Understanding the Rehabilitation Needs of Displaced Persons - Evaluation Report

Summary

From September 05 to October 30, 2022, Learning, Acting, and Building for Rehabilitation in Health Systems (ReLAB-HS), led by Physiopedia, successfully delivered a Massive Open Online Course (MOOC) entitled “Understanding the Rehabilitation Needs of Displaced Persons” via the Physiopedia Plus (Plus) online learning platform. The program consisted of seven independent courses, which included:

1. Global Context for Displaced Persons
2. Health and Well-Being for Displaced Persons
3. Communication and Trauma-Informed Care for Displaced Persons
4. Considerations for Working with Diverse Displaced Person Populations
5. Considerations and Practical Tools for Working with Survivors of Sexual Violence and Trafficking
6. Considerations for Working with Survivors of Torture
7. Assessment and Management of Pain for Displaced Persons

In each course, the learner completed required learning activities and a final quiz that tested knowledge gained from the course. To complete the overall program, the learner had the option to submit and pass a written assignment.

The program was also supported with two optional live online webinars to provide opportunity for increased learner interaction and engagement with the content experts. The webinar recordings were made available on the Plus platform for participants unable to access the webinars live.

1. Trauma Informed Care and Working with Survivors of Torture Webinar with Eric Weerts, Rehabilitation Specialist Humanity and Inclusion and Sue Piché, Psychiatric and Mental Health Nurse
2. Pain Assessment and Management for Displaced Persons Webinar with Zafer Altunbezel, Physiotherapist and Naomi O’Reilly, Physiotherapist

Course Type: Free, Open, Online

Institution: ReLAB-HS via Physiopedia About this Course: This MOOC aimed to equip health and social care professionals with a comprehensive knowledge of the rehabilitation needs for displaced persons, so they can play an effective and proactive role in local and global efforts to increase access to high-quality rehabilitation.

Target Audience: These courses were designed and written for health and social care professionals, clinicians, students, assistants, and other rehabilitation-related health systems stakeholders.

Time Commitment: 22 hours over eight weeks (with an optional extra eight hours)

Date: September 5 to October 30, 2022, with live online webinars on the 6th October 2022 (Webinar 1 Trauma Informed Care and Working with Survivors of Torture Webinar) and on the 12th October 2022 (Webinar 2 Pain Assessment and Management for Displaced Persons). Remains available on Plus platform to members.

Requirements: Participants were required to complete online learning activities, participate in discussion forums, engage with additional resources, and complete course evaluations and quizzes.

Assessment: There was a quiz at the end of each course, and participants could complete an optional written assignment to demonstrate knowledge gained from the overall program of seven courses.

Awards: Seven course completion certificates awarding a total of 22.7 Plus (P+) points with an additional four Plus (P+) points available for the optional assignment to complete the program..

Accreditation: Each individual course was accredited for continuing education and professional development (CE/CPD) in Australia, South African and the USA and is formally accepted without accreditation as a professional development activity by many other countries

Registrations MOOC: 12,604

Registrations Live Webinars: 1,150

Countries Represented MOOC: 107

Countries Represented Live Webinars: 86

Professions Represented MOOC:  24        

Professions Represented Live Webinars: 10

Acknowledgments

The Understanding the Rehabilitation Needs of Displaced Persons MOOC was developed and delivered by ReLAB-HS and Physiopedia. The delivery of this MOOC was a highly collaborative effort made possible by valuable contributions from various parties. The United States Agency for International Development (USAID) funded Learning, Acting, and Building for Rehabilitation in Health Systems (ReLAB-HS) activity would like to thank the following people for their contributions to this work:

Course Coordinators: Rachael Lowe, Naomi O’Reilly.

Content Contributors: Rachael Lowe, Naomi O’Reilly, Nimisha Gorasia, Ayman Baroudi, Chidera Lilian, Vidya Acharya, Oyemi Sillo, Shaimaa Eldib, Thalia Zamora Gómez, Donald John Auson, Jordan Awale, Adiyta Vats, Laura Ritchie, Anna Fuhrman, Eric Weerts, Sue Piché, Zafer Altenbuzel, lona Fricker, Kamal Khalifa, Wala’a Awwad, Laura Gueron, Stanley Malonza, Jeniffer Chepkemoi, Jepkemoi Kibet, Patrick Le Folcalvez, Graziella Lippolis, Pasala Maneewong, Jenny Malmsten, Mia Sandor, Patricia Rocca, Courtland Robinson,  Rachael Tribe.

Webinar Content Experts: Eric Weerts, Sue Piché,  Zafer Altenbuzel, Naomi O’Reilly.

Course Facilitators: Naomi O’Reilly, Tarina van der Stockt, Lucy Aird, Jess Bell, Carin Hunter.

Webinar Facilitators: Amanda Ager, Naomi O’Reilly, Lucy Aird.

This publication is made possible by the support of the American people through the United States Agency for International Development (USAID) through the Learning Acting Building for Rehabilitation in Health Systems (ReLAB-HS) project. The contents are the sole responsibility of Physiopedia and ReLAB-HS and do not necessarily reflect the views of USAID or the United States Government.

For information regarding this report, please contact: Rachael Lowe ([email protected])

Introduction

People have always been on the move for many reasons, including war and conflict, insecurity, disasters, poverty, and to find work and seek a better life for themselves and their families. But more people are now on the move than ever before in our history, with migration increasing every year over the last two decades, particularly forced migration. In 2021, 89.3 million people were forced to flee their homes due to conflict, violence, fear of persecution and human rights violations. This is more than double the 42.7 million people who were forcibly displaced a decade ago, and the highest it has been since World War II. Current evidence suggests that this number will continue to rise, with over 100 million people estimated to be displaced in 2022.

The need for rehabilitation services to meet the needs of displaced persons at each stage of the migration process is an urgent and growing global issue. The impact of forced migration on health and well-being is contributing to rapid global increases in the numbers of people experiencing a decline in functioning, resulting in enormous unmet rehabilitation needs. Much of these unmet needs are concentrated amongst the poorest and most vulnerable populations. Low- and middle-income countries host 83% of all displaced persons, with 27% hosted in the least developed countries, including Bangladesh, Chad, the Democratic Republic of the Congo, Ethiopia, Rwanda, South Sudan, Sudan, Uganda, the United Republic of Tanzania, and Yemen. These countries are often ill-equipped to cope with the increasing need for rehabilitation services.

The role of the health and social care professional is key in the rehabilitation process for displaced persons and this series of courses provides a comprehensive perspective on the effects of displacement on health and well-being.

During September and October 2022, ReLAB-HS, led by Physiopedia, delivered a Massive Open Online Course (MOOC) entitled, “Understanding the Rehabilitation Needs of Displaced Persons.”  The MOOC was delivered as seven individual courses with an optional written final assignment to complete the full program of courses.

