Managing Children with Clubfoot Course - Evaluation Report

Original Editor - Managing Children with Clubfoot MOOC Evaluation Report Feb 2018

Top Contributors - Candace Goh, Kim Jackson and Chelsea Mclene  

Original Editor - User Name Top Contributors - Candace Goh, Kim Jackson and Chelsea Mclene

Summary

In November/December 2017 Physiopedia, the International Committee of the Red Cross (ICRC) and the Global Clubfoot Initiative (GCI) successfully delivered the Managing Children with Clubfoot Massive Open Online Course (Clubfoot MOOC) via the Physiopedia Plus online learning platform. In collaboration with Humanity & Inclusion (HI) there was a concurrent French version of the course.

The course provided a framework to develop theoretical principles for the management of children with clubfoot relevant in all contexts. It introduced the pathoanatomy, etiology and epidemiology underpinning idiopathic clubfoot, including: idiopathic in an infant, idiopathic clubfoot in the older child, relapse and atypical clubfoot. The course explored assessment and the roles of the multidisciplinary team, as well as providing a theoretical understanding of management techniques and related clinical considerations. It did not teach practical skills or lead to any clinical qualification. The global network formed through this course will allow for shared knowledge and experiences to support good health care and a better quality of life for children with clubfoot and their parents, all around the world.

Course Type ​- Open, Online

Course Co-ordinators ​- Rachael Lowe, Barbara Rau, Rosalind Owen

Collaborating Partners ​- Physiopedia, ICRC and GCI

About this course​ - This online course covers basic theoretical knowledge of managing children with clubfoot. There was an English and a parallel French version of the course.

Who was the course aimed at​ - The course was written for physiotherapy clinicians, students and assistants; other healthcare professionals interested in this subject were welcomed to participate.

Time commitment ​- 16 hours over 4 weeks

Date ​– 6 November to 3 December 2017 (final date of free course 31 Dec 2017; the course remains available on the Physiopedia Plus platform to members)

Requirements​ – Participants were required to complete online learning activities, engage with additional resources, take part in the conversation online and complete the course evaluation.Assessment​ - There was a final quiz and participants could optionally complete an assignment to demonstrate their learning.

Awards​ - Completion certificate plus 16 Physiopedia Plus (PP+) points.

Accreditation​ - The course was accredited by the South African Society of Physiotherapy (16 CEUs) and The Federation of State Board of Physical Therapy (10 CEUs)

Registrations​ - 7,277 (7153 English course and 124 French course)

Countries represented​ - 156 (156 English course and 13 French course)

Started the course​ - 2250 (2033 English course and 217 French course)

Passed final quiz​ - 805 (693 English course and 112 French course)

Received completion certificate​ - 405 (342 English course and 63 French course)

Acknowledgements

The Clubfoot MOOC was developed as a collaboration between Physiopedia, ICRC and GCI. Physiopedia and ICRC provided funding. The ​ACT Team​ and partners, including the University of Oxford, CURE International and Global Clubfoot Initiative kindly provided content for the course, which was supplemented with additional material from global experts. HI completed the French translation of the course.

Course coordinators:

●  Rachael Lowe, Physiopedia

●  Barbara Rau, ICRC

●  Rosalind Owen, GCI

Course facilitators:

●  Aijaz Rather, ICRC, India

●  Elia Bernabeu, ICRC, Sudan

●  Santosh George, ICRC, India

●  Prem Saggurthi, ICRC, Ethiopia

●  Gul Zaman, ICRC, Pakistan

●  Denise Watson, Chelsea and Westminster Hospital, UK

●  Christine Douglas, The Royal National Orthopaedic Hospital, UK

●  Mohommad Mamun Hossen Chowdhury​, Walk For Life, Bangladesh

●  Martin Jacobs, HI, Belgium

●  Graziella Lippolis, HI, Belgium

●  Ben Gwilliam, Australia

●  Debro Mashoro, ICRC, Zimbabwe

●  Nicolas Peeters, Cliniques Universitaires Saint-Luc, Belgium

For any information regarding this report, please contact: Rachael Lowe - [email protected]

Introduction

During November and December 2017 Physiopedia ran their sixth Massive Open Online Course titled Managing Children with Clubfoot (Clubfoot MOOC). The course was developed as a collaboration between Physiopedia, ICRC and GCI. The ​ACT Team​ and partners, including the University of Oxford, CURE International and Global Clubfoot Initiative kindly provided content for the course, which was supplemented with additional material from global experts. A French version of the course, translated and facilitated by HI, ran concurrently.

The aim of the Clubfoot MOOC was to train the distributed team of ICRC staff and partners to have a basic understanding of the theoretical knowledge that underpins the management of children with clubfoot. The content of the course was designed for physiotherapists in any global context, all healthcare workers from any location and context were invited to participate. Being open for anyone to participate allowed for global conversation around the topic and enabled peer-to-peer learning across contexts and experiences.

The four week course presented different topics each week through a variety of learning activities to suit all learning styles. The required learning activities each week were proposed to take between 4-6 hours depending on the participant's learning style and optional activities were provided should the participant wish to take part in additional learning. A short orientation period before the course started provided participants with an opportunity to become familiar with the delivery platform and the topic via the provided pre-course resources.

The course was delivered through the Physiopedia Plus (PP+) online learning platform, an innovative platform specifically developed to deliver online education and provide learners with a personalised learning dashboard. Each week the new learning activities were released on a specific course page. As participants engaged with each learning activity it was recorded and displayed in their own personal learning dashboard.

To finish the course participants were required to complete all the required learning activities and pass a final quiz that tested knowledge. There was an optional assignment to demonstrate their learning. On completion of the course the participants could download a completion certificate and also export a record of their learning from their activity log.

This report evaluates the experiences and engagement of the participants on the Clubfoot MOOC.

Aim

This course aimed to provide a basic theoretical understanding of clubfoot and to align global understanding of the theoretical principles underlying the management of children with clubfoot.

Learning Objectives

At the end of this course participants were able to:

1. Describe the role of three anatomical structures in the foot and ankle that play a role in clubfoot
2. Identify the four major components characteristic of clubfoot
3. Recognise the difference between idiopathic, positional and secondary clubfoot
4. Describe the incidence or prevalence of clubfoot in your region
5. Summarise an example article of quality published evidence on the prevalence or incidence of clubfoot
6. Identify the four key features of clubfoot using C-A-V-E
7. Interpret the Pirani Score to assess and monitor clubfoot deformity
8. Explain the role of the multidisciplinary team in the management of clubfoot
9. Examine the role of a physiotherapist within the multidisciplinary team in the management of clubfoot
10. Explain the role of parents/carers within the multidisciplinary team in the management of clubfoot
11. Evaluate the use of the ponseti method in the management of clubfoot
12. Identify when a tenotomy is indicated
13. Explain the role of bracing in preventing recurrence of CAVE signs
14. Analyse the issue of adherence to the brace regime
15. Compare and contrast two types of different foot abduction braces used in the management of clubfoot
16. Develop a treatment plan utilising evidence based therapeutic interventions based on an assessment of a child with clubfoot
17. Recognise four common errors that may occur during clubfoot treatment
18. Identify two causes for clubfoot treatment not progressing
19. Describe three features of atypical clubfoot
20. Identify a sign of recurrent clubfoot deformity evident during gait
21. Discuss the difference in treatment required in clubfoot in older children
22. Outline three key elements for a successful clubfoot programme.

Intended Audience

This course was suitable for all healthcare professionals but specifically aimed at physiotherapy professionals including clinicians, assistant or students who have a good understanding of the key principles of physiotherapy but little prior experience in clubfoot. It was also of interest to any professionals (e.g. prosthetists, orthotists, nurses, occupational therapists, speech therapists, medical doctors) motivated to upgrade their knowledge on clubfoot.

Cost to Participants

The course was free to all participants who completed the course within 8 weeks from the start date.

Course Availability

The course started on the 6 November 2017 when the week one course contents were made available. A new section of the course was released each following Monday for another 3 weeks. Participants had until 31 Dec 2017 to complete the course under their free access to Physiopedia Plus. The course remains available on the Physiopedia Plus platform to members; membership is free to individuals from low income countries and available at a discounted rate to individuals in middle income countries,

Course Awards and Accreditation

Course completion certificates with 16 PP+ points were provided by Physiopedia to all participants that passed the course. The course was accredited by the ​South African Physiotherapy Society​ (SASP) for 16 CEUs and the the ​Federation of State Board of Physical Therapy​ (FSBPT) for 10 CEUs.

