

Collaborating Partners - Physiopedia, the ICRC and HI

About this course - This online programme of four courses provides a comprehensive theoretical understanding of Wheelchair Service Provision including the theoretical principles, skills and knowledge underlying the management skills and knowledge in the management of wheelchair service delivery. There was an English and a parallel French version of the programme of courses.

Who were the courses aimed at - These courses were written for physiotherapy clinicians, students and assistants; other healthcare professionals interested in this subject were welcomed to participate.

Time commitment - 17 hours over 4 weeks

Date – 1 September to 31 October 2018 (the course remains available on the Physioplus platform to members)

Requirements – Participants were required to complete online learning activities, engage with additional resources, take part in the conversation online and complete the course evaluation. Assessment - There was a final quiz and participants could optionally complete an assignment to demonstrate their learning.

Awards - 4 course completion certificates awarding a total of 17 Physioplus (P+) points. Accreditation - The courses were accredited by the Australian Physiotherapy Council, the South African Society of Physiotherapy (total 22 CEUs) and The Federation of State Board of Physical Therapy (total 16 CEUs)

Registrations - 5,559 (5296 English programme and 263 French programme)

Countries represented - 148 (143 English programme and 28 French programme)

Acknowledgements

The Wheelchair Service Provision MOOC was developed as a collaboration between Physiopedia and ICRC. Physiopedia and ICRC provided funding. The “Guidelines on the provision of manual wheelchairs in less-resourced settings” developed by the World Health Organisation were used as the basis for these courses. HI completed the French translation of the programme of courses.

Course coordinators:

  • Rachael Lowe, Physiopedia
  • Barbara Rau, ICRC
  • Martin Jacobs, HI

Content contributors:

  • Naomi O’Reily, Physiopedia
  • Lee Kirby, Wheelchair Skills Program
  • Perth Rosen, UCP Wheels for Humanity
  • Yasmin Garcia, UCP Wheels for Humanity
  • Karen Wilson, Physiopedia
  • Priya Gulla, Physiopedia
  • Ilona Malkauskaite, Physiopedia
  • Daniele Barrilla, Physiopedia
  • Mereena Baby, Physiopedia
  • Vidya Acharya, Physiopedia
  • Simisola Ajeyalemi, Physiopedia
  • Mariam Hashem, Physiopedia

Course facilitators:

  • Naomi O’Reily, Physiopedi
  • Nicky Seymour, Motivation
  • Patience Mutiti, Motivation
  • Abder Banoune, HI
  • Elia Bernabeu Mira, ICRC
  • Subhash Sinha, ICRC
  • Sidhu Mi, ICRC

Special thanks to Naomi O’Reily for managing the content and course development.

For any information regarding this report, please contact: Rachael Lowe - [email protected]

Introduction

During September and October 2018 Physiopedia ran their seventh Massive Open Online Course titled Wheelchair Service Provision (Wheelchair MOOC). This was delivered as a programme of four courses and an optional written final assignment. These courses were developed as a collaboration between Physiopedia and ICRC. The course structure and content was based on the “Guidelines on the provision of manual wheelchairs in less-resourced settings” developed by the World Health Organisation (WHO) which was supplemented with additional material from global experts. A French version of the programme of courses, translated and facilitated by HI, ran concurrently.

The aim of the Wheelchair MOOC was to train the distributed team of ICRC staff and partners to have a basic understanding of the theoretical knowledge that underpins the provision of wheelchairs to appropriate clients in a variety of contexts. The content of the courses was designed for physiotherapists in any global context, all healthcare workers from any location and context were invited to participate. Being open for anyone to participate allowed for global conversation around the topic and enabled peer-to-peer learning across contexts and experiences.

The four week long courses presented different topics through a variety of learning activities to suit all learning styles. The required learning activities within each course were developed to take between 4-6 hours depending on the participant's learning style and optional activities were provided should the participant wish to take part in additional learning. A short orientation period before the course started provided participants with an opportunity to become familiar with the delivery platform and the topic via the provided pre-course resources.

The course was delivered through the Physioplus (P+) online learning platform, an innovative platform specifically developed to deliver online education and provide learners with a personalised learning dashboard. For each course the related learning activities were released on a specific course page. As participants engaged with each course learning activity it was recorded and displayed in their own personal learning dashboard.

