Abstract
BackgroundPhysical therapists increasingly provide direct access services to patients with musculoskeletal conditions, and growing evidence supports the cost-effectiveness of this mode of healthcare delivery. However, further evidence is needed to determine if physical therapists have the requisite knowledge necessary to manage musculoskeletal conditions. Therefore, the purpose of this study was to describe physical therapists' knowledge in managing musculoskeletal conditions.MethodsThis study utilized a cross-sectional design in which 174 physical therapist students from randomly selected educational programs and 182 experienced physical therapists completed a standardized examination assessing knowledge in managing musculoskeletal conditions. This same examination has been previously been used to assess knowledge in musculoskeletal medicine among medical students, physician interns and residents, and across a variety of physician specialties.ResultsExperienced physical therapists had higher levels of knowledge in managing musculoskeletal conditions than medical students, physician interns and residents, and all physician specialists except for orthopaedists. Physical therapist students enrolled in doctoral degree educational programs achieved significantly higher scores than their peers enrolled in master's degree programs. Furthermore, experienced physical therapists who were board-certified in orthopaedic or sports physical therapy achieved significantly higher scores and passing rates than their non board-certified colleagues.ConclusionThe results of this study may have implications for health and public policy decisions regarding the suitability of utilizing physical therapists to provide direct access care for patients with musculoskeletal conditions.
Highlights
Physical therapists increasingly provide direct access services to patients with musculoskeletal conditions, and growing evidence supports the cost-effectiveness of this mode of healthcare delivery
Its de-emphasis in medical school curricula has been repeatedly implicated,[1,5,7,8,9] almost half of American medical schools still do not require any formal training in musculoskeletal medicine[10]
This trend may seem somewhat intuitive since topics related to managing musculoskeletal conditions are emphasized in physical therapy curricula
Summary
Physical therapists increasingly provide direct access services to patients with musculoskeletal conditions, and growing evidence supports the cost-effectiveness of this mode of healthcare delivery. Its de-emphasis in medical school curricula has been repeatedly implicated,[1,5,7,8,9] almost half of American medical schools still do not require any formal training in musculoskeletal medicine[10] This lack of confidence is reflected by poor performance on formal assessments of knowledge in musculoskeletal medicine[7] and less than optimal practice patterns for patients with musculoskeletal conditions[11]. The mean score was just under 60%, with only 18% of physicians scoring above a level determined orthopaedic program directors as the minimum threshold necessary to establish competency in musculoskeletal medicine in the primary care setting[7]. Matzkin et al[12] recently demonstrated similar suboptimal levels of knowledge in musculoskeletal medicine among medical students and residents. The authors concluded that training in both medical school and non-orthopaedic residency training programs was inadequate, a sentiment that has been echoed elsewhere[13]
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