Knowledge, attitude and utilisation of evidence-based therapeutic exercises in knee osteoarthritis management in Nigeria.

Background: In Nigeria, there is a disparity among physiotherapists regarding therapeutic exercise as a core treatment for patients with knee osteoarthritis (OA). The attitudes and beliefs of physiotherapists could influence this. Objective: To investigate Nigerian physiotherapists' knowledge, attitude, and utilisation of evidence-based therapeutic exercises. Design: A mixed-method of cross-sectional survey and focus group discussion. Setting: Secondary and tertiary health institutions in Nigeria. Participants: Physiotherapists consecutively sampled from the selected institutions. Main outcome measures: Participants' knowledge, attitude and utilisation of evidence-based therapeutic exercises for the management of knee OA. Results: This study revealed that 81% of physiotherapists in Nigeria had a fair knowledge of evidence-based practice and the efficacy of therapeutic exercises in managing knee OA. Despite this fair knowledge, 95.3% had a poor attitude. The important emerging categories/themes are treatment preference, clinical experience, and strength of evidence. Conclusion: Physiotherapists in Nigeria have a fair knowledge of evidence-based therapeutic exercises in managing patients with knee OA, although there is a poor attitude and disparity between the use and current recommendations. Funding: The research received no funding from a commercial or non-profit organisation.

Does Insurance Provide Adequate Coverage for Physical Therapy Visits for Common Orthopedic Diagnoses? A Survey Study.

OBJECTIVES: This study aimed to analyze the association between physical therapists' recommended number of visits for a full recovery from common orthopedic injuries/surgeries and the extent of insurance coverage for these visits. METHODS: A prospective observational study was conducted with board-certified physical therapists. A qualitative questionnaire was used to gather physical therapists' demographics and the recommended number of physical therapy visits to achieve a full recovery after 11 common orthopedic diagnoses. Physical therapists also were asked to report whether they believe that insurance provides an adequate number of visits overall. In addition to the qualitative survey, insurance coverage details of major Alabama companies were obtained for comparison. Descriptive statistics of the participating therapists were analyzed for sex, age, degree/training, and years of experience. Kruskal-Wallis statistics were used to analyze variance between the aforementioned groupings when compared with the reported average number of sessions. RESULTS: The survey (N = 251) collected data on the average number of physical therapy sessions that are necessary for a complete recovery as recommended by physical therapists for 11 common orthopedic diagnoses. From this survey, the average number of necessary visits ranged from 11.3 visits (ankle sprains) to 37.3 visits (anterior cruciate ligament reconstruction), with the overall average number of visits being 23.8. Only 24% of physical therapists believed that insurance companies provided enough coverage. Insurance coverage varied but often required additional procedures to allocate the adequate number of visits for the studied orthopedic pathologies. CONCLUSIONS: The majority of practicing physical therapists in Alabama perceive insufficient insurance coverage for physical therapy visits for most orthopedic diagnoses. This study has implications for healthcare decision making and patient-centered rehabilitation goals. Physicians and physical therapists can use this information to optimize treatment decisions and rehabilitation goals. Patients will benefit from improved physical and economic well-being. This study has the potential to drive further research and influence national insurance policies to better serve patients' needs.

Community service rehabilitation therapists' understanding of social accountability.

BACKGROUND:  Social accountability is the obligation of health care providers to address the priority health concerns of the community they serve and of universities to ensure that graduates understand these social responsibilities. Although social accountability can combat systemic health inefficiencies, it is not well-understood or practised. AIM:  The study aimed to explore community service rehabilitation therapists' understanding of social accountability. SETTING:  The study was conducted in KwaZulu-Natal, South Africa. METHODS:  This study used an interpretive exploratory design and purposively recruited 27 community service rehabilitation therapists namely, audiologists, speech-language therapists, occupational therapists, and physiotherapists working in public sector health facilities in rural and peri-urban areas. Four focus group discussions and four free attitude interviews were conducted, the results being thematically analysed. RESULTS:  Despite most of the participants not being instructed in social accountability as part of their formal training or institutional induction, three themes emerged based on their experiences. These themes include describing social accountability, values of social accountability, and values of community-based rehabilitation applicable to social accountability. CONCLUSION:  Inclusion of instruction on social accountability as part of their formal training and health facility induction would contribute to rehabilitation therapists' understanding of social accountability.Contribution: The study contributes to data on rehabilitation education and community service training regarding social accountability within a South African context and has captured how experiences gained during community service contribute to the rehabilitation therapists' understanding of social accountability.

