Experiences Of Physiotherapists Research Articles

Physiotherapists may improve management of knee osteoarthritis through greater psychosocial focus, being proactive with advice, and offering longer-term reviews: a qualitative study.

What are the experiences of physiotherapists delivering care for people with knee osteoarthritis? How do these experiences align with the national Clinical Care Standard? A qualitative study using individual interviews. Twenty-two Australian physiotherapists (mean age 34 years, 50% female) with experience in providing care for people with knee osteoarthritis. Physiotherapists participated in semi-structured individual telephone interviews. Questions were informed by seven quality statements from the national Knee Osteoarthritis Clinical Care Standard. Thematic analysis was undertaken, with themes/subthemes inductively derived. Interview data were also deductively analysed according to the Clinical Care Standard. Five themes emerged. First, physiotherapists focused on biomedical assessment with little psychosocial consideration. They managed 'mechanical' aspects of knee osteoarthritis, aiming to restore functional ability. Second, physiotherapists' perceived their role as primarily providing goal-orientated personalised exercise via short-term episodic care. Knee surgery was considered a last option, but physiotherapists 'prepped' patients who decided on surgery. Third, clinical challenges included patient comorbidity, unsatisfactory patient adherence and a patient's desire for a 'quick fix'. The other two themes were: physiotherapists described a mismatch between what they know and what they do regarding imaging, weight management and manual therapy; and physiotherapists viewed weight loss, medication and surgical advice as outside of their professional role. Physiotherapists' reported experiences of delivering care for people with knee osteoarthritis were mostly consistent with the quality care standard. Care may be improved by increasing the focus on psychosocial aspects of care, offering longer-term reviews, and being more proactive with advice and/or referral regarding weight loss, pain medications and knee surgery. By describing the potential benefits and harms of common osteoarthritis medications and surgical interventions, physiotherapists will ensure that their patients are fully informed about all their treatment options.

Trust, conversations and the 'middle space': A qualitative exploration of the experiences of physiotherapists with clients with suicidal thoughts and behaviours.

In Australia, physiotherapists are registered healthcare practitioners who possess the knowledge and skills to care for clients with poor physical health as a result of musculoskeletal, neurological, and respiratory conditions. Although physiotherapists are not considered a primary profession in the Australian mental health workforce, the association between suicide and poor physical health suggests that they may encounter clients with suicidal thoughts and behaviours. We used a qualitative approach inspired by phenomenology to explore the experiences of nine physiotherapists who encountered clients with suicidal thoughts and behaviours. We used a combination of focus groups and in-depth interviews to collect this data. The data were analysed inductively using framework analysis. The main themes identified in the data were: i) the importance of trust, ii) the mechanism of conversation, and iii) the 'middle space'. The middle space refers to the experience of working with clients at risk of low or medium risk of suicide. A trusting practitioner-client relationship was reported to be essential in facilitating the disclosure of suicidal thoughts and behaviours. Physiotherapists also reported that less structured subjective assessments encourage clients to talk more openly, which in turn facilitates the disclosure of suicidal thoughts and behaviours. Once the disclosure of suicidal thoughts and behaviours occurred, physiotherapists reported a lack of confidence regarding role clarity and issues associated with this. Difficulties were most evident during encounters with clients with low to medium suicide risk due to a lack of confidence in the accuracy of assessment of these clients. The findings suggest that physiotherapists are well placed to detect and/or receive disclosure of suicidal thoughts and behaviours, as well as the need for physiotherapists to be trained in how to support clients who disclose suicidal thoughts and behaviours.

Physiotherapists' Experiences with and Perspectives on Implementing an Evidence-Based, Chronic Pain Self-Management Programme in Primary Health Care: A Qualitative Study.

Purpose: Evidence suggests that a physiotherapist-led chronic pain self-management programme in primary health care (PHC) improves function for people living with chronic pain; however, implementing a new approach to care can be difficult. In this study, we sought to understand the experiences of physiotherapists who had implemented the ChrOnic pain self-ManageMent support with pain science EducatioN and exerCisE (COMMENCE) programme; its perceived barriers, facilitators, benefits, and drawbacks; and how the physiotherapists tailored the programme to their own clinical contexts. Method: This interpretive description qualitative study used semi-structured interviews with physiotherapists who had implemented the COMMENCE programme in PHC. Results: Themes from 11 interviews included experiences of personal and professional growth, increasing confidence with experience, and changing the culture of pain management. Barriers and drawbacks to implementation included resource intensiveness, balancing programme demands with other clinical work, and challenges with patient attendance and participation. Facilitators included training, programme design and materials, supportive teams, and previous knowledge. Benefits included offering group and individualized support, evidence-based content, and sparking interest in learning more about pain management. The participants made small changes to tailor the programme content and delivery to their context. Conclusions: This study provides a rich understanding of the experiences, barriers, facilitators, benefits, drawbacks, and tailoring related to the COMMENCE programme in PHC. The results will facilitate future implementation of this intervention in PHC settings.

