Physical Therapy Students' Reflective Thinking With Narrative Photography in Heart Transplantation

Sponsor

University of Valencia (Other)

Overall Status

Completed

CT.gov ID

NCT05800912

Collaborator

(none)

117

Enrollment

Location

Arms

9.9

Actual Duration (Months)

11.8

Patients Per Site Per Month

Study Details

Study Description

Brief Summary

Physical therapy students must learn about heart transplantation, and must be able to communicate with patients using empathy and moral sensitivity. The aim of the study is to compare the narrative photography (NP) and traditional learning (TL) methods applied to heart transplantation physical therapy, as they relate to physical therapy students' knowledge, empathy, satisfaction, and moral sensitivity.

Condition or Disease	Intervention/Treatment	Phase
Students	Other: Narrative photography Other: Traditional learning	N/A

Detailed Description

Physical therapy students must learn about heart transplantation. They need to know how to attend to the needs and emotions of these patients using empathy and moral sensitivity. The aim of the study is to compare the narrative photography (NP) and traditional learning (TL) methods applied to heart transplantation physical therapy, as they relate to physical therapy students' knowledge, empathy, satisfaction, and moral sensitivity.

This is a randomized contorlled trial with 117 participants of third year of Physiotherapy Degree. Students were divided into two groups: i) NP group (n = 56), and ii) TL group (n = 61).

Physical therapy knowledge in heart transplantation, empathy, and moral sensitivity were measured pre-intervention and post-intervention in both groups. Satisfaction was measured post-intervention in the NP group.

Study Design

Study Type:

Interventional

Actual Enrollment :

117 participants

Allocation:

Randomized

Intervention Model:

Parallel Assignment

Masking:

Single (Outcomes Assessor)

Masking Description:

The outcomes assessor was blinded to group allocation. A blinded assessor collected all baseline and post-intervention measures and entered the data.

Primary Purpose:

Other

Official Title:

Physical Therapy Students' Reflective Thinking With Narrative Photography in Heart Transplantation

Actual Study Start Date :

Sep 1, 2021

Actual Primary Completion Date :

Jun 30, 2022

Actual Study Completion Date :

Jun 30, 2022

Arms and Interventions

Arm	Intervention/Treatment
Experimental: Narrative photography group Students in the NP group performed training activities on empathy and care for patients undergoing heart transplantation.	Other: Narrative photography Students were shown real-life written stories, audio, and videos using a private online platform. The training activity included four modules: i) heart transplantation waiting list; ii) life expectancy, fear of death, and organ rejection; iii) post-transplant physical and functional limitations; and iv) lack of knowledge of physical exercise patients can perform. The students were encouraged to think about how they would feel if they had undergone heart transplantation. Afterward, they had to communicate these feelings using up to three photographs and reflective explanatory text. Two weeks later, the students met a heart transplantation expert patient followed by an educator-guided debate. Students' images were shared and discussed. Moreover, students were encouraged to explain their feelings and their acquired skills (two hours).
Active Comparator: Traditional learning group Students in the TL group performed a conventional intervention without real patients.	Other: Traditional learning A participatory lecture was carried out, in which cardiac rehabilitation in heart transplantation patients was explained. Then, there was an educator-guided debate about protocols and actions (one hour). Second, the students autonomously prepared clinical cases on physical limitations, physical exercise, risk factors, and life after transplantation (two hours). Two weeks later, the clinical session was held among students (2 hours). They adopted the roles of physical therapists or transplant patients to work on: i) post-transplant physical and functional limitations; ii) lack of knowledge of the physical exercise the patient can perform; iii) control of cardiovascular risk factors; iv) life post-transplant.

Arm

Intervention/Treatment

Experimental: Narrative photography group

Students in the NP group performed training activities on empathy and care for patients undergoing heart transplantation.

Other: Narrative photography

Students were shown real-life written stories, audio, and videos using a private online platform. The training activity included four modules: i) heart transplantation waiting list; ii) life expectancy, fear of death, and organ rejection; iii) post-transplant physical and functional limitations; and iv) lack of knowledge of physical exercise patients can perform. The students were encouraged to think about how they would feel if they had undergone heart transplantation. Afterward, they had to communicate these feelings using up to three photographs and reflective explanatory text. Two weeks later, the students met a heart transplantation expert patient followed by an educator-guided debate. Students' images were shared and discussed. Moreover, students were encouraged to explain their feelings and their acquired skills (two hours).

Active Comparator: Traditional learning group

Students in the TL group performed a conventional intervention without real patients.

Other: Traditional learning

A participatory lecture was carried out, in which cardiac rehabilitation in heart transplantation patients was explained. Then, there was an educator-guided debate about protocols and actions (one hour). Second, the students autonomously prepared clinical cases on physical limitations, physical exercise, risk factors, and life after transplantation (two hours). Two weeks later, the clinical session was held among students (2 hours). They adopted the roles of physical therapists or transplant patients to work on: i) post-transplant physical and functional limitations; ii) lack of knowledge of the physical exercise the patient can perform; iii) control of cardiovascular risk factors; iv) life post-transplant.

