About Postural Stability Instructor

Content

The course aim is to support and enable candidates to achieve understanding of the requirements of evidence-based practice and implementation FaME in primary and secondary prevention of falls, as part of referral and self-referral pathways. This course is not only evidence-based but practical in nature i.e. it focusses on the practical skills and conversations to deliver safe, effective, specialised exercise that reduce falls and promotes independence among older people.

On successful completion of the course candidate should be able to:

• undertake an appropriate pre-exercise assessment for participation in FaME.
• plan and deliver an exercise programme for frailer older people (informed by FaME) which will safely and effectively improve their physical function and their postural stability, in order to reduce their risk of falls
• be able to support this practice with relevant background knowledge of:
  • the causes and consequences of falls and fall-related injuries
  • the evidence relating to physical activity, falls and fall-related injuries
  • the medical conditions and medications likely to be encountered and their effect on exercise participation
  • the adaptations to practise, programming and supervision of falls and injury prevention sessions.

Course Objectives

• Understanding of scope of practice for exercise professionals delivering FaME in community venues
• Processes for partnership working with referring health professionals
• Effective use of decision tools/assessment tools equipping PSIs to identify suitability of participants into FaME
• Application of behaviour change principles supporting physical literacy and independent exercise in the long run
• Providing education and accurate messaging around physical activity recommendations for older people
• Training to support implementation of safe, effective, enjoyable exercise programmes for falls prevention with fidelity (FaME and Otago)

Duration and Blended Learning Approach

The PSI learner journey spans approximately 10 weeks from pre-course learning to summative assessment.

Your training will be blended learning – a mix of face-to-face training days and online learning via the LLT e-learning platform.

FOUR face-to-face days run from 9am to 5pm (including Day FOUR as summative assessment). These days will focus on the group teaching skills of the PSI and the first three will prepare you for your practical assessment on Day Four NB: These days are not consecutive

Guided Learning Hours:  Over and above the face-to-face days, we estimate that candidates will be required to invest a minimum of 26 hours to complete mandatory pre and mid-course tasks online to a minimum standard.

We recommend a minimum 50-hour investment to support successful outcomes for the course assessment and application into practice.

Pre-course learning: approx 12 hours

Mid-course (between days 2 and three): approx 6 hours

Summative Assessment: approx 8 hours.

Course enrolment is 4 weeks before the face-to-face training;

• Candidates receive an enrolment key (password) to access resources prior to attending the face-to-face training
• Online elements are mandatory and supported by your LLT tutor

Completion of the pre-course online elements will require you to have;

• Regular access to a laptop or desktop computer with a minimum browser version of Google Chrome (30+), Mozilla Firefox (25+) or Safari 6
• Regular access to reliable internet
• Please note we do not recommend using smartphones or tablets for the e-learning work

Resources

Candidates will receive by post their course resources 4 weeks prior to the first face-to-face learning days, to allow the pre-course reading and online work to be completed. The resources include a course timetable (standardised across all courses), course manuals and associated paperwork (theory manual, FaME exercise library, candidate assessment information booklet, LLTs 7 principles to make behaviour change stick, case studies).

Certification

Successful candidates will receive a certificate. Successful candidates are recognised by CIMSPA as Fellow of the Chartered Institute (fellowship is only applicable to graduates who hold an exercise referral qualification or new equivalent) and the title, Senior Activity and Health Practitioner.

The LLT FaME PSI Course Tutor and Assessor Team

The Later Life Training tutor and assessor team are experienced exercise professionals and educators with specific expertise and experience working in falls prevention services across the UK.

PSI FaME Training over the years

FaME was specifically designed to improve postural stability and reduce the risk of falls. Dawn Skelton (LLT Director) and Susie Dinan-Young (retired LLT Director) first published their rationale for FaME in 1999. With funding from the Department of Health, they developed the first PSI FaME Training with a team with extensive expertise in the fields of research, exercise, medicine and general practice, falls and injury prevention, rehabilitation, education, social services and public health. The PSI FaME Training is based on published research showing; a reduction in falls and falls injuries in people who have a high risk of falls, and reduced risk of the first fall in sedentary older people (see Evidence section). There have been multiple iterations of the PSI FaME Training over the years as the evidence base, and falls services and commissioning has developed over these years. The curriculum and resources have most recently been strengthened by the Implementation Research funded by the National institute of Health Research in the FLEXI Study (see Evidence section). Since 2003 we have trained over 4000 PSIs.  In the early days approximately half of those trained were physiotherapists, while in the last decade this has shifted in favour of exercise professionals. For more information on the development of the PSI training, see our history.

The World Falls Guidelines and the NICE falls guidelines recommend that people at risk of falls are signposted/referred to exercise programmes with a proven evidence base to reduce rate and risk of falls.

Secondary prevention of falls – reducing the rate of falls in those at high risk

The rationale for the exercises  within FaME is published. In the UK, women aged 65 and over with a history of recurrent falls halved their risk of falls (IRR 0.46) with 9 months of weekly FaME group sessions  led by a PSI, combined with twice weekly home exercises.  The women undertaking this falls management exercise (FaME) had significantly lower mortality and morbidity at 3 year follow up than the randomised control group (this is the least biased trial design and much more robust than service evaluations). They also showed improvements in strength, balance and floor rise skills. The exercise was individually tailored in both type and intensity, with most exercises in weight-bearing positions, reducing upper limb support, and an emphasis on retraining or maintaining the ability to get up from the floor and to avoid a ‘long lie’ after a non-injurious fall.