Guideline-based exercise management for hip and knee osteoarthritis: a cross-sectional comparison of healthcare professional and patient beliefs in Ireland.

OBJECTIVES: To identify within-stakeholder agreement and between-stakeholder differences in beliefs regarding exercise for osteoarthritis among general practitioners (GPs), physiotherapists (PTs) and people with hip and knee osteoarthritis (PwOA). A secondary objective was to explore the association between referral patterns and beliefs of PwOA. DESIGN: Cross-sectional. SETTING: Online surveys administered to GPs, PTs and PwOA in Ireland via social media and healthcare networks. PARTICIPANTS: 421 valid responses (n=161 GPs, n=163 PTs, n=97 PwOA). PRIMARY AND SECONDARY OUTCOME MEASURES: Nine belief statements related to exercise effectiveness, safety and delivery were rated on a 5-point Likert scale and analysed for within-stakeholder consensus. χ2 tests assessed differences in agreement between groups. Multivariable linear regression models tested associations between beliefs in PwOA and referral to/attendance at physiotherapy. RESULTS: Positive within-stakeholder consensus (>75% agreement) was reached for most statements (7/9 GPs, 6/9 PTs, 5/9 PwOA). However, beliefs of PwOA were significantly less positive compared with healthcare professionals for six statements. All stakeholders disagreed that exercise is effective regardless of the level of pain. Attendance at physiotherapy (49% of PwOA), rather than referral to physiotherapy from a GP only, was associated with positive exercise beliefs for PwOA (ß=0.287 (95% CI 0.299 to 1.821)). CONCLUSIONS: Beliefs about exercise therapy for osteoarthritis are predominantly positive across all stakeholders, although less positive in PwOA. PwOA are more likely to have positive beliefs if they have seen a PT for their osteoarthritis. Knowledge translation should highlight the effectiveness of exercise for all levels of pain and osteoarthritis disease.

Physiotherapists' attitudes and beliefs in the management of low back pain: Protocol for a systematic review.

BACKGROUND: Low back pain (LBP) poses a significant global health burden where a biopsychosocial model of care has been recommended. Physiotherapists (PTs) play a crucial role in LBP management; however, their attitudes and beliefs towards LBP were not reviewed in detail. OBJECTIVE: This systematic review aims to summarise the attitudes and beliefs of PTs towards LBP and the factors influencing them. METHODS: The review protocol and methods adhere to the PRISMA-P and Meta Analyses and Systematic Reviews for Observational Studies in Epidemiology (MOOSE) guidelines. A comprehensive search of PubMed, Scopus, CINAHL, Web of Science, PEDro and Ovid databases will be conducted to search for cross-sectional studies evaluating PTs' attitudes and beliefs towards LBP. Two reviewers will independently screen the articles, conduct data extraction and assess methodological quality using the Joanna Briggs Institute's critical appraisal tool for prevalence studies. Data synthesis will involve a narrative synthesis of study characteristics, attitudes, beliefs, and methodological quality. If feasible, a meta-analysis will be performed to quantify the pooled effects. CONCLUSION: Despite the emphasis on biopsychosocial approaches for managing LBP, the adoption of such approaches in physiotherapy practice is still suboptimal, with attitudes and beliefs of PTs being considered an important factor influencing treatment practices. Our review will summarise the literature on attitudes and beliefs of PTs towards LBP. Such knowledge would inform the need for development of additional interventions addressing the attitudes and beliefs that would eventually enhance the update of the biopsychosocial model of care in physiotherapy management of LBP.