One in six physiotherapy practices in primary care offer musculoskeletal ultrasound \u2013 an explorative survey

BackgroundThe first aim of this research was to investigate the current prevalence of musculoskeletal ultrasound in Dutch physiotherapy practices. The second aim was to explore experiences of physiotherapists with musculoskeletal ultrasound in a primary care setting with patients presenting with shoulder complaints.MethodsA random sample of 1000 owners of primary care physiotherapy practices was sent a questionnaire to investigate the prevalence of musculoskeletal ultrasound. A second questionnaire was sent to physiotherapists using musculoskeletal ultrasound to explore experiences with it in patients with shoulder complaints.ResultsThe net response rate of the first questionnaire was 57.7%. In 18% of the physiotherapy practices musculoskeletal ultrasound was offered. Sixty-nine physiotherapists returned the second questionnaire. Physiotherapists indicated they most often used musculoskeletal ultrasound in patients with shoulder complaints, mainly for suspected tissue damage (83.7%), followed by making a diagnosis (63.3%) and for determining the choice of treatment (36.7%). Physiotherapists reported the biggest advantage was that they were better able to diagnose presenting shoulder complaints. The most frequently mentioned disadvantage of the use of musculoskeletal ultrasound was that assessment is difficult and that there is a risk that findings may not be sufficiently linked to history and physical examination.ConclusionOne in six physiotherapy practices in the Netherlands offer musculoskeletal ultrasound. It is mainly used for patients with shoulder complaints, with an emphasis on detecting tissue damage and as an aid for diagnosis. Physiotherapists trained to work with musculoskeletal ultrasound seem enthusiastic and are at the same time aware of its disadvantages.

"I've found it's very meaningful work": Perspectives of physiotherapists providing palliative care in Ontario.

This study aimed to describe insights from interviews about the experience of physiotherapists providing palliative care in Ontario and their perceptions of the role and value of physiotherapists' involvement in palliative care. We conducted interviews with physiotherapists in Ontario, Canada (n = 14), and received emailed submissions from two others (one physiotherapist and one physiotherapy student) with current or recent practice experience in palliative care. We conducted inductive thematic analysis of the interview data and emailed submissions. Participants' reflections were categorized into three major themes: perceived value of the contribution of physiotherapists in palliative care; the experience of providing physiotherapy in palliative care; and reflections on the palliative care system. Participants described their role in palliative care as diverse, driven by patient goals and focused on the experience of patients and families. Participants perceived a high value in collaborative networks for supporting them to fulfill their role in palliative care settings. Participants also recommended efforts to increase awareness of the potential for physiotherapists to contribute to palliative care. The findings confirm those of research in other jurisdictions and extend our understanding of the value and meaningfulness of physiotherapy in palliative care, to patients, families, and physiotherapists themselves.

What are the experiences of therapists using the online Back Skills Training and implementing it within clinical practice?

The purpose of the present study was to explore the experiences of physiotherapists using the online Back Skills Training (i-BeST). The aim of the this programme was to enable clinicians to facilitate group-based treatment based on a cognitive behavioural (CB) approach to the treatment of lower back pain (LBP). A qualitative, exploratory approach was chosen. Seven physiotherapists were interviewed. Participants were asked broad, open-ended questions in order to explore: (a) their experiences with the training; (b) the online method; and (c) the implementation of BeST into clinical practice. The interviews were transcribed and analysed manually using interpretive phenomenological analysis. Four main themes were identified following the analysis: (a) Flexibility but lack of interactivity; (b) CB approach is a new way of working; (c) Facilitating group work after i-BeST training; and (d) The need for managerial support. The flexibility of the online tool was perceived as a major advantage. However, lack of interactivity was identified by most participants as the biggest challenge. Participants found the online tool to be acceptable for attaining knowledge but not adequate for developing skills. After completing BeST, participants reported the application of key principles of the CB approach within routine physiotherapeutic practice, but were reluctant to refer into the group-based treatment programme. Coordination of implementation of the group-based treatment programme throughout a large trust was perceived as necessary, including sufficient staff training for all clinicians. I-Best can be implemented within everyday clinical settings but should be enhanced with additional face-to-face support mechanisms to improve effectiveness.

