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The relationship between clinical reasoning assessment in musculoskeletal physiotherapy and clinical placement
Abstracts / Manual Therapy 25 (2016) e57ee169
The good intersession reliability we obtained might be the previous step for doing in the future studies that look for changes in resting position after an OMT treatment. Funding Acknowledgements: Unfunded work Ethics Approval: Ethics Committee for Clinical Research of Aragon (CEICA) Disclosure of Interest: None Declared Keywords: Hip osteoarthritis, Physical therapy, Reliability Teaching, Learning and Professional Development PO4-AP-004 RESEARCH IN THE FIELD OF PHYSICAL THERAPY G. Bungartz*, L. Jaeger, B. Schulte-Frei. Hochschule Fresenius, Cologne, Germany * Corresponding author.
Background: Universities in many western countries offer professional degrees in the health care sector, such as physical therapy, nursing, and others. With education organized differently, some countries appear not to favor an academic education for the health care professions besides medicine. However, modifications of these, often-times, traditional systems is currently debated intensively. Purpose: This study aims to evaluate the development of research in the area of physical therapy (PT) to gain new perceptions about the effects of an academic versus non-academic education in this field. Methods: To achieve this we analyzed data on amount and quality of scientific publications from 1999 to 2014 using the SCImago database. Results: Our data show that globally the number of articles published in the 50 top PT-journals doubled from approximately 3000 papers in 1999 to 6000 in 2014. Comparable data from other medical fields demonstrate that the field of PT produces more articles and most importantly, that the velocity with which the rate of publications has been increasing is twice as high. As in other areas the rate of citations generated by a given article is used as a measure of impact (IF). In the field of PT this number increased fourfold within the last 15 years and bypassed other medical fields, such as anatomy. In addition to global developments we compared the contribution of selected western countries. Normalized to population the UK had the leading position before 1999 but lost its lead to Australia and Scandinavian countries and fell back to the midfield in 2014. Germany and France contributed the fewest research papers in the field of PT. Those countries ranked highest outperformed those on the bottom by approximately sevenfold. Interestingly, this performance in quantity is in line with the average rate of citations per article. To address the question whether this is a general or a PT-specific finding, i.e. whether there are systematic issues, such as language, etc. in Germany, we analyzed respective bibliographical data for different medical fields. These data located Germany within the range of other well performing countries in terms of quantity and quality. Conclusion: These data demonstrate an enormous dynamic and innovative potential of PT-related research. With the described developments being stable in last 15 years our data suggest a further increase in number and quality in the future. The low contribution of Germany to PT research appears to be specific for this field. Implications: At this time it can only be speculated about the reasons for the latter findings. However, the very recent onset of academic education of physical therapists in Germany might well play an important role, particularly as the most productive countries, such as Australia, have a long legacy of academically educated physical therapists. These results imply that it might be essential to reform the educaton system to ensure the best possible, evidence based therapeutic care for patients. Funding Acknowledgements: This work was not funded. Ethics Approval: No ethics approval required Disclosure of Interest: None Declared Keywords: Country ranking, Impact Factor, Research
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Teaching, Learning and Professional Development PO4-ED-029 THE RELATIONSHIP BETWEEN CLINICAL REASONING ASSESSMENT IN MUSCULOSKELETAL PHYSIOTHERAPY AND CLINICAL PLACEMENT J.-P. Dumas 1, *, J.-G. Blais 2, B. Charlin 2. 1 Universit e de Sherbrooke, e de Montreal, Montreal, Canada Sherbrooke, Canada; 2 Universit * Corresponding author.