The Understanding the Rehabilitation Needs of Displaced Persons program aimed to equip rehabilitation professionals with a comprehensive knowledge of rehabilitation for displaced persons so that they can play an effective part in the interdisciplinary management of displaced persons through all stages of the migration process. It also aims to enable rehabilitation professionals to play a proactive role in global and local efforts to increase access to high-quality rehabilitation for displaced persons through all stages of the migration process.

The eight week-long program presented different topics exploring the needs of displaced persons through a variety of learning activities to suit all learning styles. The required learning activities within each course were developed to take between two to four hours depending on the participant's learning style, with optional activities provided should the participant wish to take part in additional learning. A short orientation period before the course provided participants with an opportunity to become familiar with the delivery platform and the topics via the provided pre-course resources.

The course was delivered through the Plus online learning platform, an innovative platform specifically developed to provide online education and support participants with a personalized learning dashboard. For each course, the related learning activities were outlined on a specific course page. Participants engaged with each course and the respective learning activities, and their activity was recorded and displayed in their personal learning dashboard.

A course was considered complete once the learner finished all required learning activities and successfully passed the final quiz that tested the knowledge gained within each individual course of the program. On completion of each course the participants had the option to download a completion certificate and export a record of their learning from their activity log. There was also an optional written assignment designed for participants to apply the knowledge gained from the overall program consisting of  seven courses.

This report evaluates the engagement and experiences of the participants on the Understanding the Rehabilitation Needs of Displaced Persons MOOC.

1.0 About the Program of Courses

1.1 Aim

Through this MOOC, ReLAB-HS aimed to build on recent work to strengthen the advocacy case for better access to rehabilitation for displaced persons by increasing knowledge among global stakeholders and build on Physiopedia’s global community of professional participants to amplify the growing voice of rehabilitation professionals advocating for access to rehabilitation.

In order to achieve this, a program of seven courses was created with the aim of developing a comprehensive program to equip rehabilitation professionals with a far reaching knowledge of rehabilitation for displaced persons to enable them to play a proactive role in global and local interdisciplinary efforts  to increase access to high-quality rehabilitation for displaced persons through all stages of the migration process.  

1.2 Learning Objectives

At the end of this program of courses, participants were able to:

1. identify the different types of displaced persons
2. describe the global context surrounding the migration of displaced persons
3. explain the impact of media portrayal on attitudes towards displaced persons
4. explore country-specific knowledge about policy and legislation in the migration field to enhance understanding of the life situation of displaced persons
5. describe the impact of migration on health
6. identify health, functioning and disability stemming from the migration process
7. explain the common challenges refugees face in receiving optimal health care
8. identify three barriers to accessing health care for displaced persons
9. discuss the role of the Salutogenic approach to health and well-being for displaced persons
10. describe self-care strategies to keep yourself safe and well when working with displaced persons
11. discuss how to cultivate cultural sensitivity in order to create a trusting therapeutic space and facilitate communication with patients and significant others
12. explain the role that translators and interpreters play in facilitating optimal communication when working with displaced persons
13. identify holistic approaches that reduce the impact of trauma and address patient difficulties related to trauma and psychosocial issues
14. describe strategies to reduce barriers to interprofessional communication and facilitate effective interprofessional teamwork
15. discuss the role of a rehabilitation professionals in a camp setting
16. describe the impact of forced migration on children and adolescents
17. explain the impact of forced migration on older persons
18. describe the impact of forced migration on members of the LGBTQIA+ community
19. discuss strategies to minimise barriers to culturally competent care for LGBTQIA+ displaced persons
20. explain the prevalence of sexual violence
21. describe the consequences of sexual violence and female genital mutilation
22. discuss why sexual violence occurs in conflict settings
23. explore practical strategies to calm the response of the nervous and limbic systems in displaced persons who have experienced sexual violence
24. explain what torture is and its impact on survivors
25. choose two appropriate treatment options for working with a survivor of trauma
26. describe techniques for building trust and creating a safe therapeutic relationship with survivors of torture
27. summarise the multidimensional nature of pain, its implications for displaced persons, and relationship to clinical interventions
28. describe the five main domains of the Pain and Disability Drivers Model (PDDM) that may be contributing to pain and disability
29. describe pain management strategies

1.3 Intended Audience

This course is suitable for all rehabilitation professionals, students, and assistants, including but not limited to: physiotherapists, occupational therapists, speech and language therapists, rehabilitation doctors, rehabilitation nurses, prosthetists, orthotists, psychologists, audiologists, dietetics, social workers, and community-based health workers.

1.4 Cost to Participants

The course was free to all participants who completed the course within the 8-week timeframe and remains free to all Plus members and residents of low-income countries outside of this timeframe.

1.5 Course Availability

The program of seven courses with optional assignment was made available on September 5, 2022. Participants had until October 30, 2022 to complete the courses under their free access to Plus. The course remains available on the 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.

1.6 Courses, Course Awards, and Accreditation

Seven individual courses were created for the Understanding the Rehabilitation Needs of Displaced Persons program, which could each be completed individually or can be completed as a program of courses with an additional assignment. Plus provided individual course completion certificates to all participants that passed each of the individual courses or attended the webinars. For each course completion participants were also awarded continuing professional development (CPD) points. Individuals who completed all seven courses and completed the assignment were also provided with a program certificate for recognition of completing the full program.

Course 1: Global Context for Displaced Persons (3.9 CPD points)

Course 2: Health and Well-Being for Displaced Persons (3.9 CPD points)

Course 3: Communication and Trauma-Informed Care for Displaced Persons (4.4 CPD points)

Course 4: Considerations for Working with Diverse Displaced Person Populations  (4.0 CPD points)

Course 5: Considerations and Practical Tools for Working with Survivors of Sexual Violence and Trafficking (1.9 CPD points)

Course 6: Considerations for Working with Survivors of Torture (2.4 CPD points)

Course 7: Assessment and Management of Pain for Displaced Persons (2.2 CPD points)

Course Program: Understanding the Rehabilitation Needs of Displaced Persons (5.0 CPD points)

Webinar 1: Trauma Informed Care and Working with Survivors of Torture Webinar (0.8 CPD points)

Webinar 2: Pain Assessment and Management for Displaced Persons Webinar (1 CPD points)

2.0 Demographics of the Participants

2.1 Country

Of the 12,604 individuals registered for the MOOC from 167 countries, 868 individuals completed the Pre-Course Knowledge and Competency Self-Rating Tool from 94 countries, with 796 individuals from 88 countries starting Course 1 (Global Context for Displaced Persons) and 335 individuals from 58 countries starting Course 7 (Assessment and Management of Displaced Persons with Pain) before October 30, 2022. The Post-Course Knowledge and Competency Self-Rating Tool was completed by 127 individuals from 33 countries.

Table 1 and Figure 1 below show the numbers of participants and completion rates for participants for the  top ten represented countries across all seven courses. The  highest level of participation for each of these countries occurred in Course 1 (Global Context for Displaced Persons), which had the highest overall participation of all seven courses with 796 individuals. Of these ten countries the Netherlands had the highest completion rate overall at 88%, followed by the Ukraine with a completion rate of 66%.