Identifying the risk of exercises, recommended by an artificial intelligence for patients with musculoskeletal disorders.

Musculoskeletal disorders (MSDs) impact people globally, cause occupational illness and reduce productivity. Exercise therapy is the gold standard treatment for MSDs and can be provided by physiotherapists and/or also via mobile apps. Apart from the obvious differences between physiotherapists and mobile apps regarding communication, empathy and physical touch, mobile apps potentially offer less personalized exercises. The use of artificial intelligence (AI) may overcome this issue by processing different pain parameters, comorbidities and patient-specific lifestyle factors and thereby enabling individually adapted exercise therapy. The aim of this study is to investigate the risks of AI-recommended strength, mobility and release exercises for people with MSDs, using physiotherapist risk assessment and retrospective consideration of patient feedback on risk and non-risk exercises. 80 patients with various MSDs received exercise recommendations from the AI-system. Physiotherapists rated exercises as risk or non-risk, based on patient information, e.g. pain intensity (NRS), pain quality, pain location, work type. The analysis of physiotherapists' agreement was based on the frequencies of mentioned risk, the percentage distribution and the Fleiss- or Cohens-Kappa. After completion of the exercises, the patients provided feedback for each exercise on an 11-point Likert scale., e.g. the feedback question for release exercises was "How did the stretch feel to you?" with the answer options ranging from "painful (0 points)" to "not noticeable (10 points)". The statistical analysis was carried out separately for the three types of exercises. For this, an independent t-test was performed. 20 physiotherapists assessed 80 patient examples, receiving a total of 944 exercises. In a three-way agreement of the physiotherapists, 0.08% of the exercises were judged as having a potential risk of increasing patients' pain. The evaluation showed 90.5% agreement, that exercises had no risk. Exercises that were considered by physiotherapists to be potentially risky for patients also received lower feedback ratings from patients. For the 'release' exercise type, risk exercises received lower feedback, indicating that the patient felt more pain (risk: 4.65 (1.88), non-risk: 5.56 (1.88)). The study shows that AI can recommend almost risk-free exercises for patients with MSDs, which is an effective way to create individualized exercise plans without putting patients at risk for higher pain intensity or discomfort. In addition, the study shows significant agreement between physiotherapists in the risk assessment of AI-recommended exercises and highlights the importance of considering individual patient perspectives for treatment planning. The extent to which other aspects of face-to-face physiotherapy, such as communication and education, provide additional benefits beyond the individualization of exercises compared to AI and app-based exercises should be further investigated.Trial registration: 30.12.2021 via OSF Registries, https://doi.org/10.17605/OSF.IO/YCNJQ .

Exploring needs and requirements for a prototype device measuring physical activity in pediatric physical therapy: A qualitative study.

AIMS: To analyze needs and requirements of Pediatric Physical Therapists (PPTs), parents, children and adolescents with and without developmental disabilities in the future use of an activity monitor prototype (AM-p) in everyday clinical practice. METHODS: Qualitative exploratory study with a thematic analysis approach, based on Braun and Clarke's six steps. Codes derived from the analysis and central themes were collated, based on Fleuren et al.'s groupings of determinants. RESULTS: We interviewed 25 PPTs, 12 parents, and 12 children and adolescents. Within four groupings of determinants, we found nine themes: 1) development of information materials; 2) application: output visualization and ease of use; 3) design; 4) relevance and acceptance; 5) shared decision-making; 6) compatibility in daily living; 7) finances, 8) time, and 9) legislation and regulations. CONCLUSIONS: End-users have similar basic needs, with individual fine-tuning to be addressed during further development of the AM-p. A child-friendly design, information material, and an easy-to-use application to read and interpret results, need to be developed. Efficient training for PPTs is important for the use of the AM-p and analysis of results. Communication between PPTs and children as well as parents enhances shared decision-making. We recommend involving diverse end-users to enable maximum customization of the AM-p.