Background: Clinical reasoning problem (CRP) is a relatively new test format that compares data interpretation (an important aspect of clinical reasoning) of clinical vignette by students with data interpretation of a reference panel. Even if similar format of the test has been used in medical and physiotherapy education, there is very little information about its validity. One possible aspect of the validation process of the test is to compare its results to the evaluation of clinical reasoning in authentic situations. Purpose: To compare the CRP results of three cohorts of entry-level physiotherapy students with the assessment of clinical reasoning during their clinical placements in musculoskeletal physiotherapy. Methods: The development of the physiotherapy CRP has been based on a table of specification from the content of a second year musculoskeletal de course of a four year (bachelor/master) program at the Universite Sherbrooke. Eight clinical vignettes that included 218 items has been developed. Each vignette involved different clinical decisions (diagnostic or intervention) and the interpretation of clinical data to reach those decisions. The scoring grid of the CRP test was constructed using an aggregated score based on the answers from a panel of 18 physiotherapists with expertise in musculoskeletal physiotherapy. Ninety-one physiotherapy students (2nd year ¼ 33, 3rd year ¼ 32, 4th year ¼ 26) voluntarily participated in this study. Internal consistency of the test was calculated with Cronbach’s alpha. Based on the results of the qualitative and quantitative information found in the clinical placements assessment tools for these students, their clinical reasoning performance has been classified in four categories (1: major difficulty in clinical reasoning; 2: minor difficulty in clinical reasoning; 3: according to the expected level of clinical reasoning; 4: above the expected level of clinical reasoning). One hundred and eighty three clinical placements assessment tools in musculoskeletal physiotherapy has been analysed. Results: The level of internal consistency (Cronbach alpha) was 0.88 for the CRP test. Mean score (CRP) for students (n ¼ 4) in category 1 was: 52.6 (SD 6.3); for students (n ¼ 10) in category 2: 56.1 (SD 6.1); for students (n ¼ 46) in category 3: 58.1 (SD 8.27) and 61.4 (SD 7.6) for students (n ¼ 24) in category 4 of clinical reasoning. Conclusion: Based on the result of this study, the CRP test results seem to be related the level of clinical reasoning seen during the clinical placement of physiotherapy students. Implications: The CRP test format could be a useful tool in physiotherapy education to help in the assessment of clinical data interpretation and potentially for the early screening of clinical reasoning difficulties of physiotherapy students. Funding Acknowledgements: This work was supported by the Universite de Sherbrooke start up research fund. pluriEthics Approval: Ethic approval was received form the Comite thique de la recherche de l’Universite de Montre al. facultaire d'e Disclosure of Interest: None Declared Keywords: Clinical reasoning, Assessment, Clinical placement Teaching, Learning and Professional Development PO4-LB-045 IMPACT OF AN E-LEARNING PROGRAMME ON THE BIOPSYCHOSOCIAL MODEL FOR NON-SPECIFIC LOW-BACK PAIN ON EXPERIENCED OSTEOPATHS' ATTITUDES TO BACK PAIN: A MIXED-METHODS STUDY J. Draper-Rodi 1, 2, S. Vogel 1, A. Bishop 2. 1 The British School of Osteopathy, London, United Kingdom; 2 Research Institute for Primary Care and Health, Sciences, Keele University, Keele, United Kingdom
The good intersession reliability we obtained might be the previous step for doing in the future studies that look for changes in resting position after an OMT treatment. Funding Acknowledgements: Unfunded work Ethics Approval: Ethics Committee for Clinical Research of Aragon (CEICA) Disclosure of Interest: None Declared Keywords: Hip osteoarthritis, Physical therapy, Reliability Teaching, Learning and Professional Development PO4-AP-004 RESEARCH IN THE FIELD OF PHYSICAL THERAPY G. Bungartz*, L. Jaeger, B. Schulte-Frei. Hochschule Fresenius, Cologne, Germany * Corresponding author.
Background: Universities in many western countries offer professional degrees in the health care sector, such as physical therapy, nursing, and others. With education organized differently, some countries appear not to favor an academic education for the health care professions besides medicine. However, modifications of these, often-times, traditional systems is currently debated intensively. Purpose: This study aims to evaluate the development of research in the area of physical therapy (PT) to gain new perceptions about the effects of an academic versus non-academic education in this field. Methods: To achieve this we analyzed data on amount and quality of scientific publications from 1999 to 2014 using the SCImago database. Results: Our data show that globally the number of articles published in the 50 top PT-journals doubled from approximately 3000 papers in 1999 to 6000 in 2014. Comparable data from other medical fields demonstrate that the field of PT produces more articles and most importantly, that the velocity with which the rate of publications has been increasing is twice as high. As in other areas the rate of citations generated by a given article is used as a measure of impact (IF). In the field of PT this number increased fourfold within the last 15 years and bypassed other medical fields, such as anatomy. In addition to global developments we compared the contribution of selected western countries. Normalized to population the UK had the leading position before 1999 but lost its lead to Australia and Scandinavian countries and fell back to the midfield in 2014. Germany and France contributed the fewest research papers in the field of PT. Those countries ranked highest outperformed those on the bottom by approximately sevenfold. Interestingly, this performance in quantity is in line with the average rate of citations per article. To address the question whether this is a general or a PT-specific finding, i.e. whether there are systematic issues, such as language, etc. in Germany, we analyzed respective bibliographical data for different medical fields. These data located Germany within the range of other well performing countries in terms of quantity and quality. Conclusion: These data demonstrate an enormous dynamic and innovative potential of PT-related research. With the described developments being stable in last 15 years our data suggest a further increase in number and quality in the future. The low contribution of Germany to PT research appears to be specific for this field. Implications: At this time it can only be speculated about the reasons for the latter findings. However, the very recent onset of academic education of physical therapists in Germany might well play an important role, particularly as the most productive countries, such as Australia, have a long legacy of academically educated physical therapists. These results imply that it might be essential to reform the educaton system to ensure the best possible, evidence based therapeutic care for patients. Funding Acknowledgements: This work was not funded. Ethics Approval: No ethics approval required Disclosure of Interest: None Declared Keywords: Country ranking, Impact Factor, Research
e167
Teaching, Learning and Professional Development PO4-ED-029 THE RELATIONSHIP BETWEEN CLINICAL REASONING ASSESSMENT IN MUSCULOSKELETAL PHYSIOTHERAPY AND CLINICAL PLACEMENT J.-P. Dumas 1, *, J.-G. Blais 2, B. Charlin 2. 1 Universit e de Sherbrooke, e de Montreal, Montreal, Canada Sherbrooke, Canada; 2 Universit * Corresponding author.
