2018-2019 Grant in Aid of Research

Are Musculoskeletal Physical Therapists Using Diagnostic Clinical Prediction Rules? Determining the Facilitators and Barriers to Implementation.

Drew Bourret

The scope of physical therapy is continually growing and as primary care practitioners, physical therapists need to utilize evidence-based practices. Physical therapists are now relied upon as the experts in recognizing musculoskeletal injuries, and in some cases, can order diagnostic imaging. A clinical prediction rule is a series of clinical findings, both subjective and objective, that allow the clinician to select an appropriate patient intervention with confident statistical predictability. These clinical prediction rules, or “checklists” can be very useful in determining whether or not diagnostic imaging, such as an x-ray, is needed. Although they are useful, physical therapists are not aware of them, or may not be using them. Therefore, using the theoretical domains framework, which is a tool developed to analyze and study behavior changes, this project aims to study the use of clinical prediction rules by physical therapists. An online survey will be distributed to physical therapists, asking questions on their awareness and use of clinical prediction rules. The data will then be analyzed in order to determine what behaviors are most involved in why physical therapists are not using clinical prediction rules. By determining why physical therapists are not using diagnostic clinical prediction rules, researchers and clinicians will be able to implement education strategies to encourage their usage, or future clinical prediction rules can be better developed with these behavior in mind. Overall, this study hopes to help facilitate an increase in the proper use of clinical prediction rules, which in turn will help diagnose patients who require imaging more accurately.