It is widely understood that there is a global need for the development of a Gender Equality And Social Inclusion (GESI) responsive rehabilitation workforce. However, research has shown that students and clinicians are not adequately trained to be GESI-responsive. This post explores what we found out when Physiopedia offered GESI courses for rehabilitation professionals.

Understanding GESI influences on rehabilitation is important for building a strong and capable global rehabilitation workforce. GESI considerations are crucial for rehabilitation professionals as this knowledge enhances their ability to deliver effective, culturally sensitive and equitable rehabilitation services to individuals from diverse backgrounds.

It enables clinicians to:

Provide inclusive care
Address health disparities
Challenge biases
Promote patient engagement
Advocate for systemic changes
Strengthen interprofessional collaboration around the world

Being informed about GESI issues equips rehabilitation professionals to identify gaps and areas of improvement within treatment plans, clinical workplaces, and healthcare systems that perpetuate gender-based or social inequities. Building this effective and confident GESI rehabilitation workforce starts with education.  

However, recognising the importance of GESI training, accessing GESI-related content can be a challenge for students and rehabilitation professionals. Research has shown that students and clinicians do not feel adequately trained to be GESI-responsive. At this time, there is a discrepancy between the practical need for GESI training in rehabilitation and what is taught to students and clinicians.

To meet this need, Physiopedia Plus (Plus) published two GESI-related online courses for all students and professionals of rehabilitation: Introduction to Gender Equality and Social Inclusion (GESI) (course 1 – teaching how to be a GESI-responsive clinician) and Introduction to Affirming Care for Gender and Sexual Minorities (course 2).

To understand the current trends in accessing GESI-related content, the engagement data of these two online GESI courses was explored. Below is a summary of the engagement data 12-months after publication of the online courses: 

Outcomes
Course 1
Course 2
Total Participants

# users started course
93
59
152

# users completed course
62
32
94

# learning activities logged on Plus
254
213
467

Completion rate %
64.1
57.6
–

From a demographic standpoint, the majority of participants from both courses were physiotherapists (not surprising given that most Plus members are physiotherapists – see Figure 1), with a large percentage of participants from Asia and Europe (Figure 2). A large percentage of the participants from the first course were from low-middle-income countries, whereas for the second course they were from high-income countries (perhaps not surprising given the more advanced nature of the topic for the second course – see Figure 3).

Figure 1: The professional profile of the participants who started either online GESI course. 

Figure 2 : The geographical location of the participants who started either GESI-related course

Figure 3: The geographical location of the participants who started either GESI-related course, according to the World Bank country classification 

The first course had a completion rate of 64.1%, while the second course had a completion rate of 57.6%. These rates are above the average completion rates for online courses in general, which have been noted to be around 13% to 38% for healthcare professionals and an estimated 10% for a global average captured through massive open online course (MOOC) participation (Jordan 2015, Claflin et al. 2022). The completion rate for the two GESI courses is quite normal for a Plus course; nothing is overly surprising here. However, interestingly, the overall participation level for the two GESI-related courses is exceptionally low for a typical Plus course over a 1-year period. 

The low participation rate of the two courses points to a possible initial disinterest in GESI-related learning content. But it is worth noting that the high engagement rate indicates that once people choose to participate in GESI-related learning, they are very engaged in the topic.

Given the known gap in knowledge but the low participation in GESI-related learning, there is a need to promote the importance of and opportunities to learn about GESI sensitive care to rehabilitation professionals.

Knowing that there is a discrepancy between the practical need for GESI training in rehabilitation and what is taught to students and clinicians, it would be worth exploring the prevalence of GESI-related content that is integrated into student curriculums and continuing education for clinicians. We also need to do more to raise awareness of the need for participating in GESI training. Solving the GESI gap in rehabilitation will ensure both new and existing rehabilitation is equitable and accessible to all. By actively advocating for policy changes, professional guidelines and organisational practices that promote gender equality and social inclusion, rehabilitation professionals can contribute to creating a more equitable and inclusive healthcare system around the world. 

Advancing Gender Equality and Social Inclusion in rehabilitation means taking a closer look at policy reforms (even at the clinical level) and promoting the development of academic curricula that integrate GESI-related content and courses. GESI efforts need to be cross-cutting and accessible at every level so that students, clinicians, managers and policymakers can feel comfortable and confident talking about how gender and inclusion impact the quality of rehabilitation services.

A thank you to Linda Thumba and Rosemary Morgan from Johns Hopkins University for their contributions to this ReLAB-HS work.