Novice Physiotherapists Research Articles

A practical physiotherapy treatment and rehabilitation guide for the athlete with tibial stress fracture

Introduction: Stress fracture is considered as an overuse mechanism where the partial or complete fracture occurs caused by an abnormal repeated loading exerted through a bone. It is common among physically active people, track and field athletes, dancers, and military persons. Tibial stress fracture comprises the most common among the other stress fracture. Conservative treatment is the usual way to manage stress fracture but, in some cases, surgical intervention may require. Although Physiotherapy management is an important area for the treatment and Rehabilitation of stress fracture often it is difficult for the Novice physiotherapist to apply the evidence-based treatment. Therefore the study was aimed to formulate a simple treatment guide, especially for novice physiotherapists. Method: Five good quality scholarly articles and two established treatment guidelines were used to formulate the guideline. An electronic search strategy was performed through Google, Google Scholar, Pedro, and Pub Med. The guideline was devised with simplicity so that it can easily be understood and applied by sports Physiotherapists. Conclusion: Diverse Physiotherapy treatment programs for the same condition impose a strong demand in the creation of standard treatment guidelines in order to standardize the management. Expert clinicians in different organizations can play a very important role in this regard.

Mobilization for Persons With Acute Stroke: A Survey of Current Physical Therapy Clinical Practice

Purpose: To examine reported practice patterns of physical therapists (PTs) related to mobilization of persons with acute stroke. The researchers hypothesized that (1) facilities certified as primary stroke centers by The Joint Commission (TJC) will mobilize persons with acute stroke 24 hours or less after symptom onset; (2) persons with fewer impairments following acute stroke and those with ischemic stroke, who did not receive tissue plasminogen activator (tPA), are mobilized sooner; (3) PTs are the first to mobilize among interdisciplinary team members; and (4) PTs with more experience will mobilize sooner than novice PTs. Methods Survey Development: All members of the research team independently searched and reviewed the current literature describing the timing of initial mobilization after stroke. A pilot survey was developed from themes in the literature emphasizing areas hypothesized. Once the feedback from the pilot survey was reviewed, the survey was finalized and converted to an online survey using SurveyMonkey. Survey Implementation and Analysis: The target audience for the survey was PTs who treat persons with acute stroke. “Acute stroke,” for this survey, was defined as a stroke less than 1 week from onset of stroke symptoms. Potential respondents were contacted via e-mail through the APTA acute care and neurologic listservs. The survey contained 26 questions related to participant demographics, the timing and frequency of mobilization for persons with acute stroke based on defined impairment levels, perceptions about influences on mobilization, and knowledge of current related evidence. Descriptive result statistics were generated by SurveyMonkey. One-way analysis of variance was used to compare responses by practice setting, degree, APTA membership, and specialist certification. Spearman's rank correlation was used to correlate results based on participant characteristics. Results: A total of 161 PTs participated with a mean of 15 years' clinical practice. Most (67%) of the respondents report mobilizing persons with minimal impairment and uncomplicated ischemic stroke, not treated with tPA, in 24 hours or less. PTs were identified as the first to mobilize persons after stroke with severe (95%) and moderate impairments (91%). Recipients of tPA, persons with severe impairment, and those who received neurosurgical intervention were initially mobilized between 25 and 48 hours majority of the time. PTs working for a TJC stroke-certified institution did not mobilize sooner. The number of years of PT experience had a weak negative correlation to the timing of mobilization. Most respondents (58%) reported that mobilization more than 2 times per day is optimal. The barriers to more frequent mobilization included increased caseload, lack of resources, and lack of interdisciplinary patient care coordination. Conclusions: The frequency of mobilization reported in this survey is less than proposed by the results of the most recent “A Very Early Rehabilitation Trial” (AVERT) after stroke, phase 3 trial. This study found a positive correlation between increased session frequency and recovery of walking at 3 months, survival, and a modified Rankin Scale (mRS) score of 2 or less. Respondents believe additional mobilization would be beneficial, but report barriers to implementation that include increased PT caseloads and lack of resources. Additional research is required to determine the influence of mobilization timing and frequency on patient outcomes such as the degree of disability after stroke.