Primary prevention of falls – reducing the risk of having a fall in those at intermediate risk

A larger randomised controlled trial (ProAct65+, 2014)  examined FaME over a 6 month duration in sedentary older people. It showed increased habitual moderate physical activity by more than 15 minutes a day, and reduced falls even a year after the FaME sessions finished. Gawler et al. 2016 published a more in-depth analysis of the falls reduction and has shown FaME delivered by PSIs is highly effective For those who increase their physical activity alongside, the benefits to reduced falls risk last up to two years.

Implementation of FaME in the Real World (not in a research study!)

The first implementation study to see if FaME works in the ‘real world’ (follow up of service provision across the East Midlands) showed that physical function, physical activity and confidence was improved, and concerns about falls and falls rate were reduced (Orton et al, 2021). Most of the participants in this study self-referred, but had to either have real concerns about falls or have had a fall in the previous year. Some aspects of FaME were not delivered with true fidelity (hence the reduction in falls was smaller than the randomised controlled trials). This led to changes in the PSI FaME training and a FaME Implementation Toolkit  was produced for commissioners/providers of services.

Currently, the FLEXI FaME Implementation Study , led by Prof Liz Orton, is looking at what increases the likelihood of FaME being commissioned and how we can maintain quality provision over time. To this end the National FaME Implementation Team (NFIT) has been set up and a free to access Community of Practice, hosted by LLT, is available for PSIs and Service Providers. This is all with the aim to get the best outcomes for older people.

FaME enables older people to ‘Get up, Stay up, and live their best lives’, and has a real impact on quality of life, independence and ability to remain socially and physically active.  FaME as an intervention to reduce falls has been used as an exemplar of impact by four separate universities in their REF2021 Impact Case Studies.

Policy Documents, Research Papers and Service Evaluations

Visit our Archives section where policy documents recommending FaME, research papers, and published service evaluations forming the evidence base behind the FaME programme can be viewed.

Videos from FaME Participants, Referrers and Commissioners

Livewell Southwest FaME classes – View here.
Wrexham Strength and Balance Classes – View here.
East Midlands FaME classes (participants and PSI) – View here.
East Midlands FaME classes (for commissioners) – View here.
East Midlands FaME classes (for referrers) – View here.
HSE Community Services (Cavan, Donegal, Leitrim, Monaghan and Sligo, Northern Ireland) FaME classes – View here.
Wigan FaME classes – View here.

Please read our essential eligibility guidance before applying for this training:

PSI Eligibility page.

Assessed Elements

There are FOUR assessed elements for candidates to achieve PSI FaME Certification:

1. PSI Theory into practice – multiple choice questions (MCQs) online completed pre-course and mid-course
2. PSI Reflective Practice – THREE written reflections
3. PSI FaME teaching skills, and conversation planning (practical and written) Refer/Pass outcome
4. PSI Peer feedback based on observation of one allocated candidate (written)

CPR

It is the responsibility of the candidate to hold valid CPR related to their workplace and role.

Assessment Appeals Procedure

If you wish to make an appeal against your assessment decision, please complete the form contained within our LLT Appeals Procedure.

We are a not for profit organisation and always strive to keep costs down. We have been able to avoid increases for 6 years but due to increases in course running costs, we have taken the decision to increase PSI and OEP course fees by £20.

To add further value, CPD opportunities and to support best practice implementation (of FaME and OEP) this increase in course fee will include 3 months FREE Education Connect Membership from the date of course completion. Full details will be included in your end of course results letter

The full course cost is £690 + VAT per applicant and includes the Course Manuals, Assessments and Certification, plus for those that achieve full certification, 3 months FREE Education Connect Membership.

Refer/Defer Costs
Sign up for the practical assessments occurs on Day 2 and charges will occur if you do not attend on your signed up assessment day.
Should you refer/defer, there are resit costs:
Practical assessment resit – £90 (incl. VAT)
Session plan resit – £25 (incl. VAT)
Plus you may have to take into consideration costs for travel and accommodation if the new course assessments are not local.

You can apply online here, but first we ask that you ensure you have read:

• Full course details
• The Eligibility Guidelines and the statement about Medical Conditions and Learning Support Requirements below.
• The PSI Terms and Conditions.

Course dates can be found here. If there are no courses currently in your area we will initiate a course as soon as there is enough interest but we cannot guarantee a timeframe for this.

Hosting a Course

If you are interested in hosting a PSI course in your area, we do offer discounts to hosts depending on the number of applicants enrolled, just contact the LLT Office. View the PSI Host Terms and Conditions here.

Medical Conditions and Learning Support Requirements

We encourage everyone to be responsible for their own learning. In light of this, we ask that you please inform us, at point of booking, about any learning support requirements and/or medical conditions support that will help you to access our course content and learn effectively. All information will be treated confidentially and we will make reasonable adjustments to meet your needs.

PSI CPD

Continuing Professional Development is available for PSIs, please see the PSI CPD page for more information and costs.

Want to refresh your teaching skills?

Find out more about our 2 day refresher sessions.

Career Progression ideas?

An article on career progression from PSI to Physical Activity co-ordinator can be viewed here.