Demographics of the Participants

Country

English Course		French Course
Total number of countries	156	Total number of countries	13
Pakistan	770	Haiti	62
Egypt	718	France	24
India	638	Belgium	13
Canada	458	Canada	7
Nigeria	447	Lebanon	6
United States	447	Spain	3
Australia	332	Switzerland	2
United Kingdom	242	Senegal	1
South Africa	200	Tunisia	1
Saudi Arabia	189	Reunion	1

Profession

	English Course		French Course
Physiotherapy / Physical Therapy	6348	88.75%	84	67.20%
Prosthetics / Orthotics	276	3.86%	9	7.20%
Osteopath/Chiropractor	137	1.92%	0	-
Occupational Therapy	136	1.90%	0	-
Podiatry	50	0.70%	0	-
Parent	21	0.29%	0	-
Rehabilitation Therapist	19	0.27%	26	20.80%
Medical Doctor	8	0.11%	0	-
Nurse	5	0.07%	0	-
Other	173	2.42%	8	0.11%

Role

	English Course		French Course
Clinician	4869	68.07%	65	52.42%
Student	1272	17.78%	15	12.10%
Educator	340	4.75%	6	4.84%
Assistant	224	3.13%	22	17.74%
Manager	182	2.54%	11	8.87%
Researcher	131	1.83%	1	0.81%
Other	135	1.89%	4	3.23%

Years of experience

	English Course		French Course
no experience	1552	21.70%	76	61.29%
< 1 year	3011	42.09%	33	26.61%
1 to 5 years	2009	28.09%	13	10.48%
> 5 years	1065	14.89%	6	4.84%

Engagement of the Participants

Platform

The course was provided through a page on Physiopedia Plus (https://members.physio-pedia.com/learn/clubfoot/​). This page was visited a total of 20,358 times before the final date of the supported course on 31 December 2017. This page directed participants to set up a free account with Physiopedia Plus; the participants had to login to access the course.

	English Course	French Course
Number users started course	2,033	217

Learning Activities

The course was made up of a total of 46 required learning activities (full details in Appendix 2). There was an additional X optional learning activities that participants could engage with as they wished.

	English Course	French Course
Total number of learning activities logged	47,578	8,308

Discussion Forum

Participants were required to participate in the discussion forum on a weekly basis. They were required to take part in a minimum of 8 discussions over the course with at least 2 posts per week. This was made a requirement as it provided a rich learning experience through self-reflection on learning and exposure to global discussions about clubfoot. This was the task that participants found most difficult to complete.

The discussion forum was hosted on the Physiopedia Plus platform where participants were asked to comment on the weekly guided discussions. It was clear that not all people engaging with the course joined participated in the discussions.

	English Course	French Course
Number of people who introduced themselves in the forum	945	155
Total number of discussion posts	12,428	2,481

Quizzes

Each week ​participants were given the opportunity to assess their knowledge and understanding of the topic through multiple-choice quizzes. Participants received immediate feedback on right and wrong responses making this a rich learning experience.

In the final week participants were invited to attempt the final multiple-choice quiz. This quiz was designed to assess knowledge and no feedback was given. The pass mark was 80% and they could attempt the quiz as many times as they liked.

	English Course	French Course
Number of people attempting final quiz	559	80
Total final quiz attempts	826	127
Quiz passes	693	112

Course Awards

To complete the course participants were required to fully engage with all 46 required learning activities (Appendix 2), participate in the discussion forums and pass the final quiz. From Physiopedia Plus, they received PP+ points (equivalent to hours of learning) for every learning activity that they completed and a course completion certificate on completion of all the required elements of the course. The SASP awarded 16 CEUs and the FSBPT CEUs are to be determined at the time of writing this report.

	English Course	French Course
Number of certificates awarded	342	63
Total PP+ points awarded	15,686	3,015

Final Assignment

Reflecting on their learning and using the knowledge gained throughout the course participants could submit an optional assignment. Participants were asked to follow the ​assignment guidelines​ on Physiopedia and the assignments were assessed by the Physiopedia team. The marking rubric was kept fairly simple but each assignment needed to demonstrate: evidence of learning from the course, academic skill with evidence based writing and proper referencing and written English skills.

	English Course	French Course
Assignment submissions	33	This was not an option for the french course

Participants were able to choose from 5 different assignments which allowed for different academic skills and learning styles. The patient case study and the knowledge translation resource were the most popular assignments:

Patient case study	16
Knowledge translation resource	11
Training resource	3
Physiopedia page	1
Discussion summary	1
Pilot project	1

Participant Feedback

554 (471 English and 83 french) participants completed the evaluation form at the end of the course.

Quantitative Data

Overall there was agreement that the course was enjoyable to work through, an appropriate length with the right amount of work required each week, was pitched at the right level and would be recommended to colleagues. The participants agreed that they found the Physiopedia pages, quizzes and videos most useful for learning.

English Course

French Course

Qualitative Data (based on English course)

In qualitative feedback that asked “what were the best elements of the course”, participants generally responded positively about the course, they particularly liked the Physiopedia pages and the videos. Full results can be explored in Appendix 3 (inappropriate comments, such as those that did not answer the question, have been removed).

When asked “how could this course be improved”, participants generally reported that they did not enjoy was the repetition between the videos and the Physiopedia pages, a fair proportion stated that it could not be improved. Full results can be explored in Appendix 4 (inappropriate and positive comments have been removed).

The feedback demonstrates the many different learning styles that people have. On this course, some people prefer the reading activities and others thoroughly object to it, most enjoy the videos but others say they are lengthy and boring, most people dislike the discussions but others really do like them.

Impact on clinical practice ​(based on English course)

In the evaluation form participants were asked “describe any way in which this course has changed your clinical practice”.

Many people stated that there had been positive changes to their own individual clinical practice. Participants indicated knowledge development that has changed their practice to be in line with gold standard clubfoot management (i.e. use of more appropriate assessment forms and alternative methods of treatment with Ponseti). Many highlighted how they will now pay more attention to psychological factors and the positive engagement of parents/carers for compliance and better outcomes. There was also a significant number of participants who suggested that they are now seeking to share knowledge with colleagues, review existing services and get involved in developing new services in their country. For full results see Appendix 5.

Conclusion

Clubfoot is a specialised subject that requires the health care professional to have specialist knowledge and skills to appropriately help affected individuals in reducing disability and improving lives. This course provided easy access for interested individuals to gain theoretical knowledge of managing children with clubfoot with an international network of colleagues. Continued free access to the course content via the Physiopedia website allows health care professionals and carers to gain access to knowledge at any time in an easily accessible way. Follow up practical training is offered with GCI and ICRC.

Course registration data demonstrated the unique opportunity that this course has provided in offering an easily accessible knowledge development option for health care professionals across a wide distribution of geographical locations and contexts.

Course evaluation data highlights the positive impact that this course has had on clinical practice. There is suggestion of change in practice to utilise more appropriate clinical tools and approaches to care, and to incorporate a more holistic care package to include management of psychological factors and parents/carers to improve compliance for better outcomes. One significant outcome from the course is the enthusiasm to follow up by the sharing of knowledge, review existing services and development of new services, particularly where little or nothing currently exists for children with clubfoot.

For ICRC, the opportunity to provide access of information in volatile contexts, such as Syria, Libya or Yemen, enables the planning of future clubfoot practical training and service development. The course will provide baseline knowledge for staff and partners to participate in future practical training and the initiation of new clubfoot services in ​Iraq and Palestinian Territory-Gaza.

For GCI, the course has supported their mission to educate health care professionals globally to manage children with clubfoot in the most appropriate and effective way. The course and the continued access to online resources offers an excellent introduction to the practical skills training that GCI offer.