To finish each of the four courses, participants were required to complete all the required learning activities and pass a final quiz that tested knowledge. Finally there was an optional course which included a written assignment to demonstrate their learning from all four courses. On completion of each course the participants could download a completion certificate and also export a record of their learning from their activity log.

This report evaluates the experiences and engagement of the participants on the Wheelchair MOOC.

1. About the Programme of Courses

1.1   Aim

The programme of four courses aimed to provide a comprehensive theoretical understanding of Wheelchair Service Delivery and to develop an understanding of the theoretical principles, skills and knowledge underlying the management skills and knowledge in the management of wheelchair service delivery.

1.2   Learning Objectives

At the end of this programme of courses participants were able to:

  1. describe the United Nations Convention on the Rights of Person with Disabilities with regards to wheelchair provision
  2. detail their local national prevalence and the global prevalence of people living with some form of disability
  3. explain 4 benefits of a wheelchair and 5 challenges for wheelchair users
  4. explain how wheelchair design can impact on an individual’s function and satisfaction
  5. plan the appropriate wheelchair provision and education based on the individual, their needs, environment, and activities after reviewing a case scenario
  6. identify the 8 steps to appropriate wheelchair provision
  7. explain 9 risks for developing pressure ulcers and their prevention
  8. plan a thorough assessment for an individual requiring a wheelchair
  9. justify the appropriate wheelchair prescription and preparation based upon a complete patient evaluation and current wheelchair assessment as per case scenarios
  10. revise the seating prescription for an individual in a case scenario by following the 4 steps to wheelchair fitting
  11. plan a wheelchair skills training session based upon an individual portrayed in a case scenario
  12. describe the 6 important components of taking care of a wheelchair at home with regards to why, when, and how
  13. discuss the role of outcome measures for wheelchair and seating provision
  14. describe general and local wheelchair provision service delivery models in relation to laws, strategies, policies and action plans
  15. identify five ways the multidisciplinary team can support a wheelchair user’s right to personal mobility and to be actively involved in wheelchair provision
  16. select the appropriate actions for referral, appointments, funding and ordering of wheelchairs based on a case scenario
  17. discuss a patient case scenario with reference to the assessment, wheelchair prescription, fitting, training requirements, and follow up planning

1.3 Intended Audience

This course was suitable for all healthcare professionals but specifically aimed at physiotherapy professionals including clinicians, assistant or students who have a good understanding of the key principles of physiotherapy but little prior experience in wheelchair provision. It was also of interest to any professionals (e.g. prosthetists, orthotists, nurses, occupational therapists, speech therapists, medical doctors) motivated to upgrade their knowledge on wheelchair provision.

1.4 Cost to participants

The course was free to all participants who completed the course within 8 weeks from the start date and remains free to all residents of low income countries on a permanent basis.

1.5 Course availability

The programme of courses started on the 1 September 2018 when the first course contents were made available. A new course was released each following Monday for another 3 weeks.

Participants had until 31 October 2018 to complete the courses under their free access to Physioplus. The course remains available on the Physioplus platform to members; membership is free to individuals from low income countries and available at a discounted rate to individuals in middle income countries.

1.6 Course Awards and Accreditation

Course completion certificates were provided by Physiopedia to all participants that passed each course within the programme. The programme of courses was accredited by the Australian Physiotherapy Council, the South African Society of Physiotherapy (total 22 CEUs) and The Federation of State Board of Physical Therapy (total 16 CEUs).

2.   Demographics of the Participants

2.1   Country

5,559 participants formally registered for the programme of courses before the end date of 31 October 2018 (5296 English registration and 263 French registration). They represented 148 countries, the most represented countries are detailed below. For full results see Appendix 1.

English Course French Course
Total number of countries 143 Total number of countries 28
India 483 Haiti 91
Australia 398 Lebanon 29
Nigeria 322 France 23
USA 289 Ivory Coast 15
Canada 285 Niger 15
Pakistan 258 Benin 12
Jordan 253 Togo 10
Saudi Arabia 241 Belgium 9
South Africa 227 Mali 8
UK 209 DRC 7

2.2  Profession

English Course French Course
Physiotherapy / Physical Therapy 4218 80% 173 66%
Prosthetics / Orthotics 152 3% 30 11%
Occupational Therapy 584 11% 0 -
Rehabilitation Therapist - - 13 5%
Medical Doctor 62 1% 5 2%
Nurse 68 1% 4 2%
Other 212 4% 38 14%