Spinal manipulation and mobilisation in paediatrics - an international evidence-based position statement for physiotherapists.

INTRODUCTION: An international taskforce of clinician-scientists was formed by specialty groups of World Physiotherapy - International Federation of Orthopaedic Manipulative Physical Therapists (IFOMPT) & International Organisation of Physiotherapists in Paediatrics (IOPTP) - to develop evidence-based practice position statements directing physiotherapists clinical reasoning for the safe and effective use of spinal manipulation and mobilisation for paediatric populations (<18 years) with varied musculoskeletal or non-musculoskeletal conditions. METHOD: A three-stage guideline process using validated methodology was completed: 1. Literature review stage (one scoping review, two reviews exploring psychometric properties); 2. Delphi stage (one 3-Round expert Delphi survey); and 3. Refinement stage (evidence-to-decision summative analysis, position statement development, evidence gap map analyses, and multilayer review processes). RESULTS: Evidence-based practice position statements were developed to guide the appropriate use of spinal manipulation and mobilisation for paediatric populations. All were predicated on clinicians using biopsychosocial clinical reasoning to determine when the intervention is appropriate.1. It is not recommended to perform:• Spinal manipulation and mobilisation on infants.• Cervical and lumbar spine manipulation on children.•Spinal manipulation and mobilisation on infants, children, and adolescents for non-musculoskeletal paediatric conditions including asthma, attention deficit hyperactivity disorder, autism spectrum disorder, breastfeeding difficulties, cerebral palsy, infantile colic, nocturnal enuresis, and otitis media.2. It may be appropriate to treat musculoskeletal conditions including spinal mobility impairments associated with neck-back pain and neck pain with headache utilising:• Spinal mobilisation and manipulation on adolescents;• Spinal mobilisation on children; or• Thoracic manipulation on children for neck-back pain only.3. No high certainty evidence to recommend these interventions was available.Reports of mild to severe harms exist; however, risk rates could not be determined. CONCLUSION: Specific directives to guide physiotherapists' clinical reasoning on the appropriate use of spinal manipulation or mobilisation were identified. Future research should focus on trials for priority conditions (neck-back pain) in children and adolescents, psychometric properties of key outcome measures, knowledge translation, and harms.

Physiotherapists' adherence to Clinical Practice Guidelines in fibromyalgia: a cross-sectional online survey.

To evaluate the level of knowledge and adherence to Clinical Practice Guidelines on fibromyalgia of physiotherapists in Spain. A cross-sectional study using an ad-hoc online survey was implemented to assess aspects on the assessment, treatment, and decision of the length of the therapeutic approach on fibromyalgia. Based on the results, professionals were classified as adherent, partially adherent, or non-adherent. The level of agreement with several statements on the condition was also evaluated across the professionals surveyed to evaluate the potential consensus. A total of 240 physiotherapists met inclusion criteria, amongst which 68 (28.33%) were adherent. The academic level of studies (Chi-square = 48.601, p-value = 0.001) and having had previous training in fibromyalgia (Chi-square = 151.011, p-value = 0.001) displayed statistically significant differences across adherence-based groups. Consensus was reached for 15 out of 24 statements. Our findings highlight the presence of an acceptable level of knowledge and adherence to clinical practice guidelines in the field of fibromyalgia among physiotherapists in Spain.Practice implicationsOur results also reveal the existence of an evidence-to-practice gap in the field, with potential room for improvement: further efforts on promoting and reinforcing the importance of evidence-based therapies are needed, from university teaching plans to clinical updates for daily practice.

Brazilian classification of physical therapy diagnosis.