Appendix 1 – Course participants demographics

Pakistan	770		Romania	47		Congo	18
Egypt	718		Malawi	43		Poland	17
India	638		Croatia	41		Netherlands	16
Canada	458		Zambia	37		Germany	15
Nigeria	447		United Arab Emirates	36		Switzerland	15
United States	447		Zimbabwe	35		Kuwait	15
Australia	332		Italy	32		Oman	15
United Kingdom	242		Estonia	30		Portugal	14
South Africa	200		Singapore	30		Iran	13
Saudi Arabia	189		Myanmar	30		Fiji	12
Sudan	111		Tanzania	30		Yemen	12
Lebanon	94		Hungary	29		Lao	12
Malaysia	87		Nepal	28		Czech Republic	11
Jordan	83		Spain	28		Albania	11
Palestinian Territory	75		Rwanda	27		Albania	11
Afghanistan	70		Turkey	26		Somalia	10
Bangladesh	67		Belgium	26		Chile	10
Iraq	65		Vietnam	25		Namibia	10
Kenya	62		Costa Rica	23		Peru	9
Jamaica	62		Finland	22		Lithuania	8
Ethiopia	56		Cyprus	22		Austria	8
France	56		Cameroon	21		Burundi	7
Sri Lanka	54		Hong Kong	21		Botswana	7
Israel	52		Mexico	20		Benin	7
Norway	52		Thailand	20		Mauritius	6
Qatar	52		Colombia	20		Bulgaria	6
Philippines	51		Indonesia	19		Macao	6
Ghana	50		Syria	19		China	6
New Zealand	49		Uganda	18		Bermuda	6
Suriname	49		Malta	18		Argentina	5
Ireland	48		Brazil	18		El Salvador	5

Ukraine	5		Barbados	2		French Course
Venezuela	5		Swaziland	2		Haiti	62
Serbia	5		Russian Federation	2		France	24
Burkina Faso	5		New Caledonia	2		Belgium	13
Sweden	4		Reunion	2		Canada	7
Armenia	4		Mozambique	2		Lebanon	6
Libya	4		Taiwan	2		Spain	3
Algeria	4		Denmark	2		Switzerland	2
Bahamas	4		Bhutan	2		Senegal	1
Morocco	4		Bosnia and Herzegovina	2		Tunisia	1
Guyana	4		Martinique	2		Reunion	1
Macedonia	4		Luxembourg	1		Japan	1
Slovenia	3		Sierra Leone	1		Martinique	1
Japan	3		Cambodia	1		Madagascar	1
Guatemala	3		Tajikistan	1
Papua New Guinea	3		Eritrea	1
Slovakia	3		Solomon Islands	1
Bahrain	3		Timor-leste	1
Kiribati	3		Nicaragua	1
South Sudan	3		Uruguay	1
Belize	3		Turks and Caicos Islands	1
Guinea-bissau	3		Maldives	1
Dominican Republic	3		Gambia	1
Tunisia	3		Antigua and Barbuda	1
Latvia	3		Georgia	1
Togo	3		Guernsey	1
Madagascar	3		Saint Lucia	1
Korea	3		Saint Barthélemy	1
Trinidad and Tobago	2		Samoa	1
Brunei Darussalam	2		Virgin Islands	1
Iceland	2
Niger	2

Appendix 2 – Required learning activities

Section 1
Foot and Ankle Structure and Function	Physiopedia Page
Ankle Joint	Physiopedia Page
Anatomy and Definitions	Video
Introduction to Clubfoot	Physiopedia Page
Management of Clubfoot	Physiopedia Page
Introduction to Clubfoot and the Ponseti Method	Video
Birth prevalence of Congenital Talipes Equinovarus in Low and Middle Income Countries	Journal Article
Idiopathic Bilateral Clubfoot	Case Study
Introduction to clubfoot quiz	Quiz
Section 2
Assessing Children with Clubfoot	Physiopedia Page
The Clubfoot Deformity – CAVE	Video
Pirani Score	Physiopedia Page
How to Assess the Severity of a Clubfoot Using the Pirani Score	Video
Roye Score	Physiopedia Page
Bangla Clubfoot Tool	Physiopedia Page
Multidisciplinary Team in Managing Clubfoot	Physiopedia Page
Role of Parents/Carers in Clubfoot	Physiopedia Page
Feasibility and Barriers of Treating Clubfeet in Four Countries	Journal Article
Idiopathic Bilateral Clubfoot – Pirani Score 6	Case Study
Idiopathic Unilateral Clubfoot	Case Study
Assessment of clubfoot quiz	Quiz
Section 3
Ponseti method	Physiopedia Page
The Ponseti Method of Manipulation	Video
Casting for Clubfoot	Physiopedia Page
Applying Clubfoot Casts	Video
Achilles Tenotomy	Physiopedia Page
The Tenotomy and When to Do it	Video
Bracing for Clubfoot	Physiopedia Page
Maintenance Phase: Bracing and Relapse	Video
The Ponseti Method of Treatment for Clubfoot in Brazil: Barriers to Bracing Compliance
Ponseti treatment in idiopathic clubfoot – 4 year​ follow up	Case Study
Clubfoot with Post-Surgical Relapse	Case Study
Management of children with clubfoot quiz	Quiz
Section 4
Adherence in Clubfoot Treatment	Physiopedia Page
Common Errors in Clubfoot Management	Physiopedia Page
Common Errors in Clubfoot Management	Video
Recurrent Clubfoot	Physiopedia Page
Recurrent Clubfoot	Video
Atypical Clubfoot	Physiopedia Page
Recognition and Treatment of Atypical Clubfoot	Video
Treating Older Children with Clubfoot	Physiopedia Page
Treating Older Children	Video
Creating a Clubfoot Clinic	Physiopedia Page
Neglected Idiopathic Bilateral Clubfoot	Case Study
Neglected Bilateral Clubfoot	Case Study
Effective clubfoot management considerations quiz	Quiz

Appendix 3 - Course evaluation: what were the best elements of the course

English Course

Great combination of information and step by step instructions.

All the parts of the course are useful, the videos,images and literature search activities.

I did not have any experience of clubfoot so this was all very interesting to me.

I think the course was set out in a logical manner and progressed from basic anatomy through to the condition, treatment and follow up. I think all the information was presented in a way that was easy to understand and the requirements to progress through each section were clear. There were lots of useful resources provided which will continue to be useful into the future.

The whole course was good.

I enjoyed a lot the whole course i.e all the literature, images, videos and additional information but enjoyed the videos which was on practical casting and the different techniques used as a clinician it was useful for me.

Each and every section of the course is well explained-refreshed complete knowledge about the clubfoot and even more information is acquired

Particular case study were so helpful

Anatomy videos, physiopedia pages.

For me most useful was Physiopedia pages and Videos. Discussions was useful as well because I had opportunity to stop from learning new material and think about what I have had learn.

The visual help via the pictures and videos was excellent. It made the course real life.

The Ponseti correction along with the key principles for its treatments.

Knowledge about clubfoot.

Management of clubfoot and assessment

The delivery of up-to-date and precise information was invaluable. Spread of awareness to both the problem of untreated clubfeet as well as the possible treatment is definitely important.

I enjoyed the videos.

Good interactive activities, good opportunities for enhancing knowledge and learning something new.

The best elements of the course is meet with different people and presentation and discussion

The PDF handouts on the Ponseti method and parent handouts were especially helpful to have.

I liked that the subject was introduced in a way where someone who has not dealt with/studied clubfoot before was able to learn the theory of what it is, types of clubfoot and treatments for it.

Common error in clubfoot treatment.

Videos reinforced learning of content of articles. As well a few things were hinted in the beginning (atypical clubfoot, relapse etc..) which created repetition, by the time it was explained as a topic the familiarity helped to follow reasoning smoothly.

I am interested in foot but always excuse myself with "biomechanics is deadly difficult", I really grateful that this course made me revise some foot anatomy and biomechanics, I only wish there were more learning activity dedicated to assessment of a walking child.

I learnt a lot from the various video and journal articles.

Honestly I enjoyed every section of the course. It was a refresher for me and some were new information and very important to know and to practice in my professional job. The techniques for manipulation was very clear and it build on my technique for perfect for clubfoot care. The importance of trained assistant is very essential. I work alone as the trained personnel but I use my parent or a family member to assist me in doing the treatment. Now I need to train other personnel to work along with.

Worldwide accessibility

The well explained instructional videos on the treatment of clubfoot. The detailed anatomy section.

1.Types of clubfoot. 2.Ponseti method of treatment. 2.How to start a CTEV clinic. 3.Bracing protocol.

Explaining how to evaluate the cases of clubfoot using pirani scoring and the presence of other tools which incorporate parents' satisfaction. Also the videos of the university were simple and helpful

I did enjoy 2 videos the one of the Orthopedic surgeons telling their experience with the neglected clubfeet and the video of the current situation of clubfoot clinics in Zimbabwe. I was on my own, following the course, so I did not have any discussions or reflective activities.

The best aspect of this course are the anatomy of the foot,Pirani scoring system, Ponseti treatment regimen and procedure of tenotomy.

I really enjoyed learning the Pirani scoring method, to have a standardised test for each child that I see so that I can monitor their progress.

