TRAINING REPORT
OCCUPATIONAL THERAPY
MANAGEMENT ON STROKE,
TRAUMATIC BRAIN INJURY AND
SPINAL CORD INJURY
Supported by
Hillman Foundation
Curtin University
Veterans International Cambodia
May 27, 2013
Organized by
Veterans International Cambodia and
Cambodian Physical Therapy Association
Capacity Building
Training Report
Table of Contents
Acknowledgement ................................................................................................................................ 2
I-
Introduction ................................................................................................................................ 3
II-
Objective of the Training .......................................................................................................... 4
III-
Training Methods .................................................................................................................. 4
IV-
Participants ............................................................................................................................ 4
V-
Trainers/Facilitators .............................................................................................................. 6
VI-
Training Process ................................................................................................................... 6
VII-
Financial Report: ................................................................................................................. 11
VIII-
Training Evaluation ............................................................................................................. 11
IX-
Conclusion and Recommendation ................................................................................... 13
Occupational Therapy Management on Stroke, Traumatic Brain Injury and Spinal Cord Injury
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Capacity Building
Training Report
Acknowledgement
The training of Occupational Therapy Management on Stroke, Traumatic Brain
Injury and Spinal Cord Injury, which is a National Continuing Education Program of
Cambodian Physical Therapy Association (CPTA), was organized through the
effort of CPTA in collaboration with Veterans International Cambodia (VIC).
The organizers of the training would like to express our deepest gratitude to VIC for
providing human resources and facilities for conducting this training.
We would also like to acknowledge Hillman Foundation (Hillman Medical
Education Fund) for the financial contribution for this training.
Importantly, we greatly acknowledge the Curtin University, Go Global especially
Mr. John Harmsen (Occupational Therapy Lecturer) and the three senior physical
therapy students (Ms. Caris Allen, Ms. Chloe McComish and Ms. Nicole Whitehead)
for preparing the materials and teaching in this training.
Lastly, we would like to express special thanks to the executive board members of
CPTA including Mr. Song Sit, Mr. Chap Sarun, Mr. Phan Hiep, Mr.Huoth Chantheng,
Mr. Pang Sarun, Mr. Meach Vannak and Mr. Suth Seiha, for preparing and facilitating
the training to make it run smoothly.
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I- Introduction
The Cambodian Physical Therapy Association (CPTA) was established by a team of
Cambodian physical therapists (PTs) in 1994 and was recognized by the Ministry of
Interior, Royal Government of Cambodia, on August 18, 1997. The association is
comprised of national qualified PTs graduated from Technical School for Medical
Care, University of Health Science, and Ministry of Health. CPTA is currently a
member of the World Confederation of Physical Therapy (WCPT). CPTA is locally
and internationally supported by various organizations and institutes.
Every year, CPTA always conducts at least two trainings based on the training need
assessment survey from all members attending the annual national congress.
Capacity building is one of the objectives and approaches of CPTA to improve the
quality of care and treatment of physiotherapists in Cambodia.
Occupational
Therapy Management on Stroke, Traumatic Brain Injury and Spinal Cord Injury
was a prior topic found to be useful for managing and treating those who are
suffering with Stroke, Traumatic Brain Injury and Spinal Cord Injury. This training
was initiated by Mr. Song Sit, the Program Manager of VIC and Mr. John Harmsen,
the Occupational Therapy Lecturer of Curtin University since July 2012. VIC has a
strong collaboration with Curtin University in receiving the senior Physical Therapy
and Occupational Therapy students from Curtin University to take the clinical
placement within the rehabilitation centers of VIC every year. Within the
collaboration, Curtin University was happy to share their knowledge and experience
to Cambodian Physical Therapists. Therefore, the training on Occupational Therapy
Management on Stroke, Traumatic Brain Injury and Spinal Cord Injury was
established on May 27, 2013 at Veterans International Cambodia.
Occupational Therapy Management on Stroke, Traumatic Brain Injury and Spinal Cord Injury
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Capacity Building
Training Report
II- Objective of the Training
The overall aim of the training was that participants will gain better understanding in
how to treat patients affected by Stroke, Traumatic Brain Injury and Spinal Cord
Injury and to make them able to use the knowledge to apply on those patients.
The organizers expect that after the 4-day training, the participants are able to
 Get an overview of clients
 Get an overview of occupational therapy treatment in neurological conditions
 understand the things you need to know from occupational therapy
 determine the risks or factors associated to the change of behavior of persons
with neurological conditions

