CONFIDENCE LEVELS AND CONTRIBUTION OF PREPARATION FACTORS FOR RECENT PHYSICAL THERAPY GRADUATES TO INDEPENDENTLY EVALUATE AND TREAT PATIENTS WITHOUT REFERRAL

T. Eichelberger¹, J. Lwin²

¹Azusa Pacific University, Physical Therapy, Azusa, United States, ²American Career College, Physical Therapist Assistant, Anaheim, United States

Background: Physical therapists (PT) are becoming the provider of choice for evaluation and treatment of musculoskeletal disorders and also the first point of contact for a patient to address their condition(s).Outpatient orthopaedic settings are key locations for implementation of evaluation and treatment without referral (i.e. unrestricted direct access). Since confidence is a measurable component of clinical practice and may influence independent decision-making during assessment, it is important to determine to what extent various factors can contribute to confidence with clinical skills.This is important with regards to new graduates who have limited exposure to autonomous practice, as well as clinical experience.No research has attempted to identify factors contributing to a newly graduated physical therapist’s confidence to independently evaluate and treat without referral.

Purpose: The purpose of this study was to assess the opinions of physical therapists regarding factors contributing to confidence in the ability to independently evaluate and treat without referral in an outpatient orthopaedic setting following graduation from PT school.

Methods: Following IRB approval, surveys were sent through association database contacts.Surveys utilized a Likert scale reflecting agreement/disagreement and rank ordering various factors reporting confidence utilizing manual therapy and providing unrestricted direct access within 4 weeks graduating PT school. Demographic information was also collected. Results were reported as percentages of total responses.Additionally, to assess for a potential relationship between confidence level to independently implement unrestricted direct access and preparation factors, a point-biserial correlation coefficient was calculated.

Results: Sixty-four surveys representing 31 PT programs (graduating 1980-2012) in 14 states (in the USA) were analyzed.Thirty-one percent reported confidence independently providing direct access.Twenty-five percent reported that confidence to independently implementing direct access was most influenced by clinical mentoring following graduation. There was a strong relationship between confidence levels to independently implement unrestricted direct access and type of degree (Master of Physical Therapy (MPT) or Doctor of Physical Therapy (DPT)) (r=.725, p<.00).

Conclusions: Mentoring post-graduation and having a DPT degree were important factors contributing to newly graduated PT's confidence.Further development of clinical expertise through additional internships or clinical residency programs, and/or attaining a higher-level physical therapy degree may be beneficial to a newer graduate’s confidence to independently evaluate and treat patients without a referral.

Implications: The factors identified in this study that contribute to a new graduate’s confidence to provide patient evaluation and treatment without referral provides information on potential areas of focus which could be enhanced and thus contribute to improved clinical performance.

Funding acknowledgements: none

Keywords:
Direct access
New graduates
Clinical confidence

Topics:
Professional practice: other
Professional issues
Service delivery/emerging roles

Did this work require ethics approval? Yes

Institution: Azusa Pacific University

Committee: Institutuional Review Board

Ethics number: 16-13