Learning from different people's experiences.

All elements very good.

I did not know about the Pirani scoring and how it is linked to the number of casts in the treatment of clubfoot.

clearly described the ponseti method, which to be very honest, I've never heard before.|some case studies showed how successful the method was and easy to understand the theory. |of course I got no actual technique but it was good to learn.

I liked to read the literature that was given about clubfoot and the treatment and the video's were also helpful

The best for me is the video for the management of clubfoot and assessment

Evaluation and treatment of clubfoot

Assessment using pirani score and treatment using ponseti method

Article and videos are best elements of the course

Explanation of the ponseti method.

Videos

Visual and written information

Learning the Ponseti method and the Pirani scale as well as info about FAB were most helpful. The Physiopedia pages were concise and easy to review.

Understanding the different types of clubfoot that I didn't know existed.

Physiopedia pages

The best elements are the video narrative and interviews with clubfoot clinicians all over the globe.

Everything in this topic was superb for me it is very difficult to point any one but even though pirani score ,ponseti method and the way you taught casting and are protocol was really very informative,easy to understand and follow

The illustrations with plastic foot model and the videos on how to correct the "CAVE" deformity. The tempo of the voice over is also commendable. The repetition of key words like "CAVE", snugly apply the cast and do not touch the calcaneus are excellent.

The ponseti method of correction of clubfoot and Pirani scoring

the videos and the images are one of the best parts in the course. Demonstrators had explained the contents with simple English and clearly. Quiz had given chances for me to refresh learned contents.

1.Clubfoot effective management considerations 2.Recurrent clubfoot deformity 3.Atypical clubfoot 4.Treating older children

Articles is very useful and video more detail

I enjoyed how it was laid out, good progression from one section to the next. The anatomy review of the foot and ankle was invaluable at the start of the sessions. the video on how to hold the foot for manipulation and casting were great. I also enjoyed the extra reading or video material. The cases were also very great to see the before and after.

Video presentation

I enjoyed learning about the Ponseti method of treating clubfoot. It has broadened my knowledge when it comes to managing clubfoot.

Interactive.

Evaluation of clubfoot

The video lecture and practical videos as well as the illustration images

Section 4: Effective Management Considerations

Enjoyed learning about how the Ponseti Protocol is done all over the world.

Every aspect of the course was useful.I had so limited knowledge about clubfoot and its management and I was able to gain a lot to inspire me to look into specializing as a clinician in clubfoot management.

I really enjoyed the topics concerning neglected clubfoot and how to deal with older children.

The Ponseti method

Anatomy of the foot and management of clubfoot.

I learnt a lot from the interview with Denise Watson and her experiences of what she has learnt over the years. You can't get this from books.|Having been treating babies with CTEV for one year, I found this invaluable to consolidate and further my knowledge.

I found those pages containing detailed images and video footage very useful, e.g. teaching of pirani scoring, casting techniques as well as interviews with experienced clubfoot PTs (PT from London). Those pages made me realise how detailed and delicate the ponseti treatment actually is and that it requires a lot of training and experience to successfully treat clubfoot, as well as that you can do damage (atypical clubfoot) if insufficient care is taken during treatment.

every single part of the session was very important and informative.

All part of the courses are good except the videos

Assessment of children with clubfoot, the treatment plan using Ponseti method

I enjoyed the information websites and some of the videos. The structure of the course is well constructed with the information well divided in the 4 weeks of the course.

Thanks you have more elements is perfect .

Actually every component of the course added to the others, hence, the best elements were all the elements.!

Book chapters ,videos ,images physiopedia pages and quizzes are all best.

I enjoyed mostly the treatment of older children and the experiences they were talking the doctors from Cure clubfoot in Ethiopia and patho anatomy of the foot. Case studies of neglected clubfoot and the videos presenting each topic of the course which makes me easy to understand after I read the topic

The pirani score and the ponseti method. Brand New to me. I loved learning so much about CF.

Learning the Pirani score and all aspects of the Ponseti method

I thoroughly enjoyed the physiopedia pages as well as the videos that went along with them...really enhanced my learning.

The pirani score and ponseti method. Brand New to me

I have never work with patients with clubfoot before so it was all interesting to me. But the treatment section was astonishing

I really enjoyed the videos that put everything together. I definitely learn best by reading, listening then seeing how to put everything together

The discussions session is very important and I like that very much as I can share my knowledge with my colleagues and also the quizzes helped me very much in checking the obtained knowledge.

Videos and book chapter

The complimentary videos together with the physiopedia pages, also the experience reports from practitioners working in different settings.

I enjoyed the discussions where I can gain a wider perspective on the topic studied from people of different parts of the world. And also the interviews with real-life professionals on the field, it's really interesting to hear their stories and the best part is that physiopedia had made it accessible for all without any cost. Thank you so much for sharing the knowledge, I am sure many people around the world have been greatly blessed by this course.

The videos where information was given succinctly and slowly with the use of subtitles were most beneficial. Good repetition of pertinent points was made.

The part with Ponseti, Pirani score and Recurrent clubfoot was most interesting for me.

Posetti method in correcting clubfoot

I like the additional resources section. It contains so much information and definitely is very useful for further improving myself.

The videos and images are the best part in the course. Case discussion gives clinical reasoning skill for me.

Videos and images are very useful to understand the concept. In addition to these,the cross referrals were useful to learn more information.

To have a FRENCH version! The videos with the powerpoint slides.

Videos

The best elements was the articles, videos and experience of others.

I really enjoyed that I could do this at my own pace. I also appreciated hearing from people in different centres around the world to hear about their experience with club feet.

The best elements of the course were the reinforcement of basic principles through reading physiopedia pages and the videos. I felt like I truly got a grasp of the take home points because of the multimodal learning activities. This course was at a perfect level for me as a pediatric PT with limited Clubfoot experience to understand. I feel a lot more confident if I come across this diagnosis now!

The videos

It was very good to start with anatomy of the foot and to go into the special clubfoot information.|I liked videos very much, it was nice, that there were also some questions in presentations.

Actually I got a lot of information from this course and I enjoyed with this course and a videos are very useful |finally i wont to say I am very happy because i know this website and I am trying to tell all my friend that they are work in medical department about physiopedia

Videos with questions. Back to anatomy of the foot to understand the difference.

The video showing the casting technique was very useful.

The reading aspects are very intensive and the videos are easy to learn.

Images, quizzes, case studies.

I was inexperienced with clubfoot. I was worried being from a profession other than PT that I might get lost in the jargon but it was simple to understand and practical .

The progress with the ponseti method

The provision of literature and textbook information

Case study of the patients

The best thing of this course is that all things are presented in a sequence, building knowledge from start to end.

Appropriate stuff at right time.

Full course is best.

The Physiopedia pages, quizzes,videos and images were the best elements.

I enjoyed much on treating clubfoot in older children. Actually I learned a new thing (TATT) Tibialis anterior tendon transfer and posterior release. I will so much ask surgeons to learn more practically. Thank you guys.

maintenance phase and pirani score method

The best element of the course were the videos procedure of ponseti method presented well also the physiopedia page are well articulated to rhythm with the videos.

Videos (although slightly too lengthy). Case studies.

Everything was good. I enjoyed all the topics.

I enjoyed all the parts of the course especially having to see practical videos, consented patients with follow up treatment, the ponseti method used in all types of the clubfoot mentioned. The clubfoot organisation and facilities helping out to reduce disability among people.the interview of the workers really impacted me,I could see their commitment and passion for what they do. I so much enjoyed the course.

Managing Children with Clubfoot MOOC

Evaluation Report Feb 2018 24

Although all contents of the were best, I really appreciated identification, assessment, manipulation, casting, tenotomy and bracing if clubfoot.

Most of the video show possibility that we can try to apply clubfoot treatment without having technical practical lecture. It is best element.

The videos

I enjoyed and considered very useful the videos

I enjoyed videos and case studies.

I enjoyed the treatment neglected clubfoot part the most, but all the cause is really interesting.

I liked that there were videos about casting and I got a great understanding how Ponseti method works.

The use of Ponseti technique and Pirani score

Recurrence information as that's what I work with mainly

I found all the content great. Starting from easy stuff that is often known to working your way to other types of clubfoot that are not so common

I enjoyed learning about the process of Ponseti method as well as the scoring methods and questionnaires used with parents.

I really enjoyed reading the pages - the videos reinforced the physiopedia pages. The quizzes really made it aware of how much information was retained which was great

Personally, the videos

Videos was most best elements for me because all videos was very informative and useful .