A full list of all countries with the number of participants from each country and completion rates for each course can be found in Appendix 1.  

Table 1: Top Ten Represented Countries Participation and Completion Rates Data are numbers (n) that started Course 1 and the number (n1) and percentage (%) that completed the final Course 7 (Assessment and Management of Pain in Displaced Persons) (%

Country	n (number started)	n1 (number completed)	% (percentage completed)
Nigeria	78	15	19%
Pakistan	60	17	28%
Ukraine	59	39	66%
United States of America	55	16	29%
India	54	15	28%
United Kingdom	45	15	33%
Canada	31	6	20%
Australia	23	7	30%
Uganda	19	2	11%
Netherlands	16	14	88%

Table 2 below shows a breakdown of participation and completion data by country income classification, with the highest number of participants for all seven courses and the program coming from low to middle income countries. Highest completion rates for the individual courses were also predominantly seen among those from low (range 64% - 100%) and  low to middle income countries (range 50% - 94%) with 100% compilation seen for low income countries for Course 5 (Considerations and Practical Tools for Working with Survivors of Sexual Violence and Trafficking) and Course 6 (Considerations for Working with Survivors of Torture) highlighted in red below.

Table 2: Country Income Classification - Data are numbers (n) who started each course and percentage (%) of participants from country income classification who completed each course

Country Classification	Course 1 n (%)	Course 2 n (%)	Course 3 n (%)	Course 4 n (%)	Course 5 n (%)	Course 6 n (%)	Course 7 n (%)	Program n (%)
High	229 (50%)	115 (85%)	104 (88%)	76 (92%)	72 (93%)	74 (95%)	96 (78%)	48 (2%)
High-Middle	53 (36%)	19 (84%)	16 (88%)	12 (75%)	13 (69%)	12 (83%)	30 (67%)	10 (0%)
Low-Middle	333 (50%)	168 (89%)	111 (93%)	108 (91%)	106 (95%)	100 (94%)	145 (77%)	74 (4%)
Low	50 (64%)	34 (74%)	21 (95%)	21 (86%)	12 (100%)	14 (100%)	19 (79%)	12 (0%)

Finally Table 3 and Figure 2 highlight the participation and completion of participants from ReLAB-HS countries, with the highest number of participants for all seven courses and the program coming from the Ukraine. Highest completion rates for the individual courses were seen by those from Myanmar (range 25% - 100%), Ukraine (range 71% - 100%) and Uganda (range 68% - 100%) with 100% completion rates highlighted in red  below.

Table 3: ReLAB-HS Countries Participation and Completion Rates - Data are numbers (n) who started each course and percentage (%) of participants from ReLAB-HS countries who completed each course

ReLAB-HS Country	Course 1 n (%)	Course 2 n (%)	Course 3 n (%)	Course 4 n (%)	Course 5 n (%)	Course 6 n (%)	Course 7 n (%)	Program n (%)
Myanmar	4 (25%)	2 (100%)	2 (100%)	1 (100%)	3 (67%)	4 (100%)	4 (100%)	1 (0%)
Pakistan	60 (37%)	18 (78%)	16 (75%)	15 (80%)	17 (76%)	14 (93%)	22 (17%)	18 (6%)
Uganda	19 (68%)	42 (93%)	6 (100%)	5 (80%)	4 (100%)	4 (100%)	4 (100%)	1 (0%)
Ukraine	59 (71%)	12 (75%)	39 (95%)	41 (93%)	36 (100%)	40 (93%)	44 (89%)	16 (6%)

While overall completion rates for each of the individual courses were high, the completion rates seen for the program of Courses, which involved completion of an assignment are much lower (range 0% - 6%), suggesting minimal interest or motivation of participants to complete the optional assignment.

2.2 Professions

Twenty-four different professions started the Understanding the Rehabilitation Needs of Displaced Persons program before the end date of October 30, 2022. The top ten represented professions can be found in Table 4. Physiotherapist and Physical Therapist including DPT represented the greatest number of participants in all seven courses, followed by students (all professions combined) and Occupational Therapists. Completion rates varied, but it is evident from the data below that the profession with lower numbers of participants do appear to have higher completion rates overall, in many cases with 100% rates as highlighted in red below. A full list of participants' professional backgrounds can be found in Appendix 1.

Table 4: Top Ten Participants’ Professional Backgrounds - Data are numbers (n) who started each course and percentage (%) of participants who completed each course

Profession	Course 1 n (%)	Course 2 n (%)	Course 3 n (%)	Course 4 n (%)	Course 5 n (%)	Course 6 n (%)	Course 7 n (%)	Program n (%)
Physiotherapist /Physical Therapist including DPT	338 (49%)	173 (835)	125 (96%)	119 (89%)	107 (96%)	104 (99%)	187 (72%)	76 (3%)
Student (All Professions Combined)	47 (38%)	21 (71%)	12 (67%)	8 (100%)	9 (78%)	10 (80%)	10 (70%)	10 (0%)
Occupational Therapist	46 (59%)	18 (83%)	18 (67%)	12 (100%)	14 (93%)	12 (92%)	11 (91%)	11 (0%)
Nurse	23 (78%)	18 (94%)	17 (94%)	17 (88%)	16 (94%)	16 (94%)	17 (88%)	7 (0%)
Doctor of Medicine	15 (40%)	3 (67%)	2 (100%)	3 (67%)	2 (100%)	3 (67%)	2 (100%)	2 (0%)
Massage Therapist	10 (60%)	7 (86%)	4 (5%)	5 (100%)	5 (100%)	5 (100%)	6 (100%)	2 (0%)
Physical Rehabilitation Doctor	8 (25%)	1 (100%)	1 (100%)	0	0	0	5 (20%)	1 (0%)
Physiotherapy Assistant / Physical Therapy Assistant	6 (33%)	1 (100%)	1 (100%)	1 (100%)	1 (100%)	3 (100%)	3 (100%)	1 (0%)
Psychologist	6 (100%)	5 (100%)	4 (100%)	3 (100%)	4 (75%)	4 (100%)3 (100%)	3 (100%)	4 (25%)
Speech and Language Therapist	3 (100%)	2 (50%)	1 (100%)	1 (100%)	0	0	0	0
Educator	3 (33%)	1 (100%)	1 (100%)	1 (100%)	2 (100%)	1 (100%)	1 (100%)	1(0%)

2.3 Gender and Age

Women were represented across all age ranges from under 18 to 75+ and accounted for the greatest number of course participants in every age category.

Table 5: Gender Participation and Completion Rates - Data are numbers (n) who started each course and percentage (%) of participants who completed each course

Profession	Course 1 n (%)	Course 2 n (%)	Course 3 n (%)	Course 4 n (%)	Course 5 n (%)	Course 6 n (%)	Course 7 n (%)	Program n (%)
Female	41 (56%)	19 (100%)	17 (94%)	14 (93%)	13 (100%)	18 (89%)	18 (83%)	8 (0%)
Male	32 (69%)	21 (95%)	17 (94%)	17 (88%)	16 (88%)	14 (100%)	19 (89%)	8 (0%)
Not Disclosed	440 (50%)	212 (84%)	157 (92%)	145 (90%)	137 (94%)	132 (97%)	210 (75%)	103 (4%)

2.5 Disability Related

Participants with a wide range of health impairments participated in the MOOC, with the majority of participants reporting no difficulty. For those who reported difficulty with doing certain activities as a result of a health problem, difficulties with remembering or concentration was the highest reported followed by vision and then communication difficulties.

