Background

A new pathway of care proposes early comprehensive assessment and targeted management by specialist musculoskeletal clinicians for people with musculoskeletal conditions at risk of poor outcomes. Adoption of this care pathway is likely to be influenced by beliefs and behaviours of specialist musculoskeletal clinicians.

Objective

To evaluate the effect of an interactive educational workshop about the proposed clinical care pathway on knowledge, beliefs and practice of specialist musculoskeletal physiotherapists.

Design

Mixed methods.

Methods

Fifty specialist musculoskeletal physiotherapists participated in a 2-day interactive educational workshop. Knowledge, beliefs and clinical practice behaviours were assessed immediately before the workshop and 3 months’ later using surveys.

Results

Knowledge about key guideline messages improved and were maintained at follow-up. Most participants agreed to provide more targeted interventions to patients at risk of poor outcome (92%, 95% CI: 81%–98%) and utilise prognostic screening tools (84%, 95% CI: 71 to 93). However, only 56% (95% CI: 39%–68%) of participants believed implementing a shared care pathway was easy. At follow-up, participants’ beliefs were more aligned with the proposed care pathway (i.e., shared care: 83%, 95% CI: 68%–93%). With respect to clinical practice, there were 16% more referrals back to the primary physiotherapist at 3 months than before the workshop. Barriers (practitioner, patient and system factors) to implementation of the care pathway were discussed.

Conclusion

An interactive educational workshop influenced specialist musculoskeletal physiotherapists’ knowledge, beliefs and clinical practice, but barriers need to be overcome to facilitate widespread implementation.

中文翻译：

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在为肌肉骨骼疾病患者实施新的临床护理途径时，互动研讨会对专业物理治疗师实践的影响

背景

一种新的护理途径建议由专业的肌肉骨骼临床医生对有不良预后风险的肌肉骨骼疾病患者进行早期综合评估和有针对性的管理。这种护理途径的采用可能会受到专业肌肉骨骼临床医生的信念和行为的影响。

客观的

评估关于拟议临床护理途径的互动教育研讨会对专业肌肉骨骼物理治疗师的知识、信念和实践的影响。

设计

混合方法。

方法

50 名专业肌肉骨骼物理治疗师参加了为期 2 天的互动教育研讨会。知识、信念和临床实践行为在研讨会之前和 3 个月后使用调查进行评估。

结果

对关键指南信息的了解得到改善，并在随访中得到维护。大多数参与者同意为有不良预后风险的患者提供更有针对性的干预措施（92%，95% CI：81%–98%），并使用预后筛查工具（84%，95% CI：71 至 93）。然而，只有 56% (95% CI: 39%–68%) 的参与者认为实施共享护理路径很容易。在随访中，参与者的信念更符合提议的护理途径（即共享护理：83%，95% CI：68%–93%）。在临床实践方面，与研讨会前相比，在 3 个月时转诊给初级物理治疗师的人数增加了 16%。讨论了实施护理途径的障碍（从业者、患者和系统因素）。

结论

互动式教育研讨会影响了专业肌肉骨骼物理治疗师的知识、信念和临床实践，但需要克服障碍以促进广泛实施。