I found many topics useful which i was not aware of like pirani score and ponseti method..

All parts were useful

Great information. Easy to understand with good choice of videos and journal articles to back up these information.

Treatment of clubfoot

I found learning about the Ponseti technique to be the most useful part of the course.

I found the explanations provided on the videos was very helpful and supplemented the written information effectively.

The most important was the whole process of the Ponseti Method and the maintenance. It's a very big challenge.

It's seems strongly connected to the professional ground.Different aspects of the pathology are clearly explained, in a strong structured manner.|I shared this experience with some colleagues and suggest to my manager that It could be financed by the hospital as a real way of training.

I enjoyed the topics concerning neglected clubfoot

all topic perfect good knowledge for people the don't treat clubfoot before,but there is one things missing its practice in new cases and old children .

I liked that all topics were offered and repeated in different ways of learning.|

I learned so many new things in this course like cave sign,pirani scale,ponseti Rx,types of clubfoot etc...for me the best elements are all videos and all quizzes of the course..

That after the learning pages you could also see the video's where the topics were explained .There were also links to get more information not just one but other recommendations

I enjoyed learning all aspects of this course. In my country clubfoot is not common and learning how to treat clubfoot is definitely a plus

I enjoyed every part of this course because it has helped me to refresh on the knowledge I had on clubfoot which I will apply in the clinical setting

I find videos and Physiopedia pages the best.

Learning about the Pirani score and the Ponseti method. Also that the method can also be applied to older children with good results.

Managing Children with Clubfoot MOOC

Evaluation Report Feb 2018 25

The best elements of the course is the systematic overview of the Ponseti treatment. It gives a clear manual for the therapist.

Presentations, videos, case studies

I found the best elements the educational videos, they explained everything very well.|

The practical videos especially the African Clubfoot training videos, although some moved a little slowly for me.

I very much enjoyed the conversations with the people who work in this field, thus the application and challenges, and especially the feeling of compassion they have for the children, and their passion for the using this method. obviously based on the good results they are getting from it and the huge difference they make to these children's lives. thank you!!

Everything about this course opened my eyes to the best treatment option. I enjoyed the review of the anatomy of the foot which was needed to understand the treatment.

I loved the parent handouts. I enjoyed the anatomy and physiology review pages. The provided research was interesting.

It was really helpful to understand the different stages of the Ponseti treatment based on the Pirani Score. Despite being a physiotherapist myself, I never fully understood the manipulation that was performed at the time my son was treated.

Management of Atypical clubfoot and recurrent clubfoot

Videos

I found the whole course very useful because although I thought I knew enough about clubfoot and Ponseti I learnt a great deal.

Literature and videos were best.

Videos and Quizzes

the flow of the subjects was perfect, the pictures are very useful, and the discussion board is really interesting and enjoying.

Education on the physiology of clubfoot as well as the correction through Ponseti casting was excellent. Hearing about the barriers to treatment in developing countries was very eye opening and gave perspective as to the opportunity living in the USA affords patients.

Pirani scoring|Ponseti method of manipulation,casting and bracing|Interviews of orthopedic surgeons, paediatric physiotherapists, parents of child. Treatments and modifications for different types of clubfoot. Quizzes

I sincerely did enjoyed 90% of this MOOC. It was well structured, organized, clear, with a variety of didactic material, easy to follow our learning steps thanks to the dashboard, quick concrete knowledge available. This MOOC is a valuable requirement prior any practical training. Congrats!|| To answer more concretely to the question, the best elements according to me were the chapters/videos/images on introduction to CF, management of CF, Pirani score, Ponseti method, Achilles tenotomy, bracing for CF, common errors in CF management and the regular quizzes However, I also have to admit that I was not much receptive to the chapter on incidence/prevalence of CF and the literature search (more of a hands-on physio) as well as the last part on recurrent and atypical CF. I felt more distant with the latter as a brand new CF management learner and due to the additional challenges that theses situations bring in practice. Time will come when I'll be ready though. First I need to digest all these information given!

I enjoyed the videos which often recapped the reading part of the course. The good visual aspects enabled me to see the different aspects of clubfoot and its treatment. This was especially helpful as I do not work in a clubfoot clinic at the moment. I found the interviews a good source of information and it was good to hear how it related to each country.

The entire course was excellent. I learned a great deal. I actually have a current 15 year old patient that I am going to look at much more closely. She has a very abnormal gait pattern, walking on the lateral borders of her feet. I'm now wondering if she has mild bilateral clubfoot that was never diagnosed due to other medical and cultural issues. I'll let you know the outcome.

The best elements was too many; like:chapters to read for more clarifications,videos and good images

Managing Children with Clubfoot MOOC

Evaluation Report Feb 2018 26

Understanding the mechanism of CTEV (incl neglected CTEV) and how to correct it.

Some of the video interviews. Quizzes to test my knowledge.

i enjoyed the videos from Africa clubfoot training

videos from African clubfoot

The diversity and different opportunities (articles, videos, interviews). And that people from all around the world took part.

I quite frankly enjoyed every bit of the course. I didn't know much about clubfoot but I can confidently say I am more knowledgeable now.

Combination of learning videos and research literature|

The rehabilitation of clubfoot deformity

I found all topics useful.The topic I like more is Pirani score.

I enjoyed most the video illustrations provided in every section to explain the topic being discussed like the anatomy and treatment sections.

I personally think that this was course designed efficiently by all stakeholders and the topics like video of the anatomy,manipulation,casting and advising FAB ,tenotomy were quite in detail and evidence based through we can rely to apply ponseti method to the children with clubfoot .apart from it Journal articles were also very useful to know about the research in the field of Clubfoot management outcomes,which make us confident to apply the Ponseti method to the children with clubfoot .Although here in Pakistan at the moment we have two clubfoot clinic in Peshawar,I think that more awareness and access to the Government officials to establish such clinic at least at each district level.all the topics including introduction,Management of Clubfeet ,Bangla and pirani score to identify the severity of clubfoot

For me, it was all of this course, that was the best:) I had no idea before about complexity of clubfoot, it's treatment and all.

The videos was the best part for me as i could learn more practically from them.

The Ponseti treatment - corrective and maintenance phase, Pirani score and parents education.

I found that the information in each "chapter" provided enough understanding to gain a basic understanding of this topic area in relation to our profession. |It was a really good refresher to have all the anatomy and to see others experience in this area, although since there are so many participating that I only read those just before my posting!

the best elements were the videos explaining anatomy and biomechanics as well as the process of ponseti method. good to have these to follow up the written explanations. very comprehensive

I really enjoyed the videos from people working at clubfoot clinics. I have very limited experience in this field so I felt like I learned a lot about how they approach the subject - form assessment to treatment. And knowing that the Ponseti method can make such a huge difference in someone's life is amazing!

The videos and learning forums

I found the revision of ankle anatomy and all the ponseti videos useful

The reading was helpful that it followed up with a video. It was just hard to stay interested in the video

For me the best elements of the course was the discussion on the correction for atypical clubfoot and neglected club as i am not so good or confused on this type of clubfoot in my practice.

Liked the videos as was good to see actual examples of clubfeet.

My best elements of the course on clubfoot is mostly in the assessment of clubfoot(section 2)using the pirani scoring method, followed by the ponseti method of treating clubfoot especially the videos aspect. |I really enjoyed the course,thanks to physiopedia.

I enjoyed from the videos a lot

I am a visual learner so I enjoyed watching the videos.

It was focussing on practical management of clubfoot. It was great to be able to do this at my own pace and. In my own time.

Distinguishing the different types of clubfoot.|Understanding the casting technique.|Management process and what it takes to set up a clinic.

Managing Children with Clubfoot MOOC

Evaluation Report Feb 2018 27

Videos are simple but very informative and sub section quiz also aids understanding

The part which was the best was|-Introduction part|-all the topics afterward was so useful to me|

I enjoyed all parts of the course especially the videos.

The case studies were one of the best elements, as well as the physiopedia pages.

In general the whole course too much informative and some repetition of same elements also helpful in the sense again you through which is a kind of recalling what we learned.

I enjoyed the most video presentations by the Africa Clubfoot Training and interviews with experts.

The videos and pictorial illustrations gave life to all lectures. It made it easier for one to understand the management of clubfoot. I really enjoyed the management of clubfoot in neglected cases. I used to think only babies can get help.

The detailed video lessons was the best part for me.

