Advanced Certification in Pelvic Health

Transcription

1 Advanced Certification in Pelvic Health Curriculum July

2 Advanced Certification in Pelvic Health Program Director: Jennifer Stone PT, DPT, OCS, Certified Pelvic Health Therapist Program Description This Advanced Certification program incorporates critical thinking, clinical judgment, research knowledge and foundation, teaching opportunities, and mentoring to generate thoughtful clinicians, knowledgeable teachers, and evidence based practitioners specializing musculoskeletal treatment of pelvic floor dysfunction. This advanced level program consists of mentored teaching experience, enhanced virtual rounds with case based discussion, and a series of advanced clinical practice topics participants can choose from to further tailor their educational experience. Advanced Pelvic Health Certification Program Objectives: 1. Advance clinical knowledge and skills in the area of pelvic musculoskeletal health care for men, women, and children. Deepen knowledge and application of such skills as therapeutic neuroscience education application, trigger point dry needling, and visceral mobilization work, among others. 2. Advanced teaching skills both in didactic teaching and technique demonstration/teaching. Both online and in person mentored teaching will be included. 3. For Advanced Certification students, targeted mentoring will further deepen knowledge and application of clinical skills and advanced clinical reasoning. 4. Participation in the community and education within the community. Admission requirements 1. Completion of Evidence in Motion s Pelvic Health Certification Program or equivalent. (NOTE: If completed Pelvic Health Training from another educational institute please review the portfolio requirements below) 2. All applicants must have and submit a current license to practice physical therapy or occupational therapy in a US state. This license must not be under suspension, revocation, probationary status, or subject to disciplinary proceedings or inquiry. 3. Have a minimum of one year of postprofessional pelvic health clinical experience. 4. Be graduates from a APTA accredited Physical Therapy Program or AOTA accredited Occupational Therapy Program. 5. Portfolio Requirements for students that did not complete EIM s Pelvic Health Certification Program: i. Completion of APTA Section on Women s Health Pelvic Health Physical Therapy levels 1-3 OR Herman & Wallace Pelvic Floor 1, 2A, 2B, and 3 or equivalent 2

3 ii. Documentation of number of hours spent treating primary pelvic floor dysfunction iii. Short statement on philosophy for pelvic health integration into therapy plan of care for patients of various types iv. Relevant teaching, research, or clinical mentoring experiences in the area of pelvic health v. Telephone interview with program director 6. If English is not the applicant s native/first language, specified language proficiency requirements must be met. 7. All applicants must have and submit current CPR certification and professional liability insurance coverage that applied to all clinical settings in which they work. Curriculum The EIM Advanced Pelvic Health Certification program consists of 17 credit hours of blended online and onsite learning. The student has 3 years (36 months) of active enrollment to complete the program. The curriculum consists of the following outlined academic courses: TPS 6410 Therapeutic Neuroscience Education 4 ORPT 6530 Advanced Pelvic Floor Assessment and Intervention 5 PHPT 6510 Pelvic Health I (TA and Virtual Rounds) 1 PHPT 6520 Pelvic Health II (TA and Virtual Rounds) 1 RES 6110 Writing Case Reports and Case Series* 1 PHPT 6110 Lifestyle Considerations* 1 PHPT 6120 Sexuality Considerations* 1 PHPT 6130 Pelvic Floor Post-Op/Pharmacology* 1 PHPT 6140 Special Populations* (Includes Peds)* 1 PHPT 6160 Pelvic Heath From Adolescence Through Older Adulthood* 1 PHPT 6170 Body Systems Impacting Pelvic Musculoskeletal Health* 1 FDN 6150 Functional Dry Needling of the Pelvic Floor* 1 (**FDN 6110 pre-req) - Will count toward 2 elective options. The FDN 6110 is not included within this tuition) PROF 6100 Professionalism: Roles and Responsibilities* 1 PHPT 7190 Targeted Pelvic Health Clinical Mentoring* 2 PHPT 7670 Pelvic Health Virtual Rounds 3 PHPT 7090 Scholarly Project/Capstone Examinations N/C 17 credits *Elective courses: Advanced Certification students will complete a minimum of (3) 3