Background: Clinical reasoning problem (CRP) is a relatively new test format that compares data interpretation (an important aspect of clinical reasoning) of clinical vignette by students with data interpretation of a reference panel. Even if similar format of the test has been used in medical and physiotherapy education, there is very little information about its validity. One possible aspect of the validation process of the test is to compare its results to the evaluation of clinical reasoning in authentic situations. Purpose: To compare the CRP results of three cohorts of entry-level physiotherapy students with the assessment of clinical reasoning during their clinical placements in musculoskeletal physiotherapy. Methods: The development of the physiotherapy CRP has been based on a table of specification from the content of a second year musculoskeletal de course of a four year (bachelor/master) program at the Universite Sherbrooke. Eight clinical vignettes that included 218 items has been developed. Each vignette involved different clinical decisions (diagnostic or intervention) and the interpretation of clinical data to reach those decisions. The scoring grid of the CRP test was constructed using an aggregated score based on the answers from a panel of 18 physiotherapists with expertise in musculoskeletal physiotherapy. Ninety-one physiotherapy students (2nd year ¼ 33, 3rd year ¼ 32, 4th year ¼ 26) voluntarily participated in this study. Internal consistency of the test was calculated with Cronbach’s alpha. Based on the results of the qualitative and quantitative information found in the clinical placements assessment tools for these students, their clinical reasoning performance has been classified in four categories (1: major difficulty in clinical reasoning; 2: minor difficulty in clinical reasoning; 3: according to the expected level of clinical reasoning; 4: above the expected level of clinical reasoning). One hundred and eighty three clinical placements assessment tools in musculoskeletal physiotherapy has been analysed. Results: The level of internal consistency (Cronbach alpha) was 0.88 for the CRP test. Mean score (CRP) for students (n ¼ 4) in category 1 was: 52.6 (SD 6.3); for students (n ¼ 10) in category 2: 56.1 (SD 6.1); for students (n ¼ 46) in category 3: 58.1 (SD 8.27) and 61.4 (SD 7.6) for students (n ¼ 24) in category 4 of clinical reasoning. Conclusion: Based on the result of this study, the CRP test results seem to be related the level of clinical reasoning seen during the clinical placement of physiotherapy students. Implications: The CRP test format could be a useful tool in physiotherapy education to help in the assessment of clinical data interpretation and potentially for the early screening of clinical reasoning difficulties of physiotherapy students. Funding Acknowledgements: This work was supported by the Universite de Sherbrooke start up research fund. pluriEthics Approval: Ethic approval was received form the Comite thique de la recherche de l’Universite de Montre al. facultaire d'e Disclosure of Interest: None Declared Keywords: Clinical reasoning, Assessment, Clinical placement Teaching, Learning and Professional Development PO4-LB-045 IMPACT OF AN E-LEARNING PROGRAMME ON THE BIOPSYCHOSOCIAL MODEL FOR NON-SPECIFIC LOW-BACK PAIN ON EXPERIENCED OSTEOPATHS' ATTITUDES TO BACK PAIN: A MIXED-METHODS STUDY J. Draper-Rodi 1, 2, S. Vogel 1, A. Bishop 2. 1 The British School of Osteopathy, London, United Kingdom; 2 Research Institute for Primary Care and Health, Sciences, Keele University, Keele, United Kingdom