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Mabry LM, Keil A, Young BA, Reilly N, Ross MD, Gisselman AS, Goss D. Physical therapist awareness of diagnostic imaging referral jurisdictional scope of practice: an observational study. J Man Manip Ther 2024; 32:435-445. [PMID: 38130076 DOI: 10.1080/10669817.2023.2296260] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2023] [Accepted: 12/13/2023] [Indexed: 12/23/2023] Open
Abstract
OBJECTIVES To examine physical therapist awareness and utilization of imaging referral privileges in the United States (US) and how it relates to direct access frequency. METHODS This study utilized survey data collected in 2020-2021 from US physical therapists. Subjects were asked about imaging referral jurisdictional authority in their state. Responses were analyzed for accuracy and compared to the level of jurisdictional authority and its impact on imaging referral. Analysis of imaging skills performance and imaging referral practices were compared to direct access frequency. RESULTS Only 42.0% of physical therapists practicing in states that allow imaging referral were aware of this privilege. Those practicing where imaging referral was allowed via state legislation were significantly more likely (p < 0.01) to be aware of this privilege (71.4%) compared to those granted by the state board (25.2%). Those aware of their imaging referral scope were more likely (p < 0.01) to practice imaging referral (44.5%) compared to those who were unaware (3.2%). Direct access frequency was positively associated with imaging skill performance and imaging referral practice (p < 0.01). Doctors of Physical Therapy, residency/fellowship-trained physical therapists, and board-certified physical therapists all reported practicing greater frequency of direct access (p < 0.01). DISCUSSION/CONCLUSION There is a striking lack of awareness of imaging privileges among physical therapists as influenced by the level of jurisdictional scope. These results suggest that the lack of awareness may have a dampening effect on diagnostic imaging referrals. The American Physical Therapy Association should consider engaging with state boards to raise imaging privilege awareness.
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Affiliation(s)
- Lance M Mabry
- Department of Physical Therapy, High Point University Congdon School of Health Sciences, High Point, NC, USA
| | - Aaron Keil
- Department of Physical Therapy, University of Illinois at Chicago, Chicago, IL, USA
| | - Brian A Young
- Department of Physical Therapy, Baylor University, Waco, TX, USA
| | - Nicholas Reilly
- Department of Physical Therapy, High Point University Congdon School of Health Sciences, High Point, NC, USA
| | - Michael D Ross
- Department of Physical Therapy, Daemen University, Amherst, NY, USA
| | | | - Don Goss
- Department of Physical Therapy, High Point University Congdon School of Health Sciences, High Point, NC, USA
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Dice JL, Brismee JM, Froment FP, Henricksen J, Sherwin R, Pool J, Milne N, Clewley D, Basson A, Olson KA, Gross AR. Perceived factors and barriers affecting physiotherapists' decision to use spinal manipulation and mobilisation among infants, children, and adolescents: an international survey. J Man Manip Ther 2024; 32:295-303. [PMID: 38940281 PMCID: PMC11216267 DOI: 10.1080/10669817.2024.2363033] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/27/2023] [Accepted: 05/24/2024] [Indexed: 06/29/2024] Open
Abstract
OBJECTIVE To identify factors and barriers, which affect the utilisation of spinal manipulation and mobilisation among infants, children, and adolescents. METHODS Twenty-six international expert physiotherapists in manual therapy and paediatrics were invited to participate in a Delphi investigation using QualtricsⓇ. In Round-1 physiotherapists selected from a list of factors and barriers affecting their decision to use spinal manipulation and mobilisation in the paediatric population and had opportunity to add to the list. Round-2 asked respondents to select as many factors and barriers that they agreed with, resulting in a frequency count. The subset of responses to questions around barriers and facilitators are the focus of this study. RESULTS Twelve physiotherapists completed both rounds of the survey. Medical diagnosis, mechanism of injury, patient presentation, tolerance to handling, and therapist's knowledge of techniques were the dominant deciding factors to use spinal manipulation and mobilisation among infants, children, and adolescents across spinal levels. More than 90% of the respondents selected manipulation as inappropriate among infants as their top barrier. Additional dominant barriers to using spinal manipulation among infants and children identified by ≥ 75% of the respondents included fear of injuring the patient, fear of litigation, lack of communication, lack of evidence, lack of guardian consent, and precision of the examination to inform clinical reasoning. CONCLUSION This international survey provides much needed insight regarding the factors and barriers physiotherapists should consider when contemplating the utilisation of spinal mobilisation and manipulation in the paediatric population.
