TY - JOUR
T1 - Physiotherapists’ perceptions on using a multidimensional clinical reasoning form during psychologically informed training for low back pain.
AU - Cowell, Ian
AU - McGregor, Alison
AU - O'Sullivan, Peter
AU - O'Sullivan, Kieran
AU - Poyton, Ross
AU - Murtagh, Ged
N1 - Publisher Copyright:
© 2023 Elsevier Ltd
PY - 2023/8
Y1 - 2023/8
N2 - Purpose: Building clinical reasoning skills is important to effectively implement psychologically informed practice. We developed a multidimensional clinical reasoning form (CRF) to be used by physiotherapists in a psychologically informed practice training programme for low back pain. In this paper we describe the development of the CRF, how the CRF was used in the training, and present an evaluation of physiotherapists’ perceptions of the CRF. Methods: Qualitative semi-structured interviews were conducted with ten physiotherapists purposively sampled in primary care. Data were gathered through pre, and post training focus group interviews and a secondary analysis of individual physiotherapist interviews conducted after the training. Thematic analysis was used to analyse the data and capture the emergent themes. Results: Two main themes emerged before the training: (1) the CRF ‘needs formal training’ and (2) ‘lacked instruction’. Three main themes emerged after the training (1) it provided ‘a helpful framework for multidimensional clinical reasoning’ (2) the CRF, and accompanying operational definitions, helped physiotherapists ‘elicit information, with ‘question prompts’ helpful in facilitating patient disclosure (3) ‘Utility’ - although the CRF was not formally used by the physiotherapists it provided a conceptual reasoning framework to work from with more challenging patients. Conclusion: The CRF was not designed to be used in isolation by clinicians without training. However, when used as a training adjunct it appears to be valued by physiotherapists to help develop their critical thinking and better characterise patients’ presentations in order to personalise care from a bio-psychosocial perspective.
AB - Purpose: Building clinical reasoning skills is important to effectively implement psychologically informed practice. We developed a multidimensional clinical reasoning form (CRF) to be used by physiotherapists in a psychologically informed practice training programme for low back pain. In this paper we describe the development of the CRF, how the CRF was used in the training, and present an evaluation of physiotherapists’ perceptions of the CRF. Methods: Qualitative semi-structured interviews were conducted with ten physiotherapists purposively sampled in primary care. Data were gathered through pre, and post training focus group interviews and a secondary analysis of individual physiotherapist interviews conducted after the training. Thematic analysis was used to analyse the data and capture the emergent themes. Results: Two main themes emerged before the training: (1) the CRF ‘needs formal training’ and (2) ‘lacked instruction’. Three main themes emerged after the training (1) it provided ‘a helpful framework for multidimensional clinical reasoning’ (2) the CRF, and accompanying operational definitions, helped physiotherapists ‘elicit information, with ‘question prompts’ helpful in facilitating patient disclosure (3) ‘Utility’ - although the CRF was not formally used by the physiotherapists it provided a conceptual reasoning framework to work from with more challenging patients. Conclusion: The CRF was not designed to be used in isolation by clinicians without training. However, when used as a training adjunct it appears to be valued by physiotherapists to help develop their critical thinking and better characterise patients’ presentations in order to personalise care from a bio-psychosocial perspective.
KW - Clinical reasoning form
KW - Low back pain
KW - Psychologically informed practice
KW - Training
UR - http://www.scopus.com/inward/record.url?scp=85162086165&partnerID=8YFLogxK
U2 - 10.1016/j.msksp.2023.102797
DO - 10.1016/j.msksp.2023.102797
M3 - Article
C2 - 37343402
AN - SCOPUS:85162086165
SN - 2468-8630
VL - 66
SP - -
JO - Musculoskeletal Science and Practice
JF - Musculoskeletal Science and Practice
M1 - 102797
ER -