The physiopedia pages, The videos of explanation

I found the entire course very useful. The refreshing of the anatomy, the pathology, pathogenesis, assessment, treatment, epidemiology and the evidence based practice of clubfoot was very welcome |

the video interviews, since I do not have much experience in the field, I enjoyed experiencing the life participation and passion of the speakers, and how they put the knowledge to practice!|

the physiopedia pages where very informative.

Physiopedia pages where informative

Best element of the course is smaller aspect like neglected clubfoot. and extensive literature search.the videos were amazing, clearing our concept very well.

Quizzes,contents,duration,video and images

I enjoyed by studying manipulation and casting of clubfoot

I enjoyed by studying manipulation and casting of clubfoot

Management of clubfoot and the different types of clubfoot. Also the role of parents in clubfoot management.

Video, images, quizzes

What i found most enjoyable was the physiopedia pages. They were very educative, short and precise for even somebody like me who doesn't like lengthy reading

Video about casting and pirani score was useful for me because it clear my concept and by this video i m able to check improvement in clubfeet patient by using pirani score

Types of clubfoot|assessment and grading of clubfoot|outcome measure|ponseti method as the most effective treatment

Effective management considerations was the best element of the course.

Effective management considerations

Case discussions

The videos and pictures - because they enabled me relate well and have a better understanding of each lessons taught.

I think the course outline itself gives an adequate information on things that we need to learn in case not familiar with Clubfoot Management ( Ponseti Method). The best elements for me are the case studies, a video conversation with different disciplines-clinicians who are practicing Ponseti Method and discussion or reflections portions because for me as a PT it gives me freedom to exercise what I have learned from each week's topic and what I have understood.

I really very glad from this course, I have learnt a lot from this course. Before this course i even didn't know, what is clubfoot and what is their prevention. i know about the types of clubfoot, which is new knowledge for me. and also casting techniques, foot abduction Brace timing, know about CAVE and much more. Thanks a lot Physiopedia and their colleges.

Watching the cases

Managing Children with Clubfoot MOOC

Evaluation Report Feb 2018 28

The personal experiences of those interviewed. The videos that reinforced the readings. A few of the journal articles.

Assessment of Clubfoot

Videos were very informative.

Videos

Videos and Quizzes

Quizzes

The case studies and presentations

I enjoyed every part of the course. When I started I knew I had much to do and I am glad it paid of. I am looking forward to putting my learning to work.

videos was great part in this course . was very easy

the best elements were the video lectures and the case studies

I have learned the lot from your course ,anatomical knowledge is very important for treatment and videos about the anatomical structure of the foot and ankle made more easy in understanding ponseti method.

For my the best elements of the course was the pages and the videos, because they explain very well the information. Also the pictures in the beginning of the course was very useful for understood and remember the anatomy of the foot

I enjoyed the videos the most cause it's one thing to read about the condition but when you start to see how the treatments are done and the lives that are being affected positively it really does make a difference.

I found units 2, 3 and 4 most useful. They were well designed, each one building on the last.

using multiple methods to portray the information and reinforce the concepts (i.e. having a video and an article or physiopedia page to give similar information)

All the videos were very useful. The references provided were useful too.

The course was very useful. It exceeded any expectations I had. The practical videos were especially useful, rather than reading the outline of the method. I don't work in direct clubfoot care but my understanding of current care and past care informs my assessments of mature clubfoot presenting in my community.

Correction phase of casting

The education videos and materials of education

The Videos and materials were very useful and important

I enjoy a lot the section four, which is very interesting and also difficult.

the best part I find it very interesting was quizzes and images with marks|it was so useful.

The visuals and videos added the most to my course experience. I enjoyed how clearly the quizzes reviewed the weekly learning points.

The visuals and videos added the most to my course experience. I enjoyed how clearly the quizzes reviewed the weekly learning points.

Visuals and videos

The ponseti method

Videos and discussion comments from clinicians who work in different countries to help understand their challenges and strategies for overcoming these challenges; course was presented in a very clear and logical fashion - easy to follow and understand

I enjoyed the anatomy of the foot

This is a topic that not everyone gets exposed to on a daily basis. Therefore the fact that it started at a very basic, foundation level meant that it was very easy to get up to speed on the topic.

Detailed anatomy and explanation of all elements of the course!!

The physiopedia pages where very informative

The videos on treatment

Managing Children with Clubfoot MOOC

Evaluation Report Feb 2018 29

Ponseti method, quizzes and discussion sections were best elements of the course. Overall, course was so much informative.

Videos and interviews

The videos and physiopedia pages.

Pirani score and videos are very informative

Learning about the gold standard in clubfoot treatment. Now it's not just about abducting the ankle and bracing.

Videos were super helpful

I found the video about the management of clubfoot mst useful|Besides, the journal article on the comparison between physiotherapist led or physician led management of clubfoot is good for references.

The physiopedia write ups

Advanced treatment method

The best part were the video, photo and presentations. Overall the course was the best online course that i have followed. Thank you.

Videos were most helpful. Also liked additional research articles

teaching through demonstration and using simple language to elaborate,making anatomy look simple.

The photos, video and the presentations.

All was interesting and helpful actually, thank you very much.

I found the videos which were backed up with written text to be the most useful.

I appreciated the anatomy review. I learned a lot about the Ponseti method of correction and maintenance, which I was completely unfamiliar with prior.

concise and clear information

The videos and the quizzes.

chapters & videos r very interested & useful.

Watching the interviews and videos.

I liked the layout of the course and the multiple teaching styles. It was easy to navigate and more engaging than traditional courses.

Physiopedia pages and images were very thorough and helpful. I enjoyed all the articles involved and how every page had references to refer to.

The combination of physiopedia pages and the video presentations. It helped reinforce the acquired knowledge. The quizzes were quite fun as well.The best part was being able to do it in my own time.

The most important thing that I learned is how to prevent recurrent of clubfoot

There were various different elements which made this course interesting. To start off, the fact that after every piece of information given was followed by a video gave a better image of the various topics. Furthermore, I believe that the information given was very detailed. Apart from so listening to other professionals speaking about clubfoot, helped me to analyse the importance of proper treatment for such patients. Also, the discussion forum helped me to discuss further any queries that I had, and also it gave participants room to express their feelings about the topic.

I thought the best elements were the Physiopedia pages and the African videos. |Although I could have managed with something a bit faster and more technical, given the language issues and differing levels globally I thought they were done well.

Everything

Integration on anatomy, clinical practice and real life scenarios

I found the video and visual learning great resources that helped with learning.

Videos and pictures were very helpful to me, considering I had no experience with clubfoot to draw from in my mind. Being able to see pictures and hear others with experience discuss clubfoot was very beneficial to my learning.

Section 3: Understanding the Management of Children with Clubfoot

Managing Children with Clubfoot MOOC

Evaluation Report Feb 2018 30

The videos and images used in teaching.

Learning about Ponseti method, watching the videos on casting and learning more about global clubfoot initiative.

Actually, this course was very interesting and I have learned much by completing this course. the most amazing parts were both section 3 and section 4 Understanding the Management of Children with Clubfoot and Effective Management Considerations. Thank you||

Videos is the best

I enjoyed the foot anatomy course with the videos.|I also enjoyed the introduction to clubfoot course. The study videos were very detailed.

Videos

Videos

The physiopedia pages were very easy to read and understand. The cases studies were brilliant.

The video gives the clear picture of the clubfoot and the treatment.The narration in the video is really awesome because anyone can understand easily.The veteran professionals sharing the experience also really inspiring.Resources also very good to understand that provided in this course.The journals also give detail picture of each steps of this topic.

Videos and images

All the elements in this course is very useful especially the videos.The narration in all video is really excellent and outstanding.journals also give details about the clubfoot treatment by ponseti method.

This whole course is great for understanding about management of children with clubfoot but i liked the videos very much.

Pirani scoring and management of children living with clubfoot.

I enjoyed learning about the various types of clubfoot. I also enjoyed the pictures and videos; they helped me to better understand the concepts better.

All of the resources and links provided.|The quizzes to consolidate learning, and content presented.

the videos were the best element of the course

I enjoyed the extra resources ie: the zulu translated pamphlets and parents handouts. I enjoyed the discussion videos with the clubfoot clinics from around the world.

Management of the children with clubfoot

The videos and case studies helped me a lot, because I have not seen a lot of clubfoot patients having visual input was good.

Physiopedia pages, helping me understand best practice

I liked the first section that went over the basics of foot and ankle. Sometimes you lose sight of normal when all the feet are clubbed.