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Affiliation(s)
- Jenifer L. Dice
- School of Physical Therapy, Texas Woman’s University, Houston, TX, USA
| | - Jean-Michel Brismee
- Center for Rehabilitation Research, School of Health Professions, Texas Tech University Health Sciences Center, Lubbock, TX, USA
| | - Frédéric P. Froment
- Center for Rehabilitation Research, School of Health Professions, Texas Tech University Health Sciences Center, Lubbock, TX, USA
- International Academy of Musculoskeletal Physiotherapy, Paris, France
| | - Janis Henricksen
- School of Physical Therapy, University of St. Augustine, Dallas, TX, USA
| | - Rebecca Sherwin
- NELA Rehabilitation, Physical Therapy Department, West Monroe, Louisiana, USA
- Hauser School of Physical Therapy, University of the Cumberlands, Williamsburg, KY, USA
| | - Jan Pool
- Institute of Movement Studies, University of Applied Sciences, Utrecht, The Netherlands
| | - Nikki Milne
- THINK Paediatrics Research Group, Faculty of Health Sciences and Medicine, Bond University, Robina, Queensland, Australia
- International Organisation of Physiotherapists in Paediatrics (IOPTP)
| | - Derek Clewley
- Doctor of Physical Therapy Division, Duke University, Durham, North Carolina, USA
| | - Annalie Basson
- Faculty of Health Sciences, Physiotherapy Department, University of the Witwatersrand, Johannesburg, South Africa
| | | | - Anita R. Gross
- Rehabilitation Sciences, McMaster University, Hamilton, Canada
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Garner J, Berg MVD, Lange B, Vuu S, Lennon S. Physiotherapy assessment in people with neurological conditions-Evidence for the most frequently included domains: A mixed-methods systematic review. J Eval Clin Pract 2023; 29:1402-1424. [PMID: 37538002 DOI: 10.1111/jep.13909] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/06/2023] [Revised: 07/04/2023] [Accepted: 07/11/2023] [Indexed: 08/05/2023]
Abstract
RATIONALE There is a lack of consensus in the literature related to what is assessed clinically by physical therapists in people with neurological disorders. AIMS This mixed-methods systematic review aimed to identify domains that physiotherapists routinely assess in people with neurological conditions in clinical settings and explored factors influencing assessment domains including country, clinical setting, therapist experience and neurological condition. METHOD Five databases were searched from 1946 to 31st January 2023. Studies with any design reporting on domains assessed by a physiotherapist, in people with neurological conditions in any clinical setting, were included. Independent reviewers assessed eligibility and risk of bias using relevant McMaster critical appraisal tools. Data were extracted and synthesised following the Joanna Briggs Institute approach for mixed systematic reviews. RESULTS A total of 23 (16 quantitative, 7 qualitative) studies involving 3134 participants were included. The studies were rated as high (n = 14) or medium (n = 9) quality. The domains of function (n = 14); postural alignment and symmetry (n = 11); gait (n = 11); balance (n = 9), and muscle strength (n = 8) were most frequently included in assessments. Five key themes were identified from the qualitative studies: the clinical reasoning process, clinical use of standardised measures, utilisation of the senses, clinician experience and information gathering. There was minimal data on how country, clinical setting, therapist experience and neurological condition influence inclusion of assessed domains. CONCLUSION Five domains were most frequently included in assessment: function; postural alignment and symmetry; gait; muscle strength; and balance. This limited number of domains is in stark contrast to the full neurological physiotherapy assessment recommended by expert textbooks. Further research is needed to understand the reasons why this might be so.