Reliability of Single Limb Squat and Lateral Step Down Assessment in Novice and Expert Clinicians

The single limb squat (SLS) and lateral step down (LSD) are common lower extremity tests used to assess gross lower extremity strength and motor control. PURPOSE: To compare intra-rater reliability of lower extremity tests between novice and expert clinicians between sessions. METHODS: Six licensed physical therapists (3 “novice” and 3 “expert”) rated 20 frontal plane video recordings of healthy adults who participated in a previous study performing the SLS and LSD. The sample size required to find a kappa of at least 0.50 with a 95% confidence interval of ±0.40 was estimated to be 18. Novice physical therapists were operationally defined as those within 3 years of initial licensure. Expert physical therapists were licensed for at least 10 years and held a board certification in either orthopedics or sports. Prior to data collection, clinicians practiced rating the SLS and LSD on a separate set of recordings. Kappa statistics were calculated based on previous reported formula and interpreted using a standard index. If bias or prevalence indices were above 0.5, the prevalence-adjusted bias-adjusted kappa (PABAK) was calculated. RESULTS: For the SLS, intra-rater reliability of all raters, except one, had moderate reliability or better. For the LSD, most raters had substantial reliability except for two raters, one novice and one expert, who had fair and moderate reliability, respectively. CONCLUSIONS: Our findings suggest using the SLS to assess lower limb strength and control given its higher reliability in novice and experts. The SLS rating was based on knee movement, while LSD was based on trunk, arm, pelvis, knee, and foot. The higher reliability on SLS than LSD may be due to evaluating only one component rather than several simultaneously.Table 1: Intra-rater reliability of single leg squat and lateral step down test performance by novice and expert raters; kappa (95% confidence interval)

Managing osteoarthritis: a qualitative study of novice physical therapists’ perceptions, experiences and learning needs

Purpose: Exercise is recommended as first line management for osteoarthritis (OA) in all clinical guidelines. Physical therapists (PTs) play a critical role in OA management, mainly through the design and delivery of exercise programs. However, there is some evidence that PT practice is not always in line with recommended guidelines. Entry-to-practice PT training is critical to ensure PTs develop the requisite knowledge and skills to enact evidence-based management of OA. Novice PTs rely more on their entry-to-practice education for clinical decision making and treatment planning relative to experienced PTs and are more likely to be able to reflect on their learning gaps now that they are practising clinicians. Yet, little is known about the perceptions, experiences or learning needs of novice PTs related to OA and OA management. Methods: Ten novice PTs (PTs working for approximately two years or less) participated in this qualitative descriptive study. Semi-structured interviews were conducted in person or over the phone with PTs across Canada. Sampling was purposive to achieve variation in university programs and geographic locations across Canada. The DEPICT model, an approach to collaborative qualitative data analysis, was followed, including dynamic reading of transcripts, development of a coding framework, participatory coding, summarizing of codes and collaborative analysis of codes. Themes were developed from the coded data. Results: Five themes were identified: i) Beliefs about OA: participants’ beliefs about OA pathophysiology and prognosis varied but most participants indicated OA was a disease linked to aging and “wear and tear”; ii) Role of chronic pain in OA management: managing chronic OA pain was perceived to be a challenge and participants expressed difficulty prescribing and progressing exercise in the face of persistent pain; iii) Communication with patients: participants reported low confidence in communicating a diagnosis, choosing language to discuss OA and motivating patients to adhere to exercise; iv) Appraisal of the OA curriculum: participants perceived a gap in transferring theoretical knowledge learned in their courses to clinical application on patients (clinical internships had the most significant influence on their OA knowledge); and v) Perceptions of preparedness to manage OA: participants confidence in managing OA after graduation varied; however, the majority felt inadequately prepared to manage OA. Conclusions: This research highlights novice PTs’ learning needs related to OA and OA management. Addressing these learning needs in entry-to-practice training may enhance novice PTs’ skills and confidence to manage OA, and ultimately enhance the quality of OA care.

Reliability of novice and experienced physiotherapists using the normalized navicular height truncated and the foot posture index-6 for classifying static foot posture in adults.