4 ISPI 6410 Therapeutic Neuroscience Education 4 credits Description: Teaching people about pain can have a therapeutic effect. This course is designed to update attendees on the latest evidence and clinical application of therapeutic neuroscience education for patients in pain. Current best evidence has shown that neuroscience educational strategies utilizing neurobiology and neurophysiology are able to reduce pain, increase function, reduce fear and catastrophization, and improve movement and change cognitions and brain activation during pain experiences. Therapeutic neuroscience education changes patient beliefs regarding their pain, thus reducing the threat of pain. This course will discuss the evolution of therapeutic neuroscience education, why neuroscience education is needed in patient care and, more importantly, the clinical application and implementation of therapeutic neuroscience education for patients with acute, sub-acute and chronic pain. Special features include various metaphors, images, examples and case studies explaining neuroscience to patients in pain. In addition, the class will cover clinical issues such as compliance, pacing exercise and activity, incorporation of therapeutic neuroscience education with traditional movement based therapy, billing and insurance reimbursement concerns and delivering therapeutic neuroscience education in busy, time-constrained clinical environments. This class is a must for all professionals dealing with patients in pain. : 1. Discuss the latest evidence for therapeutic neuroscience education 2. Demonstrate the clinical ability to apply therapeutic neuroscience education to clinical practice with the use of at least one metaphor shared in class. 3. List at least half of the output systems discussed in class and their response in a chronic pain patient 4. List potential strategies to implement therapeutic neuroscience into clinic practice regarding time, staff, billing and traditional therapeutic treatments 5. Design a treatment plan for a chronic pain patient based on output system dysfunctions with correct pain neurophysiological reasoning behind the treatment with information provided in the course. PHPT Advanced Pelvic Floor Treatment and Intervention 5 credits This advanced management course uses research and case based didactic learning to explore topics related to pelvic health management, including differential diagnosis, male pelvic floor assessment and intervention, pediatric pelvic floor assessment and intervention, nutritional and hormonal applications for the pelvic floor, pelvic floor care in patients with a history of cancer, common comorbidities impacting patients with pelvic floor dysfunction, and care for patients who have undergone a surgical procedure to or impacting the pelvic floor. The associated 4

5 weekend intensive goes through advanced techniques for visceral mobilization, male specific techniques, myofascial and rectal techniques, and a brief introduction to dry needling applications for the pelvic floor. 1. Participants will demonstrate an advanced knowledge of pelvic floor assessment and differential diagnosis and be able to generate plans of care that take into consideration all accompanying comorbidities and lifestyle related challenges. 2. Participants will demonstrate ability to perform selected visceral mobilization techniques as well as understanding of when and how to select patients for use of these techniques. 3. Participants will demonstrate clear understanding of nutrition and hormonal impacts on the pelvic floor as well as ability to help patients adjust their choices in these areas to optimize outcomes. 4. Participants will demonstrate ability to review the literature to come up with the answer to a pre-selected question and make an informed choice due to available current evidence. 5. Participants will demonstrate clear understanding of surgical procedures that impact the pelvic floor and demonstrate the ability to come up with suggested post-surgical protocols for these procedures. PHPT 6510/6520 Pelvic Health I & II (TA/Rounds) 2 credits Participants will re-take Pelvic Health I and II (8 weeks with weekend intensive each) in the role of teaching assistant. They will be responsible for creating a higher level discussion post with additional resources pulled in for that week s topic as well as interacting with and grading Pelvic Health Certification students on their weekly discussion posts. Additionally, there will be a required concurrent Virtual Rounds which will consist of a weekly real-time meeting via conference call during which participants will present cases which are relevant to that week s topic of choice to drive deeper discussion into higher level clinical processes and patient management. 1. Participants will demonstrate ability to teach and give high level feedback to students going through the material for the first time, both via didactic online discussion and in person weekend intensive technique demonstration and discussion. 2. Participants will demonstrate ability to present case discussions which drive higher level conversations and thought processes for complex patient management. 5