2.3  Role

English Course French Course
Clinician 3449 65% 136 52%
Student 859 16% 40 15%
Educator 254 5% 5 2%
Assistant 216 4% 24 9%
Manager 142 3% 24 9%
Researcher 82 2% 2 1%
Other 289 5% 4 3.23%

2.4  Years of experience

English Course French Course
no experience 1762 33% 121 46%
< 1 year 1331 25% 57 22%
1 to 5 years 1301 25% 53 20%
> 5 years 905 17% 32 1%

3. Engagement of the Participants

3.1   Platform

The four courses were delivered on Physioplus. The related course pages were visited a total of 39,340 times before the final date of the supported course on 31 October 2018.

English French
Number users who started the first course of the programme 1,621 109

3.2  Learning Activities

The four courses involved a total of 91 required learning activities (full details in Appendix 2).

English French
Total number of learning activities logged 35,481 6,734

 3.3  Discussion Forum

Participants were required to participate in the discussion forum on a weekly basis. They were required to take part in a minimum of 10 discussions over the programme of courses with making between 2 and 3 posts per course. This was made a requirement as it provided a rich learning experience through self-reflection on learning and exposure to global discussions about clubfoot. This was the task that participants found most difficult to complete.

The discussion forum was hosted on the Physioplus platform where participants were asked to comment on the weekly guided discussions. It was clear that not all people engaging with the course joined participated in the discussions.

English French
Number of people who introduced themselves in the forum 880 80
Total number of discussion posts 5,813 1,116

3.4  Quizzes

In each course participants were given the opportunity to assess their knowledge and understanding of the topic through a multiple-choice quiz. Participants received immediate feedback on right and wrong responses making this a rich learning experience. The pass mark was 80% and they could attempt the quiz as many times as they liked.

English French
Number of attempts made on the four course quizzes 2,353 450
Quiz passes 1,485 258

3.5   Course Awards

To complete each course participants were required to fully engage with all the related required learning activities (Appendix 2), participate in the discussion forums and pass the course quiz. From Physioplus, they received P+ points (equivalent to hours of learning) for every learning activity that they completed and a course completion certificate on completion of all the required elements of each course.

English French
Number of certificates awarded for all four courses 1077 212
Total P+ points awarded 9,217 2,170

3.6   Final Assignment

Reflecting on their learning and using the knowledge gained throughout the courses participants could submit an optional assignment. Participants were asked to follow the assignment guidelines on Physiopedia and the assignments were assessed by the Physiopedia team. The marking rubric was kept fairly simple but each assignment needed to demonstrate: evidence of learning from the course, academic skill with evidence based writing and proper referencing and written English skills.

English French
Assignment submissions 72 This was not an option for the french course

Participants were able to choose from 3 different assignments which allowed for different academic skills and learning styles. The patient case study and the knowledge translation resource were the most popular assignments:

Assignment Type No
Patient case study 60
Clinical guideline 11
Physiopedia page 1

3.7   Engagement versus completion

English French
Started the first course 1621 109
Received first course completion certificate 374 54
Started the final course 362 65
Received final course completion certificate 209 48

4.     Participant Feedback

529 (507 English and 22 french) participants completed the evaluation forms at the end of each of the programme courses.

4.1 Quantitative Data

Overall there was agreement that the courses were enjoyable to work through, an appropriate length with the right amount of work required each week, was pitched at the right level and would be recommended to colleagues. The participants stated that they found the Physiopedia pages, videos and quizzes most useful for learning. Broadly all the activity types were found useful with no activity type reported as not useful for learning.

4.1.1 English Course

WSPC English Why choose course.PNG

WSPC English Overall Rating.PNG

WSPC English Useful to.PNG

WSPC English General Impressions.PNG

WSPC English How Useful.PNG

4.1.1 French Course

WSPC French Why choose course.PNG

WSPC French Overall Rating.PNG

WSPC French Useful to.PNG

WSPC French General Impressions.PNG

WSPC French How Useful.PNG

4.2  Qualitative Data (based on English course)

In qualitative feedback that asked “what were the best elements of the course”, participants almost universally responded positively about the course. It was clear that each and every type of resource and activity was identified by a significant proportion as being the best element with no clear pattern emerging. Some individuals identified the wide variety of resources and activities as their best element of the course. Illustrative sample comments can be read in Appendix 3.

