Course type: Practical
Pelvic, Obstetric and Gynaecological Physiotherapy
Pelvic Health Physiotherapy:
lower bowel dysfunction – an entry level course
Part A: 16 May 2024 - online
Part B: 18-19 May 2024
University Southampton Hospital
£370 POGP member/affiliate
£445 non-member
This POGP certified workshop has been developed for Registered Physiotherapists who have not completed an accredited continence course but wish to develop their knowledge and skills in the assessment and management of women with lower bowel dysfunction. It may be of value to those already working in the speciality who wish to update their knowledge and practical skills. It is not suitable for physiotherapy students but may be useful for a newly qualified physiotherapist preparing for a rotation in Pelvic Health.
POGP recommends that participants complete of a number of specified learning tasks prior to the workshop.
The workshop content includes: professional issues; relevant anatomy and physiology; subjective and objective assessment of the patient with lower bowel dysfunction and relevant treatment. Practical sessions include ano-rectal examination as well as the application of treatment techniques including rectal sensation testing, rectal balloon expulsion training and electrical stimulation.
During the workshop each participant will normally carry out at least one ano-rectal examination. The practical sessions include peer physical examination. Female participants may choose to act as a model during the practical sessions. Valid consent procedures are used throughout. A participant choosing to act as a model may opt out of having practical techniques performed on them at any stage.
Please note: vaginal examination is not included as any part of this workshop.
Whilst not a pre-requisite POGP advises that completion of the ‘Pelvic Health Physiotherapy: female urinary dysfunction – an entry level course’ (or equivalent) is beneficial before attending this workshop.
Programme objectives
1. To introduce essential and current evidence-based information on the physiotherapy assessment and management of lower bowel dysfunction.
2. To provide tutor led practical experience of both ano-rectal examination and the application of techniques used in the treatment of lower bowel dysfunction.Learning outcomes
On completion of the programme the participants should be:
Able to adequately assess a patient with lower bowel dysfunction
Able to formulate an effective management plan of a patient with lower bowel dysfunction
Able to apply appropriate treatment modalities
Aware of and conform to professional standards in relation to the assessment and management of men and women with lower bowel dysfunction
Pre-workshop learning
It is recommended that you familiarise yourself with the following documents prior to the workshop:
Any protocols/policies from your own workplace that are relevant to your professional practice in the assessment and management of people presenting with lower bowel dysfunction
Chartered Society of Physiotherapy (2013) Chaperoning and related issues PD104, Chartered Society of Physiotherapy, UK
If you practice outside of the UK you are not likely to be able to access these information papers. It would be appropriate for you to review the legislation and professional guidance applicable in your country. Consider how it applies to practice with this client group. If you are practising in the UK but are not a CSP member you are also not likely to access these document. If this is the case, please contact the course administrator.
For those participants who have not previously attended the ‘Pelvic Health Physiotherapy: female urinary dysfunction – an entry level course’ programme it is recommended that you review the anatomy of the pelvic floor – the endopelvic fascia, levator ani, perineal membrane, external superficial muscles, external anal sphincter and associated pelvic muscles (eg obturator internus & piriformis).
You may find it helpful to view diagrams to demonstrate the layers, especially regarding the muscles that you are able to palpate. If you have an Athens password you may be able to access www.anatomy.tv Alternatively you may you may find the following YouTube link helpful: http://www.youtube.com/watch?v=P3BBAMWm2Eo (accessed 12/3/20)
It is also recommended that you update yourself on the current legislation/guidance relating to consent. If you practice in the UK this will include the CSP guidance on consent: PD078, which is available as a downloadable PDF file at: http://www.csp.org.uk/publications/consent-physiotherapy-practice (accessed 12/3/20), as well as relevant sections of the HCPC ‘Standards of conduct, performance and ethics’. You may also include relevant consent policies in operation in your workplace. Consider how the issues raised in the legislation/guidance apply to people presenting for physiotherapy assessment and management of lower bowel dysfunction.
The following books may be helpful for any further pre-workshop learning that you have identified:
Bo K, Berghmans B, Morkved S, Van Kampen M (2015) Evidence-Based Physical Therapy for the Pelvic Floor Bridging Science and Clinical Practice. Churchill Livingstone. ISBN 9780702044434
Laycock J., Haslam J. (eds) (2008) Therapeutic Management of Incontinence and Pelvic Pain (2nd Ed). Springer, London.