Outcome Measures

Primary Outcome Measures

Knowledge of physical therapy in heart transplantation [Baseline]
Knowledge of physical therapy in heart transplantation was measured using an ad-hoc multiple-choice questionnaire. To avoid any test preparation, students were not informed that there would be knowledge tests. The tests included 10 multiple-choice questions that assessed physical therapy knowledge of heart transplantation-related issues-this included rate of perceived exertion, cardiopulmonary exercise test, cardiac rehabilitation, symptoms, and signs. The minimum and maximum values were 0 and 10, respectively. Higher scores mean a better outcome.
Knowledge of physical therapy in heart transplantation [After the intervention (2 weeks)]
Knowledge of physical therapy in heart transplantation was measured using an ad-hoc multiple-choice questionnaire. To avoid any test preparation, students were not informed that there would be knowledge tests. The tests included 10 multiple-choice questions that assessed physical therapy knowledge of heart transplantation-related issues-this included rate of perceived exertion, cardiopulmonary exercise test, cardiac rehabilitation, symptoms, and signs. The minimum and maximum values were 0 and 10, respectively. Higher scores mean a better outcome.

Secondary Outcome Measures

Empathy using the Interpersonal Reactivity Index [Baseline]
Empathy was measured using the Interpersonal Reactivity Index (IRI). The tool comprises 28 Likert questions ranging from 1 to 5 (1 = it does not describe me at all; 5 = it describes me very well). Four dimensions were explored using this questionnaire. These were perspective taking, fantasy, empathetic concern, and personal distress. Each scale score was the sum of the responses given for each item. The minimum and maximum values were 28 and 140, respectively. Higher scores reflected greater empathy.
Empathy using the Interpersonal Reactivity Index [After the intervention (2 weeks)]
Empathy was measured using the Interpersonal Reactivity Index (IRI). The tool comprises 28 Likert questions ranging from 1 to 5 (1 = it does not describe me at all; 5 = it describes me very well). Four dimensions were explored using this questionnaire. These were perspective taking, fantasy, empathetic concern, and personal distress. Each scale score was the sum of the responses given for each item. The minimum and maximum values were 28 and 140, respectively. Higher scores reflected greater empathy.
Moral sensitivity with the Revised Moral Sensitivity Questionnaire [Baseline]
Moral sensitivity was measured with the Revised Moral Sensitivity Questionnaire (RMSQ). The questionnaire included nine items rated on a 6-point Likert scale (1 = totally disagree, 6 = totally agree). The RMSQ comprises three dimensions. These are a sense of moral burden, moral strength, and moral responsibility. The minimum and maximum values were 9 and 54, respectively. Higher scores reflected greater moral sensitivity.
Moral sensitivity with the Revised Moral Sensitivity Questionnaire [After the intervention (2 weeks)]
Moral sensitivity was measured with the Revised Moral Sensitivity Questionnaire (RMSQ). The questionnaire included nine items rated on a 6-point Likert scale (1 = totally disagree, 6 = totally agree). The RMSQ comprises three dimensions. These are a sense of moral burden, moral strength, and moral responsibility. The minimum and maximum values were 9 and 54, respectively. Higher scores reflected greater moral sensitivity.
Satisfaction questionnaire [After the intervention (2 weeks)]
Satisfaction questionnaire was measured using a narrative photography questionnaire. This tool has previously been used to evaluate students' satisfaction with the narrative photography methodology as a tool to improve their skills and attitudes. This 32-item questionnaire was composed of sociodemographic questions, satisfaction with improving attitude, satisfaction with improving skills, and general satisfaction. It uses a 5-point Likert scale (1 = totally agree, 5 = totally disagree). The percentage of people who have rated each item is then calculated. Additionally, the questionnaire included a reflective open-ended question.

Eligibility Criteria

Criteria

Ages Eligible for Study:

19 Years to 50 Years

Sexes Eligible for Study:

All

Accepts Healthy Volunteers:

Yes

Inclusion Criteria:

Third-year physical therapy students who were studying the heart transplantation physical therapy course in a Physical therapy Degree.

Exclusion Criteria:

Who did not meet the above inclusion criteria.

Contacts and Locations

Locations

	Site	City	State	Country	Postal Code
1	University of Valencia	Valencia		Spain	46010

Sponsors and Collaborators

University of Valencia

Investigators

Principal Investigator: Elena Marqués Sulé, PhD, Univeristy of Valencia

Study Documents (Full-Text)

None provided.

More Information

Publications

Responsible Party:

Elena Marques-Sule, Professor, University of Valencia

ClinicalTrials.gov Identifier:

NCT05800912

Other Study ID Numbers:

1821073

First Posted:

Apr 6, 2023

Last Update Posted:

Apr 6, 2023

Last Verified:

Mar 1, 2023

Individual Participant Data (IPD) Sharing Statement:

Plan to Share IPD:

Studies a U.S. FDA-regulated Drug Product:

Studies a U.S. FDA-regulated Device Product:

Keywords provided by Elena Marques-Sule, Professor, University of Valencia

Physiotherapy

Education

Heart transplantation

Study Results

No Results Posted as of Apr 6, 2023