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Affiliation(s)
- Jill Garner
- Department of Physiotherapy, Caring Futures Institute, College of Nursing and Health Sciences, Flinders University and Southern Adelaide Local Health Network, Adelaide, South Australia, Australia
| | - Maayken van den Berg
- Department of Clinical Rehabilitation, Caring Futures Institute, College of Nursing and Health Sciences, Flinders University, Adelaide, South Australia, Australia
| | - Belinda Lange
- Department of Physiotherapy, Caring Futures Institute, College of Nursing and Health Sciences, Flinders University, Adelaide, South Australia, Australia
| | - Sally Vuu
- Department of Clinical Rehabilitation, Caring Futures Institute, College of Nursing and Health Sciences, Flinders University, Adelaide, South Australia, Australia
| | - Sheila Lennon
- Department of Physiotherapy, College of Nursing and Health Sciences, Flinders University, Adelaide, South Australia, Australia
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Mabry LM, Severin R, Gisselman AS, Ross MD, Davenport TE, Young BA, Keil AP, Goss DL. Physical Therapists Are Routinely Performing the Requisite Skills to Directly Refer for Musculoskeletal Imaging: An Observational Study. J Man Manip Ther 2022; 30:261-272. [PMID: 35968741 PMCID: PMC9487956 DOI: 10.1080/10669817.2022.2106729] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/15/2022] Open
Abstract
OBJECTIVES To explore if physical therapists are practicing skills necessary to refer patients for musculoskeletal imaging. METHODS An expert panel established a list of nine requisite skills to refer for musculoskeletal imaging. A blinded expert panel validated the list using a 5-point Likert scale. The skills list was examined via an electronic survey distributed to United States physical therapists. RESULTS 4,796 respondents were included. Each of the nine skills were routinely performed by a majority of the respondents (range: 54.52-94.72%). Respondents routinely performed 6.95 (± 0.06) skills, with 67.41% routinely performing seven or more skills. Doctors of physical therapy routinely performed more imaging skills (7.15 ± 0.06) compared to their masters- (6.44 ± 0.19) and bachelors-trained (5.95 ± 0.21) counterparts (p < 0.001). Residency/fellowship-trained physical therapists were more likely to routinely perform more imaging skills (7.60 ± 0.11 vs. 6.79 ± 0.07, p < 0.001). Imaging skill performance was greater among board-certified physical therapists (7.39 ± 0.09 vs. 6.71 ± 0.08, p < 0.001) and APTA members (7.06 ± 0.07 vs. 6.65 ± 0.12, p < 0.001). CONCLUSION Physical therapists are routinely practicing the requisite imaging skills to directly refer to a radiologist for musculoskeletal imaging.
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Affiliation(s)
- Lance M. Mabry
- Department of Physical Therapy, Congdon School of Health Sciences, High Point University, One University Parkway, High Point, NCUSA
| | - Richard Severin
- Department of Physical Therapy, College of Applied Health Sciences, University of Illinois at Chicago, Chicago, IL, USA
- Department of Physical Therapy, Robbins College of Health and Human Sciences, Baylor University , Waco, TX, USA
| | - Angela S. Gisselman
- Doctor of Physical Therapy Program, Department of Public Health and Community Medicine, School of Medicine, Tufts University, Phoenix, AZ, USA
| | - Michael D. Ross
- Department of Physical Therapy, Daemen University, Amherst, NY, USA
| | - Todd E. Davenport
- Department of Physical Therapy, School of Health Sciences, University of the Pacific, Stockton, CA, USA
| | - Brian A. Young
- Department of Physical Therapy, Robbins College of Health and Human Sciences, Baylor University , Waco, TX, USA
| | - Aaron P. Keil
- Department of Physical Therapy, College of Applied Health Sciences, University of Illinois at Chicago, Chicago, IL, USA
| | - Don L. Goss
- Department of Physical Therapy, Congdon School of Health Sciences, High Point University, One University Parkway, High Point, NCUSA
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Ho-Henriksson CM, Svensson M, Thorstensson CA, Nordeman L. Physiotherapist or physician as primary assessor for patients with suspected knee osteoarthritis in primary care - a cost-effectiveness analysis of a pragmatic trial. BMC Musculoskelet Disord 2022; 23:260. [PMID: 35300671 PMCID: PMC8932301 DOI: 10.1186/s12891-022-05201-3] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/15/2021] [Accepted: 03/07/2022] [Indexed: 11/17/2022] Open
Abstract