develop a knowledge of Tenodesis training for Spinal Cord Injury

aware of the pressure stages
 determine the risk of pressure sore and how to manage it
III- Training Methods
The facilitators and trainers used a variety of methods and techniques to deliver the
information to the participants. Those methods include Power Point presentation,
brainstorming, practical demonstration, and case studies.
IV- Participants
There were a total of 30 participants
who attended the training. Among
them, 9 were female and 21 were male.
50% of participants were staffs from
Varous Institutes Attended the Course
NGO
25%
Gov't
47%
government, 30% and 20% were staff
from private sectors and organizations
respectively.
figure1. Proportion of
Private
28%
Figure 1. Proportion of different kind of institutes
different kind of institutes
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Capacity Building
Training Report
Below is the list of physiotherapists who joined the training.
No
Name
Sex
Work Place
1
Chey Rin Raya
M
PRC Takeo
2
Chhoeng Vannak
M
Battam Bang Hospital
3
Eak Ratha
M
Private Clinic
4
Em Cheas
M
Humanity Organization
5
Heang Rachana
M
Calmette Hospital
6
Iv Botummara
F
CENAT
7
Keo Chamnan
M
Kuntha Bopha
8
Keo Molyta
F
Private Clinic
9
Kong Buntha
M
PRC Prey Veng
10
Kruy Kimleang
F
Calmette Hospital
11
Meach Vannak
M
Calmette Hospital
12
Mok Arun Chhorleak
M
Monkul Borey Hospital
13
Nan Keang
F
PRC Kien Khleang
14
Net Kanha
F
RCRC
15
Phlang Tetra
M
PWDF
16
Phok Khemara
M
P & T Clinic
17
Saing Veasna
M
Private Clinic
18
Seng Sai
M
PRC Kratie
19
Seng Sophak
M
Private Clinic
20
Soeun Tongsim
M
Humanity Organization
21
Sok Kimcheang
M
Private Clinic
22
Sok Sopheaktra
M
Referral Hospital
23
Srey Hoeurn
M
CT Kg. Chhnaing
24
Srin Leangkheng
M
Private Clinic
25
Suth Seiha
M
Preah Kossomak Hospital
26
Thlang Vannchom
M
Humanity Organization
27
Thong Kim Sok Lina
F
National Pediatric Hospital
28
Thorn Saokea
F
Humanity Organization
29
Tith Saroth
F
Private Clinic
30
Yem Thida
F
Private Clinic
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V- Trainers/Facilitators
There were one main instructor and three co-instructors who were willing to share
their knowledge and experiences with participants. The instructors were:


Mr. John Harmsen, Lecturer, Lecturer School of Occupational Therapy and
Social Work Curtin University.
Ms. Caris Allen, Ms. Chloe McComish and Ms. Nicole Whitehead, the
Senior Physical Therapy students, Curtin University.
There were four facilitators in this training:

Mr. Song Sit, Program Manager of VIC and Executive Director of CPTA

Mr. Chap Sarun, head of physical therapist of Kien Khleang Rehabilitation
Center and director of administration and finance department of CPTA

Mr. Meach Vannak, physical therapist of Calmette hospital, deputy director of
administration and finance department of CPTA

