By Martina Lukin and Neelum Zehra for ReLAB-HS
The Learning, Acting, and Building for Rehabilitation in Health Systems (ReLAB-HS) clinical skills training program offered a rare opportunity for a multidisciplinary group of rehabilitation professionals in Pakistan to observe and train with a leading spinal cord injury rehabilitation center in Peshawar. The experience sparked a movement to improve rehabilitation outcomes in a neighboring province.
Interdisciplinary practice among rehabilitation professionals is still an evolving concept in Pakistan. Rehabilitation professionals rarely work together toward achieving shared patient goals. However, there is a growing drive among rehabilitation professionals in Pakistan to work toward a more cohesive approach based on the principles of interprofessional collaboration.
In September 2023, 14 rehabilitation professionals from two provinces of Pakistan (Sindh and Khyber Pakhtunkhwa) completed a three-month comprehensive training program covering all aspects of spinal cord injury (SCI) management. As part of the program, participants completed a series of online courses on the Plus eLearning platform, attended online mentoring sessions, and engaged in discussions on the Rehabilitation Community Platform.
A key component of the training program was a three-day, in-person, hands-on training hosted by the Paraplegic Center Peshawar (PCP) in Khyber Pakhtunkhwa, known throughout the country for its expertise in SCI management and training. The training offered a rare opportunity for the participants—occupational therapists, physiotherapists, prosthetists and orthotists, speech and language therapists, and clinical psychologists—to meet face-to-face and share experiences and differing management approaches with like-minded professionals from a neighboring province.
Nabeela Wali, an occupational therapist and lecturer at Ziauddin University in Sindh emphasized the value of the program in supporting her professional development. “Clinical skill training has been an integral part of my continued professional development, offering a bridge between theoretical knowledge and practical application. The hands-on experience gained through this training has been invaluable, enhancing my ability to assess, diagnose, and manage patient care effectively.”
After observing the quality of care provided by the rehabilitation professionals at PCP and the interprofessionalism they demonstrated, Neelum Zehra (also an occupational therapist at Ziauddin University) was encouraged to further implement her learning from the clinical skills training program. Together with other motivated training participants from Sindh, she sought out ways to improve the rehabilitation services available in Karachi.
The Sindh Trauma Center, is one of the largest rehabilitation facilities in Pakistan, providing a wide range of SCI and trauma and physical rehabilitation services, including physiotherapy. However, the center does not currently offer occupational therapy or exhibit a culture of interprofessional collaboration.
After a series of planning meetings and discussions led by Neelum and Nabeela, the rehabilitation staff at Sindh Trauma Center are set to complete a clinical skills training program based on the same format pioneered by ReLAB-HS. The training will form part of a wider plan for continued professional development that aims to strengthen the rehabilitation workforce and lead to improved patient outcomes. The training program will be carefully tailored to the training needs of the rehabilitation professionals working at the center, with a strong emphasis on interprofessional collaboration, as well as improved patient education and training prior to discharge. Additionally, indicative of its commitment to strengthen the physical rehabilitation workforce, the Sindh Trauma Center plans to add an occupational therapist to its rehabilitation team.
“I am obliged to learn clinical skills from skilled professionals and now transferring learned skills into my students with practical implementation,” Nabeela shared. “It has been a transformative journey, shaping me into a more empathetic and skilled health care professional.”
The movement to improve rehabilitation services is a testament to the value of clinical skills training in empowering rehabilitation professionals to drive positive changes in their workplace and communities alike. Most importantly, the implementation of clinical skills training led by a local team of rehabilitation professionals demonstrates the sustainability of the clinical skills training program through its ease of replication in different contexts.
This clinical skills training concept is currently in the process of being developed into a free online tool that will guide others to develop and deliver a clinical skills training program, such as the one completed in Pakistan, in any context globally.