[Purpose] To investigate the reliability of novice and experienced physiotherapists using the normalized navicular height truncated and the foot posture index-6 for classifying foot posture in healthy adults. [Participants and Methods] Thirty asymptomatic adults participated in this study. After brief training, inter-rater reliability was performed by an expert and inexperienced rater (the novice physiotherapist). On the same day, both raters independently performed the normalized navicular height truncated and the foot posture index-6. For intra-rater reliability, the inexperienced rater repeated data collection on the 8th day after the first assessment. Intraclass correlation coefficients (ICCs) and Cohen’s Weighted Kappa (Kw) were used for continuous and categorical data, respectively. [Results] The normalized navicular height truncated and the Rasch-converted foot posture index-6 scores demonstrated an excellent inter- and intra-rater reliability (ICCs=0.98–0.99). For classifying foot posture, the normalized navicular height truncated and the total foot posture index-6 scores represented more than 90% inter- and intra-rater agreement with Kw values ranging from 0.92–0.94, while each item of foot posture index-6 demonstrated inter- and intra-rater agreement ranging from substantial to almost perfect (Kw=0.71–0.94). [Conclusion] The normalized navicular height truncated and the foot posture index-6 are simple and reliable methods that can be used by the inexperienced rater.

An online model of international clinical mentoring for novice physical therapists

Objectives: Clinical mentoring is important for novice clinicians as they are developing advanced critical-thinking skills. Research exploring innovative mentoring strategies to reduce barriers and enhance learning is needed. The purpose of this study was to examine the effects of providing online clinical mentoring to small international groups of novice clinicians treating patients with spinal dysfunction in the outpatient setting.Methods: Eleven novice and four expert clinicians were allocated into small international groups. Four one-hour group video-conference mentoring sessions were held in which each novice clinician presented a case study. Data were collected from pre- and post-participation surveys and post-participation focus groups. Data were evaluated with a mixed-methods phenomenological analysis.Results: Four themes emerged from the novice qualitative data: improved confidence, enhanced critical thinking, appreciation of the structured design and accessibility to peers and mentors. The quantitative data revealed significant improvement in three confidence measures, improvement of 1.48 points on self-selected clinical goals, and 82.0% reported improved clinical decision-making. Two themes emerged from the expert data: value of the model to fill a need within the profession and viability of the model to stand alone or as part of an educational program. All participants rated their experience on average at 8.76/10 and expressed interest in future mentoring programs.Discussion: Online small group international clinical mentoring appears to be an effective strategy to provide clinical mentoring to promote confidence and critical-thinking skills. This research could provide a viable model to increase accessibility to clinical mentors and fill a need within the profession.

Clinical Rating of Movement-Pattern Quality in Patients With Femoroacetabular Impingement Syndrome: A Methodological Study.

Study Design Cross-sectional study. Objectives To evaluate intrarater and interrater agreement among physical therapists with different clinical experience in performing a visual rating of movement-pattern quality of patients with femoroacetabular impingement (FAI) syndrome using a semi-quantitative scale. Background Visual rating of movement patterns in patients with FAI syndrome is of interest, because poor control of dynamic hip motion is frequently noted. Methods A video camera was used to record the performance of 34 patients with FAI syndrome performing single-limb standing, squat, frontal lunge, hop lunge, bridge, and plank. Visual rating of movement, as recorded on video, was performed by a highly experienced, a moderately experienced, and a novice physical therapist on 2 occasions using a semi-quantitative scale. Hip abductor strength was assessed using dynamometry, and hip pain and function were assessed with a patient-reported questionnaire. Intrarater and interrater agreement among physical therapists was evaluated using Gwet's agreement coefficient 1. Construct validity was evaluated as the association between physical therapists' rating and patients' hip abductor strength, pain, and function. Results Good intrarater and interrater agreement was observed in the highly experienced and moderately experienced physical therapists when rating single-limb standing, bridge, and plank. Poor to moderate intrarater and interrater agreement was found when they rated squat, frontal lunge, and hop lunge. Poor performers, as rated by the highly experienced physical therapist only, demonstrated lower hip abductor strength (P<.05), and similar hip pain and hip function compared to those of good performers. Conclusion Movement-pattern quality of patients with FAI syndrome should be rated by a highly experienced physical therapist. J Orthop Sports Phys Ther 2018;48(4):260-269. doi:10.2519/jospt.2018.7840.

Reliability of novice physiotherapists for measuring Cobb angle using a digital method.