Mr. Suth Seiha, physical therapist of Preah Kossomak hospital, deputy
director of law and policy department of CPTA
VI- Training Process
The training of Occupational Therapy Management on Stroke, Traumatic Brain
Injury and Spinal Cord Injury was held at the training room of VIC on May 27,
2013. The opening was presided over by Mr. Keo Rithy, a Country Representative of
VIC.
Mr. John Harmsen was invited to give a remark speech. John expressed his gratitude
to all guests of honor, and fellow
physical
therapists
for
their
participation. He explained that the
Occupational Therapy Management
on Stroke, Traumatic Brain Injury
and Spinal Cord Injury was a
fantastic
course
that
was
well
organized by CPTA and VIC. All
patients need to get back their
functional activities as what they were
Occupational Therapy Management on Stroke, Traumatic Brain Injury and Spinal Cord Injury
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Capacity Building
Training Report
able to do before their conditions; therefore, helping them with occupational therapy
intervention was very important.
John impressed and appreciated the standard of
physical therapy in Cambodia that is growing to reach the high profession. Before the
end, he gratefully thanked the VIC and CPTA for giving an opportunity for him to
present in this training.
Following Mr. John Harmsen, Mr. Song Sit, the Executive Director of CPTA was
invited to give a welcome speech. Mr. Song
Sit expressed his respect and welcome to
all guest of honors and participants. He
briefly informed them about the history of
arranging and preparing this course in
Cambodia since mid of this year 2012
when he worked with John and his senior
students last year. Mr. Song Sit thanked
VIC and Curtin University for the great
collaboration in order to come up with this training. He informed that CPTA is going
to conduct at least two more training in this year, so the participants are encouraged
to apply for the trainings. The more participation of the Cambodian physical
therapists, the more motivation and hard work of CPTA leaders are. Therefore, the
participation from all Cambodian physiotherapists was an invaluable encouragement
for instructors and facilitators to teach and share their knowledge. Last but not least,
he gratefully thanked the organizers, especially VIC for providing the facilities and
human resources to support for this training. He hoped this training will benefit to the
participants.
Finally the course was presided over by Mr.
Keo Rithy, Country Representative of VIC. Mr.
Rithy had a very good impression on CPTA for
jointly organizing and leading in this course with
VIC. He expressed his kind support on this
course as VIC had a lot of human resources to
conduct various training every year. He strongly
expected that all participants would find the
Occupational Therapy Management on Stroke, Traumatic Brain Injury and Spinal Cord Injury
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Capacity Building
Training Report
effectiveness of this course, gain knowledge and experience from it and to bring this
knowledge back to their workplaces for the effective service provision to people with
Occupational Therapy Management on Stroke, Traumatic Brain Injury and
Spinal Cord Injury. Importantly, he gave a special thanks to Curtin University,
especially Mr. John Harmsen and his senior students for spending their time to
develop the materials and teach in the training. Lastly, Mr. Rithy officially opened the
Occupational Therapy Management on Stroke, Traumatic Brain Injury and
Spinal Cord Injury.
After the opening ceremony at 9:00am, Mr. John Harmsen begun with his first lecture
on Assessment & Intervention on
Clients with a neurological conditions.
He listed the main type of neurological
conditions that Occupational Therapy
involves in Australia, particularly on
Stroke and Traumatic Brain Injury. He
shared the effect of the functional
activities which those patients will
affect, how to assessment and they
intervention strategies to gain those
activities.
In the afternoon, John presented another lecture on the Management of Behaviors.
He showed factors associated to the risks of behavioural changes and listed the four
encounter problems of behaviour changes such as Loss of self-control, Physical
impairment, Mood & thought disorders, Cognitive and perceptual impairment. Then
he explained the main items of each problem encounter with how to manage and
provide the interventions.
Within the third presentation on Maximising
function in Spinal Cord Injury (SCI), Mr. John
Harmsen reviewed the spinal anatomy (bone
and spinal cord), spinal syndromes and levels
of spinal injury and its effects. He mainly
focused on the management and intervention
on Tenodesis trainig for SCI.
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Finally, the three senior physical therapy students (Ms. Caris Allen, Ms. Chloe
McComish and Ms. Nicole Whitehead) presented their topic on Pressure sore
prevention and identification. They
shared the anatomy of the skin, stage
of
pressure
sore,
secondary
complications of pressure sores and
its preventions. They also introduced
to use the Braden-scale screening
questionnaire to find how high of the
risk of developing the pressure sore,
so
the participants can work to
prevent
the
unnecessary
tissue
trauma.
At 4:30pm of the same day, Mr. John Harmsen was invited to give his remark on the
training. He expressed his positive feeling on participants who were willing to learn
from his lecturers. There were many crucial
questions come from the participants. He
strongly appreciated the participations from
them and their willing to learn from this
training. He promised to come back next
year and hopefully, he may give a longer
training than this time. Finally, again he
thanked VIC and CPTA for the fruitful
preparation and facilitation in this training.
Particularly, thanked for a good collaboration with Curtin University to allow his
students to work in Cambodia.
Following Mr. John Harmsen, Mr. Song Sit reported the outcome of the full day
training. The training had run smoothly towards the expected outcomes. All
participants participated fully, were punctual and very much enjoyed the course. They
Occupational Therapy Management on Stroke, Traumatic Brain Injury and Spinal Cord Injury
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Capacity Building
Training Report
also had a lot of critical questions for the presenters to increase their knowledge and
fill gaps in their understanding.
Mr. Song Sit would gratefully acknowledge VIC and Curtin University, particularly
Mr. John Harmsen who spent his own time
to develop the materials and gave a fantastic
training today. He strongly encouraged all
Cambodian physical therapists who attended
this training to bring the knowledge and
experience from it to share and teach other
colleagues and physical therapy students, so
that those who were not able to join this
training will get benefit too.
Mr. Keo Rithy was invited to give a speech and officially closed the course. Mr. Keo
Rithy deeply thanked the instructors and organizers (Curtin University and CPTA),
particularly Mr. John Harmsen and his
students and Mr. Chap Sarun for managing
this training to get the successful outcome.
Based on the report by Mr. Song Sit, he
could say that this course was run
smoothly.
He
really
appreciated
all
participants and instructors who worked
together to get this course well-done. He
strongly hoped that all participants would
gain a lot of knowledge from this course. Finally
he would also give very important advice to all
participants with the following:

