We have designed a curriculum based on our scoping review, interviews and consensus process. We use this curriculum to make an online course that will be available from January 2021. The curriculum might develop during this process and will be updated on this page.
Course Aim
This course will enable physiotherapists to develop competencies to provide equitable, high quality and culturally responsive rehabilitation for people with refugee experience. Using applied reasoning we will explore a range of topics including migration experience, health systems, legislation and their impact on refugee health. This will enable learners to understand their scope of practice and role to provide person centred and deal with ambiguity and changing situations when working with people with refugee experience.
Course Design and Pedalogical Approach
The course will be made up of ten blocks and will be run over ten weeks. This course equates to 5ECTS credits and will take participants approximately 102-140 hours to complete. Participants will have two options regarding the structure of the course. In the first option, the Stream, participants will complete the blocks in sequential order. There will be facilitated discussion sessions in each block so all participants will need to complete each block on time so that they are ready to contribute in the next discussion. Participants who choose the second option, the Garden, will be able to complete the blocks in whichever order they prefer. The assessments and facilitated discussions will be different for those taking the Garden option and will be decided by the participants as a group.
The course has been designed under the philosophy of ‘mindlines’ with the aim that evidence from a range of sources is synthesised with knowledge gained from experience to become internalised as the learner’s personal guide to practice. The course will help the learner to develop phronesis on which to base decisions so that when the context changes, their thinking can adapt and change to meet the new circumstances. Reflection is a core component of this course and participants will be asked to reflect on their own beliefs, behaviours and practices and to identify gaps in their knowledge. Participants will be presented with complex case studies and ethical dilemmas to allow them to put their knowledge and reflections into practice. Central to the course will be recognition that persons with refugee experience are individuals and that principles and practices cannot be applied in a blanket approach but instead must be tailored to the individual.
The course is aimed at physiotherapists who are novice in the area of working with people with refugee experience. Learning activities will include group discussions, reading materials, videos, case studies, reflective activities, quizzes and assignments (e.g. essays, guidelines for accessing care, advocacy letter). Before beginning the course, participants will be asked to complete a pre-course competency and confidence check. They will also be asked to complete this again at the end of the course.
Intended Learning Outcomes
Through engagement with this course, participants will:
- Seek country specific knowledge about policy and legislation in the migration field to enhance their understanding of the life situation of people with refugee experience.
- Recognize when past and/or present violation of human rights has occurred and take action as required.
- Cultivate cultural sensitivity in order to create a trusting therapeutic space and facilitate communication with patients and significant others.
- Identify barriers to accessing healthcare and increase knowledge of health systems and support networks to enable them to guide people with refugee experience towards empowerment and optimal service.
- Strive to reduce barriers to interprofessional communication and facilitate effective interprofessional teamwork.
- Detect and document health, functioning and disability stemming from the migration process and adapt treatment approach as appropriate.
- Use holistic approaches to reduce the impact of trauma and address patient difficulties related to pain, trauma and psychosocial issues.
- Explore what the physiotherapy role can be in response to challenges and to patients’ changing needs.
- Recognize the importance of self care, peer guidance and multiprofessional teamwork to safeguard and sustain their own health.
- Take a critical role towards current practice and act as a change agent.
Topics
- A brief history of refugees including definitions of terms
- Global context – geopolitics, where refugees are from and where they go, the changing political landscape
- Legislative differences between countries
- The Dublin regulation
- Epidemiology of communicable and non-communicable disease among poeple
- Epidemiology of mental health problems among people with refugee experience
- Climate migrants
- Barriers to accessing healthcare in host countries including bias and stereotyping.
- Understanding of refugees’ expectations of the health care system
- How society and the media contextualises and portrays people with refugee experience.
- Human rigths.
- Overcoming barriers to accessing care and providing guidance for navigating the healthcare system
- Carlos Sluzki’s Model of Migration
- Interprofessional working to improve access to services and navigation of health service.
- Duty to document human rights violations (past and present).
- Physiotherapist’s role in terms of working with people with refugee experience
- Changing role of physiotherapy
- Scope and boundaries of physiotherapy practice
- Self-care for health professionals
- Interprofessional teamwork strategies
- Peer guidance
- Addressing racism in the workplace
- Advocacy strategies
- Salutogenetic approach to wellness.
- Health-related factors and determinants of health
- Health literacy
- Consequences of migration and living in exile
- Stages of the migration process and their influence on migrants’ health
- Trauma-informed care.
- Holistic approaches to address patient difficulties related to trauma and psychosocial role
- PTSD
- Providing care for survivors of torture (understanding types and consequences of torture)
- Mental health and physiotherapy
- Considerations for working with children with refugee experience
- Biopsychosocial approach
- ICF model
- AAAQ framework
- Cultural differences in understanding of pain
- Physiotherapy assessment of pain within a trauma-informed care model
- Evidence-based management of pain
- Cultural beliefs about pain and alternative therapies
- Building trust and creating therapeutic space and alliance
- Building a therapeutic relationship and facilitation of communication
- Use of translator and understanding the role of the translators (overcoming challenges, strategies to emply)
- Cultural self-awareness
- Providing culturally sensitive care
- Ethical issues related to different beliefs about health and illness
- Culturally sensitive palliative care and cultural beliefs about dying