3.0 Engagement of the Participants

3.1 Platform

The Understanding the Rehabilitation Needs of Displaced Persons program and associated seven courses were delivered on the Plus learning platform. Twenty-four knowledge-sharing topic summary articles on Physiopedia were either created or updated for the participants to use during these courses; these articles received 27,244 unique page views and 31, 972 total views before the final date of the supported course on October 30, 2022.

A full list of all knowledge-sharing topic summary articles on Physiopedia countries with unique page views, total page views and average time spent on page can be found in Appendix 1.  

Table 6: Top Ten Physiopedia Pages Reviewed

Page	Unique Page Views	Total Page Views	Average Time on Page
Salutogenic Approach to Wellness	2,830	3,264	00:05:24
Understanding Migration and Displacement	1,391	1,613	00:06:35
Mental Health and Forced Displacement	870	1,025	00:04:37
Human Rights and Health	869	1,024	00:04:50
Culture and Communication	863	992	00:05:24
Effective Communication for Displaced Persons	861	962	00:05:26
Media Portrayal of Displaced Persons	755	856	00:06:01
Trauma-Informed Care	700	788	00:05:01
Rehabilitation for Survivors of Torture	632	718	00:05:03
Evidence Based Assessment of Pain in Displaced Persons	624	866	00:04:57

3.2 Learning Activities

The program included a total of 81 required learning activities across the seven courses with 6 extra learning activities and an assignment required to complete the overall program, including videos, directed reading, and case studies (the full list of learning activities can be found in Appendix 2.

To complete each individual course, participants were required to fully engage with the required learning activities and pass a quiz. Once successfully completed, Plus CPD points (equivalent to hours of learning) and a completion certificate were awarded. Over the course of the MOOC 25,109 learning activities were logged with 8,826 Plus CPD points awarded. A breakdown of the number of required learning activities and the number of learning activities that were completed for each course and the program can be found in Table 7.

Table 7: Learning activities logged and total Plus Points awarded for each course

	Course 1	Course 2	Course 3	Course 4	Course 5	Course 6	Course 7	Program	Total
Required Learning Activities	14	12	11	14	11	11	8	6	87
Learning Activities Logged	8104	4359	3785	3192	1614	1137	2309	609	25,109
Plus Points Awarded	3096	1437	1398	961	556	515	701	162	8826

3.3 Discussion Forums

Each course contained a number of optional forum discussions. Participants were encouraged to engage with other course participants on a wide range of different topics associated with the course. These discussions were intended to provide a rich learning experience to the learner through self-reflection and community engagement. Participants submitted thousands of forum comments and questions, an impressive level of engagement given all Plus discussions throughout this course were optional.

In total there were 1,832 discussion posts over the course of the program. There were 332 comments on the most active discussion, which considered the individual context participants were working in, their experiences of working with displaced persons, and the challenges they were facing in providing rehabilitation services for displaced persons. Table 7 presents an outline of the number of discussion posts for each discussion forum in each of the seven courses.

Table 8: Number of Discussion Forum Posts - Data are Number (n) of Individual Posts

	Course 1	Course 2	Course 3	Course 4	Course 5	Course 6	Course 7	Total
Discussion 1	332	65	97	67	68	52	56	N/A
Discussion 2	151	N/A	79	66	N/A	52	N/A	N/A
Discussion 3	97	N/A	63	68	N/A	N/A	N/A	N/A
Discussion 4	69	N/A	56	52	N/A	N/A	N/A	N/A
Discussion 5	84	N/A	N/A	54	N/A	N/A	N/A	N/A
Discussion 6	51	N/A	N/A	N/A	N/A	N/A	N/A	N/A
Reflections	48	41	13	15	14	10	12	105
Total	832	106	308	322	82	114	68	1,832

The discussion forums have provided an overview of barriers and challenges that rehabilitation workers currently face when providing rehabilitation services for displaced persons. Many creative solutions to increase access to services have been highlighted in these discussion forums across a broad range of settings and contexts worldwide.

Two forums in particular provide great insight to what is happening globally in relation to how displaced persons are treated. Discussion 6 of Course 1 (Global Context for Displaced Persons) asked participants to share their knowledge of legislation that is specific to their country and/or community most, with many highlighting the inconsistency in legislation with poor access to information common for many displaced persons and rehabilitation professionals on how to navigate the system, with peer advise rated highly by many. Similarly Discussion 2 and 4 in Course 3 (Communication and Trauma-Informed Care for Displaced Persons) highlighted the challenges around communication needs, with access to interpreter services often inadequate with many individuals reliant on family members, and commonly children and young people to provide interpretation services, often resulting in increased pressure within the health service. Team working was also highlighted as a challenge in many settings, particularly during the early stages of the migration process, with limited access to the broader interdisciplinary team with many team members having to work alone, or with limited access to other team members.

"I work in a private practice and it remains very difficult to have verbal conversations regarding mutual patients given physicians general unavailability to speak by phone etc….. In general terms, collaborative communication remains poor and from my perspective it's often one-way"

These forum discussion posts provide great insight into the state of rehabilitation for displaced persons across the world. The forums will stay active, and Plus members can continue to read and contribute to the discussion points as they complete the courses.

3.4 Webinars

For the first time during a MOOC we trialled the introduction of two live webinars (Webinar 1 Trauma Informed Care and Working with Survivors of Torture Webinar and Webinar 2 Pain Assessment and Management for Displaced Persons Webinar) mid way through the 8-week MOOC to  to try to provide more opportunity for learner interaction and engagement to create connection and minimise the impact of isolated learning. Further detail on the webinars are available in the independently available webinar reports.

Table 9: Webinar Initiation and Completion - Data are Numbers (n) of Participants from all Countries, number (n1) of participants from ReLAB-HS Countries, percentages (%) or participants who attended the webinar and percentage (%1) of participants from ReLAB-HS Countries who attended the webinar.

	Webinar 1 Overall Number (ReLAB Country Numbers)	Webinar 2 Overall Number (ReLAB Country Numbers)
Participants who Registered (n)(n1)	588 (100)	562 (95)
Participants who Attended (n)(n1)	173 (50)	174 (40)
Percentage who Attended (%) (%1)	29% (50%)	31% (42%)
Number  Countries Attended (n)(n1)	31 (4)	77 (4)

Of the participants who participated in the live online webinars the majority had no previous experience of working with or treating survivors of torture (77%) or displaced persons (76%). Of those who did have experience of working with survivors of torture and/or displaced persons most were within a stable environment where there was no current conflict or instability occurring, with only a small number working within an unstable environment.

