[Solved] discuss the principles of neurological physiotherapy, based on current neurological research

Course Work 2 – Report

Course work 2 is a 2,500 word report which critically evaluates the chosen treatment or management strategy in neurological physiotherapy. The main focus of this report is ‘critical evaluation’. You should examine the issue as though important clinical, educational, management, or resource decisions rely on your evaluation of the evidence. It is anticipated that the chosen topic will be relevant to your current, recent or anticipated development as a physiotherapist. The chosen topic will be the same area discussed in the presentation, but whereas the presentation will focus on clinical reasoning about a particular patient, the report will be a more general presentation of the evidence. You should discuss and agree your choice of area with the module leader. This course work addresses the learning outcomes 1, 2, 3 & 5.

The essay should be written in the style of a scholarly paper, as seen in the physiotherapy literature, and thus should avoid the use of the first person (for example ‘I’ or ‘we’). You will be expected to demonstrate analytical and evaluative skills throughout your report.

It is important that you incorporate the evidence (the literature) to support the points you are making, and this literature should be reported critically, not descriptively. Please look at the article by Pomeroy VM and Tallis RC (2003) Avoiding the Menace of Evidenced-tinged Neuro-rehabilitation Physiotherapy 89 (10), 595-601. (This article will be provided, and it is posted on CUOnline in the ‘Assessment’ box.) In the light of this article appraise the evidence concerning the topic you have been assigned.

 

We would like you to identify the principal pieces of research which are often referred to or cited when there is discussion of the subject concerned. In other words we are not expecting a full literature review or systematic review which attempts to review all the evidence available. However, you should report on any searches of the literature, and why you have selected the cited bits of evidence, and then integrate your discussion into a readable narrative. Those pieces of research identified should in theory be the best research, but on critical evaluation you may disagree. If so, you should identify which pieces of research (if any) are worth using to model clinical practice in the area under scrutiny and why. Even though not evaluating many pieces of research, you should have some idea of the breadth of literature on the subject, whether they come from one researcher or from many, whether the research has been principally on animals or human subjects, or on children but not adults, or on people with stroke but not on those with other neurological conditions etc. It may be appropriate to confine your report to the use of a treatment for a particular patient group, or for a particular condition, enabling you to be more precise, to take your analysis to greater depth, and to involve more specific critical appraisal. If you have any doubt about this please consult with the Module Leader.

Much of the literature which you incorporate should be in the form of paraphrasing, and summarising, rather than quotations. (If you are quoting from the literature, then the extract must be in quotation marks.) This demonstrates your understanding of the subject. You need to show not just your ability to include the right key words, but also to show your understanding of those key words by incorporating them into an argument, and that you are able to write about the subject in depth – giving detailed information to the reader. Again, you might look at the style used in scholarly papers to see how a topic might be explored in depth, to help you see how literature can be incorporated into an essay, and to see how authors can give their own conclusions on the subject.

 

The marker should be able to see in your work evidence of your understanding, your grasp of the breadth of the subject and your familiarity with the literature in the field. You should conclude with some recommendations about the use or non-use of your chosen treatment or management strategy.

Please use Arial font, size 12 and 1.5 spacing as a minimum, with a minimum of 2cm margins on each side of the page. At M level the emphasis in coursework is on synthesis. The learning outcomes should not be addressed separately. Critical thinking is also emphasised at M level, but this does not mean a succession of paragraphs each critiquing a research article. Your critique must be integrated into your overall argument. Use of headings, tables and diagrams may be appropriate but should not get in the way of synthesis, and they therefore need to be used judiciously. It is not appropriate to use appendices.

Module Learning Outcomes The intended learning outcomes are that on completion of this module the student should be able to:

  1. Critically discuss the principles of neurological physiotherapy, based on current neurological research;
  2. Integrate theoretical knowledge into plans for practice of neurological physiotherapy;
  3. Evaluate and critically appraise existing approaches to neurological physiotherapy; 4. Develop skills in assessment, clinical reasoning, and treatment, enabling more advanced holistic management of people with neurological disorders;
  4. Communicate effectively with colleagues, demonstrating ability to describe in depth assessment findings and to justify treatments with appropriate clinical reasoning.

Report writing: (further comments in addition to Module Handbook)

As with all Masters level assignments you are expected to show in your writing a Masters level awareness of the level of evidence for your statements, using critique, analysis and synthesis as is appropriate.

