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Undergraduate occupational therapy students’ perceptions of their preparedness for splinting in hand rehabilitation: An exploratory study at the University of KwaZulu-Natal

by Sizophila Gwala, Nompumelelo Mtshali, Sithembile Nene, Casey Stanley, Luther Lebogang Monareng

Background

Hand rehabilitation, particularly splinting, is a key area in occupational therapy. However, existing literature suggests that students often feel inadequately prepared, particularly concerning splinting in hand rehabilitation. This highlights the need for further research and improvements. This research explored the perceptions held by undergraduate occupational therapy students regarding splinting in hand rehabilitation at the University of KwaZulu-Natal, with the aim of informing curriculum improvements. The novelty of this study lies in its focus on the University of KwaZulu-Natal, providing institution-specific insights that are currently underexplored in the literature, using Kolb’s Experiential Learning Theory, to contextualise this study.

Methods

This qualitative study gathered data from 3rd and 4th year occupational therapy students at the University of KwaZulu-Natal using purposive sampling. The Consolidated Criteria for Reporting Qualitative Research (COREQ): a 32-item checklist for interviews and focus groups was followed. The data were collected through semi-structured interviews using a piloted question guide and thematic analysis was used to analyse the data. Ethical clearance was received for this research.

Results

This research comprised 16 participants: n = 5 males and n = 11 females, all of whom were undergraduates. The number of physical clinical fieldwork blocks completed by the participants ranged from two to three. The number of splints made during these blocks ranged from no splints to four or more. Four distinctive themes emerged: student readiness and preparedness, challenges in splinting, comparison of readiness in 3rd and 4th year, and suggested solutions to bridge the gaps.

Conclusion

Despite acquiring theoretical knowledge, students felt underprepared and uncertain due to limited clinical opportunities, inadequate supervision, and minimal hands-on practice during fieldwork. This lack of confidence and competence may deter students from pursuing specialisation in hand rehabilitation. To address these gaps, students recommended strategies such as increasing practical time dedicated to splinting, introducing training earlier in the program, expanding the splinting curriculum to cover a broader range of splint types, and strengthening university support structures, which align with existing literature, that emphasises the crucial role of hands-on experience in fostering confidence and competence. These findings have implications for curriculum development and suggest the need for policy reforms prioritising clinical competency in undergraduate occupational therapy education.

Interruptive versus Non-Interruptive Reminders for Statin tHerApy in Primary Care (INIRSHA-PC): protocol and statistical analysis plan for a randomised clinical trial

Por: Wright · A. P. · Choi · L. · Nairon · K. G. · Gatto · C. L. · Dear · M. L. · Van Winkle · G. · Lagalante · S. · Neal · E. B. · Wright · A. · Rice · T. W. · for the Vanderbilt Center for Learning Healthcare · Bernard · Dittus · Luther · Pulley · Self · Semler · Qian
Introduction

Statins are a cornerstone of cardiovascular disease prevention yet remain underused among eligible patients. Clinical decision support systems embedded in electronic health records (EHRs) are commonly used to encourage guideline-concordant prescribing. Interruptive reminders (eg, pop-ups) may be effective but interfere with clinical workflows and contribute to alert fatigue. Non-interruptive alerts are less intrusive, but their effectiveness remains unclear. The Interruptive versus Non-Interruptive Reminders for Statin tHerApy in Primary Care (INIRSHA-PC) trial is designed to evaluate the comparative effectiveness of interruptive and non-interruptive reminders on statin-prescribing rates.

Methods and analysis

INIRSHA-PC is a single-centre, pragmatic, three-arm, parallel-group randomised controlled trial embedded in the EHR at Vanderbilt University Medical Center. The trial will enrol adults aged 18–74 seen in primary care who are eligible for, but not currently prescribed, statin therapy. The planned sample size is 3000 patients (1000 per arm). Enrolled patients will be randomised 1:1:1 to (1) interruptive reminder, (2) non-interruptive reminder or (3) no reminder (usual care). The primary outcome is statin prescription within 24 hours of enrolment. Secondary outcomes are statin prescribing within 12 months and low-density lipoprotein cholesterol levels measured between 30 days and 12 months after enrolment. Enrolment began on 14 August 2024. The study is expected to be completed on 19 November 2025.

Ethics and dissemination

The trial has been approved by the Vanderbilt University Medical Center Institutional Review Board with waiver of patient informed consent (IRB number: 240419). Results will be disseminated through peer-reviewed publication and presentation at scientific conferences.

Trial registration number

NCT06456658.

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