Physiotherapists perceived developing positive rapport facilitates participation in exercise among people with Prader-Willi Syndrome: a qualitative study

Purpose: To explore the experiences of physiotherapists delivering community-based progressive resistance training for people with Prader-Willi syndrome (PWS).Method: Participants in this qualitative study were fifteen physiotherapists (13 female) who had supervised 14 young adults with PWS to complete a progressive resistance training program, twice per week for 10 weeks. Semi-structured interviews with the physiotherapists were audio-recorded and transcribed verbatim. Interview transcripts were checked for accuracy by the physiotherapists. Data were analysed using thematic analysis with an inductive approach and data were managed using NVivo software.Results: Development of positive rapport between physiotherapists and people with PWS emerged as the critical factor. Components of developing positive rapport with a person with PWS included clear communication, adaptability in approach, fostering independence in the person with PWS, and motivating the person by developing confidence. Creating a routine, empowering the people with PWS to take ownership of their progress and developing confidence made continued participation in exercise by the people with PWS more likely.Conclusions: Our findings highlight the importance of developing rapport with people with PWS to facilitate their participation in exercise. Physiotherapist attributes and skills such as adaptability and communication positively influence participation in community-based exercise for people with PWS. Implications for rehabilitationThe critical factor for maximising the participation of people with PWS in high-intensity exercise is the development of positive rapport by the physiotherapistDevelopment of positive rapport was facilitated by therapist adaptability and clear communication.People with PWS might be motivated to exercise by developing their confidence and fostering their independence.

Physiotherapists’ perception of a community-based primary healthcare clinical education approach to undergraduate learning

Background. South African health systems are challenged by numerous stressors, such as a lack of resources, staff shortages and overburdened public sector demands. This necessitates appropriately equipped and trained healthcare professionals to meet the demands of this system. Community-based primary healthcare (PHC) clinical education is an approach towards preparing health science students to meet these demands. Clinical education is the cornerstone of undergraduate training. Physiotherapists are among the healthcare professionals who require undergraduate training that drives competence for independent practice. Objective. To explore the perceptions and experiences of physiotherapists as clinical supervisors within a physiotherapy undergraduate programme that adopted a community-based PHC approach to clinical training. Methods. An explorative qualitative approach was used, with semi-structured interviews with 10 purposively selected physiotherapists supervising students on the newly introduced platform. Data were transcribed and analysed using content analysis. Results. Seven themes emerged from the data, which relate to curriculum redress, organisational factors, stakeholder dynamics, barriers and enablers to decentralised clinical training, perceived preparedness for practice and recommendations. Conclusions. As the need for an increasing number of health professionals is realised, more innovative methods for clinical education of undergraduate health science students are required. Community-based PHC training for physiotherapy students is one such approach and was generally perceived as a valuable framework to incorporate competencies required for practice as future independent practitioners. Furthermore, improved communication between students, clinicians and academic staff was seen as a recommendation to influence clinical education.

The Experience and Perception of Physiotherapists in Nigeria re: Fall Prevention in Recurrent-Faller Older Adults

Background: Effective fall prevention practices are essential for reducing falls among older adults. Rehabilitation professionals like physiotherapists are essential members of the fall prevention team, yet little is known about the experiences of physiotherapists practicing fall prevention in developing nations. Objective: To explore the experiences of physiotherapists in Nigeria who practice fall prevention among older adults. Method: We adopted a phenomenological approach to the traditional qualitative design in this study. We purposefully selected and conducted face-to-face interview with twelve physiotherapists who have treated at least one older adult who reported falling two or three times within last six months. Data was analyzed using thematic analysis. Results: Four themes emerged from our participants: characteristics of recurrent fallers, fall prevention practices, hindrances to fall prevention, and strategies to promote fall prevention practices. In practice, understanding the characteristics (risk factors) of older adults with a history of recurrent falls is important for effective fall prevention practices among physiotherapists. Among other characteristics, our participants believed that older adults who have patronized “traditional bone setters/healer” are at the higher risk of having multiple falls. Conclusion: This study adds to the sparse amount of literature concerning the experience of physiotherapist in fall prevention practices in the developing world. More importantly, the findings of this study will strengthen or stimulate discussion around development of fall prevention strategies specific to the developing world context.

What are the experiences of therapists using the online Back Skills training and implementing it within clinical practice?

