Transdisciplinary Clinical Practice between Physiotherapists and Traumatologists in Orthopaedic Medicine

Introduction: The transdisciplinary scope is conceived as an emerging practice and corpus of knowledge since it comes from the interactions between different disciplines. Transdisciplinarity emerges to solve in a more efficient way health problems of humanity that overcome the traditional biomedical interdisciplinary attention model. In this article, the transdisciplinary physiotherapist is exposed as the beginning of an authentic dialogue between the physiotherapist and the traumatologist in the care of the orthopedic patient that includes all treatment phases of integral rehabilitation, as well as its factors to consider the possible advantages and dares that this scope may present to the health services. Objective: This paper aims to propose to the scientific community the context of transdisciplinary clinical practice between traumatologists and physical therapists. Methods: It is performed a grounded theory approach to develop a thesis based on our observations and a reflection of literature that intends to explain transdisciplinary clinical practice phenomenon between traumatologists and physical therapists and pose the potential outcomes of this interactions and its implications. Conclusion: Exist theoretical and practical background to support the clinical practice of transdisciplinary care in Orthopedic and Physical Therapy attention; which make possible professionals to develop transdisciplinary clinical skills, and team shared decision making. Transdisciplinary clinical practice, as with any educational process, should ideally foster specific shared competencies in healthcare professionals, including teamwork, leadership, consensus building, the ability to identify and achieve common patient care goals and variable shared practical skills that may even include other specialization areas.

Perceptions of Orthopaedic Medicine Students and Their Supervisors About Practice-Based Learning: An Exploratory Qualitative study

Background Practice based learning is crucial in forming appropriate strategies for improving learning among the medical students that support the country’s understaffed health sector. Unsatisfactory learning consequently results into poor performance of students and poor quality of health care workforce in the long run. Exploring the perceptions about the current practice-based learning system and how to improve is thus vital. This study therefore set out to explore perceptions of Orthopaedic medicine students and their supervisors about practice-based learning at a tertiary training hospital. Methods This was an exploratory qualitative study that involved in-depth interviews among 10 orthopedic students during their rotation in the emergency ward of Mulago hospital and 6 of their supervisors. Interviews were audio recorded, transcribed and then imported into Atlas ti 8.3 for analysis. The data was coded and grouped into themes relating to perceptions of practice-based learning, general inductive analysis was used. The general inductive approach involved condensing the raw textual data into a brief and summary format. The summarized format was then analyzed to establish clear links between the perceptions of practice-based learning and the summary findings derived from the raw data. Results Perceptions explored in the in-depth interviews included: presence of too many students on the wards during the rotation, frequent stock-outs of supplies for learning and supervisors being overwhelmed caring for the large number of patients. Conclusion Barriers to satisfactory practice-based learning were overcrowding on the wards and insufficient training materials. In order to improve practice-based learning, adequate learning materials are required and the number of students enrolled need to be appropriate for the student – supervisors’ ratio.

Applying the Hashin–Shtrikman bounds to predict stiffness of multicomponent 3D printed structures: Towards regenerative orthopaedic medicine

Customised orthopaedic implants made from polymer materials would have advantages over metallic implants, if the mechanical properties could be matched more closely to bone. Here, the Hashin–Shtrikman bounds for isotropic composites are used to examine the feasibility of using scaffolds made from 3D printed polyether–etherketone (PEEK) that may adequate modulus immediately after printing, but when integrated and mineralised could approach the modulus of bone. The ability to predict the mechanical properties of 3D printed objects is essential for skeletal implants that require both immediate and long-term strength, such as the mandible and the femur. However, there is no method for predicting the change in mechanical properties due to the effect of ossification of bone scaffolds. Our aim was to calculate the upper and lower limits of the elastic moduli of polymer composites using the Hashin–Shtrikman bounds for isotropic composite solids and use them to compare the pre- and post-ossification properties for a range of scaffolds. We describe 3D printed PEEK as a composite of fully dense PEEK and air, water or bone. We confirm, by mechanically testing three designs, that our 3D printed scaffolds lie within the Hashin–Shtrikman bounds for PEEK–air composites. Improvements in strength achieved by integrating the PEEK scaffold with bone are predicted by calculating the Hashin–Shtrikman bounds for a three-phase composite and show the feasability of reaching bone equivalence. These predictions can be implemented for orthopaedic applications, customising the implant such that it can provide the appropriate immediate and long-term mechanical support for a specific implant size.