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.

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.