Background Over the next decade, the number of osteoarthritis consultations in health care is expected to increase. Physiotherapists may be considered equally qualified as primary assessors as physicians for patients with knee osteoarthritis. However, economic evaluations of this model of care have not yet been described. To determine whether physiotherapists as primary assessors for patients with suspected knee osteoarthritis in primary care are a cost-effective alternative compared with traditional physician-led care, we conducted a cost-effectiveness analysis alongside a randomized controlled pragmatic trial. Methods Patients were randomized to be assessed and treated by either a physiotherapist or physician first in primary care. A cost-effectiveness analysis compared costs and effects in quality adjusted life years (QALY) for the different care models. Analyses were applied with intention to treat, using complete case dataset, and missing data approaches included last observation carried forward and multiple imputation. Non-parametric bootstrapping was conducted to assess sampling uncertainty, presented with a cost-effectiveness plane and cost-effectiveness acceptability curve. Results 69 patients were randomized to a physiotherapist (n = 35) or physician first (n = 34). There were significantly higher costs for physician visits and radiography in the physician group (p < 0.001 and p = 0.01). Both groups improved their health-related quality of life 1 year after assessment compared with baseline. There were no statistically significant differences in QALYs or total costs between groups. The incremental cost-effectiveness ratio for physiotherapist versus physician was savings of 24,266 €/lost QALY (societal perspective) and 15,533 €/lost QALY (health care perspective). There is a 72–80% probability that physiotherapist first for patients with suspected knee osteoarthritis is less costly and differs less than ±0.1 in QALY compared to traditional physician-led care. Conclusion These findings suggest that physiotherapist-led care model might reduce health care costs and lead to marginally less QALYs, but confidence intervals were wide and overlapped no difference at all. Health consequences depending on the profession of the first assessor for knee osteoarthritis seem to be comparable for physiotherapists and physicians. Direct access to physiotherapist in primary care seems to lead to fewer physician consultations and radiography. However, larger clinical trials and qualitative studies to evaluate patients’ perception of this model of care are needed. Clinical trial registration The study was retrospectively registered in clinicaltrial.gov, ID: NCT03822533. Supplementary Information The online version contains supplementary material available at 10.1186/s12891-022-05201-3.
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Affiliation(s)
- Chan-Mei Ho-Henriksson
- Region Västra Götaland, Primary Care Rehabilitation, Närhälsan Lidköping Rehabmottagning, Lidköping, Sweden. .,Department of Health and rehabilitation, Unit of Physiotherapy, University of Gothenburg, Sahlgrenska Academy, Institute of Neuroscience and Physiology, Gothenburg, Sweden.
| | - Mikael Svensson
- University of Gothenburg, Sahlgrenska Academy, Institute of Medicine, School of Public Health and Community Medicine, Gothenburg, Sweden
| | - Carina A Thorstensson
- Department of Health and rehabilitation, Unit of Physiotherapy, University of Gothenburg, Sahlgrenska Academy, Institute of Neuroscience and Physiology, Gothenburg, Sweden.,Research and Development Department at Region Halland, Halmstad, Sweden
| | - Lena Nordeman
- Department of Health and rehabilitation, Unit of Physiotherapy, University of Gothenburg, Sahlgrenska Academy, Institute of Neuroscience and Physiology, Gothenburg, Sweden.,Region Västra Götaland, Research, Education, Development and Innovation, Primary Health Care, Research, Education, Development and Innovation Centre Södra Älvsborg, Borås, Sweden
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Understanding the Process and Challenges for Return-to-Work Post-Hematopoietic Cell Transplantation from a Musculoskeletal Perspective: A Narrative Review. Occup Ther Int 2021; 2021:5568513. [PMID: 34316293 PMCID: PMC8277503 DOI: 10.1155/2021/5568513] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2021] [Revised: 05/02/2021] [Accepted: 06/18/2021] [Indexed: 12/20/2022] Open
Abstract
The current paper seeks to inform healthcare professionals on how adapting various components of return to work (RTW) programs that are already in use by other musculoskeletal rehabilitation settings can help optimize return to work process for patients with or without musculoskeletal manifestations, posthematopoietic cell transplantation. Since there is no universally agreed RTW structure for hematopoietic cell transplant patients, a narrative approach has been taken utilizing evidence from the existing musculoskeletal return to work assessment publications to help draw parallel for the hematopoietic cell transplant patients. Databases were searched including PUBMED, CINHAL, AMED, SCOPUS, and Cochrane using keywords RTW, functional restoration program, hematopoietic cell transplant, bone marrow transplant, stem cell transplant, and musculoskeletal functional assessment. The authors have managed to outline and propose a structured RTW assessment and monitoring program which can aid in getting patients back to employment by utilizing the functional capacity and job evaluation to help hematopoietic cell transplantation patients reintegrate socially. Patients undergoing hematopoietic cell transplant require additional support