To develop a conceptual framework that contextualizes the intended use of ultrasound imaging in physiotherapy, while providing a foundation for clinical reasoning and decision-making.
A three-step process supports the development of the proposed conceptual framework, which will serve as the foundation for a larger-scale project. First, a panel of experts, consisting of four physiotherapists with advanced competencies in ultrasound imaging, conducted a literature search for relevant frameworks related to clinical reasoning, decision-making, and ultrasound imaging. Second, the same panel inventoried various intended uses of ultrasound imaging in physiotherapy clinical practice using a taxonomic approach and organized these elements to highlight their connection to clinical reasoning and decision-making within the framework. Third, consultations with external experts were conducted to validate the approach selected to contextualize the intended use of ultrasound imaging in physiotherapy.
First, after considering various models, the panel selected the documentation model HSOAPIER, currently in use by physiotherapists in Québec, as the pillar for the conceptual framework. This model, an expansion of the internationally recognized SOAP note method, supports clinical reasoning and decision-making. It includes the following key domains: history (H) and subjective information (S), objective evaluation (O), analysis (A) and treatment planning (P), intervention (I), evaluation of the intervention’s outcomes (E), and recommendations (R). Second, the panel inventoried all current intended uses of ultrasound imaging in physiotherapy and organized them into a two-tier hierarchical structure within key dimensions, with its use being particularly prominent in the O, A, and I domains. The first-tier defines categories of ultrasound intended use, while the second tier provides definitions or examples. Finally, consistent with the patient-centred care model, all key domains are illustrated and interconnected in a honeycomb shape, revolving around the central elements: the context, clinical reasoning, and client.
The proposed conceptual framework contextualizes the intended use of ultrasound imaging in physiotherapy and may facilitate its implementation in clinical practice. It is currently being validated by physiotherapists and other healthcare professionals skilled in ultrasound imaging through an iterative, convergent mixed-method design.
This framework presents a unique approach to clarify the intended use of ultrasound imaging in physiotherapy. Once validated, it could further accelerate implementation into clinical practice and facilitate inter-professional collaboration as the use of ultrasound imaging within the physiotherapy scope of practice is defined. It may also prove useful to further specify the professional competencies that need to be developed for physiotherapists to use ultrasound imaging and practice to the full extent of their capabilities.
Ultrasound imaging
Physiotherapy