Background:The Cobb’s method is the most accurate and reliable method for kyphosis measurement. Conventionally, a sagittal Cobb angle was commonly derived from a lateral plain film. With computer technology, a digital method is widely used in common clinical settings, but the existing reliability data involved only experienced raters.Objectives:To assess the interrater and intrarater reliability of a digital Cobb’s method using novice physiotherapists.Methods:Fifteen participants, with an occiput wall distance of more than 0 cm, were interviewed and assessed for their demographics. Then they were filmed for lateral spinal radiography over the area of thoracic spine in a standing position, and the Cobb angle was analyzed by four raters, including an expert physician and three novice physiotherapists, using a SurgimapSpine programme.Results:The average Cobb angles among the four raters showed no significant difference (p = 0.984). Outcomes of their measurements had excellent intrarater and interrater reliability [intraclass correlation coefficient (ICC3,3) = 0.995–0.997] with a small range of standard errors of the measurement (<1°).Conclusion:A digital Cobb’s method had excellent reliability when used by a novice health professional rater. The findings confirm the ease of using this method to detect and monitor kyphosis in general hospitals, clinics, or research facilities.

A comparison of patient education practices and perceptions of novice and experienced physiotherapists in Australian physiotherapy settings

BackgroundPatient education is an integral component of physiotherapy practice. Little is known about the differences in reported use and perception of patient education between experienced and novice physiotherapists. Understanding these differences has important implications for training approaches and physiotherapy practice. ObjectivesTo compare how experienced and novice physiotherapists report frequency of patient education practices and their perceptions of the importance of these practices. Design and methodsA web-based purpose-designed survey was developed, piloted and administered to practicing physiotherapists through direct email. Of 305 complete responses, two subgroups were explored for comparative analysis: ‘novice’ (≤5years' experience, n = 52); and ‘experienced’ (≥11 years' experience, n = 204). ResultsThe experienced group rated 14 of 15 educational items higher than the novice group in relation to frequency of use and perceived importance. Experienced physiotherapists reported a significantly higher frequency of using one-to-one discussion, personalised handouts and explicitly seeking patient understanding (p < 0.05). Novice physiotherapists perceived more barriers to patient education, particularly those related to characteristics of the patient (p < 0.05). ConclusionExperienced physiotherapists report higher use of self-management education and education content that is patient-centred. Experienced therapists report a higher frequency of seeking explicit patient understanding to evaluate their teaching than novice physiotherapists and perceive fewer patient-related barriers to their practice. These findings are important when considering teaching and learning of patient education skills. Students or novice physiotherapists may benefit from strategies to facilitate patient-centred education, self-management education, evaluation approaches and strategies to manage barriers.

Third Annual Geneva R. Johnson Forum on Innovations in Physical Therapy Education: Formation of a Doctoring Professional: Are We Shying Away From Education that Really Matters in the Lives of Our Graduates?

INTRODUCTIONDr Geneva R. Johnson (Figure 1) continues to influence physical therapy education as an inspirational participant in the Third Annual Geneva R. Johnson Innovations in Physical Therapy Education Forum (GRJ Forum). Dr Johnson is recognized for her longstanding leadership and mentorship, having contributed to the advancement of physical therapy education, practice, and research for over 60 years. The GRJ Forum started in 2014 through the collaborative efforts of the Academic Council of Academic Physical Therapy (ACAPT) and the Physical Therapy Learning Institute (PTLI).3,12 Once again it was the keynote for the 2016 Education Leadership Conference (ELC) held in Phoenix, Arizona. As expected, the Forum continues to foster creative ideas for positive change to promote excellence in physical therapist education, a hallmark of Dr Johnson's legacy.As in previous years, the Forum set the stage for energy, enthusiasm, and excitement for conference participants as discussions evolved to explore new opportunities to promote excellence in education. The GRJ Forum design is like no other in our profession. Key to its success is provocative speakers who share personal perspectives, immediately followed by active engagement all participants. As Tschoepe shared in her recognition to Dr Johnson and the introduction of the Forum, many remember what has become known as "Dr Johnson's 3 Ps of strong leadership skills": passion, persistence, and perseverance. Illustrations of these, as well as other essential personal leadership skills, were explored throughout the Forum by many speakers at ELC 2016.THE GRJ FORUM: ORGANIZATION AND STRUCTUREThe GRJ Forum is designed to:* Create a safe environment for key stakeholders in physical therapy education to discuss the infinite possibilities of the future, rather than solving problems of the past.* Encourage vision, innovation, creativity, and provocative new ideas that can positively influence the future of physical therapy education.* Challenge educators to proactively advance physical therapy education to prepare graduates to meet projected societal and professional needs rather than merely react to external pressures.3The 2016 GRJ Forum featured Dr Emma Stokes, an international visionary leader and current World Confederation for Physical Therapy (WCPT) president, who energized the over-800 conference participants and set the stage for ongoing conversation and idea development throughout the conference. Her keynote was followed by 3 Ignite Talks from active leaders in physical therapy education in the United States - Dr Michael Majsak, Dr Bob Rowe, and Dr Chris Sebelski. Collectively, they shared individual perspectives of what each believed to be critical to foster graduate success in physical therapist practice that is entrepreneurial in spirit, illustrates personal ownership and accountability, and offers a unique value to the health care team to facilitate optimal, efficient, and effective individual-centered health promotion and management. Discussion by over 200 participants followed these speakers, and they more thoroughly explored the 13 themes presented, and discussed "how might we" or "wouldn't it be great if..." Participants had options to discuss 2 different themes, and table facilitators shared 3 possible highlights that might illustrate innovation and educational change to include education that really matters to better prepare physical therapist graduates for success in their future professional careersTHIRD ANNUAL GRJ FORUM HIGHLIGHTSKeynote Address - Walk With the DreamersEmma Stokes, PT, PhD, is deputy head of the Department of Physiotherapy and a fellow of Trinity College in Dublin, Ireland. She teaches in the university's entry to practice and PhD programs in Dublin and Singapore. Her research focuses on matters related to professional practice; particularly, leadership in the profession. She has received numerous awards and professional recognitions for her contributions to the physiotherapy profession and has been a board member of the World Confederation for Physical Therapy (WCPT) since 2007. …