and a robust assessment system to allow safe RTW. The proposed model of RTW assessment can prove to be beneficial in helping patients return to work safely. Clinical Significance. To acknowledge the individuality in functional limitation is important in determining not only the rehab needs but also the RTW capabilities. The proposed RTW plan not only promotes an individualized approach to patients but also provides a structure for return to work assessments for hematopoietic cell transplantation patients, thus, eliminating the need for guess work by healthcare professionals. In line with the International Classification of Functioning, Disability, and Health (ICF) recommendations, a RTW assessment combined with a job evaluation helps healthcare professionals and stakeholders to understand the unique challenges and strengths of a patient and thereby design an individualized therapy approach.
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Kulnik ST, Latzke M, Putz P, Schlegl C, Sorge M, Meriaux-Kratochvila S. Experiences and attitudes toward scientific research among physiotherapists in Austria: a cross-sectional online survey. Physiother Theory Pract 2020; 38:1289-1304. [PMID: 33084456 DOI: 10.1080/09593985.2020.1836695] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
INTRODUCTION Research is important for the development of physiotherapy practice, but several countries have a rather short history of physiotherapy as an academic profession. PURPOSE This study investigated physiotherapists' experiences and attitudes toward scientific research in Austria, where physiotherapists have only been qualifying at bachelor level since 2009. METHODS A convenience sample of 597 qualified physiotherapists completed an anonymous cross-sectional online survey. RESULTS Most respondents were female (n = 467, 78.2%) and in age groups between: 26-35 years (n = 149, 25.0%); 36-45 years (n = 178, 29.8%); and 46-55 years (n = 173, 29.0%). Seventeen respondents (2.8%) held doctoral degrees, and 61 (10.2%) had substantial research experience beyond undergraduate or master-level student research. More positive research attitudes were observed in participants who were male, younger, without children, had completed their physiotherapy qualification since 2009, were engaged in teaching and education, and held postgraduate degrees. Most frequently reported barriers and/or enabling factors for physiotherapy research were time, training, finances and a "critical mass" of research activity. CONCLUSION These findings highlight low levels of research activity among physiotherapists in Austria, despite general appreciation of the importance of research for the profession. The identified attitudinal profiles, barriers, and facilitators may inform initiatives for advancing physiotherapy research in the Austrian context.
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Affiliation(s)
- Stefan Tino Kulnik
- Faculty of Health, Social Care and Education, Kingston University and St George's, University of London, London, UK.,Department Health Sciences, FH Campus Vienna - University of Applied Sciences, Wien, Austria
| | - Markus Latzke
- Department of Business, IMC University of Applied Sciences, Krems, Austria
| | - Peter Putz
- Department Health Sciences, FH Campus Vienna - University of Applied Sciences, Wien, Austria
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O Mir M, Blake C, Cunningham C, Fennelly O, O'Sullivan C. Orthopaedic consultant surgeons perceptions of an advanced practice physiotherapy service in paediatrics: A qualitative study. Musculoskeletal Care 2020; 19:149-157. [PMID: 32881295 DOI: 10.1002/msc.1508] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2020] [Revised: 08/24/2020] [Accepted: 08/25/2020] [Indexed: 11/06/2022]
Abstract
OBJECTIVES The objective of this study is to determine orthopaedic consultants' perceptions of an advanced practice physiotherapy (APP) service in paediatrics. DESIGN This is a qualitative study that use semi-structured interviews to explore consultant doctors' experiences of an APP paediatric orthopaedic service and its development. Data were transcribed verbatim and subsequently underwent thematic analysis. PARTICIPANTS Five orthopaedic consultants in two hospital settings participated, and all of whom had experience of working with paediatric orthopaedic APPs. RESULTS Seven themes were derived from the analysis, with all participants in the study identifying factors affecting the development of the service and demonstrating broad support for the APP role, with benefits noted as including improved efficiency of service, expansion of skill mix within the team, positive impressions of the standard of care and improved education and liaison with the families and community practitioners at large. CONCLUSIONS This paper highlights many of the factors that should be considered when introducing an APP service in an outpatient setting. This study demonstrates consistent cross-site positive regard in the skill and competency of the APP in paediatric orthopaedics, to enhance orthopaedic services for children.