BACKGROUND: The Brazilian Classification of Physical Therapy Diagnosis, developed by the Federal Council of Physiotherapy and Occupational Therapy (COFFITO), has the constitutional objectives of standardizing ethical, scientific and social aspects of the Physical Therapy profession. OBJECTIVE: To describe the work process, rationale and proposal for standardization of a physical therapy diagnosis classification system in Brazil. METHODS: A working group was created to propose a standardized classification for the description and codification of physical therapy diagnoses. Some terminologies common to the International Classification of Functioning (ICF) were used to make the nomenclature of diagnoses compatible with the outcomes inherent in the field of physical therapy. RESULTS: The Brazilian Classification of Physical Therapy Diagnosis project culminated in a physical therapy diagnosis model consisting of terms grouped by organic systems and identifying codes. In addition, an application was developed to allow professionals to use the standardized diagnostic classification in an online system. CONCLUSION: The diagnostic classification system is expected to advance the Physical Therapy profession allowing the identification of structural and/or functional alterations in a simplified and standardised manner. From a physical therapy perspective, this classification may help to consolidate the autonomy of the Brazilian physical therapists by establishing a clearer pathway between the diagnosis and interventions.

Use of cervical traction for managing neck pain: A cross-sectional survey of physiotherapists in India.

BACKGROUND: Neck pain remains the fourth leading cause of disability and work loss, and a multimodal treatment approach is effective in reducing neck pain and disability. PURPOSE: The purpose of this study is to examine the use of cervical traction for managing neck pain by Physiotherapists in India, including how and when the traction is used, the modes and parameters of traction, any additional interventions given with traction, and the influence of professional demographic characteristics in decision making in traction usage. STUDY DESIGN: A cross-sectional survey. METHODOLOGY: A random sample of approximately 2500 musculoskeletal physiotherapists was surveyed, and the data was presented in a descriptive form. Chi-square analyses were used to identify the association between responders' qualifications and traction usage. RESULTS: From the total physiotherapist approached 18.52% (n = 463) responses were obtained, and 62% (n = 287) respondents reported that they would use traction in their clinical practice. Out of 92.3% of responders indicated using traction for radiculopathy, 78.7% of respondents used traction for patients with neck pain without radiculopathy. It is used as a combination therapy by 58.8% for radiculopathy and 52.2% for stiffness. There was no association between the responder's qualification and traction usage (χ2 = 0.707, p = 0.40). Traction is used in combination with other physiotherapeutic techniques. CONCLUSION: Traction use was consistent with the proposed criteria identifying patients likely to benefit. However, disregarding current guidelines, physiotherapists also use traction for non-radicular neck pain. Various traction delivery modes and parameters were used within a comprehensive plan of care incorporating multiple interventions.

Satisfactory adherence to the Dutch physical therapy guideline for patients with a total knee arthroplasty. A survey study involving 103 specialised physical therapists.

OBJECTIVE: To explore and gain more insight into the usual preoperative and postoperative physical therapy (PT) treatment of patients with a total knee arthroplasty (TKA) among Dutch physical therapists experienced with TKA rehabilitation. Secondly, to evaluate physical therapists' adherence to guideline recommendations for postoperative rehabilitation. METHODS: In this cross-sectional study, physical therapists working in primary care within a designated Dutch hospital's catchment area were surveyed online. The survey queried PT treatment approaches before surgery, during hospitalisation, and after surgery. All data were analysed descriptively. When both education and all recommended exercise modalities were used postoperatively, therapists were considered fully adherent with the Dutch clinical practice guideline. RESULTS: One hundred and three therapists participated, representing a response rate of 58%. Postoperative PT treatment was applied by all therapists, of which 65 (63.1%) were fully adherent to the guideline. Partial adherence was mainly due to not using the aerobic exercise modality. Furthermore, beyond the modalities recommended in the guideline, a range of PT interventions were used. Preoperative treatment was applied by 73 therapists (70.9%). These 73 indicated that only a median of 20% (IQR 10%-40%) of their patients received preoperative PT. CONCLUSIONS: This study revealed satisfactory adherence to guideline recommendations on postoperative management of patients with a TKA among experienced physical therapists. Aerobic exercises were utilised less often or with inappropriate intensity. Correct adherence to guideline recommendations on aerobic exercise training can result in more physically active individuals and important general health benefits.