When asked “how could this course be improved” the most common opinion was that the course was excellent and did not need improvement. Of the issues raised the most common was the number and duration of reading activities and the limited nature of the discussion in the forum. Common suggestions were to increase the use of images and videos and to offer the course in more languages. Illustrative sample comments can be read in Appendix 4.

This feedback demonstrates the many different learning styles and preferences that course participants have. For this programme of courses, some people prefer the reading activities, others the videos, while for a handful the discussion forum activities were the highlight.

4.3  Impact on clinical practice (based on English course)

In the evaluation form participants were asked “describe any way in which this course has changed your clinical practice”.

Many participants had no prior experience of working with wheelchair users and these individuals reported increased confidence if they did encounter such a clinical situation in the future. Many expressed a greater awareness of the variety of types of wheelchair available and their suitability in different circumstances, the biomechanical issues to be considered in fitting and the physical conditions that can be experienced by wheelchair users. Overall most participants expressed the opinion that they felt able to provide a better quality of service to this client group following the course. Illustrative sample comments can be read in Appendix 5.

Conclusion

The wheelchair is a commonly used assistive device which provides an opportunity for its users to dramatically increase their quality of life. This course provided an accessible introduction for interested individuals to gain theoretical knowledge of the process of providing wheelchairs to appropriate clients and learn with an international network of colleagues. Continued free access to the course content via the Physiopedia website allows health care professionals and carers to gain access to knowledge at any time in an easily accessible way.

The course registration data demonstrated the unique opportunity that this course has provided in offering an easily accessible knowledge development option for health care professionals across a wide distribution of geographical locations and contexts.

Course evaluation data indicates that the variety of resources and activities is an important characteristic of the courses that is required to meet the wide range of learning styles and preferences. Highlighted areas for improvement should involve adding further visual elements, reducing the length of long reading materials, avoid repetition of content and also aim to increase conversation within the discussion forum. Participants in low resource settings sometimes requested to access an offline version of the course to avoid problems caused by poor Internet connection.

The evaluation also provides strong evidence that improvements in clinical practice will result from participation in the courses. This will include more appropriate wheelchairs being prescribed, improved biomechanics in the fitting of the wheelchair, and increased focus on providing the user with training in the long-term use and maintenance of their device.

Appendix 1 – Course participants demographics

English course:

India 483 Haiti 18 Czech Republic 3
Australia 398 Portugal 16 Oman 3
Nigeria 322 Somalia 16 Latvia 3
United States 289 Italy 15 Kiribati 3
Canada 285 Malta 15 Cyprus 3
Pakistan 258 Romania 14 Guinea-bissau 3
Jordan 253 Estonia 13 Bulgaria 3
Saudi Arabia 241 France 13 Slovakia 3
South Africa 227 Yemen 13 Venezuela 3
United Kingdom 209 Puerto Rico 13 Taiwan, Republic of China 3
Palestinian Territory 195 Turkey 13 Lao People's Democratic Republic 3
Sudan 105 Kuwait 13 El Salvador 3
Malaysia 103 Spain 12 Cambodia 3
Egypt 95 Suriname 12 Russian Federation 2
Rwanda 63 Botswana 11 Bahamas 2
Nepal 61 Albania 11 Namibia 2
Philippines 61 Chile 11 Armenia 2
New Zealand 59 Indonesia 10 Austria 2
Israel 47 Hungary 10 Cayman Islands 2
Bangladesh 47 Cameroon 10 Madagascar 2
Kenya 47 Congo, The Democratic Republic of the 9 Benin 2
Singapore 45 Libya 8 Cape Verde 2
United Arab Emirates 45 Fiji 8 Saint Lucia 2
Jamaica 41 Georgia 8 Timor-leste 1
Myanmar 41 Sierra Leone 8 Serbia 1
Mexico 39 Bolivia 7 Brunei Darussalam 1
Syrian Arab Republic 39 Bhutan 6 Netherlands Antilles 1
Afghanistan 38 Japan 6 Cuba 1
Colombia 37 Switzerland 6 Panama 1
Ireland 36 Ecuador 6 Korea, Republic of 1
Qatar 36 South Sudan 6 Chad 1
Lebanon 36 Croatia 6 Luxembourg 1
Uganda 35 Belgium 6 Tunisia 1
Sri Lanka 35 Iran, Islamic Republic of 6 Belize 1
Thailand 33 Guyana 6 Tajikistan 1
Vietnam 33 Netherlands 6 Solomon Islands 1
Hong Kong 31 Azerbaijan 5 Niger 1
Slovenia 31 Costa Rica 5 Liberia 1
Zimbabwe 31 Finland 5 Burkina Faso 1
Trinidad and Tobago 30 Sweden 5 Togo 1
Tanzania, United Republic of 30 Mauritius 5 Bahrain 1
Ghana 28 Swaziland 5 Martinique 1
Ukraine 28 Lithuania 4 Turks and Caicos Islands 1
Ethiopia 28 Poland 4
Iraq 27 Dominican Republic 4
Brazil 26 Germany 4
Greece 22 Burundi 4
Malawi 22 China 4
Argentina 19 Norway 4
Zambia 18 Peru 4