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Affiliation(s)
- Marie O Mir
- Physiotherapy Department, Our Lady's Children's Hospital, Crumlin, Dublin, Ireland.,UCD School of Public Health, Physiotherapy and Sport Science, University College Dublin (UCD), Dublin, Ireland
| | - Catherine Blake
- UCD School of Public Health, Physiotherapy and Sport Science, University College Dublin (UCD), Dublin, Ireland
| | - Caitriona Cunningham
- UCD School of Public Health, Physiotherapy and Sport Science, University College Dublin (UCD), Dublin, Ireland
| | - Orna Fennelly
- UCD School of Public Health, Physiotherapy and Sport Science, University College Dublin (UCD), Dublin, Ireland
| | - Cliona O'Sullivan
- UCD School of Public Health, Physiotherapy and Sport Science, University College Dublin (UCD), Dublin, Ireland
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Fennelly O, Desmeules F, O'Sullivan C, Heneghan NR, Cunningham C. Advanced musculoskeletal physiotherapy practice: Informing education curricula. Musculoskelet Sci Pract 2020; 48:102174. [PMID: 32560874 DOI: 10.1016/j.msksp.2020.102174] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/14/2020] [Revised: 04/15/2020] [Accepted: 04/22/2020] [Indexed: 11/30/2022]
Abstract
INTRODUCTION Physiotherapists are operating at an advanced level of practice, usually on ad hoc basis with inhouse training, in response to the increasing burden of musculoskeletal (MSK) disorders. Discrepancies in role-specific education of advanced practice physiotherapists (APPs) creates challenges in ensuring a quality service, workforce mobility and formal recognition. This study reviewed existing MSK APP competency frameworks and education offerings, and explored physiotherapist learning needs with a view to informing international standardisation of MSK APP education curricula. METHODS A scoping review of the literature and relevant university and regulatory websites identified APP competency frameworks and education curricula, which were verified by international experts. Content analysis, performed on the identified competencies and modules, produced a list of themes existing in MSK advanced practice internationally. A survey based on those themes identified the learning priorities of physiotherapists (n = 25) participating in an APP symposium in Ireland. RESULTS Six APP competency frameworks and eleven curricula from the UK, Canada and Australia were identified. Themes emerging, regarding MSK APP practice internationally, included both entry-level physiotherapy (e.g., Assessment and Diagnosis) and traditionally medically-controlled tasks (e.g., Injection Therapy), as well as Research, Leadership, Service Development, Professional-related Matters and Education. Participating physiotherapists more commonly prioritised competencies which would be deemed beyond entry level physiotherapy skills (i.e., Radiology versus Manual Therapy). CONCLUSION Despite variances in profiles of APPs both between and within countries, common themes emerged regarding their expected competencies and skills. This study provides the foundation for the adoption of internationally-recognised MSK APP competencies and education standards.
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Affiliation(s)
- Orna Fennelly
- School of Public Health, Physiotherapy and Sports Science, University College Dublin, Belfield, Dublin, Ireland.
| | | | - Cliona O'Sullivan
- School of Public Health, Physiotherapy and Sports Science, University College Dublin, Belfield, Dublin, Ireland.
| | - Nicola R Heneghan
- School of Sport, Exercise and Rehabilitation Sciences, University of Birmingham, United Kingdom.
| | - Caitriona Cunningham
- School of Public Health, Physiotherapy and Sports Science, University College Dublin, Belfield, Dublin, Ireland.
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