Figure. 6 and 7 highlight the range of clinical experience of participants of working with survivors of torture and displaced persons.

3.6 Final Assignment

An optional final assignment was designed to give participants an opportunity to reflect on their learning and use the knowledge gained throughout the courses. Participants were asked to follow the assignment guidelines or video assignment guidelines on Plus, and the Physiopedia team assessed the submitted assignments. To successfully pass the final optional assignment, participants needed to demonstrate: evidence of learning from the course, academic skill with evidence-based writing, and proper referencing. Assignments had to be written in English.

A total of 22 assignments were submitted of which seven have met the assignment requirements before October 30, 2022 and were rewarded with a passing grade and program certificate, with two needing just minor amendments to achieve a passing grade.,  

3.7 Engagement versus Completion

Of the 12,604 participants who registered to take part in Understanding the Rehabilitation Needs of Displaced Persons program, 868 completed the pre-MOOC competency check and 796 (1% of registered participants) began the first course before October 30, 2022. 796 participants began course 1 (Global Context for Displaced Persons) of the Understanding the Rehabilitation Needs of Displaced Persons Program, with 42% completion rate.

Course 4 (Considerations for Working with Diverse Displaced Person Populations) and Course 6 (Working with Survivors of Torture) had the highest completion rates with 87% participants completing these two courses. The number of participants who began and completed each of the seven individual courses and the program with assignment can be found in Table 8.

Table 10: Course Initiation and Completion - Data are Numbers (n) of Participants

	Course 1	Course 2	Course 3	Course 4	Course 5	Course 6	Course 7	Program
Participants who Started (n)	796	367	280	225	225	217	335	173
Participants who Completed (n)	333	287	227	195	191	189	223	7
Percentage who Completion (%)	42%	78%	81%	87%	85%	87%	67%	4%

High numbers of dropouts are a common challenge for MOOCs, suggested to be related to limited participant interactions (Fricton et al., 2015) and lack of face-to-face sessions, which generate a sense of isolation and disconnection (Jessica et al., 2021).

Two hundred and twenty three participants completed Course 7, the final mandatory course of the MOOC, which is a completion rate for the MOOC of 28%. While smaller numbers completed each consecutive course, the completion rates for the later courses were much higher than for the initial course, suggesting a good connection with the content.

Overall, these completion rates for both the full MOOC and each individual course are well above those seen for both health-related MOOCs, with completion rates reported to range between 4.3% and 11% (Maxwell et al., 2018), and technology-related MOOCs that are generally below 13% (Onah et al., 2014).

4.0 Participant Feedback

After the completion of each of the seven courses, participants had the option to share their feedback. Participants were asked to rate their overall opinion of each course on a five-point scale ranging from excellent to poor. Overall all seven courses received a predominant excellent rating with no ratings of poor in any of the seven courses. Figures 6 to 13 display the results for each individual course.

4.2 Qualitative Data

Participants were provided with the opportunity to give qualitative feedback on their experience with each course. When asked, “What were the best elements of this course?” overall, the participants reported that they enjoyed the variety of materials in the courses, in particular the videos that were supported by transcripts and up-to-date research highlighting the current global perspectives on displacement, the impact on rehabilitation services and strategies for working with diverse displaced person populations. Participants reported that the information provided was presented clearly and in an engaging way with excellent speakers who were experts in their field.

In Course 1 (Global Context for Displaced Persons), the participants highlighted the videos and articles that explored the terminology and global data surrounding displacement as most beneficial to their learning. providing a detailed overview of the context surrounding displacement, which helps when advocating for improved rehabilitation services to meet the needs of displaced persons.

“I really loved the videos by Courtland Robinson, he has a wonderful way of throwing out the facts without making them feel heavy. Conveying the importance of specific information, but doing it with a very 'human' tone. It was engaging and started off the section well to peak curiosity.”

In Course 2 (Health and Well-Being for Displaced Persons) participants highlighted the important role that understanding cultural difference plays when working with displaced persons and identified the importance of understanding health literacy. Participants also identified that the flow of the course going from the health and well-being needs of the displaced person to the self-care needs of the rehabilitation professional as a key positive of the course, ensuring recognition of equal importance of these factors for a well functioning health service.

“Reminders to be sensitive to cultural differences of the refugees and migrants and need to make them feel comfortable to be able to properly assess their health needs and inquiries.”

“The course structure is useful going from the needs of the displaced person to the personal needs of the physiotherapist. both are equally important for a well functioning rehabilitation process.”  

“It also gives attention to healthcare workers or any rehab personnel. Most topics will only involve honing one's skill or understanding of certain topics, and finding ways on how to better in giving medical or health care services, but this topic gives importance to self-care to the manpower of health care service.”

In Course 3 (Communication and Trauma-Informed Care for Displaced Persons), it was evident that participants enjoyed the content and felt the course enhanced their current level of understanding around communication within the rehabilitation team members and the importance of collaboration in build trust and a positive therapeutic relationship when working with displaced persons who may have experienced trauma. Additionally, they recognize the impact that using an interpreter can have on the quality of care, and how vital it is to develop our skills as rehabilitation professionals to work with interpreters to ensure we can provide the best possible care to people who have been displaced and arrive in a country where a different language is spoken.

“Emphasis on the clinician as the facilitator - oftentimes due to our expertises, we get put into sole decision-making roles, with pts having to defer to us for further care. Making care collaborative removes a lot of the barriers that come with "white-coat syndrome"

“Trauma informed care, the need for us as rehabilitation professionals to understand that displaced persons have experienced a serie (s) of events which has adverse effects on an individual's functioning and mental, physical, emotional, social or spiritual well being. In our intervention as rehabilitation professionals,we ought to be mindful in our assessment and treatment approach to displaced persons to prevent re-traumatization and improve treatment outcomes for individuals who have experienced traumatic events. “

“A broader knowledge on who an interpreter is, their role and importance in the management of the displaced persons resonated in me and left an impression that to better achieve results a good, clear understanding is required both from the affected people and the health professional involved.”

In Course 4 (Considerations for Working with Diverse Displaced Person Populations), participants highlighted the importance of recognising diversity, and valued the opportunity to consider the needs of diverse populations that are represented in displaced persons.

“I was reminded that vulnerable groups of people in every society are represented within the refugee population. And there were practical ways to address each group.”

“Addressing the large issues of war and climate are not the only reasons why someone seeks to flee their place of origin. The challenges of LGBTQ+ individuals are certainly unique and the traumatic experiences are often intimate and of a different nature. To bring attention to that amongst healthcare providers is still something that is greatly needed.”

To be honest, I'm still processing everything I've learned about LGBTQIA+ , it involves a lot of terminologies and some of which are interchangeable. However, the bottom line is, just like any other patients, LGBTQIA+ clients deserves the same respect and care every client gets during our service provision and confidentiality is key is building a long lasting therapeutic relationship while using receptive language as preferred by the clients not assuming based on your knowledge or cultural beliefs/social perceptions . Communication goes a long way in our interactions with our clients of diverse displaced population.”