Cognitive behavioural interventions led by a physiotherapist in chronic non-specific low back pain: A systematic review and meta-analysis.

BACKGROUND: The effectiveness of physiotherapist-led Cognitive Behavioural Interventions (CBI) with or without physiotherapy is still unclear. OBJECTIVE: This systematic review (PROSPERO registration number CRD42022321073) aims to determine the effectiveness of physiotherapist-led CBI with or without physiotherapy in comparison to physiotherapy alone on quality of life, disabilities and catastrophization. METHODS: MEDLINE, Web of Science, Science Direct, and PEDro were searched for randomized controlled trials that investigate the use of CBI versus conventional physiotherapy in chronic NSLBP. To be included CBI had to be performed by a physiotherapist. The primary and secondary outcomes were respectively quality of life and disability. RESULTS: Fourteen studies were included in qualitative analysis, in which 4 did not meet the PEDro score of 6 or higher. Pooled standardized mean differences from 3 studies showed no difference in quality of life between groups for mental and physical sub-scores at 3 months (SMD 0.02, 95% CI -0.17 to 0.21 and SMD 0.07, 95% CI -0.12 to 0.26 respectively). Pooled standardized mean differences from 9 studies showed no difference in disability between groups at 3, 6 and 12 months (SMD = - 0.40, CI 95% -0.80 to 0.01; SMD -0.18, CI 95% = -0.41 to 0.05; and SMD -0.24, CI 95% = -0.48 to 0.00 respectively). CONCLUSION: Results of CBI, especially cognitive functional therapy, seem promising in disability management despite a substantial heterogeneity. Furthermore, we found no difference in quality of life.

Non-surgical management of posterior tibial tendon dysfunction- a UK survey.

BACKGROUND: Posterior Tibial Tendon Dysfunction (PTTD) is commonly seen within musculoskeletal care. The condition's prevalence and management is poorly understood. This study aims to demonstrate current practice by multi-professional clinicians across the United Kingdom within the National Health Service. METHODS: A national (UK) cross-sectional online survey was conducted among multi-professionals who treat PTTD within their NHS practice. The survey covered assessment, management and evaluation. This was shared via social media and professional groups. RESULTS: Two hundred thirteen surveys were completed, with 153 matching the eligibility criteria. The main respondents were Physiotherapists (48%) and Podiatrists (38%). Ultrasound scanning was used most frequently when considering initial imaging (67%). Many different treatment modalities were used, but a core set of education/advice, foot orthoses, and foot specific as well as general exercise were most commonly chosen. Outcome measures routinely used were pain scale (96/269) and single leg heel raise (84/269), but patient reported outcome measures were not routinely used. The most frequent reason to escalate care was failure to manage symptoms with conservative management (106/123; 86.2%), followed by fixed deformity (10/123; 8.2%). CONCLUSIONS: This survey provides evidence on current non-surgical management for PTTD from UK NHS practice. It provides a valuable marker for clinicians to use to compare their own practice and can be used in further research as a comparator.

Large language models in physical therapy: time to adapt and adept.

Healthcare is experiencing a transformative phase, with artificial intelligence (AI) and machine learning (ML). Physical therapists (PTs) stand on the brink of a paradigm shift in education, practice, and research. Rather than visualizing AI as a threat, it presents an opportunity to revolutionize. This paper examines how large language models (LLMs), such as ChatGPT and BioMedLM, driven by deep ML can offer human-like performance but face challenges in accuracy due to vast data in PT and rehabilitation practice. PTs can benefit by developing and training an LLM specifically for streamlining administrative tasks, connecting globally, and customizing treatments using LLMs. However, human touch and creativity remain invaluable. This paper urges PTs to engage in learning and shaping AI models by highlighting the need for ethical use and human supervision to address potential biases. Embracing AI as a contributor, and not just a user, is crucial by integrating AI, fostering collaboration for a future in which AI enriches the PT field provided data accuracy, and the challenges associated with feeding the AI model are sensitively addressed.