French course:

Haiti 91 Canada 6 Morocco 1
Lebanon 29 Burundi 5 Mayotte 1
France 23 Afghanistan 5 Singapore 1
Côte d'Ivoire 15 Rwanda 4 Chile 1
Niger 15 Madagascar 4 Senegal 1
Benin 12 Cameroon 3 Italy 1
Togo 10 Burkina Faso 3 Guinea-bissau 1
Belgium 9 Tunisia 2 Romania 1
Mali 8 Switzerland 2
Congo, The Democratic Republic of the 7 Spain 2

Appendix 2 – Required learning activities

Course 1. Introduction to Wheelchair Service Provision

1 Introduction to Wheelchair Service Provision Physiopedia article
2 Global Disability Context and Wheelchair Mobility Physiopedia article
3 Convention on the Rights of Persons with Disabilities Physiopedia article
4 Wheelchair Users Physiopedia article
5 Forum post - Prevalence of wheelchair mobility Forum topic
6 Role of the Wheelchair Physiopedia article
7 WSTP Basic Video Series: 2. The benefits of an appropriate wheelchair Video
8 WSTP Intermediate Video Series: 3. The benefits of an appropriate wheelchair Video
9 Forum post - Benefits of having a wheelchair Forum topic
10 Wheelchair Design Physiopedia article
11 Wheelchair Biomechanics Physiopedia article
12 Wheelchair Service Provision Case Study - Meeting the Wheelchair Users Environments Physiopedia article
13 Wheelchair Service Provision Case Study - Meeting the Wheelchair Users Needs Physiopedia article
14 Wheelchair Service Provision Case Studies - Appropriate Wheelchairs Physiopedia article
15 Forum post - What type of wheelchair and accessories Forum topic
16 Introduction to Wheelchair Service Provision - Quiz Quiz

Course 2. Steps to Appropriate Wheelchair Provision

1 Eight Steps to Appropriate Wheelchair Provision Physiopedia article
2 WSTP Intermediate Video Series: 2. Wheelchair service steps Video
3 WHEELCHAIR Service Training Package Session B.2: Assessment Presentation slides
4 Wheelchair Assessment Physiopedia article
5 ICF in Relation to Wheelchair Users Physiopedia article
6 WHEELCHAIR Service Training Package Session B.3: Assessment interview Presentation slides
7 Wheelchair Assessment - Assessment Interview Physiopedia article
8 WHEELCHAIR Service Training Package Session B.4: Physical assessment Presentation slides
9 Wheelchair Assessment - Physical Assessment Physiopedia article
10 Wheelchair Assessment - Body Measurements Physiopedia article
11 WSTP Basic Video Series: 11. Measurement demonstration Video
12 Wheelchair Service Provision Case Studies - Assessment Physiopedia article
13 Forum topic - Choosing a wheelchair case study Forum topic
14 WSTP Basic Video Series: 5. Pressure sore testimonial Video
15 Decubitus ulcers Physiopedia article
16 Cushions Physiopedia article
17 Postural Support Devices Physiopedia article
18 WSTP Intermediate Level: 4. People using postural support devices Video
19 WHEELCHAIR Service Training Package Session B.5: Prescription (Selection) Presentation slides
20 Wheelchair Prescription Physiopedia article
21 Wheelchair Service Provision Case Studies - Prescription Physiopedia article
22 Forum topic - Type of wheelchair and components 2 case studies Forum topic
23 Wheelchair Service Provision Case Study - Selecting Wheelchair Size Physiopedia article
24 Wheelchair Service Provision Case Study - Select Cushion Size Physiopedia article
25 Wheelchair Preparation Physiopedia article
26 WHEELCHAIR Service Training Package - Session B.7: Product (wheelchair) preparation Presentation slides
27 WHEELCHAIR Service Training Package - Session B.8: Cushion fabrication Presentation slides
28 WSTP Basic Video Series: 12. Wheelchair safe and ready checklist demonstration Video
29 Steps to Appropriate Wheelchair Provision Quiz Quiz

