Step 7: User training

Background

Step Description: Each user needs to be trained on how to handle, use, and maintain their new wheelchair to optimize their independence and the wheelchair and cushion proper operation and durability.
Planning considerations: Students will need to see demonstrations of the skills, practice them, and then practice explaining and demonstrating them to be able to effectively teach the users. WHO recommends having a model user who is actually assessed and fitted with a wheelchair and provided user training during the course. This may be possible in places where wheelchair service provision is available whereby the training institute collaborates and arranges  students to go to the wheelchair service workshop. Alternatively, different wheelchair users can be invited to demonstrate how they use their wheelchairs including the pressure relief techniques and care of the chair. In addition to these and more if model users are not available, video series of user training can be made available to the students. These videos could be from similar contextual regions where students can easily relate to their context and environment. May also include case studies from open sources or within the context that compares and contrasts between the users who got appropriate training and not. Access to literature databases and case studies.
Human resources: 
  • You may identify peer trainers in your location.
Location/facility: 
  • Classroom environment with laptop/stationary computer and overhead projector.
  • Classroom/workshop space/Gym/Corridor/Steps  – for practice & user training of wheelchair mobility skills. Access to sports hall and city center, active/lightweight wheelchairs, set of wooden obstacles imitating real obstacles (platforms with different heights, thresholds, ramps with different angles, steps, stairs etc.).   
  • Physical location to teach mobility and maintenance.
How to teach the content:
  • Classroom learning – review of techniques of wheelchair mobility and transfer skills, and pressure relief techniques.
  • Case studies/scenarios – group learning.
Recommended equipment and tools:
  • Different types of wheelchairs so students can practice and feel the differences. Consider the wheelchair: student ration. 
  • 1 Spotter strap per wheelchair. If you don’t have any, you may consider using blankets. 
  • Used wheelchairs and cushions to practice maintenance.
  • Basic maintenance tools (e.g. rags, Allen Wrenches, screw drivers, rubber mallet).
Documentation:
  • Local wheelchair service user training checklist. You may use or adapt the WHO user training checklist – an important guide for user training or create your own from the Wheelchair Skills Training Program.
  • WHO user training and skin care posters.
Other comments related to contextual adaptation/implementation: 
  • Collaborate with professional bodies that may have expertise in wheelchair service provision, user groups that may be able to support in wheelchair access and information, relevant non-governmental organisations that may have access to wheelchair users; relevant government organisations that  may be able to assist with the service provision, Assistive Technology service centers that may also have wheelchair service provision.  
  • If Step 3 (prescription) is not taught, consider including learning objectives regarding the description of manual wheelchairs and its components, so students will review the types and features of wheelchairs that are locally available and how this impacts the training for handling, mobility skills, and maintenance of the products.

Objectives

Learning Objective

Understand the importance of training for users and caregivers.

How to Teach

User interviews or discussions.
Descriptions of user experience.
Video description of user experience.
Case examples including scenarios.
Relevant literature.

How to Evaluate

Oral examination.
Written exam.
Graded group seminar.
Case report.
ISWP Wheelchair Service Provision Basic Knowledge test.

Learning Objective

Describe common mobility, handling, and maintenance skills that personnel can teach wheelchair users.

How to Teach

Video description.
User demonstration.
Case examples.
Relevant literature.

How to Evaluate

Oral examination.
Written exam.
Graded group seminar.
Case report.

Learning Objective

Apply the different mobility, handling, and maintenance skills performed by wheelchair users and caregivers.

How to Teach

Demonstration and explanation of different techniques/skills (online or in-person)
Practical sessions in wheelchair friendly environment and in real daily environment, it could be done in “boot-camp” or with several practice days.
Relevant literature.
Handouts of protocol to identify local maintenance and repair services.

How to Evaluate

Observed performance: practical examination for skills, behaviours (potentially task).
Video-based examination with pre-recorded performance of student.
Wheelchair SKills Test.
Wheelchair Skills Test Questionnaire.
Wheelchair Use Confidence Scale (WheelCon).
SEATS Self-efficacy on Assessing, Training, and Spotting for manual wheelchair skills.
Wheelchair Skills Program Certification Exam.

Learning Objective

Demonstrate and explain the user to self-assess skin integrity, posture and wheelchair fit.

How to Teach

Explanation and demonstration.
User demonstration. 
Descriptions of user experience.
Video description of user experience.
Role-play group activities.
Relevant literature.

How to Evaluate

Oral examination.
Written exam.
Case report.
Class observations student’s performance

Learning Objective

Demonstrate more advanced wheelchair skills, handling, and transfer skills.

How to Teach

Methodology of teaching advanced wheelchair skills, handling and transfer skills
You can use this lab guide from an Occupational Therapy program at University of Jordan, Jordan.
User demonstration and explanation of different techniques/skills. 
Instructional video film/slides/pictures.
Practical sessions in wheelchair friendly environment and in real daily environment.

How to Evaluate

Wheelchair Skills Test (sports hall).
Treasure Hunt Game i.e. test of the wheelchair skills in a natural environment while doing different daily tasks (city center).

Learning Objective

Formulate user instruction based on user preferences/context ensuring understanding.

How to Teach

10 Tips for Giving and Checking Instructions 
Wheelchair plays & games with different levels of complexity (giving instruction – explanation of game rules).  

How to Evaluate

“Command drill”
(students have to respond to instructions with the correct action).
“Role-play with commands” (students are pair up to give each other instructions).
Click here to view resources