Changes in rehabilitation students' clinical placement and clinical competence at graduation during the COVID-19 pandemic: A pilot study.

BACKGROUND: The COVID-19 pandemic has affected physical and occupational therapist education in various ways. OBJECTIVE: This study investigated whether the pandemic changed clinical placement, thus influencing the clinical competence of physical and occupational therapists at a hospital in Japan. METHODS: Eleven therapists (seven physical and four occupational) participated in this study in April 2021. Clinical placement teaching methods were surveyed using an online questionnaire. The Objective Structured Clinical Examination (OSCE), comprising attitudinal and technical items, was used to examine clinical competence. The results were calculated as the sum of the attitudinal and technical scores, and the ratios of these scores to the full score were compared using a paired-sample Wilcoxon signed-rank test. RESULTS: During the pandemic, some schools implemented shortened practical clinical placements. The substituted classes included online-only classes and combined online and face-to-face classes. Regarding clinical competence, scores on the OSCE were mostly high. The median proportion of the total attitudinal score to the perfect score was 100% for all three items (range-of-motion test, muscle strength test, Stroke Impairment Assessment Set). The median proportion of the total technical score to the perfect score ranged from 56.7% to 76.7% for the three items. The ratio of the total attitudinal score to the full score was significantly higher than that of the total technical score to the full score (p = 0.001). CONCLUSIONS: Most clinical placements were canceled or partially administered through online learning during the pandemic. This decrease in clinical placements did not affect newly recruited physical and occupational therapists' clinical competence.

Clinical Education Data Management: Current Landscape in Entry-Level Physical Therapist Education.

BACKGROUND: Data management (DM) systems represent an opportunity for innovation in education and data-driven decision-making (DDDM) in allied health education. Understanding clinical education (CE) DM systems in entry-level physical therapy (PT) education programs could provide valuable insight into structure and operation and may represent opportunities to address CE challenges. The purpose of this study is to describe how PT programs are using CE DM systems to inform recommendations for CE DM and support knowledge sharing and DDDM. SUBJECTS: CE faculty and administrators were recruited from entry-level PT education programs to participate in a cross-sectional survey. METHODS: The authors designed a novel survey which included demographics and use of CE DM systems. Descriptive statistics and content analysis of narrative data were used to examine responses. RESULTS: The survey was distributed to 220 academic PT programs in June 2021 with 111 respondents (50% response rate). Respondents use multiple systems to complete CE tasks (e.g., placement process, on-boarding, agreement tracking, as a CE site database). Forty-three percent (n=47) use one system, 76% (n=35) of those use the same Software as a Service vendor. Eighty-six percent (n=96) are satisfied with their current CE DM system. Respondents enter data related to CE site information, CE environment, length of the CE experience, and accreditation-required clinical instructor information. Ninety-four percent (n=93) and 70% (n=70) extract data to make decisions about the placement process and curriculum, respectively. CONCLUSION: While variability across CE DM systems presents a challenge, survey respondents indicated common practices related to functionality, data entry, and extraction. Clinical education DM systems house critical data to address challenges in CE. Strategies to improve accessibility and use of this data to support DDDM should be explored.

Best Practices in Clinical Education: A Site Visit Decision-Making Model in Physical Therapist Education.