6 3. Participants will demonstrate ability to teach via advanced discussion and research into the topic at hand for the benefit of one another and the certificate students. RES 6110 Writing Case Reports & Case Series* This course is designed to improve knowledge regarding the importance of case reports/series in the medical literature and provides the foundation of the skill-set needs as Fellows-in- Training (FiT) work towards completing their own original case report or case series. This course reviews the steps involved in completing a case report suitable for publication. This involves examining foundational material and critiquing the initial submission of a published case report. Learning the process of producing a meaningful case report along with the ability to critically appraise other published reports will improve the student's foundational knowledge as an evidence-based clinician. PHPT 6110 Lifestyle Considerations* This elective course is designed to give the student an understanding of how certain lifestyle factors may contribute to orthopedic conditions and pelvic floor dysfunction and pain as well as provide an overview of additional factors that may impact the pelvic floor. 1. Explain how to complete a bladder/bowel diary and the purpose of completing diary. 2. Discuss common comorbidities and their impact on the pelvic floor. 3. List the most common dietary irritants to the bladder. 4. Demonstrate appropriate recommendations and interventions for lifestyle modification to aid in recovery of pelvic pain and dysfunction. PHPT 6120 Sexuality Considerations* Patients with pelvic floor dysfunction may also exhibit sexual dysfunction. This elective course is designed to teach the student how to take a history from a client with sexual dysfunction. The student will learn modifications for sexual positioning for clients with orthopedic or pelvic floor dysfunction. 1. Describe normal physiological processes that occur during intercourse. 2. Demonstrate understanding of psychosocial factors associated with sexual dysfunction. 6

7 3. Determine appropriate positioning modifications for the patient with orthopedic and pelvic floor dysfunction. 4. Demonstrate an understanding of reproductive anatomy. 5. Develop intimacy plans for clients and couples wishing to return to intimacy. PHPT 6130 Pelvic Floor Post-Op/Pharmacology* This elective course is designed to give the student knowledge of surgical techniques used to treat pelvic floor disorders, post surgical rehabilitation, and common medications used in the treatment of pelvic floor disorders. 1. Demonstrate understanding of the most common gynecologic, urologic, and urogynecologic surgeries. 2. Know contraindications for exercise following these surgeries. 3. List common medications used to treat bladder and bowel dysfunction and their effects on the client. PHPT 6140 Special Populations* This elective course describes the etiology, pathology, and prognosis for pelvic floor dysfunction in some populations that are often overlooked even by pelvic floor therapists: men, athletes, children, and postmenopausal women. The learner will receive information allowing him or her to understand the variation in care that is needed for each of these populations as well as learn how to incorporate pelvic floor intervention into these populations when the pelvic floor is a primary or secondary component of their complaint. 1. Describe the etiology, pathology, and prognosis for pelvic floor dysfunction in men, athletes, children, and postmenopausal women. 2. Understand and be able to describe the variation in treatment plan that is needed for all of the above mentioned special populations. 3. Describe and implement a plan for treatment for the above mentioned special populations. 7

8 PHPT 6170 Body Systems Impacting Pelvic Musculoskeletal Health* This self-directed 4 week elective course overviews normal anatomy and physiology of the gastrointestinal, urinary, and male and female reproductive systems as well as providing a brief overview of common pathologies that will impact each and which may impact the structure and function of the pelvic floor. 1. Participants will demonstrate understanding of normal physiology of the gastrointestinal, urinary, and reproductive systems. 2. Participants will demonstrate understanding of common pathologies that impact the gastrointestinal, urinary, and reproductive systems as well as potential impact on pelvic floor. 3. Participants will be able to engage in informed dialogue with other medical practitioners to enhance patient care and outcomes. PHPT 6160 Pelvic Floor from Adolescence Through Older Adulthood* This self-directed 4 week course seeks to educate the pelvic health practitioner on normal pelvic floor changes that occur during the life span, during adolescence, childbearing years, during and after menopause, and during older adulthood. Participants will also learn about common pelvic floor dysfunction during these time periods and be able to screen for common and uncommon problems following completion of this course. 1. Participants will be able to articulate challenges inherent with each of the stated periods of life as well as discuss appropriate ways to address each. 2. Participants will demonstrate understanding of normal changes to the pelvic floor at each stage and have an ability to distinguish normal age related changes from pathology or dysfunction. 3. Participants will be able to customize their plan of care to accommodate for needs specific to each age category and adjust care appropriately. FDN 6150 Functional Dry Needling of the Pelvic Floor* (Note: FDN 6110 is a prerequisite. This course can count toward 2 elective options. The cost of this course is not included as part of the Pelvic Health Adv. Cert. tuition) Functional Dry Needling of the Pelvic Floor is a lab intensive on-site course designed to instruct participants in the application of dry needling to female and male pelvic floor musculature and 8