I like quizzes. So you will have feedback right now.

variety of videos and written information, repeating important concepts

I enjoyed the variety of ways to learn and the quality of the audio visual resources

Discussions

I had no previous knowledge about clubfoot so found the whole course very interesting.

I enjoyed the videos that went over the ponseti method assessment in great detail. Showing how to score and what things you were looking for to assess severity.

every part were very educative

The most useful information was learning about the Ponseti Method of treatment and how essential it is for families to fully understand what is involved and what their role is in the care of their child. I liked the case studies and the videos of the people working in this field as well.

The powerpoints/videos which showed the info in action, felt supported, frequent quizzes to ensure I was thinking about what I was learning

Managing Children with Clubfoot MOOC

Evaluation Report Feb 2018 31

Best element of the course was the literature as well as the video graphic presentations made us learn it quite easy along with that self ask questions in them. That was great.

I really enjoyed the course and definitely increased my knowledge regarding clubfoot and the Ponseti method. I think the practical examples, case studies and images illustrating clubfoot were very useful. I also found the videos going through the Ponseti method step by step very good!

Video presentation.

I think the best element of the course was that If you know a little bit about it before starting the course you will end up learning a lot from it. Images are really helpful and some journal articles as well.

Videos about clinical experiences of other clinicians. It gives a precise insight to the challenges I might face when I encounter clubfoot and the solutions that can be taken. i

Videos

I really liked the combination of videos/pictures with articles and written text. It was organized well and the course flowed from topic to topic in a way that was easy to follow.

The videos an ankle and foot kinematics and power points of Ponseti method

The practical videos of ponseti management is very helpful.

The videos were very informative

Videos on assessment and casting

Gaining insights into work being done around the world with children with clubfeet; hearing from experts about clinical issues as well as managing a clinic for children with clubfeet

I enjoyed the more applicable learning such as the Pirani scoring and the Ponseti method learning the most useful.

The videos and some of the articles were apt. They reinforced the information presented in the Physiopedia pages.

The videos and journal articles.

book chapters and videos

Pirani score

The anatomy of the foot and ankle joint helped me understand clubfoot presentation. It also made sense how the posenti concept is applied throughout all the stages namely; correct first,then maintain.

Learning about Clubfoot experiences in different countries; hearing from experts about casting techniques and maintenance strategies

I especially enjoyed the interview and the work of Dr Nunn and Gardner. They truly inspired me to the point that I am going to try in find work with ICRC. It would be a privilege to to learn from them and work under their tutelage.

The best elements of the course were the videos.

The entire set up.

Quizzes and some of the videos

Treating older children with clubfoot.|Atypical clubfoot.|Idiopathic clubfoot.

I extremely enjoyed with physiopedia pages way of providing informations and book chapters with resources is very useful.

Full ponseti method is best and the way you teach us amazing

Videos and pictures I found very useful. Quizzes are the best for knowing what we have learned for some time.

The entire course was excellent.

The course content was good, i also liked how the sections were divided into the different stages. the quizzes were also great as it served as a refresher of what we have read

thorough overview of clubfoot with different teaching modalities

I found the video presentations with actual case studies the best part of this course.

Managing Children with Clubfoot MOOC

Evaluation Report Feb 2018 32

I enjoyed advanced casting technique by Dr Norgrove. Manipulating and casting the foot using two handed.

The in-depth explanation of the presentation and management were very useful - I've already used this knowledge in practice to help to inform parents of newborns with clubfoot.

Learning about the Pirani score and the readings and video that went with it. Also about the Ponseti and what an incredible difference it makes , I had limited knowledge about the treatment of clubfoot.In this course I have learnt so much.

I think all the videos were excellent, and the content was pitched perfectly for the course. The references were thorough and provide a good list of further reading. I thoroughly enjoyed the course and hope that it will enable me to undertake a practical course.

The videos were extremely helpful. To see real life case histories was excellent. Really was a useful learning medium.

the videos showing pictures along with narration.

I found very interesting this course overall the multimedia content. The videos of presentations we followed was very very useful for me because made me feel like if I were in a class. The different interventions of the colleagues who shared their experiences was quite good. |Many thanks

All of it...It's amazing!

The bringing together of useful information and the progression of the course was thoughtful

The videos and case studies

The course was easy to understand. Pirani scoring and ponseti technique was a very useful topic for me.

The ponseti casting presentations and videos was very informative and I now have a much better understanding of the management of clubfoot.|Learning more about FAB

The videos gave a clear and understanding view of this course. It also made the course more interesting

The videos and pictures

I enjoyed every part of the course but especially the part three with all the video and practical illustrations on how to manipulate and correct clubfoot deformity.

The assessment using pirani score

I found the patient images very helpful as examples. I enjoyed the variety of learning using videos and reading of articles. I like that if you get a question wrong on the quiz you are able to learn the correct answer and try again.

Videos and lecture were best and provide a brief knowledge

I enjoyed the presentation including multiple styles of reading, video lectures, interviews, forums...a very well - rounded course. Also, I learned so much more on a topic I'm interested in but haven't had the personal experience in.

Illustrative videos and articles

Foot Structure and Function,Assessment of Clubfoot,Pirani Score,videos and journal articles

I really liked the video presentations and the journal material.

Assessment using the pirani score

Videos, Quizzes, Images

The visuals were helpful for me.

The video of interviews with experts from different parts covering the world whereby I could get to hear and understand how the clubfeet is challenging other population especially in Europe and Asia compared to here in Tanzania

The video interviews especially the interviews with experts already working with children with clubfoot.

Hearing the experiences of clinicians in the field. |Having access to great information.

I found the aspects relating to the assessment and measurements tools more valuable and useful.

The videos were very informative

All parts of the course. In particular, the Ponseti Method and Pirani Score.

Managing Children with Clubfoot MOOC

Evaluation Report Feb 2018 33

The videos on assessment, manipulation & casting are very well clear to understand the complicated features of Clubfoot

All parts. In particular, learning about Ponseti Method and Pirani Score.

All of it

Overall it was really fantastic, I personally enjoyed it very much because I was in practical training in clubfoot clinic sponsored by ICRC. I appreciate the efforts of physiopedia and all organization who put their share in it. I enjoyed the videos of this course very much.

Section 1 was very interested and the way of teaching is very excited. All content of this course is very very good and helpful.

The section 2 and 3 are wonderful

I really appreciated having discussions to ask questions (although i would have loved answers too) and the videos coupled with the readings helped me to understand the material more thoroughly.

Quizzes, discussions, videos, pictures

Videos, Literature search activities, physiopedia pages, book chapters and journal articles

the videos and pictures made the written information solidified. the quizzes were spaced well to also reinforce learning. I appreciated the global emphasis as I live in the USA.

Very informative, lots of information regarding basics of clubfoot treatment|

Seeing how varied clubfoot services and experiences are across the world.||The anatomy component was very well covered.

very good initiative, many persons across the globe involved

the best element of the course was learning about ponseti method in correcting clubfoot.

I enjoyed the outcome of the interventions on the children

Videos were very good

This course has wide journal articles and book chapters. So I found very useful researches.

Pictures were great as well as multiple sources of learning (ie. videos, pictures, journal articles)

All videos as well as the content with good details were enjoyable for me,

Though I am a physical therapist who works with the pediatric population, I have minimal experience with clubfoot. This course was very well organized and helpful in building a strong foundation for me if/when I get to work with children with clubfeet.

Learning the Ponseti method.

I find all the topic very educational and useful. I think the best elements are the crucial roles of health practitioners and parents.

The best elements of this course is that, very clear explained about ponseti method with video presentation.

The Physiopedia reading parts and the quizzes at the end.

The physiopedia reading material and the quizzes.

Learning from experts, application to starting a clinic, exposure to charities involved in work, exposure to social ramifications of non intervention (disability)

1. Physiopedia pages 2. Articles 3. Cases study

First of all, I feel this is the first time I really understand the clubfoot topic although I did read about it before. The course was done so good, so seriously deep into all the elements of diagnosis, treatment, and follow-up. |I feel I can much more understand what parents and children are going through and know much more of what to look at during the years following the maintenance phase.

It was such a great to have the course laid out so well. It was very well planned. The progression of information was very appropriate. I liked the fact that it had information for the complete beginner. The video presentations were very helpful and showed such a variety of learning opportunities.

I enjoyed a lot learning on managing children with clubfoot, to me the videos are the best part, so much to learn!

Managing Children with Clubfoot MOOC

Evaluation Report Feb 2018 34

French Course

Comprendre la prise en charge des enfants ayant un pied bot.