Reproducibility of Muscle Strength Testing for Children with Spina Bifida

ABSTRACTAims: Examine the inter-rater reliability of the Daniels and Worthingham (D&W) manual muscle test (MMT) protocol for children with spina bifida between experienced and novice physiotherapists. Methods: Thirteen children with spina bifida (two males) aged 6 to 18 years were recruited from a spina bifida service in a state-wide tertiary children's hospital. Each child had the muscle strength of 19, and lower limb muscles were measured bilaterally by one experienced and one novice physiotherapist using the D&W MMT protocol. Examiner and limb order were counterbalanced. Standard training and recording sheets were used. Agreement between raters was examined with quadratic weighted kappa (κw2), percentage exact agreement (%EA), and the Bland–Altmann Limits of Agreement (LoA). Minimal detectable change (MDC) was calculated. Results: Inter-rater agreement between the experienced and novice raters was excellent (κw2 = 0.95; 95% confidence interval: 0.94–0.96); %EA was good (72.3%); and clinically appropriate LoA levels were −1.30–1.40. The MDC was 1.11 points on a six-point MMT scale. Conclusions: The D&W MMT protocol, when used after standard training and with standard recording sheets, was reproducible for children with spina bifida, aged 6–18 years.

Inter-rater reliability of mini balance evaluation system test in ambulatory people with multiple sclerosis

Background: Balance deficits are common in people with multiple sclerosis, and accurate measurement of balance using clinical measures is important. This study investigates the inter-rater reliability of the mini Balance Evaluation System test (mini-BESTest) in ambulatory people with multiple sclerosis. Methods: People with multiple sclerosis attending physiotherapy in an acute hospital were invited to take part. Participants gave demographic information and completed the mini-BESTest twice. Raters were experienced and novice physiotherapists. Data were analysed using intraclass correlation coefficients and Bland and Altman analysis. Agreement of individual items were analysed using weighted Kappa. Results: Fifty participants (37 female) had a mean age of 45.73 (5.65) years; 61.5% did not use a walking aid. The mean difference between the raters was 0.27 (Standard deviation: 1.8; 95% confidence interval (CI): -2.5+2.02), which was not significantly different (P=0.816). The intra class correlation coefficient was 0.98 (95% CI: 0.96–0.99). The standard error of the measures was 1.27, with a minimum detectable change of 3.91. Most items (2–4, 7–10, 12–14) on the mini-BESTest had Kappa values greater than 0.51; item 14 demonstrated complete agreement (k=1). Percentage agreement for individual questions ranged from 69% to 100%. Conclusions: Agreement between raters was high for the total score and for the majority of individual items. A change greater than 3.9 points on the mini-BESTest is required to be confident that change is not due to measurement error when two raters are used.

Reliability and concurrent validity between two-dimensional and three-dimensional evaluations of knee valgus during drop jumps.