Stakeholders in health science education engage in site visits during student clinical education experiences, which may occur in person or remotely via videoconference, telephone, or email. Significant variability in practice highlights the need for a more consistent approach to conducting site visits based on evidence-based best practices. Site visits can be burdensome to both clinical and academic stakeholders considering the significant time and resources needed to conduct them effectively. Despite these obstacles, site visits have been shown to add value to the clinical experience for all parties involved. This paper presents the available literature in health science education regarding clinical site visits and describes how it was used to develop and implement a model of best practice for conducting clinical site visits in physical therapist education. The Site Visit Decision-Making Model is based upon findings from contemporary research exploring the interests of each stakeholder, as well as the multifaceted and purposeful decision-making process that takes place when conducting site visits in physical therapist clinical education. Implementation of this model may assist academic stakeholders in health science education in prioritizing which methods of communication for conducting site visits are most effective and efficient.

The supply and demand for rehabilitation health workforce in Saudi Arabia.

Background: Adequate supply of rehabilitation health workforce is a prerequisite for enhancing access to rehabilitation care. However, there is a lack of comprehensive data regarding the supply of rehabilitation health workers in Saudi Arabia. Aims: To determine the need for, and supply of, rehabilitation workforce, and investigate the relationship between rehabilitation workforce supply and rehabilitation needs in Saudi Arabia. Methodology: This cross-sectional study measured the ratio of physiotherapists and occupational therapists per 10 000 population. Data were obtained from the Ministry of Health, family health survey and census data of the General Authority for Statistics and published literature. To assess the need for rehabilitation services, we computed a composite disability index based on 3 variables: count of individuals with physical disabilities, those with chronic diseases, and those aged > 65 years. Determinants of the supply potential were population size, rural population percentage, and physician supply. Data were analysed using descriptive statistics and simple linear regression. Results: The ratios of physiotherapists and occupational therapists working at the Ministry of Health facilities were 0.69 and 0.03 per 10 000 population, respectively. Overall rehabilitation health workforce ratio was 0.73 per 10 000. Supply varied across regions, from 0.4 for Riyadh to 2.5 for Al Jouf. Nine regions exceeded the overall ratio. Rehabilitation need index ranged from 0.144 in Najran to 0.212 in Aseer. No significant associations were found between rehabilitation workforce supply on one hand, and need and other potential determinants on the other hand. Conclusion: The rehabilitation workforce supply in Saudi Arabia surpassed the regional and global averages, but was lower than the average for high-income countries. Workforce distribution varied by region across the country and was not related to need. It is important to consider the need for rehabilitation services and context-specific factors when determining the optimal size and distribution of the rehabilitation health workforce in Saudi Arabia.

Patients presenting with musculoskeletal disorders in the emergency department: A qualitative study of their experiences when cared by advanced practice physiotherapists in the province of Québec.

BACKGROUND: Advanced practice physiotherapy (APP) models of care are promising to alleviate pressure in emergency departments (EDs) where physiotherapists' new roles include being a first-contact practitioner and leading the overall care and management of patients with minor musculoskeletal disorders (MSKDs) to alleviate ED physicians' caseload. PURPOSE: To explore patients' acceptability, experience, satisfaction, and perception of a new APP-led model of care in the ED. METHODS: Patients presenting to the ED with a minor MSKD and who agreed to participate in a multicenter, pan-Canadian randomized controlled trial assessing the efficacy and costs of an APP model of care were invited to participate in this qualitative study. Semi-structured interviews were performed to identify themes related to their experiences with this model. Verbatim transcripts were coded and analysed using an inductive thematic analysis. RESULTS: 11 patients participated and three themes were identified: 1- They were satisfied with the care received within the model; 2- They found APPs to have the appropriate skill set to manage MSKDs and to assume medical-delegated tasks; 3- Timely access to care was a key factor in the acceptability of this model and participants believed physiotherapists were appropriate first-contact practitioners. One participant proposed that the APP model of care should also offer follow-up care. CONCLUSION: Participants had a positive experience of care in this new model. These results support the implementation of APP models of care in EDs as the participants appear receptive to new roles for APPs.