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Lackenbauer W1,2, Selfe J1, Janssen J3, Roddam H3
1Manchester Metropolitan University, Faculty of Health, Psychology and Social Care, Manchester, United Kingdom, 2University of Applied Sciences Krems, Health Sciences, Krems, Austria, 3University of Central Lancashire, School of Health Sciences, Preston, United Kingdom
Background: An ongoing discussion about increased practice autonomy for physiotherapists in Austria has led to amendments in the mandatory learning outcomes within the Austrian undergraduate physiotherapy curriculum. In the case of enhanced practice autonomy, it will be then paramount for new graduates to independently screen patients for the presence of serious pathology which require medical attention.
Purpose: Future challenges of increased practice autonomy for physiotherapists in Austria require the development of a curriculum that properly educates physiotherapy students to make sound and autonomous keep/refer decisions and to recognise the presence of serious medical conditions. This study examined the feasibility, acceptability and potential effectiveness of an educational intervention which aimed to improve the keep/refer decision making competencies of Austrian undergraduate physiotherapy students.
Methods: This mixed-methods randomised pilot study recruited sixth semester undergraduate physiotherapy students in Austria. Participants were randomised in either a) the educational intervention which consisted of a single, one hour face-to-face case based learning (CBL) lecture on the principles of differential diagnosis, screening for red flag pathologies and review of the body systems, or b) a control group. The feasibility of the intervention was analysed in terms of recruitment rates for Universities and students. The acceptability was measured with affective attitude, burden and perceived effectiveness. Participating students completed 11 validated vignettes which were analysed using descriptive statistics. The potential effectiveness of the educational intervention was examined by observing a difference in the average percentage of correct keep/refer decisions for medical critical vignettes between the intervention and control group.
Results: Recruitment rates (feasibility) and the acceptability of the intervention were high. Half of Austrian Universities (n=6out of 12) took part in the study. The total number of 116 study participants represented 24.7% of all final year Austrian undergraduate physiotherapy students. 100% of students from the intervention group were satisfied with the intervention (affective attitude) and 77.6% found the intervention beneficial for making keep/refer decisions based on clinical vignettes (perceived effectiveness). 89.7% did not find the intervention too time consuming (burden).
A potential effectiveness of the intervention could not be demonstrated. Students from the intervention group did not on average make more accurate keep/refer decisions for vignettes from the medical critical category. A correct keep/refer decision for the medical critical vignettes was made on average in only half of the cases by both groups.
Conclusion(s): A single-hour CBL educational intervention which aimed at improving the keep/refer decision making abilities of Austrian undergraduate physiotherapy students was found to be feasible and acceptable.
To assess the efficacy of similar CBL educational interventions, future studies should involve more contact hours over a longer period of time.
Implications: In light of the ongoing discussion about enhanced practice autonomy for physiotherapists in Austria, more needs to be done to develop a curriculum that properly educates undergraduate physiotherapy students on how to make sound and autonomous keep/refer decisions and recognise the presence of serious pathologies which require medical attention.
Keywords: Keep/refer decisions making, red flag screening, physiotherapy education
Funding acknowledgements: This study received no specific grant from any funding agency in the public, commercial or not-for-profit sectors.
Purpose: Future challenges of increased practice autonomy for physiotherapists in Austria require the development of a curriculum that properly educates physiotherapy students to make sound and autonomous keep/refer decisions and to recognise the presence of serious medical conditions. This study examined the feasibility, acceptability and potential effectiveness of an educational intervention which aimed to improve the keep/refer decision making competencies of Austrian undergraduate physiotherapy students.
Methods: This mixed-methods randomised pilot study recruited sixth semester undergraduate physiotherapy students in Austria. Participants were randomised in either a) the educational intervention which consisted of a single, one hour face-to-face case based learning (CBL) lecture on the principles of differential diagnosis, screening for red flag pathologies and review of the body systems, or b) a control group. The feasibility of the intervention was analysed in terms of recruitment rates for Universities and students. The acceptability was measured with affective attitude, burden and perceived effectiveness. Participating students completed 11 validated vignettes which were analysed using descriptive statistics. The potential effectiveness of the educational intervention was examined by observing a difference in the average percentage of correct keep/refer decisions for medical critical vignettes between the intervention and control group.
Results: Recruitment rates (feasibility) and the acceptability of the intervention were high. Half of Austrian Universities (n=6out of 12) took part in the study. The total number of 116 study participants represented 24.7% of all final year Austrian undergraduate physiotherapy students. 100% of students from the intervention group were satisfied with the intervention (affective attitude) and 77.6% found the intervention beneficial for making keep/refer decisions based on clinical vignettes (perceived effectiveness). 89.7% did not find the intervention too time consuming (burden).
A potential effectiveness of the intervention could not be demonstrated. Students from the intervention group did not on average make more accurate keep/refer decisions for vignettes from the medical critical category. A correct keep/refer decision for the medical critical vignettes was made on average in only half of the cases by both groups.
Conclusion(s): A single-hour CBL educational intervention which aimed at improving the keep/refer decision making abilities of Austrian undergraduate physiotherapy students was found to be feasible and acceptable.
To assess the efficacy of similar CBL educational interventions, future studies should involve more contact hours over a longer period of time.
Implications: In light of the ongoing discussion about enhanced practice autonomy for physiotherapists in Austria, more needs to be done to develop a curriculum that properly educates undergraduate physiotherapy students on how to make sound and autonomous keep/refer decisions and recognise the presence of serious pathologies which require medical attention.
Keywords: Keep/refer decisions making, red flag screening, physiotherapy education
Funding acknowledgements: This study received no specific grant from any funding agency in the public, commercial or not-for-profit sectors.
Topic: Education
Ethics approval required: Yes
Institution: Manchester Metropolitan University
Ethics committee: Manchester Metropolitan University Ethics Committee.
Ethics number: Ethical approval 1390
All authors, affiliations and abstracts have been published as submitted.
