Little has been published regarding methods to provide education about the International Classification of Functioning, Disability and Health (ICF) to Physical Medicine and Rehabilitation (PM&R) residents. Our goal was to increase knowledge of the ICF and encourage residents to use the ICF framework to inform their clinical thinking through a case-based exercise. Based on feedback from prior iterations of this assignment, we also hypothesized that this project would increase residents’ feelings of professional fulfillment.
First year PM&R Residents received a one-hour lecture on the ICF. They were then assigned a condition which corresponded to their clinical rotation (SCI, TBI, amputation, medical debility). They were instructed to pick a patient, explore their case using the ICF, and develop an intervention based on this review. They then presented these cases. Residents were asked to rate their familiarity with the ICF and how their understanding of the ICF shaped their clinical thinking both before and after the assignment. Responses were on a 5 point Likert scale. We also used the professional fulfillment portion of the Professional Fulfillment Index (PFI) to measure self-reported professional fulfillment before and after the assignment.
Self-reported understanding of the ICF among first year PM&R residents increased significantly. Clinical thinking influenced by the ICF also increased. Self-reported Professional fulfillment scores were relatively unchanged.
Our approach shows that a combination of didactic lecture and a case based approach using actual patient examples is an effective method to increase PM&R resident knowledge of the ICF. We believe this is a novel approach for ICF education. Self-reported professional fulfillment did not increase. This suggests that increased knowledge and experience using tools and understanding conceptual frameworks, like the ICF, does not impact professional fulfillment. It also suggests further study is necessary to understand what drives professional fulfillment in PM&R trainees.
Nick Freedman– Acting Assistant Professor, University of Washington Department of Rehabilitation Medicine
Nethra Ankam– Associate Professor, Sidney Kimmel Medical College at Thomas Jefferson University
Michael Mallow– Assistant Professor, Sidney Kimmel Medical College at Thomas Jefferson University