Purpose: The purpose of this study was to explore the experiences of physiotherapists using the online Back Skills Training (BeST). The aim of the training programme was to enable clinicians to facilitate group-based treatment based on a cognitive behavioural approach (CBA) to the treatment of lower back pain (LBP). A qualitative, exploratory approach was chosen for the study to ascertain the participants’ perception of the tool and their ability to use the content in clinical practice.

Obstetric fistula: The role of physiotherapy: A report from the Physiotherapy Committee of the International Continence Society.

To discuss the role of physiotherapy in the management of women who have suffered an obstetric fistula, referring to research findings when appropriate and available, and the experiences of clinical specialists in the field. The experiences of physiotherapists who have worked in countries where obstetric fistula is prevalent, and the limited literature available, were considered in producing this consensus document on behalf of the ICS Physiotherapy Committee. The role of physiotherapy both pre- and post-fistula repair was identified, and is multi-faceted. Women may have general rehabilitation needs based on the obstructed labor itself and subsequent care. All affected women may benefit from pelvic floor muscle assessment, education and exercises to optimize the outcome of their surgery; further pelvic floor physiotherapy may be indicated for those who experience persistent genitourinary dysfunction following closure of the fistula. Further robust research is required to confirm the effectiveness of physiotherapy in the management of women who have suffered an obstetric fistula and the optimum development of such services. Based on the available literature and the experience of physiotherapists in the field, there was consensus within the ICS Physiotherapy Committee that patient outcomes can be improved if physiotherapy is provided as part of the multidisciplinary team. Physiotherapy should not be overlooked when fistula services are being developed.

The feasibility of using exergames as a rehabilitation tool: the attitudes, awareness, opinions and experiences of physiotherapists, and older people towards exergames.

[Purpose] The aim of this study was to investigate the feasibility of using exergames as a rehabilitation tool by determining the attitudes, awareness, opinions and experiences of physiotherapists, and older people towards exergames. [Subjects and Methods] A cross-sectional study was conducted and two short self-developed questionnaires (for physiotherapists and older people) were distributed in three hospitals in Cork (Ireland) to assess the attitudes towards and familiarity with exergames among physiotherapists and older people. The data were analysed using Microsoft Excel version 2013. [Results] The results show that a lot of older people have seen exergames devices but have not attempted to play them. This may indicate a lack of interest in or information about these devices and how to use them. With regard to the second group, physiotherapists underestimate older people’s knowledge about exergames. [Conclusion] Older people were not very familiar with exergames but they were willing to try them. In addition, despite physiotherapists being familiar with exergames, they see them as an additional tool that will not replace or change any traditional exercise methods.

The views and experiences of physiotherapists on physiotherapy service provision for people with neurological conditions in primary care in Ireland: A qualitative study

The views and experiences of physiotherapists on physiotherapy service provision for people with neurological conditions in primary care in Ireland: A qualitative study

The experiences of physiotherapists treating people with dementia who fracture their hip

BackgroundIt is estimated that people with dementia are approximately three times more likely to fracture their hip than sex and age matched controls. A report by the Chartered Society of Physiotherapy found that this population have poor access to rehabilitation as inpatients and in the community. A recent scoping review found a paucity of research in this area, indeed there has been no qualitative research undertaken with physiotherapists.In order to address this evidence gap, the aim of this current study was to explore the experiences of physiotherapists treating this population.MethodsSemi-structured interviews with physiotherapists were undertaken in order to gain an in-depth understanding of how they manage this population. Physiotherapists were recruited from all over the UK and a purposive sampling strategy was employed. Thematic analysis was utilised.ResultsA total of 12 physiotherapists were interviewed, at which stage data saturation was reached as no new themes were emerging. The participants had a broad range of experience both in physical and mental health settings. Analysis identified three separate themes: challenges, “thinking outside the box” and realising potential.Physiotherapists felt significant pressures and challenges regarding many aspects of the management of this population. Mainly this was the result of pressures placed on them by guidelines and targets that may not be achievable or appropriate for those with dementia. The challenges and importance of risk taking was also highlighted for this population with an appreciation that standard treatment techniques may need adapting. “Rehabilitation potential” was highlighted as an important consideration, but challenging to determine.ConclusionInterventions for the management of people with dementia and hip fracture need to consider that a traditional biomedical physiotherapy approach may not be the most appropriate approach to use with this population. However physiotherapists reported feeling pressurised to conform to a biomedical approach.