Course 3. Wheelchair Fitting, Skills and Maintenance

1 WHEELCHAIR Service Training Package Session B.9: Fitting Presentation slides
2 Wheelchair Fitting Physiopedia article
3 WSTP Basic Video Series: 14. Fitting demonstration Video
4 WHEELCHAIR Service Training Package Session B.10: Problem solving Presentation slides
5 Forum topic - Wheelchair fitting case studies Forum topic
6 WSTP Basic Video Series: 15. Problem solving - fit or adjustment

- example 1

Video
7 WSTP Basic Video Series: 16. Problem solving - fit or adjustment

- example 2

Video
8 Wheelchair Skills Physiopedia article
9 WHEELCHAIR Service Training Package Session A.3: Wheelchair mobility Presentation slides
10 WHEELCHAIR Service Training Package Session A.8: Transfers Presentation slides
11 WSTP Basic Video Series: 3. Learning to use my wheelchair Video
12 Wheelchair Service Provision Case Studies - Wheelchair Skills Case study
13 Forum topic - wheelchair skills case studies Forum topic
14 Wheelchair Service Provision Case Studies - Transfers Case study
15 Forum topic - Transfer case studies Forum topic
16 Wheelchair Skills Assessment and Training Physiopedia article
17 WHEELCHAIR Service Training Package Session B.12: Maintenance and repairs Presentation slides
18 Wheelchair Maintenance Physiopedia article
19 WSTP Basic Video Series: 17. How to care for a wheelchair at home Video
20 Outcome Measures for Wheelchair and Seating Provision: A Critical Appraisal Journal article
21 Wheelchair Fitting, Skills and Maintenance - Quiz Quiz

Course 4. Wheelchair Service Delivery

1 Wheelchair Services Physiopedia article
2 Forum topic - Wheelchair Service Models Forum topic
3 Multidisciplinary Team in Wheelchair Service Provision Physiopedia article
4 WHEELCHAIR Service Training Package Section B: Wheelchair Service Steps Presentation slides
5 Wheelchair Referral and Appointments Physiopedia article
6 Not a Tragedy but a Tool Journal article
7 WHEELCHAIR Service Training Package B.6: Funding and ordering Presentation slides
8 Wheelchair Funding and Ordering Physiopedia article
9 WHEELCHAIR Service Training Package Session B.13: Follow up Presentation slides
10 Wheelchair Service Follow Up Physiopedia article
11 Wheelchair Service Provision Case Studies - Follow Up Physiopedia article
12 Wheelchair follow up form Guideline
13 Forum topic - Wheelchair service provision case study Forum topic
14 Interview with Jess Markt - sport for wheelchair users Video
15 Wheelchair Service Delivery - Quiz Quiz

Appendix 3 - Course evaluation: what were the best elements of the course

Sample evaluation responses:

  1. Videos and Quiz.
  2. I enjoyed reading the articles and reading the replies from the group discussion.
  3. Videos and journal articles
  4. Videos and case studies
  5. The videos and the comprehensive text of the topic makes the course more understandable and deeply knowledgeable.
  6. Virtually, I found all parts very useful and informative.
  7. Overall it was enjoyable. The videos which were shown of people using different chairs in the community was useful to see the difference in the chairs after reading the wheelchair biomechanics page. The biomechanics page was also really informative
  8. The great amount of information and free documents
  9. I found all elements of the course very useful
  10. The best elements of the course: the dynamics, the exchange in the forum, the videos and the texts to read.
  11. I enjoyed every aspect of the course very much
  12. The best elements of the course was the experiences shared by wheelchair users, references through journals.
  13. It was a good combination of different aspects - reading, tasks and videos.
  14. Seeing the video of the different people using different wheelchairs to negotiate their environment and discussions
  15. I enjoyed the quiz and case studies
  16. The physiopedia pages are very interesting and have a lot of important information.
  17. I enjoyed the detail that was including regarding the different features of the wheelchairs that are available along with a review of how to take appropriate measurements.
  18. Having different modules from article, journal, videos, etc. Both basic and intermediate level contents in ready format helps well.
  19. The discussions,the physiopedia pages and the quizzes were especially interesting to me
  20. The variety of activities, it wasn't just a single form of education delivery.
  21. WHO training materials
  22. The videos were the best elements of the course.
  23. Almost all parts of the course were very valuable, but especially discussion about effect of backrest height on wheelchair propelling mechanism, about rear wheel and front wheel, discussion related 2 cushion

