Disability and rehabilitation · 2025
Improving physiotherapists' reasoning for planning rehabilitative treatment: A second-phase pilot study of a teaching intervention designed to promote uptake of the Rehabilitation Treatment Specification System (RTSS) in an acute rehabilitation hospital.
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Gibson Jamie, Sampford Jade, Myers-Ingram Richard, Ashford Stephen, Corcoran Jeremy, Jones Gareth D
Аннотация
PURPOSE: To determine the preliminary efficacy of a teaching programme designed to promote uptake of the Rehabilitation Treatment Specification System (RTSS) into clinical practice.
MATERIALS AND METHODS: Second phase pilot pre-post study. UK inpatient acute hospital. Three physiotherapist groups (total n = 26); specialising in elective orthopaedics, head and neck surgeries, and older persons' medicine received teaching, including case-based learning. Outcomes included frequency of RTSS terminology in case notes, and evidence of clinical reasoning using self-assessment and external review, measured before, immediately after, and two months after the interventions.
RESULTS: Significant increase in median controlled-vocabulary count was observed across time points within orthopaedics [𝜒2(2)=30.094, p < 0.001], head and neck [𝜒2(2)=16.979, p < 0.001], and older persons [𝜒2(2)=21.227, p < 0.001] teams. There was significant improvement across all physiotherapists in median total Self-Assessment of Clinical Reasoning & Reflection tool (SACRR) scores pre-post teaching, sustained at 2months [𝜒2(2)=9.051, p = 0.011]. Only the head and neck team demonstrated significant improvements in mean-ranked quality rating distributions, in problem lists [H(2)=13.148, p = 0.001] and treatment goal [H(2)=6.593 p = 0.037] components according to the clinical reasoning rubric.
CONCLUSION(S): Our study demonstrated that despite variable RTSS uptake, the RTSS may advance clinical reasoning. Our findings inform experimental study of the effect of the RTSS on clinical reasoning.
MATERIALS AND METHODS: Second phase pilot pre-post study. UK inpatient acute hospital. Three physiotherapist groups (total n = 26); specialising in elective orthopaedics, head and neck surgeries, and older persons' medicine received teaching, including case-based learning. Outcomes included frequency of RTSS terminology in case notes, and evidence of clinical reasoning using self-assessment and external review, measured before, immediately after, and two months after the interventions.
RESULTS: Significant increase in median controlled-vocabulary count was observed across time points within orthopaedics [𝜒2(2)=30.094, p < 0.001], head and neck [𝜒2(2)=16.979, p < 0.001], and older persons [𝜒2(2)=21.227, p < 0.001] teams. There was significant improvement across all physiotherapists in median total Self-Assessment of Clinical Reasoning & Reflection tool (SACRR) scores pre-post teaching, sustained at 2months [𝜒2(2)=9.051, p = 0.011]. Only the head and neck team demonstrated significant improvements in mean-ranked quality rating distributions, in problem lists [H(2)=13.148, p = 0.001] and treatment goal [H(2)=6.593 p = 0.037] components according to the clinical reasoning rubric.
CONCLUSION(S): Our study demonstrated that despite variable RTSS uptake, the RTSS may advance clinical reasoning. Our findings inform experimental study of the effect of the RTSS on clinical reasoning.