Shouldering the burden of evidence-based practice: The experiences of physiotherapists partaking in a community of practice

The study aim was to elicit the motivators, barriers, and benefits of participation in a Community of Practice (CoP) for primary care physiotherapists. We used a qualitative approach using semistructured interviews. The participants were twelve physiotherapists partaking in a newly formed Shoulder CoP. A desire for peer support was the strongest motivator for joining, with improving clinical practice being less apparent. Barriers to participation included time and work pressures and poor research skills. The structure of the CoP, in terms of access to meetings and the provision of preparation work and deadlines for the journal clubs, was reported to be a facilitator. Multiple benefits ensued from participation. The role of teamwork was emphasised in relation to reducing isolation and achieving goals. The majority of participants reported positive clinical practice changes in terms of improved patient education, increased confidence, and availability of new resources. All participants reported some element of personal growth and development, in particular in their evidence-based practice skills. The results provide support for the use of CoPs as a means of continuing professional development for physiotherapists in the workplace, as significant benefits are gained in terms of evidence-based practice (EBP), patient care, and therapist personal development.

To disclose or not to disclose? The workplace experiences of physiotherapists with a specific learning difficulty

Relevance: This is a qualitative study, w hich investigates the experiences of physiotherapists w orking in the NHS in relation to having a specific learning difficulty. Better understanding of the issues faced by the physiotherapist in the w orkplace has the potential to impact on their practice making it relevant to Congress Theme 2. Purpose: To explore the w orkplace experiences of physiotherapists w ith a SpLD, in relation to disclosing their SpLD, their support needs, and the impact on continuous professional development (CPD) and career progression. Methods/Analysis: This w as Phase 2 of a 3-phase evaluation. The study w as underpinned by the social model of disability. An exploratory qualitative design w as undertaken to address the aim of the study. A purposive sample of eight qualified physiotherapists recognised as having a SpLD, w ere recruited. All participants studied on one of tw o programmes at a university in England betw een 2004-2012. Their NHS w orkplace experience w as from across the UK. Participants w ere invited to take part by the investigators via Facebook and email. Ethical approval w as obtained from Manchester Metropolitan University. Eight in-depth interview s w ere undertaken w ith practising physiotherapists w ho had been diagnosed w ith a SpLD. All interview s w ere carried out by the same researcher (GY). Each interview lasted 40-70 minutes and w as digitally recorded. An interview schedule w as used to guide the interview . Interview data w ere transcribed verbatim and analysed using thematic analysis. Results: Four participants w ere female. Participants w ere w orking as a Band 5 (n=3) or Band 6 (n=5) physiotherapist. Four main themes w ere identified: 1) Having dyslexia; 2) Disclosure; 3) Support and strategies; 4) NHS positive and negative responses. Discussion and conclusions: 'Having dyslexia': Participants did not perceive themselves as having a disability; they perceived stigma w as attached to the diagnosis. Participants indicated strengths and w eakness related to their SpLD. 'Disclosure': Disclosure decisions w ere influenced by: perception of their SpLD being a disability; perceived stigma; fear of discrimination; levelling the playing field; support provided follow ing disclosure; the guaranteed interview scheme; w ho they disclosed to, and previous experiences of disclosure/non-disclosure. 'Support and strategies': Some participants benefited from extra time to w rite up clinical notes. There w as a lack of aw areness regarding the UK Access to Work scheme. Their SpLD w as not felt to impact on career progression. Several participants felt their SpLD did impact on CPD, although they had developed strategies to lessen the influence of this. 'NHS positive and negative responses': Positive and negative responses w ere experienced follow ing disclosure. Positive responses, for some, included managerial support in the w orkplace. Negative responses included: failure to disseminate to the w ider team adjustments that had been put into place to support the participant's specific learning needs; and perceptions of being 'bullied' by the line manager. Impact and Implications: Better understanding the issues faced by the physiotherapist in the w orkplace has the potential not only to improve support mechanisms for the employee but also to facilitate the transition of physiotherapists w ith SpLD, from student to employee and back again. Funding Acknowledgement: Health Education Northw est (HENW)

Intervención fisioterapéutica en el niño quemado: construcción desde la práctica basada en la experiencia

