| 1. |
- Elvén, Maria, 1973-, et al.
(författare)
-
Assessing clinical reasoning in physical therapy : discriminative validity of the Reasoning 4 Change instrument
- 2022
-
Ingår i: Physiotherapy. - : Elsevier BV. - 0031-9406 .- 1873-1465. ; 117, s. 8-15
-
Tidskriftsartikel (refereegranskat)abstract
- Objectives: To evaluate discriminative validity of the Reasoning 4 Change (R4C) instrument by investigating differences in clinical reasoning skills between first semester, final semester physical therapy students and physical therapy experts.Design:Cross-sectional designSetting: University and physical therapy practiceParticipantsStudents from the first (n = 87) and final semester (n = 47) of an entry-level physical therapy program and experts in physical therapy with a behavioral medicine approach (n = 14).Methods: The students and experts answered the web-based R4C instrument on one occasion. The R4C instrument includes four domains designed to assess physical therapists’ clinical reasoning skills with a focus on supporting clients’ behavior change and has demonstrated acceptable content validity, convergent validity and reliability. Data was analyzed with one-way analysis of variance and Games-Howell post hoc test.Results: Differences in all domains and subscale scores were found between the three groups. Pairwise comparisons demonstrated that experts scored higher (better clinical reasoning skills) than first semester students in all domains and subscales; and higher scores than final semester students, except for two subscales. Final semester students scored higher than first semester students, except for one subscale.Conclusions: The findings highlight differences in clinical reasoning skills focusing on clients’ behavior change among physical therapy students with different degrees of training and education in clinical reasoning and physical therapists with extensive experience and expertise. The results provide evidence for the discriminative validity of the R4C instrument which support the use of the R4C instrument in education, research and clinical practice.
|
|
| 2. |
- Fritz, Johanna, et al.
(författare)
-
Do Physical Therapists Practice a Behavioral Medicine Approach? : A Comparison of Perceived and Observed Practice Behaviors
- 2023
-
Ingår i: Physical Therapy. - : NLM (Medline). - 0031-9023 .- 1538-6724. ; 103:5
-
Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVE: A behavioral medicine approach, incorporating a biopsychosocial view and behavior change techniques, is recommended in physical therapy for the management of musculoskeletal pain. However, little is known about physical therapists' actual practice behavior regarding the behavioral medicine approach. The aim of this study was to examine how physical therapists in primary health care judge their own practice behavior of a behavioral medicine approach in the assessment and treatment of patients with persistent musculoskeletal pain versus how they practice a behavioral medicine approach as observed by independent experts in video recordings of patient consultations. METHODS: A prospective cohort study was conducted. Video recordings of 23 physical therapists' clinical behavior in 139 patient consultations were observed by independent experts and compared with the physical therapists' self-reported practice behavior, using a protocol including 24 clinical behaviors. The difference between observed and self-reported clinical behaviors was analyzed with a Chi-square test and a Fisher exact test. RESULTS: The behavioral medicine approach was, in general, practiced to a small extent and half of the self-reported clinical behaviors were overestimated when compared with the observed behaviors. According to the observations, the physical perspective dominated in assessment and treatment, the functional behavioral analysis was never performed, and the mean number of behavior change techniques used was 0.7. CONCLUSION: There was a discrepancy between how physical therapists perceived the extent to which they practiced a behavioral medicine approach in their clinical behavior compared with what the independent researchers observed in the video recordings. IMPACT: This study demonstrates the importance of using observations instead of using self-reports when evaluating professionals' clinical behavior. The results also suggest that-to ensure that physical therapy integrates the biopsychosocial model of health-physical therapists need to increase their focus on psychosocial factors in clinical practice.
|
|
| 3. |
- Sandborgh, Maria, 1955-, et al.
(författare)
-
Integration of Behavioral Medicine Competencies into Physical Therapy Curriculum in an Exemplary Swedish Program : Rationale, Process and Ten-year Review
- 2020
-
Ingår i: Physiotherapy Theory and Practice. - Philadelphia : Taylor & Francis. - 0959-3985 .- 1532-5040. ; 36:3, s. 365-377
-
Forskningsöversikt (refereegranskat)abstract
- In 2004, Mälardalen University, Sweden, introduced a new undergraduate entry-level physiotherapy program. Program developers constructed the curriculum with behavioral medicine content that reflected the contemporary definition and values of the physiotherapy profession aligning it with current best practices, evidence, and the International Classification of Functioning, Disability, and Health (ICF). The new curriculum conceptualized movement and function as modifiable behaviors in that they reflect behavioral contingencies, perceptions, beliefs, and lifestyle factors as well as pathophysiology and environmental factors. The purpose of this article is to describe how one university accordingly structured its new curriculum and its review. We describe the rationale for the curriculum's behavioral medicinecontent and competencies, its development and implementation, challenges, long-term outcomes, and its related research enterprise. We conclude that physiotherapy practiced by our graduates augments that taught in other programs based on accreditation reviews. With their expanded practice scope, graduates are systematically practicing within the constructs of health and function conceptualized within the ICF. Our intent in sharing our experience is to exemplify one university's initiative to best prepare students with respect to maximizing physiotherapy outcomes as well as establish a dialogue regarding minimum standards of behavioral medicine competencies in physiotherapy education and practice.
|
|
| 4. |
|
|