Appendix 4 – Course evaluation: how could this course be improved

Sample evaluation responses:

  1. At the moment I have no improvements to suggest
  2. I don't personally see any concerns
  3. Some of the readings are super long & can get tedious
  4. The discussion forum feels a bit forced and not useful.
  5. Provide downloadable info to read offline
  6. There is a lot of reading - probably too much.
  7. This course could be improved more if it's translated in many more languages.
  8. To make it easy to reach the subject and download it all
  9. There is a lot of read work!
  10. Unlike other courses I've taken the interaction on the discussion board was not as good. It felt more like people writing the same thing and less about collaboration
  11. Already well structured and varied!
  12. I think if the course was more visual (more pictures, videos, presentations) it would be easier to understand, especially the mechanical issues of the wheelchair.
  13. More videos and quizzes and less journal articles
  14. Every aspect of this course is good. But it's quite tricky/ hard for me to navigate from one topic to another and sometimes it's quite confusing. But overall I do love the information provided in this course.
  15. If the moderator are more involved in the discussion to correct information when needed
  16. It can be improved by reducing the volume of the articles to be read, yet maintaining the content.
  17. There were some spelling errors, but these were not a hindrance to learning.
  18. I found some of the questions in the quiz a bit challenging/confusing
  19. Some information was repetitive in the readings.
  20. Increased number of discussion
  21. An offline version
  22. Should include more of videos and practical aspect and cut down theory aspects and give answers to the case study and quiz
  23. It is already perfect.
  24. Parts of the course felt rather long and time consuming. I would have appreciate an estimate time of completion for each section so I can plan my spare time around it rather than staying up late at night in order to finish it.
  25. No comment! I feel like this course is better except that maybe considering the length of this course it would be nice if the period of the course be lengthened a bit

Appendix 5 – Course evaluation: how has the course changed your practice

Sample evaluation responses:

  1. I have a broader perspective about the purpose and design of wheelchairs used around the world. I will be more conscientious of evaluating my patient's environment when selecting an appropriate chair.
  2. The impacts of biomechanics and seating on propulsion will impact how to evaluate children for wheelchairs.
  3. In my NHS practice I do not see any wheelchair users but I have a cousin who has quadriplegia, I have convinced him to buy new motorised wheelchair and send his family the video links on the physiopedia page to gain more understanding around appropriate wheelchair use.|
  4. I will consider an extended-castor 3 wheel option for folks that live out in more rural communities.
  5. To be able to assess proper wheelchair need for specific individual
  6. For patients with Spina Bifida, for the wheelchair prescription, I will have to look into account the Shoulder overuse syndrome.
  7. I see wheelchair very differently now. I also see the need for not having a general type of wheelchair for everybody
  8. i will be more structured when looking to the wheelchair and study well the person's needs of the wheelchair taking into consideration the environmental factors
  9. Take a holistic approach keeping in mind the impairment and environment and other barriers. Also how to propel efficiently
  10. I got to understand that not everyone can use the same wheelchair. it is important to access the conditions first.
  11. I learnt to prescribe wheelchair according to need,environment etc of patient
  12. I will be able to be more knowledgeable when completing my wheelchair assessments, even working with ATPs, and will be more thorough in completing measurements to provide the best fit w/c.
  13. More aware of pressure injury types and steps to take to reduce pressure
  14. I think more, how can I make wheelchair more suitable for patient. Even one change of the biomechanics make a huge difference.
  15. I would try to keep everything in my mind whatever i have learned here before i prescribe a wheelchair to my patient.
  16. I now have a grounded knowledge on wheelchair and wheelchair users. In my 2 years of practice in Nigeria I've had very very little knowledge of the topic. Now I'm going to create an awareness in whatever way I can.
  17. Check well the WC before the user use it .take into consideration the postural support devices to add according to person needs
  18. I will probably take into the biomechanics and the design of the chair a lot more. Although you listen to your patients, you can always learn from them so paying bit more attention to activities etc may always help too!

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