OPEP-DV Report on physiotherapy and Domestic Violence

In the framework of the European OPEP DV project, an investigation and mapping of the field was carried out in order to describe the theoretical background and the educational programme that physiotherapists receive during their studies. An attempt was made to investigate both the curriculum and the training of physiotherapy students on potential issues of abuse and domestic violence. Below, we present a summary of the main findings according to the above-mentioned requests, as they were extracted from the research carried out by the European Project partners in their local areas. The results collected come from the countries: Cyprus, Estonia, Greece and Spain

Mapping of the field How is the curriculum in physiotherapy schools structured? Are there differences among the different departments per university? Is there a distinction among private and public institutions? If so, are there different national processes in integrating the curriculum into compulsory and elective courses?

Studies in physiotherapy involve education at higher education, which has a minimum of 3 years of study and is mostly carried out by public educational institutions. Usually, university education is defined as 4 years of study, i.e., 8 academic semesters. During the period of study there is a variety of courses are offered to equip students with the required knowledge and skills This curriculum is offered according to national, European, and international standards, so that they become well-trained professionals who will cover professional positions and provide services as optimally and efficiently as possible. In Cyprus, physiotherapy studies are not offered by the state universities (University of Cyprus) but by 2 private universities. At the same time, in Greece and Spain, it is possible to study physiotherapy in both state and private educational institutions (minimum of 3-year study) which are recognized and accredited by the relevant ministry which is responsible for education and the national education system of each country. In all countries, it is stated that physiotherapy studies have theoretical and practical training. Upon completion of the theoretical part of the education and courses, students are required to proceed with practical training. It is worth mentioning that in Estonia, especially at the University of Tartu, there is an additional compulsory teaching practice, which requires physiotherapy students to work in a clinical environment. Furthermore, in all countries and highereducationinstitutions, itisstipulatedthat physiotherapystudentsneedtoprepareathesis to obtain the degree upon completion of the theoretical and practical part of the studies

In addition, in all countries, it is reported that the curriculum of physiotherapy is describedin a transversalway, from the bachelor's degree level topossibilitiesofspecialization through postgraduate programmes offered by higher education institutions, as well as doctoral programmes and studies for even more advanced training in the subject and academic training. In Greece, to practice physiotherapy, it is required to acquire a professional license which is awarded to graduates after receiving their degree from the services of the Ministry of HealthWelfare and Social Insurance and completing required procedure for its issuance in accordance with the specified qualifications and rights of the physiotherapist, as provided for under P. D. 90/1994 (Government Gazette 53/8-3-95/T.A.).

Finally, there are structured curricula offered in the field of physiotherapy in higher academic education in line with the guidelines set by each educational system and academic qualifications both at the national and European levels. Apart from theoretical education, students are provided with workshops, practical training, and thesis writing to enhance learning and enable transition to fieldwork/ the career path.

Curriculum for physiotherapists Does the curriculum for physiotherapists includes courses (lectures or seminars) or workshops on forms of violence or ways of perpetrating violence (e.g. physical violence, covert violence, ambiguous signs of violence)? If so, by whom are these courses run? By a physiotherapist or by an expert in violence? If so, is the curriculum used in a one-year course or is it taught for all academic years in universities?

In Cyprus, Estonia, and Greece, there is no reference and specific course covering this subject in the curriculum Only in Spain where the seminars and courses do not focus exclusively on gender-based violence, a reference is made in the university curricula of physiotherapy. In this regard, universities offer elective or compulsory courses which aim to provide students with the knowledge of psychological and physical effects of gender-based violence, the recognition of signs of violence, and the investigation of suspected violence through asking appropriate questions to address and prevent cases of gender-based violence promptly.

Academic studies As part of the academic studies as physiotherapists, is there the provision of information or training regarding the recognition or signs of suspected physical (gender-based) violence?

In Cyprus, Estonia, and Greece, there does not seem to be a structured learning and training programme in the academic physiotherapy curriculum on how to recognize and report the suspected physical injury, gender-based violence, and/or abuse. Information and education on the subject depend on the personal interest of each student and the professional. In Spain, following the revision of the Spanish Health System Review (2010), a specific strategy for the prevention and treatment of gender-based violence is foreseen. Through this strategy, physiotherapists must report to the authorities their suspicions regarding situations of domestic violence and abuse against children, elderly or disabled people.

Curriculum programs / Identification Are there any curriculum programs, trainings or seminars on the identification and treatment of abuse with a target group of physiotherapists? If so, what are they?

In Cyprus andGreece, there do not seem to be any programmes, trainings, and seminars related to the recognition and treatment of violence and abuse that are addressed to physiotherapists. In Estonia, from time to time, there are crisis psychology courses for physiotherapists so that they are trained to deal with crises, but this training does not put emphasis on (mental) violence. Also in Spain, the Ministry of Education and Health offers special curricula, with training and seminars, to recognize and deal with violence and abuse.

Curriculum programs/Communication: Are there any curriculum programs, training or seminars to improve the communication and development of physiotherapistbeneficiary relationships?

In physiotherapy curricula in Estonia, Greece, and Spain there are courses on psychology, patient treatment and approach, rehabilitation psychology, communication psychology, crisis psychology, and counseling techniques, which also aim at familiarizing physiotherapists with the most appropriate way to approach patients and beneficiaries. In addition, through learning the code of ethics of the physiotherapy profession, the basic principles of the physiotherapist-patient-beneficiary relationship are defined, in a relationship of safety, trust, and intimacy.

Monitoring and evaluation Is there any monitoring and evaluation for the physiotherapist training system? How is it implemented, by whom and how is it carried out? If this monitoring and evaluation physiotherapist training system is active at the moment, what are the results of these actions exploited?

In Estonia, the curriculum for physiotherapists is assessed by the Estonian Quality Agency for Higher and Vocational Education. Higher Education Institutions accept both institutional and curricular assessments to ensure the improvement of the quality of education and the achievement of high-quality education for students. In Greece, Higher Educational Institutions (HEI) are legal entities under public law and fully self-governed, which constitutes an independent and autonomous service of the Ministry of Education and Religious Affairs. Their supervision by the state is exercised by the Ministry of Education, Research and Religious Affairs under the provisions of Article 16 of the Constitution and the provisions in force. In Cyprus, physiotherapy curricula are only supervised for the recognition of higher education qualifications by the Council of Recognition of Higher Qualifications (KYSATS) while the Spanish higher education system, including physiotherapy studies, is supervised and evaluated by the National Agency for Quality Assessment and Accreditation of Spain (ANECA) established under Act 15/2014 and the Statutes of ANECA (Royal Decree 1112/2015).

According to the above-given information, it can be reasonably concluded that there is no single supervisory body according to international and European standards, but the supervision and evaluation of the education and training of physiotherapists, along with the entire constitution of the educational programme of physiotherapists, are carried out by different supervisory bodies in local regions and respective countries.