In Course 5 (Considerations and Practical Tools for Working with Survivors of Sexual Violence and Trafficking), teh content was found to be chall;enging, and discussed content that can be difficult to be exposed to but participants highlighted how the content experts made learning about this challenging area more palatable with their empathetic approach, knowledge  and composure.

“Tactfully presented subject matter that is extremely intimate”

“I found this course quite confronting and upsetting but the presenters calm composure made the topic more palatable”

“The different treatments provided for both women and men's health and in how to cater to survivors of sexual violence was a very good learning experience. Knowing about sexual violence during armed conflicts and the psychological bases of committing such acts was surprising for me. Hearing the experiences that these people have experienced has left me sobered up on the harsh realities and injustice placed upon them.”

In Course 6 (Considerations for Working with Survivors of Torture), the case study was the most important element highlighted by participants, which they felt provided an opportunity to put into practice much of the theory that they had learnt across the MOOC. Participants also valued the process and strategies encompassed within eth Herman Model to in provide a structure to work within when working with survivors of torture, to support them to minimise teh risk of re-traumitisation..

“Herman model that emphasizes safety and stabilization, integration and reconnection. Safety allows the client to feel more comfortable and ease and open up about their story letting you in on their trauma. As a therapist,we play an important to ensure we don't cause re-traumatization by asking our clients a lot of questions as this may feel like interrogation, allow room for open discussion, clients taking control, and making choice of where they prefer to be treated,or even sitting during the session”

“ It was enlightening to learn about the re-traumatization of the patients and how to avoid such things. How certain body movements, temperature, changes in the environment and others could make them revisit their trauma makes it very sobering. It made me reflect on how careful I must be and how I must make sure to be more considerate and make sure of my patient's comfortability.”

In Course 7 (Assessment and Management of Pain for Displaced Persons), what was most valued by participants was the range of strategies provided that can be used in both assessment and management of pain for displaced persons, while recognising the impact of trauma on pain.,

“The way the concept of pain in displaced persons was explained along with multiple treatment options was very helpful and delivered in an easy manner.”

“It was really helpful to understand the global context, and I liked the encouraging tone and how the course content showed me links between what I already know and do as an OT and the needs of displaced persons. It helped me to feel more confident accepting referrals for this population.”

Finally for those that completed the full program of seven  courses

“Although the background information is important, I loved the parts with specific therapy related examples and suggestions to treat this population.”

“Communication on a cultural level. Learned much more than I thought I knew.”

When asked, “How could this course be improved?” participants requested that the course be offered for a longer period of time. Participants felt that having access to more case studies across a range of different settings and contexts would have been helpful for their learning. A majority of participants stated that they would have liked to have more video content, including content more representative of low-and middle-income countries. There were also multiple suggestions to simplify language, have less written materials, and, where possible, provide a summary at the end of each course that highlights key learning points. There were also a number of participants who highlighted the benefits of teh live webinars and requested the opportunity for more frequent live webinars to be incorporated as part of the course to allow for more feedback and opportunities for questions throughout the MOOC.

“If more case studies could be added to the course, it would help a lot.”

“I wish I could have some videos with patients telling us about their experiences with pain treatments. What helped and what wasn't a good fit.”

“This course can be improved if you can include real time online classes for questions and answers sessions.”

“Not repeating the same information between videos and articles.”

“By providing a single PDF file that covers the whole course”

“Bullet point summary at the end”

“The user experience -- the text of the course is light gray on a white background, it's difficult to read”

Throughout the MOOC, it is evident from all the qualitative feedback that a key value highlighted by many participants has been discussion forums and the opportunity they provide for rehabilitation professionals, across all disciplines, to share their experience and knowledge with others from across the world. It highlights the key role that online learning can play as a communication and collaboration tool to provide a community of practice for rehabilitation professionals who can help support each other and strengthen the development of responsive and sustainable physical rehabilitation services in the communities where they are most needed.

“I liked the discussion groups and the fact that it was both videos and write ups. Knowing that there are discussions helps you pay better attention and the entire format of the course is captivating, ensuring that you learn a lot. I also like that it was very integrating, involving different professionals in different countries, pooling together their experience and resources.”

4.3 Impact on Knowledge

In order for a participant to show increased knowledge they needed to complete both the Pre- and Post-Course Knowledge and Competency Self-Rating Tools. Increase in knowledge can be evidenced by an increase in the average (mean) self-assessment scores between the Pre- and Post-Course Knowledge and Competency Self-Rating Tools.

Only 127 participants completed the Post-Course Knowledge and Competency Self-Rating Tool, accounting for 57% of the participants who completed the final Course 7 of the MOOC . Of those, 127 participants (95%) registered an increase in knowledge. A general rate of knowledge increase across all course participants could be inferred from this percentage, which would suggest about 756 participants would show increased knowledge from taking part in the MOOC.

Evidence from the Post-Course Knowledge and Competency Self-Rating Tool also show improvement in knowledge across all areas post course completion. All participants were asked to complete a pre and post-competency survey noting their perception of comfort with the knowledge and skills taught within the MOOC.  Data was analysed using the Wilcoxon Matched Pairs test. Due to the number of comparisons, a Bonferroni correction was utilized to determine significance level (.004).  Ten of the 11 questions demonstrated statistically significant increases in scores indicating improvement in participant perceptions. The only question that did not have a statistically significant improvement was; “Who are displaced persons?”.

Table 11: Understanding Data from Pre and Post-Competency Course Knowledge and Competency Self-Rating Tool

Stem: At this point in time rate your confidence to perform the following were 1= no confidence and 10 = very confident
Question	Mean Pre	Mean Post	Sig
Who are Displaced Persons?	6.8	8.9	.013
Global Context surrounding Displaced Persons	5.1	8.4	.002
International Legislation for Displaced Persons	3.4	7.6	<.001
Knowledge of complexity of needs of Displaced Persons	4.5	8.3	.001
Impact of Displacement on Health and Well Being	5.3	8.6	.003
Communication for Displaced Persons	4.6	8.4	.002
Cultural Competency	4.7	8.3	<.001
Trauma Informed Care	4.4	8.5	<.001
Roles of Rehabilitation Team Members	5.5	8.6	.004
Working with Diverse Displaced Persons Populations	4.3	8.4	<.001
Impact of Torture and Sexual Violence on Displaced Persons	4.4	8.4	<.001

Figures 16 to 26 below show the data around understanding of displaced persons pre and post course completion.

4.4 Impact on Clinical Practice

In the evaluation, participants were asked to “describe any changes to your clinical practices that you have made or intend to make as a result of participation in this course.” Generally, it appears that the Understanding the Rehabilitation Needs of Displaced Persons program facilitated improvement of participants' awareness of the role that all rehabilitation professionals can play in advocating and developing rehabilitation services.

One important area highlighted by a number of participants was the the recognition for self-care in their practice, particularly when working with people who have experienced trauma. Self-care is such a vital strategy for rehabilitation professionals to recognise and implement within their practice to minimise stress and burn-out.

