Development of standards for undergraduate occupational health in a physiotherapy curriculum: a case in Kenya

Abstract

Background: Occupational health (OH) in physiotherapy is well known for addressing work- related musculoskeletal disorders (WRMDs), which are high in number according to the available statistics (Fingerhut, Concha, Punnet, Steenland, & Driscoll, 2014). The introduction of the Bachelor of Science in Physiotherapy degree in Kenya in 2010 created a good platform for the development and review of occupational health content in the curriculum. Aim: To develop standards of competency, teaching, learning and assessment strategies that focuses on occupational health for an undergraduate physiotherapy curriculum in Kenya. Objectives: To determine the prevalence of WRMDs in Africa, conduct a situational analysis of the content of the occupational health course at the universities offering physiotherapy in Kenya with regard to the occupational health competency framework, explore the competencies needed by physiotherapists in relation to occupational health, explore the relevant content as well as the teaching, learning and assessment strategies that could be used to develop a draft occupational health module in the undergraduate physiotherapy curriculum. Design: A mixed method, exploratory, sequential design was implemented in four phases; systematic review, document analysis, Delphi study, and curriculum draft development. Population and sampling: Occupational health content for all universities offering physiotherapy degree course. A minimum of 15 experts within the field of occupational health were recruited in each round of the Delphi study which included both academic and clinical physiotherapists. Data analysis: Thematic content analysis was used for the qualitative data and descriptive statistics. This included frequencies, modes, and averages used for the analysis of the quantitative data. Ethical considerations for the study were observed. Results: The systematic review revealed a heterogenous prevalence of WRMDs throughout Africa with the highest prevalence in the administrative cadre. All professional cadres had complaints of lower back pain. Document analysis revealed that there was no stand-alone occupational health module in the Kenyan universities, but rather that it consisted of an aggregation of courses taught throughout the training, albeit with no clear links between them. Experts in occupational health shared their opinions via the Delphi study that determined the competencies needed by physiotherapists. These included the necessary OH topics, return to work process, how to assess risks for injury and prioritising hazards, and finally the medico-legal reporting and compensation, as well as how to communicate with various OH stakeholders. All these aspects of the study enabled the researcher to develop the draft OH course content for the undergraduate curriculum. Conclusion: The OH draft curriculum content is a stand-alone course composed of the findings from the different phases of this study. It will be used to equip the undergraduate Kenyan physiotherapist to develop the necessary competencies that aim to prevent and avoid the WRMDs that are prevalent in Africa.