9 associated neuroanatomical structures including the thoracolumbar spine, abdomen, pelvis and hip joint complex. This course will provide a comprehensive review of anatomy, practice handson examination techniques and discuss clinical reasoning related to disorders of the pelvic floor. This course is a revolutionary approach to treating patients with pelvic floor dysfunction commonly associated with pelvic pain, incontinence, voiding dysfunction and/or sexual pain or dysfunction. Dry needling will assist with the restoration of muscle function, improve proprioception, reduce and eliminate pain, and normalize tissue sensitivity to optimize patients function and quality of life. 1. Participants will demonstrate competency with anatomy, palpation and the application of dry needling to the muscles of the pelvic girdle, thoracolumbar spine, and abdomen. 2. Participants will understand the rationale for selecting dry needling to achieve optimal patient outcomes using clinical reasoning and evidence-based practice. 3. Participants will gain a strong appreciation of neurology and dysfunction in the nervous system associated with the pelvic floor, including visceral and somatic dysfunction. 4. Participants will practice the application of electrical stimulation with dry needling to the pelvic floor and associated anatomical structures to improve identified neuromuscular dysfunction. PROF 6100 Professionalism: Role and Responsibilities * This course covers the following topics: 1. Understand the importance and impact of participation in professional associations. 2. Review the core values of professional associations and how they pertain to the topic of professionalism. 3. Understand what it means to be a professional and how it differs from simply having an occupation. 4. Understand the importance of communication skills with colleagues and clients. 5. Develop an appreciation for legislative efforts, how it impacts our profession and patients, and learns ways to become more engaged. PHPT 7190 Targeted Pelvic Health Clinical Mentoring* 2 credits Participants will complete 30 hours of clinical mentoring, at least 20 of which must take place 1:1 in a clinical setting (either shadowing the mentor or having the mentor shadow them). The 9

10 remaining 20 hours may be 1:1 in the clinical setting or consist of case discussion via phone or video conference call. Mentors may be program faculty or qualified mentors in the community (must submit qualifications to program director for approval). This course will be graded based on documentation of time spent/how time was spent and feedback from the clinical mentor as well as submission of a video of a mentoring session (not necessarily a clinical session). Documentation of the completed mentorship hours must be submitted prior to the capstone examinations. Note: This course will count as 2 credits and/or 2 electives. Objectives: 1. Participants will observe and/or be observed in clinical practice, paired with detailed case and clinical reasoning discussion to promote advanced diagnostic and problem solving skills as well as the acquisition of skills. 2. Participants will develop the ability to present cases to their mentor in an efficient yet thorough way to promote effective case discussion. PHPT 7670 Pelvic Health Virtual Rounds 3 credits Virtual Rounds will take place throughout the program and will consist of case based discussion. Students are expected to demonstrate advanced clinical reasoning during these Virtual Rounds. These discussions will take place weekly during Pelvic Health I and II, and advanced certification students will take turns presenting cases relevant to the weekly topics during these courses. There will be an additional 4 week long Virtual Rounds which will take place following the Advanced Pelvic Floor course which will be focused on the topics covered during this course. PHPT 7090 Capstone Scholarly Project N/C All students will complete a capstone project at the conclusion of the program. This may consist of a case study written up and submitted to a journal, an in depth case presentation recorded for the purposes of education, a presentation given to the community to raise awareness about pelvic health, or a presentation to other healthcare providers to raise awareness about pelvic health physical therapy. Project proposals must be submitted to the program director for approval. 10