“Bring all your new knowledge gained from
this training to apply and serve your
persons with disabilities and patients at
your workplace.”

“Importantly, share the knowledge with
your colleagues especially with the clinical
placement students in order to provide the
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Capacity Building
Training Report
effective services and treatment to PWDs and patients in Cambodia.”
Before the end, Mr. Keo Rithy, Mr. John Harmsen, and Mr. Song Sit honorifically
offered the training certificate of attendance to the 30 participants and appreciation
letters to three facilitators.
VII-
Financial Report:
For the total expenses in this course,
there were 238.27 USD including
administrative costs, refreshments and
solidarity dinner were 80.8USD,
54.1USD and 103.37USD respectively.
(See figure2).
Expense in OT Course (in USD)
120
100
80
60
40
20
0
103.37
80.8
54.1
Adminstrative
cost
Refreshment Solidarity dinner
Figure 2 Expense in OT course
VIII-
Training Evaluation
a. Assessment
Based on the results of the pre- and post-test survey in regards to the lessons taught
by the trainer, we found that the participants improved their knowledge by average of
23%, from 4.010 at pre-teaching to 6.3/10 at post-teaching. (Please see the figure 3
below).
Comparison of Average Mark in Pre and Post
Teaching (100%=10/10)
7
6.3
6
5
4
Pre-test
4
3
2.3
2
Post-test
Gain
1
0
Pre-test
Post-test
Gain
Figure 3 Comparison of Average Mark in Pre and Post Teaching
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Capacity Building
Training Report
b. Participant Feedback
Based on the results of the evaluation provided by the participants from the training,
88% of them reported that all trainers made them meet and exceed their expectation
on the knowledge of the topics and the interaction of them with participants. 76% of
them also responded that the trainers taught them to meet and exceed their
expectation on the delivery skill following by 74% reported the same judgment on the
ability to make the topic relevant to the participants of the trainers (see figure4
below).
Feedback on the Trainers
80%
70%
60%
50%
Needs Improvement
40%
Partially Meets
30%
Meets Expection
20%
Exceeds Expectation
10%
0%
Knowledge of
topics
Ablility to make
topics relevant
Delivery skills
Interaction with
participants
Figure 4 Feedback from Participants
With the training preparation and facilitation, 100% of participants reported that the
coverage of topics and contents, registration, general administration and support of
facilitators/organizers
met and exceeded their expectation. Following that 96% met
and exceeded their expectation on the program handouts/ notes and physical setting
& facilities, 94% met and exceeded their expectation on the use of delivery methods
Occupational Therapy Management on Stroke, Traumatic Brain Injury and Spinal Cord Injury
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Capacity Building
Training Report
and 92% met and exceeded their expectation on the meeting the stated objectives/
learning outcomes of the programme and use of audio-visual/ training aids. With
these results, 98% of them completely gained their knowledge from this training and
96% generally rated that this training met and exceeded their expectation. However,
only 68% are confident to share their knowledge from this training to their colleagues
and 78% requested to increase the duration for this training. (Please see the figure 5
below)
Evaluation on Training Preparation and Facilitation
90%
80%
70%
60%
50%
40%
30%
20%
10%
0%
Needs Improvement
Partially meets
Meets expectation
Exceeds expecation
Figure 5 Evaluation on Training Preparation and Facilitation
IX- Conclusion and Recommendation
The one-day training was well-organized, run smoothly and enjoyable. The
participants learnt a lot from this intensive course. With the crucial teaching methods
from instructors and facilitators of the key Curtin University lecturer, VIC and CPTA,
the training proved a great success.
The following are some recommendations for the next training:

Continue to conduct similar training every year.

Increase duration of training day.
Occupational Therapy Management on Stroke, Traumatic Brain Injury and Spinal Cord Injury
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Capacity Building
Reported by:
Training Report
Song Sit
Program Manager, Veterans International Cambodia
Elected President, CPTA (2013-2017)
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