Introducción. La quemadura pediátrica es una problemática de salud pública en Latinoamérica, no ajena al quehacer del fisioterapeuta. Sin embargo, la revisión del estado del arte de la intervención fisioterapéutica en niños quemados evidencia escasa producción investigativa. Por eso, existe la necesidad de plantear lineamientos que orienten la intervención en el niño quemado y que rescaten la experiencia de fisioterapeutas dedicados a la atención de estos pacientes. Objetivo. Formular una propuesta de intervención fisioterapéutica en niños quemados a partir de la práctica basada en la experiencia. Materiales y métodos. Investigación de tipo cualitativo, fenomenológico y exploratorio, realizada en tres momentos: primero, identificación del estado del arte; segundo, sistematización de la experiencia de un colectivo profesional, y tercero, trabajo observacional de campo en la unidad de quemados de una institución de salud de tercer nivel de atención del país. Además, se emplearon entrevistas semi-estructuradas, etnografías y el software SPSS para la recolección y análisis de resultados. Resultados. Se presenta el estado del arte, las entrevistas realizadas a un colectivo experto y las etnografías, producto de la observación participativa. A partir de ellos, se realiza una propuesta de lineamientos de intervención fisioterapéutica para el niño quemado. Conclusión. Los lineamientos de intervención fisioterapéutica para el niño quemado, desde la memoria viva de los profesionales, aportan al fisioterapeuta herramientas para cuestionar los criterios sobre los cuales se soporta la atención. Así mismo, estimulan a la comunidad científica y académica a producir nuevas investigaciones.

Acquired brain injury rehabilitation: dilemmas in neurological physiotherapy across healthcare settings

People with acquired brain injury (PwABI) are usually hospitalized for emergency care and often require both specialist and primary healthcare long-term follow-up. Higher intensity rehabilitation featuring early intervention is recommended. This study investigated how implementation of redistributed responsibilities in Norway affects neurological physiotherapy practice within and across healthcare levels and how physiotherapists experience and address these changes. We performed qualitative research interviews with physiotherapists, complemented by non-participatory field observations of physiotherapist treatments, during the rehabilitation of 10 PwABI from specialist to primary healthcare. We performed a content analysis of the interviews connected to perspectives on professionalism. Physiotherapy services for PwABI seem to be constrained, as reforms shift responsibilities for rehabilitative work between healthcare levels. Earlier hospital transfer, structural limitations and resource insufficiencies challenge the ability to provide good-quality and intensive physiotherapy services for PwABI, especially in primary care. Furthermore, the traditional division of responsibilities and organizational boundaries appears to limit expectations of future treatment and to influence the delivery of recommendations across healthcare levels. This study draws attention to the possible unintended consequences of reform initiatives, which should be considered during further development and efficiency improvements in rehabilitative work across healthcare levels.

Acute burns of the hands - physiotherapy perspective.

Acute burns of the hands are complex and may impact on various aspects of a person's life. Physiotherapy rehabilitation and restoration of hand function is critical for the patient's independence and re-integration into society. This study aimed to explore the perceptions and experiences of physiotherapists in the management of patients with their hand burn injuries. Five focus groups consisting of physiotherapists and physiotherapy assistants working with burn injured patients from each of the five selected public hospitals in KwaZulu-Natal were recruited. An explorative qualitative approach was adopted. Physiotherapists emphasised that the acute management of the hand was trivialised due to a primary focus on the survival of the burn sufferer. Therapists identified several factors that determined the patients' level of participation and motivation in therapy one of which was the procedural pain experienced. The role of the therapists' within the rehabilitation framework was found to be critical to their recovery however there appeared to be a breakdown in the collaboration and communication among health care professionals to the detriment of effective intervention. A multidisciplinary team approach is the foundation in the management of acute burn injuries and during the trajectory of the trauma care continuum.

Shouldering the Burden of Evidence-Based Practice: The Experiences of Physiotherapists Partaking in a Community of Practice.

The study aim was to elicit the motivators, barriers, and benefits of participation in a Community of Practice (CoP) for primary care physiotherapists. We used a qualitative approach using semistructured interviews. The participants were twelve physiotherapists partaking in a newly formed Shoulder CoP. A desire for peer support was the strongest motivator for joining, with improving clinical practice being less apparent. Barriers to participation included time and work pressures and poor research skills. The structure of the CoP, in terms of access to meetings and the provision of preparation work and deadlines for the journal clubs, was reported to be a facilitator. Multiple benefits ensued from participation. The role of teamwork was emphasised in relation to reducing isolation and achieving goals. The majority of participants reported positive clinical practice changes in terms of improved patient education, increased confidence, and availability of new resources. All participants reported some element of personal growth and development, in particular in their evidence-based practice skills. The results provide support for the use of CoPs as a means of continuing professional development for physiotherapists in the workplace, as significant benefits are gained in terms of evidence-based practice (EBP), patient care, and therapist personal development.