PurposeThe aim of this study was to establish the concurrent validity and reliability of four different two-dimensional (2D) video-based techniques for quantifying frontal plane knee kinematics during a 40 cm double-legged drop jump.Participants and methodsA convenience sample of 16 healthy participants (nine males and seven females; age: [mean ± standard deviation] 25.5±2 years; body mass index: 24.33±2.98 kg/m2) participated in this investigation. A total of five trials during a 40 cm drop jump maneuver with a countermovement jump were used as the functional task. Four knee valgus measures, such as two different frontal plane projection angle measures, knee-to-ankle separation ratio (KASR), and knee separation distance (KSD), were measured using 2D and three-dimensional (3D) systems. To generalize to the greater population of possible evaluators, the testers performing the biomechanical analyses were three novice physical therapists. Intra- and intertester intraclass correlation coefficients (ICCs) were estimated for 2D analysis variables. ICCs were estimated for all measures between systems to determine concurrent validity of the 2D system.ResultsAll four 2D measures showed good to excellent reliability (ICC: 0.89–0.99). KASR and KSD showed excellent correlation (ICC: 0.96; 95% CI: 0.82–0.98 and ICC: 0.94; 95% CI: 0.90–0.96, respectively) with the 3D system, while both methods of frontal plane projection angle showed poor to moderate correlation (ICC: 0–0.57) with the 3D system.Conclusion2D KASR and KSD measures are cost effective, reliable, and highly correlated with the same measures using 3D techniques for the evaluation of knee valgus.

Development of clinical competence assessment tool for novice physical and occupational therapists-a mixed Delphi study.

[Purpose] The aim of this study was to clarify essential abilities of novice physical and occupational therapists for independent execution of their duties and to develop a clinical competence assessment tool. [Subjects] Forty-five experienced therapists participated in this study. [Methods] A two-phase mixed-methods design was used. First, semi structured interviews were conducted on 15 experienced therapists to create a comprehensive list of essential abilities that novice therapists need. Second, 30 experienced therapists participated in a two-round Delphi study to select items for the assessment tool being developed. [Results] Fifty-five items were extracted and classified into three categories: basic attitudes, therapeutic skills, and clinical practice-related thoughts. [Conclusion] Present results suggest that not only knowledge of execution of therapy-related duties and therapeutic skills is essential in novice therapist, but also appropriate abilities in social adjustment, self-management, and self-education. The newly developed tool might be useful for postgraduate education in clinical practice.

Preparedness for physiotherapy in private practice: Novices identify key factors in an interpretive description study

BackgroundPhysiotherapists in Australia deliver services to a diverse range of clients, across many settings, however little research exists examining graduate preparedness for practice, even in the populous field of private practice. ObjectivesTo explore novice physiotherapist perspectives on preparedness for work in private practice. DesignThe qualitative approach of interpretive description was used to guide in-depth interviews with 8 novice physiotherapists from 3 universities working in 5 private practices in Melbourne. MethodsAll interviews were digitally recorded, transcribed verbatim and analyzed thematically. FindingsFour main themes influencing graduate preparedness for work in private practice were identified: 1) non-curricular experiences (e.g. sports training) 2) elective curricular: practicum experiences; 3) curricular: attainment of skills specific to private practice; and 4) the private practice setting: supportive colleagues. This combination of non-curricular, curricular, and practice setting factors offered the necessary scaffolding for the graduates to report feeling prepared for work in private practice. ConclusionsNon-curricular activities, radiological instruction, clinical placements, building supportive colleague relations and professional development in private practice are recommended as potential means of building preparedness in novice therapists. Findings have implications for physiotherapy students, educators and private practice clinics looking to recruit new graduates.

Evaluating novice physiotherapists satisfaction with simulation experience using a previously validated tool