POGP workshop programme (3 day taught workshop)
Part A : 16 May 2024 - online
Day 1
8-45 Registration
9-00 Welcome and introduction
9-20 Professional issues: infection control, consent, chaperones and confidentiality
10-30 Break
10-50 Anatomy and physiology of the lower bowel and pelvic floor complex
12-00 Patho-physiology of ano-rectal dysfunction
13-00 Lunch
14-00 Verbal/subjective assessment
15-15 Break
15-30 Objective assessment
16-45 Close
Part B : 18 May 2024 – face to face
Day 2
9-00 Observation of ano-rectal examination
Concurrent case study discussions
Practical session: ano-rectal examination
Break will be taken at a suitable time within this session
12-30 Facilitated reflective practice (including case study discussions)
13-00 Lunch
14-00 Anal sphincter/pelvic floor muscle training
14-45 Theory of treatment/management of constipation
Break will be taken at a suitable time within this session
16-45 Close
Day 3: 19 May 2024
9-00 Theory of neuromuscular electrical stimulation for lower bowel dysfunction
10-00 Break
10-15 Theory of treatment/management of anal incontinence
11-45 Case study discussions
12-30 Lunch
13-30 Demonstration of practical techniques used in the treatment of lower bowel dysfunction
Practical session:
Rectal sensation testing, balloon expulsion techniques, teaching optimal position/action for defaecation
Break will be taken at a suitable time within this session
15-30 Facilitated reflective practice
16-15 Final comments
16-30 Close
Information for the practical session on anorectal assessment.
All participants have the right to opt in or out of the practical sessions. All participants may choose to act as a model during the practical sessions, however they also have the right to decline to be examined by any specific course participants due to embarrassment or other factors. If a participant does not want to examine a course participant they usually have the option of completing the examination on one of the tutors. Another alternative is for course participants to arrange to have their own ‘live’ model present but they must meet any extra costs incurred.
In the case of a participant declining to complete at least one ano-rectal examination on a ‘live’ model it will not be possible to complete the skills checklist and the participant will not be able to complete the programme.
Valid consent procedures are used throughout. A participant choosing to act as a model may opt out of having practical techniques performed on them at any stage.
Delegate Terms and Conditions
CANCELLATION POLICY
This cancellation policy sets out the terms and conditions relating to bookings for courses offered by POGP, including receiving payments, course cancellations and refunds.
1. Definitions
POGP: Pelvic, Obstetric and Gynaecological Physiotherapy
Delegate: A person attending the course
2. Scope
This policy covers all courses offered by POGP
3.1. Policy Detail
3.1.1. Payment of course fees
Confirmation that a place on the course has been finalised will be sent by POGP to the delegate on receipt of payment of the course fee or received proof of a purchase order number for the course fee invoice.
3.1.2. Cancellation, Refunds and Transfers to an alternative course date by Delegates
Summary of cancellation charges are as follows:
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Timescale of cancellation notice
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Refund/Transfer of course fee
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28 days or more before the course start date
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90% refund will be given -or-
90% transfer will be given towards another POGP course
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27-15 days before the course start date
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50% refund will be given -or-
50% transfer will be given towards another POGP course
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14 days or less before the course start date
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We regret that no refund or transfer to an alternative course can be given if a cancellation is made 14 days or less before the course start date (including online day)
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To prevent cancellations where possible, POGP may accept a change of delegate name, with no administration fee, up to 96 hours before the start of the course. Requests will be dealt with on an individual basis, considering whether this allows time for any pre-course learning requirements to be completed.
Refunds will only be made to the payee’s account from which the original payment was made. Refunds must be claimed within 28 days of notice of the cancellation.
All requests to cancel, change a delegate name or transfer to a new course date must be made in writing to courses@thepogp.co.uk.
Refunds for non-accessibility: where the delegate has not informed POGP about a special accessibility requirement, cancellation and refund of the course fee is not possible. When notified in advance, if POGP are not able to offer a solution to the special accessibility requirement the delegate may transfer to another POGP course without penalty.
3.1.3. Non-attendance
Delegates who fail to attend the course without giving notice, or who give notice after the course has started, are not entitled to a refund or a transfer to another course regardless of the reason for non-attendance.
3.1.4. Course cancellation by POGP
Minimum delegate numbers
To ensure the best learning experience possible, there will be a minimum number of delegates required for each course to run effectively, this number may vary for each course type. If the minimum course threshold is not met POGP reserve the right to cancel the course. For cancellations made in these circumstances delegates will be notified within at least 14 days of the course start date. Delegates will be offered an alternative date(s). If the delegate is unable to attend an alternative date a full refund will be given.
Course tutors
All courses offered by POGP will be delivered by experienced tutors within a course specific tutor group. In the event of illness, or unforeseen circumstances, POGP may, at short notice, substitute a tutor for another tutor from the course specific tutor group. If for any reason a replacement tutor cannot be found at short notice, POGP reserves the right to cancel and reschedule the course at its sole discretion. Where possible 24 hours’ notice will be given to delegates but, in the event of emergencies, this may happen on the day of the course.
General
POGP reserves the right to cancel a course at any time without incurring any additional liability to the delegate or organisation in which they work. Such circumstances are, but not limited to: weather conditions, fire, flood, transport strikes, closures or delays or any other force majeure. In such circumstances, POGP will offer alternative dates where possible, with delegates able to transfer their booking, free of charge, to an alternative date. Special consideration may be given to individual cases if necessary if this occurs. Refunds given are at the sole discretion of POGP.
POGP is not responsible for any travel or other expenses which may have been incurred and recommends that travel and accommodation bookings for the courses are made on a fully cancellable basis.
3.1.5. Covid cancellations
Delegate cancellations relating to Covid will be treated on an individual basis where necessary and at the sole discretion of POGP.
April 2024