Here are some examples of official reports that you can see on the web:

 

http://webarchive.nationalarchives.gov.uk/+/http://www.dh.gov.uk/en/Publicationsandstatistics/Publications/PublicationsPolicyAndGuidance/DH_4074426

Wanless Report: Securing Good Health for the Whole Population (2004)

http://webarchive.nationalarchives.gov.uk/20121013010431/http://www.dh.gov.uk/prod_consum_dh/groups/dh_digitalassets/@dh/@en/documents/digitalasset/dh_4101475.pdf

Report of the Scientific Committee on Tobacco and Health (SCOTH), Secondhand Smoke: Review of evidence since 1998 (2004)

 

https://www.gov.uk/government/uploads/system/uploads/attachment_data/file/259796/report.pdf

Report of the Scientific Committee on Tobacco and Health (1998)

‘Each of the nine parts in this report presents the facts considered, draws conclusions and makes concise recommendations for action.’

Which sounds like a description of a Report(!).

First of all….

Use the lessons you have learnt from the Research and EBP modules. Remember the Pomeroy and Tallis article on Evidence Tinged Practice!

Critique and Synthesis

Whilst critique is an essential part of Masters level writing, it is rarely deployed to examine one research article in one paragraph, another research article in another paragraph, and a third research article in a third paragraph. This is often boring, and is a feature of undergraduate writing, where students do little more than find fault with the research, using newly acquired critiquing skills.

Your responsibility in a report is to make the corpus of research that you have found and read, accessible to the reader. This will require skills of synthesis as well as critique, looking for themes and connections. You might want to look at and present the corpus of evidence under different aspects such as methodologies/ methods/ types of study, or outcome measures, or populations investigated, incorporating your skills in critique as is appropriate as an important aspect of the presentation, but without it being the only focus.

Introduction

 

At the very least your introduction should:

  • define your subject and indicate broadly its extent, composition and clinical significance
  • state your purpose and terms of reference (which may include a specific question, e.g. ‘what is the effectiveness of….?’). It would be helpful to make this question structured and precise using PICO(T) or SPICE.
  • provide the background context which your readers will need, and which they may not know or clearly remember.

NB Bearing mind your target audience, there is no need to go into a huge amount of detail about the pathophysiology and prevalence of a common condition such as CVA. However, you might pick out a particular aspect of the pathology or prevalence that is particular to the outcome targeted by your treatment modality. For example, the high numbers of people with on-going upper limb problems after CVA is a relevant feature if you have chosen a treatment aimed at promoting better upper limb function. You might then mention aspects of pathophysiology relevant to UL recovery.

Use of PICO/ SPICE

Identifying a precise question will help you to structure your report. You may want to be specific about the population you are interested in, or about the outcomes of interest.

For example, the Report of the Scientific Committee on Tobacco and Health (1998) included sections on particular segments of the population (Pt 4 was on Smoking and Young People), and on particular outcomes (Pt 6.2 related to cancers of the Mouth and Pharynx, 6.3 to Tooth Loss, etc.).

Your short reports may be more focussed if they are limited to particular populations or to particular outcomes. But you may be forced to be more general by the lack of specific evidence.

Executive Summary?

For the short report for M53PH, I do not think an executive summary is necessary, so long as you spend some time in your conclusions making very clear the main points and recommendations of your report.

You may want to state fully or summarise your results, conclusions or recommendations at the beginning of the report (as in an Executive Summary), but it more normal in a report of this length to leave this to the conclusion.

Curve Resource on Report Writing:

There is a Curve resource which you can access via CUOnline > My Modules > Study Support > Study Skills Archive > Report writing, or by following this link

https://curve.coventry.ac.uk/cu/items/33362904-d31d-ad7a-a7ff-b5f63bca5bc2/1/studyskills.zip/INDEX_OLD.HTM  and scroll down to the bottom.

This resource is more about reports of engineering products and recommendations for changes in process, but there are some important reminders of good practice in report writing that you can use.

http://webarchive.nationalarchives.gov.uk/+/http://www.dh.gov.uk/en/Publicationsandstatistics/Publications/PublicationsPolicyAndGuidance/DH_063117

Report of the Expert Group on Phase One Clinical Trials (2006)

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