Background: Simulation-based learning is increasingly being utilized by physiotherapists in Singapore as part of preparatory training for after-hours cardiorespiratory physiotherapy services in acute hospitals. There is a paucity of evaluative reports on the efficacy of this mode of training. Purpose: The purpose of this study is to provide an example of how the efficacy of high-fidelity system based simulation training may be evaluated using a previously validated tool. Methods: Participants were novice physiotherapists (n= 10) involved in a year-long simulation training program designed to prepare them for after-hourswork in an acute hospital, with a focus on cardiorespiratory techniques. A total of 10 simulation sessions were conducted based on common patient presentations seen in acute care areas. Participant satisfaction was evaluated immediately after debriefing using the Satisfaction with Simulation. Experience Scale (Levett-Jones, 2011). The Simulation Experience Scale (SSE) has a three-component structure which evaluates Debriefing and Reflection, Clinical Reasoning and Clinical Learning, as well as an open-ended section for comments. Results: Mean scores for all components of the SSE were high for all components (Debrief and Reflection: mean = 4.21; SD= 1.21, Clinical Reasoning: mean = 4.13; SD= 1.19, Clinical Learning: mean = 4.2; SD= 1.22). Common themes in the open-ended response section included requests for more sessions and hands-on practice time, as well as positive reports on how the sessions improved clinical reasoning skills. Conclusion(s):This study demonstrates that the SSEmay be a useful tool to evaluate one aspect of the efficacy of highfidelity system bases simulation programs, and participants consider such training modes to be valuable and applicable. Implications: Other aspects of the efficacy of simulation programs may need to be addressed, for example, carry-over into clinical practice and retention of learning.

Reliability of clinical competency evaluation list for novice physical and occupational therapists requiring assistance.

[Purpose] This study examined the reliability of a clinical ability evaluation table developed in a previous study with the aim of clarifying the abilities necessary for therapists to independently implement their duties. [Subjects and Methods] Forty-eight physical therapists with less than 2 years of clinical experience were targeted for evaluation, 48 main supervisors, and 48 sub-supervisors, 144 in total, were studied. [Results] The total score was lower when the evaluation was conducted by the target therapists themselves than when it was conducted by the main or sub-supervisors. Regarding the reliability of the total scores for the entire scale and each category, values representing the intra-rater reliability were higher when the evaluation was conducted by the target therapists or main supervisors, while there were marked differences between high and low values for each item. Regarding the inter-rater reliability, both the total scores for the entire scale and each category, as well as values for each item, were low. [Conclusion] Values representing the intra-rater reliability of the study table were low, indicating the necessity of further improvement.

Evidence-based learning and practice in physical therapy: A need for novice physical therapists

Evidence-based learning and practice in physical therapy: A need for novice physical therapists

Do we see the same movement impairments? The inter-rater reliability of movement tests for experienced and novice physiotherapists

Study design: Inter-rater reliability study. Background: Physiotherapists (PTs) use clinical tests including movement tests to identify faulty movement patterns. Aims: To investigate the inter-rater-reliability of active movement tests in the cervical spine, shoulder joint and scapulo-thoracic joint, and to describe the reasons for judgment of a positive test. Methodology: Four PTs, two experienced and two recently educated (novice), rated performance of five movement tests for 36 participants. Twenty-one of the participants were patients under treatment because of neck and/or shoulder problems, while 15 participants declared no problem from this region of the body. All tests were video recorded and the ratings were done by observing the video recordings. First, the PTs judged the tests as negative (the movement being ideally performed) or positive (the movement not being ideally performed). Then, the PTs described why the movements that they judged positive were not being ideally performed, using a predefined protocol, which represented different movement quality aspects. The inter-rater reliability was calculated for each test using Kappa statistics between the two experienced and the two novice PTs, respectively, and between each of the experienced and each of the novice PTs. Major findings: The experienced PTs had a higher inter-rater reliability than the novice PTs. The reasons for considering a movement test being positive differed highly between the (novice) PTs. Principal conclusion: This study supports previous studies concluding that the observation of active movement tests is reliable when assessed by experienced PTs. Novice PTs might benefit from further supervision.

The Perceptions of Slovak Physiotherapists of their Practice Placement Experience

The practice education of undergraduate physiotherapy students is crucial for developing skilful and knowledgeable healthcare professionals. In Slovakia, there is a lack of literature exploring physiotherapists’ practice education, which might have a serious impact on its future provision. Therefore, this study aimed to explore novice physiotherapists’ perceptions of their practice placement experience using a qualitative design. A purposive sampling of five participants was recruited to conduct semi-structured interviews which were translated and transcribed verbatim. Collected data underwent Interpretative Phenomenological Analysis (Smith et al. 2009). This resulted in four major themes that fully captured participants’ perceptions of their practice placement experience. Identified themes were as follows: ‘The practice educator who cares?’; ‘Clinical placement issues’; ‘Learning sources’ and ‘Ready for practice?’. Overall dissatisfaction and frustration from participants’ experience of practice placements suggested the necessity to put more focus on development, delineation and provision of practice education in Slovakia. Also, more research related to practice education of physiotherapists and preparation of the practice educators in Slovakia was recommended.