Dr Caitlin Farmer MACP is an advanced practice physiotherapist at Royal Melbourne Hospital who has worked in various roles in emergency departments (EDs) since 2008.

She has a keen interest in helping people experiencing vestibular conditions, particularly in acute settings.

People presenting to EDs with vestibular issues often have debilitating symptoms such as extreme dizziness, disorientation and vomiting.

For a long time, the role of physiotherapists in treating and managing people with vestibular conditions has been under-recognised and many junior physiotherapists lack the confidence to treat these patients.

‘The difficulty is that the dizziness could stem from a benign condition such as a middle ear infection or it could indicate a serious condition such as stroke,’ says Caitlin.

‘So we need to equip physios to confidently differentiate, knowing that they can get the patient to the right treatment options.’

Caitlin’s research project is titled ‘Development, implementation and evaluation of an online acute vestibular learning package’.

The package will detail how to assess and manage acute vestibular disorders, with a particular focus on the ED and acute settings.

It will also assess skills to ensure that participants are ready to put their new knowledge into action.

‘Our plan is to pilot it with about 50 physios whom we’d like to upskill and then expand it to isolated rural and regional physios,’ says Caitlin.

‘But the long-term goal is to offer it to anyone who wants training for treating the acute ED patients and for performing differential diagnosis so they can tell if this is something that needs escalating or something that can be managed with physio.’

Caitlin credits the earlier work of ED physiotherapists Matthew Ogle and Lisa Eadie at the Royal Melbourne Hospital, who have already done a lot of day-to-day upskilling of physiotherapists in vestibular and who developed the ‘bones’ of the learning package.

‘It has many potential advantages for other healthcare providers such as interns and residents working in the ED because some may not have much experience with vestibular conditions,’ says Caitlin.

Another major benefit of the learning package will be that people can come back to it at any time for a refresher.

‘Vestibular is not an area of medicine that changes rapidly,’ says Caitlin.

‘So there are tried-and- true practices that can help to differentiate and guide the management of vestibular issues—the package shouldn’t become outdated too quickly.

'We can commit to this and know that if we do some videos, they’ll still be relevant for a long time.’

Caitlin says the grant from the Pat Cosh Trust will aid her research in many ways.

‘The grant will help in the early stages with medical photography to demonstrate handling and positioning.

'Without it, it would be difficult to find the budget to create the videos and resources for the online training package and then to expand it to rural and regional areas.

'And without dedicated project time, due to the demands of working in an ED with more and more complex patients, it’d be very challenging to get these things going.’