Overall, the most important change highlighted by a large number of individuals has been the need to ensure more person-centred or family-centred care that involves the patient and their support structures throughout each phase of the rehabilitation process. Participants emphasized that they acquired a new appreciation for the role that rehabilitation can play in supporting displaced persons through each phase of the migratory process.

“As someone who I feel is getting close to burn out at the moment, the self care section helped me to recognise my signs and remind me what I can do to prevent a full episode. I have spoken to work colleagues and made changes that will help support me. I have taken on a new project- instead of something else I am working on rather than in addition to- and this has boosted my enthusiasm. I feel this will have a positive impact on my patients now that I am feeling calmer.”

“Prior to this moment, I didn’t think rehabilitation had anything to do with displaced persons or refugees..Another aspect has been unlocked and I’m not ignorant about that again”

“Sharing this knowledge with colleagues as we look to improve the Physiotherapy service we offer our migrant patients. This increased knowledge base has a direct impact on the empathy I have for my patients.”

“I am more aware of the legal aspects and complexities to take into account when advocating for equal access to services”

Illustrative sample comments on the impact of clinical practice can be found in Appendix 4.

Evidence from the Post-Course Knowledge and Competency Self-Rating Tool also show increased confidence in skills across all areas identified as relevant when working with displaced persons after completion of the course. All participants were asked to complete a pre and post-competency survey noting their perception of comfort with the knowledge and skills taught within the MOOC.  Data was analysed using the Wilcoxon Matched Pairs test. Due to the number of comparisons, a Bonferroni correction was utilized to determine significance level (.004). All nine questions demonstrated statistically significant increases in scores indicating improvement in participant perceptions.

Table 12: Confidence in Skills Data from Pre and Post-Competency Course Knowledge and Competency Self-Rating Tool

Stem: At this point in time rate your confidence to perform the following were 1= no confidence and 10 = very confident
Question	Mean Pre	Mean Post	Sig
Deliver person-centred care to meet the needs of diverse displaced persons populations	5.4	7.8	<.001
Collaborate effectively within a multidisciplinary rehabilitation team	6.6	8.3	<.001
Refer appropriately to other professions or services	6.6	8.4	.001
Ability to build therapeutic relationships	7.0	8.6	.004
Ability to work with interpreters	6.6	8.2	.002
Apply appropriate rehabilitation guidelines to meet the needs of diverse displaced persons populations within your practice and/or healthcare system	5.9	8.2	<.001
Adapt rehabilitation services to meet the needs of diverse displaced persons populations within your practice and/or healthcare system	5.9	8.2	<.001
Apply appropriate treatment options for working with survivors of torture or sexual violence	5.1	7.9	<.001
Assess and Manage Pain in Displaced Persons	5.8	8.2	.001

Figure 27 to 35 show the data around confidence in working with displaced persons pre and post course completion.

5.0 Conclusion

Physiopedia, in collaboration with ReLAB-HS, successfully delivered a MOOC on Understanding the Rehabilitation Needs of Displaced Persons program over eight weeks in September and October 2022. Over 868 participants from across 94 countries from around the world completed one or more of the courses provided within the program. It is apparent from the course registration data that this course was a topic that was important to all health, social care, and rehabilitation providers across the world. It is evident from participants’ feedback that participants gained a new appreciation for the global perspectives surrounding displacement and  a new appreciation  for the rehabilitation needs for the diverse populations of displaced persons in all settings globally.

Future Physiopedia MOOCs will build on the feedback received from participants in this program to improve resources, attrition rates, and engagement throughout the entire course with a plan to incorporate a weekly live online webinars with some of the content experts during future MOOCs to provide opportunities for more questions, feedback and interactive learning.

Appendices ===== Appendix 1 Course Participants Demographics =

Country	Course 1 n	Course 2 n	Course 3 n	Course 4 n	Course 5 n	Course 6 n	Course 7 n	Program n
Albania (AL)	2	1	1				3
Armenia (AM)								1
Australia (AU)	23	10	8	4	5	4	9	3
Austria (AT)	4	2	1	1	2	1
Azerbaijan (AZ)	2						1
Bangladesh (BD)	4	2	1	1	1	1	4	1
Bhutan (BT)	2
Brazil (BR)	3
Cameroon (CM)	5	2			1	1	1	1
Canada (CA)	31	8	10	6	8	7	7	3
China (CN)	1						2	2
Croatia (HR)	1	1	1	1	1	1	1	1
Czech Republic (CZ)	1	1	1		1	1	1
Denmark (DK)	1	1	1	1	1	1	1
Ecuador (EC)	1
Egypt (EG)	13	4	2	2	2	2	9
El Salvador (SV)	1	1	1	1	1	1	1
Ethiopia (ET)	5	5	3	3	2	2	2	3
Fiji (FJ)	1
Finland (FI)	1						1
Georgia (GE)	1	1	1				1
Germany (DE)	3	2	2	1	1	1	2	1
Ghana (GH)	10	3	3	3	3	3	3	3
Guatemala (GT)	1
Haiti (HT)	2
Hong Kong (HK)	1
Hungary (HU)	3	1	1					1
India (IN)	54	41	13	9	9	10	21	12
Indonesia (ID)	2	2	1	1	1	1	1
Iran, Islamic Republic (IR)	1	1	1	1	1	1	1	1
Iraq (IQ)	2	1	1	1				1
Ireland (IE)	5	3	4	2		1	1	1
Israel (IL)	1
Italy (IT)	9	3	2	2	2	1	3	3
Jamaica (JM)	1	1	1				1
Jordan (JO)	4						2
Kenya (KE)	6	4	3	2	1	1		2
Kuwait (KW)	1
Lebanon (LB)	2			1			2
Lesotho (LS)	1
Lithuania (LT)	1
Macao (MO)			1
Madagascar (MG)	1	1	1	1		1	1
Malawi (MW)	4	1	1	1	1	1	1	1
Malaysia (MY)	8	3	3	3	3	3	4	3
Moldova (MD)	1	1						1
Morocco (MA)	2
Myanmar (MM)	4	2	2	1	3	4	4	1
Nepal (NP)	5	2	1	1	2	2	2
Netherlands (NL)	16	14	14	12	9	14	16	1
New Zealand (NZ)	4	2	2	1	3	1	1	2
Nigeria (NG)	78	36	23	21	20	15	21	12
Oman (OM)	1	1	1	1	1	1	1	1
Pakistan (PK)	60	18	16	15	17	14	22	18
Panama (PA)	1
Philippines (PH)	10	4	4	3	3	3	3	3
Portugal (PT)	1	1	1	1	1	1	2	1
Qatar (QA)	4	1					3
Romania (RO)	1
Russian Federation (RU)	1						1
Rwanda (RW)	8	8	6	7	3	4	6	5
Saudi Arabia (SA)	3	1	1	1	1	1	1	1
Serbia (RS)	2	1	1	1	1	1	1	1
Singapore (SG)								1
Somalia (SO)	6	3
South Africa (ZA)	15	7	6	5	7	5	7	1
Spain (ES)	4	3	3	2	2	3	2	1
Sri Lanka (LK)	4						3
Sudan (SD)	1						1
Swaziland (SZ)					1
Sweden (SE)	2	1	1
Switzerland (CH)	1	2						1
Syrian Arab Republic (SY)	1	1	1	1	1	1	2	1
Taiwan (TW)	1	1	1	1	1	1	1	1
Tanzania (TZ)	5	2	1	4	1		1
Trinidad And Tobago (TT)								1
Turkey (TR)	7	3	2	2	2	3	7	2
Uganda (UG)	19	12	6	5	4	4	4	1
Ukraine (UA)	59	42	39	41	36	40	44	16
United Arab Emirates (AE)	3	2	2	1	1	1	3	1
United Kingdom (GB)	45	25	20	15	13	16	20	7
United States (US)	55	29	26	23	19	17	20	17
Uzbekistan (UZ)	1							1
Virgin Islands, British (VG)	1
Viet Nam (VN)		1		1	1	1	1
Yemen (YE)	3	2	2	2	1	1	2	1
Zambia (ZM)	2	1	1	1	2
Zimbabwe (ZW)	2	1					1