L'évaluation |La méthode de Ponseti que je ne connais pas est très important |L'implication des parents dans le traitement

Pour moi les chiffres était très intéressant concernant le nombre de cas dans le monde

J'ai apprécié le plus la troisième module.

-Rappel d'anatomie du pied|-Épidémiologie du pied bot varus équin congénital|-La prise en charge du pied bot par la méthode de ponseti|-Les erreurs courantes dans la pratique de la méthode de ponseti|-La conduite à tenir en cas d'une récidive et d'un pied bot chez un enfant plus âgé.|-La pratique correcte de ténotomie et son indication|-La conduite à tenir et indication d'application de l'attèle pédieuse en abduction|-Le rôle des parents dans la réussite du traitement du pied bot

La troisième module

Pour moi tout les parties du cours sont très utiles parce que j'apprends beaucoup de chose à propos de pied bot que je n'ai jamais connu dans ma vie ,qui va me servir durant toute ma carrière professionnelle.

J'apprécie tout parce on peut pas prendre une partie le tout sont vraiment intéressant ,il nous aidera dans notre carrière professionnelle.

Le score de pirani,l'utilisation des étapes des phases de la méthode de ponseti, prise en charge des pieds bot et différencier les types de pied bot.

J'apprécie tout parce on peut pas prendre une partie le tout sont vraiment intéressant ,il nous aidera dans notre carrière professionnelle.

La prise en charge des pieds bots avec la méthode de Ponseti

Les vidéos et les articles. Moi personnellement je lis d'abord les articles ensuite je visionne les vidéos je comprends mieux le module.

toutes les parties de ce cours ont été d'une grande utilité. Mais les parties traitant la question de moulage et le score étaient vraiment intéressante.

Toutes les parties étaient intéressante, mais j'apprécie très fort les vidéos.

Un tas de cours était à ma portée telle que:la prise en charge du pied bot idiopathique,atypique,la méthode de Ponseti, le score de Pirani, la différence entre la prise en charge du nourrisson et l'enfant le plus âgé.etc...

Révision de l'anatomie |Évaluation du pied bot et différent méthode|Prise en charge du pied bot avec différents technique |Les études de cas|Les expériences des autres participants |

Pour moi, toutes les parties du cours étaient utiles pourquoi, parce que pour corriger un pied bot ils nous faut tout un processus pour avoir obtenu un meilleur résultat du problème causé par le pied bot. C'est la raison pour laquelle que toutes les chapitres ont une importance capitale. Merci!

La partie de la définition de la méthode de Ponseti et surtout le traitement ; c'est à dire les 3 premières sections.

les parties les plus utiles sont:|- la première section: l'anatomie et physiopathologie du pied bot.|-la 3eme section: les phases du traitements et comment les faire.

Le score de Pirani et la méthode Ponseti. Mon plus grand problème était de ne pas pouvoir traduire les vidéos en français.

le moulage du pied|le score de pirani|l attelle pédieuse en abduction|

La partie qui était plus intéressante pour c’est la où on explique de façon méthodique méthode de ponseti et j apprécie beaucoup les vidéos, ils sont très explicite et instructifs, les expériences également était agréable donc en résumé c était complètement parfait.

evaluation des enfants pied bot|le score de pirani|role de l equipe multidisciplinaire|l appareillage du pied bot|moulage du pied bot|role des parents

Savoir ce quoi pied bot

Les parties le plus apprecié et utile sont pour moi:les differentes types de pied bot comment les connaitres leurs traitement surtout la methode de ponseti et le score pirani.

Managing Children with Clubfoot MOOC

Evaluation Report Feb 2018 35

Chacune des 4 sections a été utile pour moi en raison de mon manque de connaissance sur les pieds bot. Plus principalement je dirais que toute l'information sur la méthode Ponseti a été la partie qui m'a le plus intéressée en plus de la section sur le pied bot récurrent.|

Le traitement du pied bot par la methode de Ponseti.

L'introduction du pied bot,Méthode Ponseti,Pied bot atypique, L'approche multidisciplinaire dans la prise du pied bot, Ténotomie, évaluation du pied bot, Pied idiopathique bilatéral, adhésion au traitement du pied bot, score de Pirani, erreurs courantes dans la prise en charge du pied bot, le moulage, la manipulation etc.

Les vidéos où les spécialistes du domaine explique leurs expériences dans le traitement du pied bot. C'était très intéressant!

Les meilleurs éléments contenus du cours les évaluations et vidéo

J ai tout apprécié.et ce qui m'attire ,j’estime que les formateurs étaient tous enthousiasmés pour nous partager leurs connaissances.

J'ai bien aimée la partie explicative des différents types de pieds bots et la dernières partie du cours avec les pieds atypique et chez les jeunes plus âgés.

Les parties qui etaient les plus interessantes pour moi sont l'espace forum, les videos et les chapitres pdf.

Le fait d'avoir les notes accompagnés de vidéos était très utiles. Les discussions m'ont permis de voir ce que les autres pensent et de clarifier mes doutes. |

La 4ème partie à été très meilleure pour moi

La traduction en français du cours a été indispensable pour moi, j'ai préféré la partie sur les pieds bots récurrents et atypique car c'est là où j'ai le moins d'expérience, je pense que cela va m'en permettre d'améliorer Ma pratique

Les diaporamas étaient très compréhensibles, précis, très pédagogiques. |

La méthode Ponseti et la manipulation du pied bot furent, selon moi, les meilleurs contenus dudit cours.De surcroît, les quiz intégrés à la formation nous ont grandement aidé.

Je trouve que les cours écrits + les vidéos créent une certaine répétition qui permet de bien apprendre et retenir les éléments. |Le questionnaire me semble facile mais permet aussi de se remémorer les différents éléments.

J'ai apprécié beaucoup le rappel sur l'anatomie du pied.je dis presque tout.il n'y a rien qui me déplaît je pense que tout a été très utile.

Les pages Physiopédia étaient très claires et bien synthétisées.

Les articles en français ainsi que les vidéos

L'apprentissage de la méthode Ponseti

La prise du moulage des enfants avec pied bot

Les meilleurs éléments du cours ont été les présentations en video

J'ai tout apprécié,plus encore les vidéos qui expliquent les théories en gestes,les suggestions de livres et articles. Les discussions,les quiz

Le pied bot idiopathique, atypique, le traitement du pied bot de l'enfant le plus âgé etc...

l'evaluation.la methode ponseti

La methode de ponseti

les vidéos complètent vraiment bien les supports écrits et permettent une bonne visualisation des techniques à appliquer

Le videogrammes et les illustrations

Les cours sont assez succints, les discussions et les vidéos qui sont très explicites.

La partie la plus intéressante est la quatrième.

Je pense que tous les parties étaient util, bien détaillé.

La partie la plus apprécié est la quatrième .

Je pense que tous les parties étaient util, bien détaillé.

Managing Children with Clubfoot MOOC

Evaluation Report Feb 2018 36

Les vidéos ont été très intéressant. |La révision sur l'anatomie du pied était d'une importance capitale.

C'est la 4eme partie, car elle a mis l'accent sur des cas les plus facile à retrouver en Haïti.

Les images et les cas cliniques m'ont Bcp aidé, vu qu'on ne pouvait Pas pratiqué cela m'a permis de mieux m'orienter et de comprendre de quoi il s'agit.

La section 3 et 4

La quatrième partie car elle nous permet d'avoir une idée plus global de la chose.

Pour moi les vidéos me sont très utiles car je suis visuelle.

les videos où on peut vraiment voir comment faire la manipulation et moulage du platre.

Le méthode ponseti m'à vraiment impressionné

les infos generales en ce qui concerne le pied bot

J'ai beaucoup apprécié que le cours utilise différentes méthodes d'enseignement.. P.ex. le texte avec des images, les vidéos, les questionnaires et les forums! Super beau cours que je recommande à tous les physiothérapeutes qui travaillent en pédiatrie.

Le forum,les vidéos, les quizs, les images etc...

La mesure de la déformation du pied bot via le score Pirani, la méthode Ponseti sont, entre autres, les meilleurs éléments du cours.

La manipulation du pied bot

Je pense qu'il faut revoir la traduction en français. La traduction automatique n'est pas appropriée á cette formation.

La participation dans les forums de discussion, les articles et les témoignages des praticiens et les parents

Introduction au pied bot ||Prise en charge du pied bot

Les vidéos ET Les images

La méthode de ponseti est très formidable