IMPACT OF LEARNING THE ICF-CY FRAMEWORK AS A CLINICAL REASONING TOOL FOR PAEDIATRIC PHYSIOTHERAPISTS WORKING WITH CHILDREN WITH CEREBRAL PALSY

¹University of Strathclyde, School of Psychological Sciences and Health, Glasgow, United Kingdom

Background: Cerebral Palsy (CP) is the most common motor disability in Saudi Arabia (SA). Learning how to use the International Classification of Functioning Disability and Health for Children and Youth (ICF-CY) model enables Paediatric Physiotherapists (PPTs) to consider environmental and personal factors in the management of a child with CP. Using the ICF-CY model as a clinical reasoning tool may also help to improve PPTs' clinical reasoning. However, the actual level of PPTs' ICF-CY knowledge, their use of the model in the management of children with CP, their decision-making processes and decision-making behaviour in the application of environmental and personal factors, are unknown.

Purpose: To explore the impact on PPTs' clinical reasoning of learning the ICF-CY model, and using it as a clinical reasoning tool in Saudi Arabia for children with CP.

Methods: Longitudinal quasi-experimental study design to evaluate the impact of a two-day ICF-CY in-service training called Application of the ICF-CY Framework as a Clinical Reasoning Tool for Children with Cerebral Palsy (CP). The training was developed and delivered in Saudi Arabia in order to train paediatric physiotherapists to develop their clinical reasoning in the management of children with CP using the ICF framework. 36 PPTs who attended the training, and answered pre-and-post self-completion questionnaires. Pre-and-Post PPTs’ questionnaires developed and used during training to measure three clinical reasoning elements; self-reported levels ICF knowledge, PPTs’ decision-making process, intention, attitude and belief in applying environmental and personal factors in the management of children with CP.

Results: The level of ICF knowledge after the ICF-CY training, there was an increase in self-reported ICF-CY knowledge (post-training M = 5.3, SE = 0.30) (pre-training M = 2.7, SE = 0.20). After ICF-CY training, mean scores of the PPTs’ decision-making, from the sum of the three case scores, was higher (M = 3.5, SE = 0.26), compared to pre-training (M = 2.5, SE = 0.26). There was a significant difference t (35) = -2.06, p = 0.04, and showed a small effect of training d = 0.4. PPTs’ attitude toward the application of environmental and personal factors between pre- and post-training was a significant difference in the scores for the ICF-CY post-training (M = 32.4, SE = 0.33) compared to pre-training (M = 28.1, SE = 0.3) conditions; t (35) = -3.5, p = 0.00.

Conclusion(s): The impact of ICF-CY training was significant on PPTs factual, conceptual and procedural ICF knowledge, their decision-making process and on their intentions and attitudes to the application of environmental and personal factors in the management of a child with CP.

Implications: The results suggest that training the ICF-CY model as clinical reasoning tool could facilitate application environmental and personal factors in management children with CP.

Funding acknowledgements: This study was funded by Medical Service of the Ministry of Defence in Saudi Arabia
for PhD scholarship.

Topic: Education: clinical

Ethics approval: Ethical Approval obtained from University of Strathclyde Ethics Committee and Medical Service of the Ministry of Defence in Saudi Arabia.

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