Effects of an Online Education Program on Physical Therapists' Confidence in Weight Management for People With Osteoarthritis: A Randomized Controlled Trial.

OBJECTIVE: To evaluate effects of an online education program about weight management for osteoarthritis on physical therapists' self-reported confidence in knowledge and skills in weight management and attitudes toward obesity. METHODS: In a 2-group randomized controlled trial, 80 physical therapists (58 female physical therapists) were randomized to education or control groups. The theoretically informed and evidence-informed online self-directed training program covered biopsychosocial elements of obesity and weight management. The primary outcome was self-reported confidence in knowledge in weight management using a customized validated tool (scale 14-70, higher scores indicating higher confidence) assessed at baseline and 6 weeks. Secondary measures included confidence in nutrition care, clinical skills in weight management, and weight stigma. Process measures evaluated participant experience. Differences in change between groups were compared using linear regression models adjusted for baseline scores and stratifying variables (clinical setting; confidence in weight management). Moderation analysis was performed using an interaction approach in a linear regression model and multivariable fractional polynomial interaction approach. RESULTS: A total of 79 participants (99%) completed outcome measures at 6 weeks. The education group demonstrated greater improvement in confidence in knowledge than the control group (adjusted mean difference 22.6 units, 95% confidence interval 19.6, 25.5). Greater improvement in knowledge was associated with lower baseline values (interaction P = 0.002). Secondary outcomes showed greater improvements in confidence in skills and nutrition care and in weight stigma domains favoring the education group. Over 90% of participants would recommend the program to peers. CONCLUSION: An online education program improves physical therapists' short-term confidence in knowledge and skills in weight management for people with osteoarthritis and reduces weight-stigmatized attitudes.

Development and validation of a written credentialing examination for overseas-educated dietitians.

AIM: Health professionals seeking employment in foreign countries are commonly required to undertake competency assessment in order to practice. The present study aims to outline the development and validation of a written examination for Dietetic Skills Recognition (DSR), to assess the knowledge, skills, capabilities and professional judgement of overseas-educated dietitians against the competency standards applied to dietetic graduates in Australia. METHODS: The present study reviews the design, rationale, validation and outcomes of a multiple choice question (MCQ) written examination for overseas-educated dietitians based on 5 years of administration. The validity of the exam is evaluated using Messick's validity framework, which focuses on five potential sources of validity evidence-content, internal structure, relationships with other variables, response process and consequences. The reference point for the exam pass mark or "cutscore" is the minimum standard required for safe practice. RESULTS: In total, 114 candidates have completed the MCQ examination at least once, with an overall pass rate of 52% on the first attempt. Pass rates are higher from countries where dietetic education more closely reflects the Australian model. While the pass rate for each exam tends to vary with each cohort, the cutscore has remained relatively stable over eight administrations. CONCLUSIONS: The findings provide important data supporting the validity of the MCQ exam. A more complete evaluation of the validity of the exam must be sought within the context of the whole DSR program of assessment. The DSR written component may serve as a model for use of the MCQ format for dietetic and other professional credentialing organisations.