Table 14: Number of Participants’ from Each Professional Background - Data are numbers (N) and percentage of total participants (%)

Country	Course 1 n	Course 2 n	Course 3 n	Course 4 n	Course 5 n	Course 6 n	Course 7 n	Program n
Physiotherapist	338 (49%)	173	125	119	107	104	187	76
Physical Therapy Assistant	6 (33%)	1	1	1	1	3	3	1
Doctor of Medicine	15 (40%)	3	2	3	2	3	2	2
Nurse	23 (78%)	18	17	17	16	16	17	7
Occupational Therapist	46 (59%)	18	18	12	14	12	11	11
Occupational Therapy Assistant	0 (0%)	1		1	1	1	1
Orthotist	1 (0%)
Prosthetist	3 (33%)	1	1					1
Physical Rehabilitation Doctor	8 (25%)	1	1				5	1
Speech Therapist	33 (100%)	2	1	1
Psychologist	6 (100%)	5	4	3	4	4	3	4
Sports Therapist	1 (100%)	2	2	1	2	1	1	1
Athletic Trainer	1 (100%)	1
Massage Therapist	10 (60%)	7	4	5	5	5	5	2
Student	47 (38%)	21	12	8	9	10	10	10
Orthopaedic Technologist	2 (50%)	2	1	1
Clinical Exercise Physiologist	1 (100%)	1	1
Pharmaceutical Technologist	1 (0%)	1
Personal Trainer	2 (0%)					1		1
Biokineticist	3 (67%)	1	1	1	1	1	1	1
Chiropractor	1 (100%)	1	1	1	1	1	1
Allied Health Assistant (AHA)	2 (50%)	1
Exercise Therapist	1 (100%)	1	1	1	1	1	2	1
Kinesiologist	1 (100%)	1	1	1	2	1	1
Educator	3 (33%)	1	1	1	2	1	1	1
Medical Rehabilitation Technician	0 (0%)						1

Appendix 2 Platform

Table 15: Physiopedia Articles Page Views

Physiopedia Page	Unique Page Views	Total Page Views	Average Time on Page	Course 4 n	Course 5 n	Course 6 n	Course 7 n	Program n
Salutogenic_Approach_to_Wellness	2,830	3,264	00:05:24	119	107	104	187	76
Understanding_Migration_and_Displacement	1,391	1,613	00:06:35
Mental_Health_and_Forced_Displacement	870	1,025	00:04:37
Human_Rights_and_Health	869	1,024	00:04:50
Culture_and_Communication	863	992	00:05:24
Effective_Communication_for_Displaced_Persons	861	962	00:05:26
Media_Portrayal_of_Displaced_Persons	755	856	00:06:01
Trauma-Informed_Care	700	788	00:05:01
Rehabilitation_for_Survivors_of_Torture	632	718	00:05:03
Evidence_Based_Assessment_of_Pain_in_Displaced_Persons	624	866	00:04:57
Health_Concerns_for_Displaced_Persons	606	750	00:05:20
Health_Literacy	605	700	00:04:11
Displaced_Persons:_The_Global_Context	604	741	00:06:47
Self_Care_for_Rehabilitation_Professionals_Working_with_Displaced_Persons	590	678	00:09:05
Health_Care_Access_for_Displaced_Persons	501	570	00:03:49
Role_of_Rehabilitation_Professionals_in_Camps_for_Displaced_Persons	480	533	00:07:21
Considerations_for_Working_with_Survivors_of_Sexual_Violence	434	505	00:05:14
Considerations_For_Working_With_Displaced_Children	401	475	00:05:19
Salutogenic_Approach_to_Health_for_Displaced_Persons	395	453	00:04:17
Evidence-based_Management_of_Pain_in_Displaced_Persons	382	494	00:03:39
Child_Health_Conditions_and_Migration	307	364	00:04:36
Evidence_Based_Assessment_of_Pain_in_Displaced_Persons_-_Case_Study_1	301	353	00:02:07
Considerations_for_Working_with_LGBTQIA%2B_Displaced_Persons	286	330	00:09:20
Rehabilitation_for_Survivors_of_Torture:_Observations_from_Humanity_and_Inclusion	281	332	00:06:29
International_Legislation_Governing_Forced_Displacement	280	310	00:08:02
Cultural_Competence_and_Access_to_Healthcare_for_Displaced_Persons	133	146	00:02:38
Working_With_Interpreters	65	75	00:09:56
Availability,_Accessibility,_Acceptability_and_Quality_Framework	49	56	00:04:54
Facilitation_of_Inter-professional_Working_in_Camps_for_Displaced_Persons	44	49	00:02:44
Displaced_Persons:_The_Syrian_Context	34	35	00:05:41
Considerations_for_Working_with_Displaced_Persons_with_a_Disability	14	14	00:00:04
Considerations_for_Working_with_Displaced_Older_Persons	12	13	00:00:12

Appendix 3 Required Learning Activities

3.1 Course 1: Global Context for Displaced Persons

Required Learning Activity		Delivery Medium
1	Introduction to Displaced Persons	Video
2	Who Is a Displaced Person Jenny Malmsten	Video
3	Understanding Migration and Displacement	Reading
4	International Migration Law No 34 - Glossary on Migration	Reading
5	Global Context for Displaced Persons - Key Terms and Concepts Cortland Robinson	Video
6	Global Context for Displaced Persons - Key Trends and Patterns Courtland Robinson	Video
7	Displaced Persons - The Global Context	Reading
9	Migration Data Portal - Explore Data for Your Country	Database
8	UNHCR Data Finder	Database
9	Global Internal Displacement Data	Database
10	Media Portrayal of Displaced Persons	Reading
11	Human Rights for Displaced Persons	Reading
12	International Legislation for Displaced Persons	Reading
13	Global Context for Displaced Persons Quiz	Quiz
14	Course Reflection	Discussion Forum