Physical and occupational therapists' perceptions of sustainability of a knowledge translation intervention to improve the use of outcome measures in inpatient rehabilitation: a qualitative study.

PURPOSE: To assess the perceptions, barriers, and facilitators of sustaining the use of outcome measures of physical and occupational therapists following a three-year knowledge translation intervention. METHODS: A phenomenological qualitative study was conducted at an inpatient rehabilitation hospital on 13 clinicians (6 physical therapists and 7 occupational therapists) participating in the knowledge translation intervention. Data collection used semi-structured interviewing during three focus groups to understand the lived experience of clinicians participating in the knowledge translation project. Data were analyzed using the Consolidated Framework for Implementation Research (CFIR) codebook. RESULTS: Two investigators coded twelve CFIR constructs into barriers and facilitators for outcome measure use. Four key themes emerged as determinants for outcome measures use: (1) Organizational support and clinician engagement; (2) the knowledge translation intervention; (3) the outcome measures themselves; and (4) the patients. Clinicians reported using outcome measures for patient education, treatment planning, and goal setting, while they found other outcome measures lacked functional significance. Facilitators included organizational support, access to knowledge, ongoing training, and clinician engagement. Ongoing barriers included the need for more training and the need to select different tests. CONCLUSIONS: This study found proper selection of outcomes measures is important and attributed the sustainability of the knowledge translation intervention to organizational support, clinician engagement and ongoing training. The clinicians wanted continued training to overcome new barriers. Barriers identified in this study were unique to the typical barriers identified for outcome measure use. Ongoing barrier assessments are needed for continued refinement of knowledge translation interventions to enhance sustainability.

Systematic Development of Standards for Mixed Methods Reporting in Rehabilitation Health Sciences Research.

OBJECTIVE: Mixed methods research (MMR) integrates quantitative and qualitative methods throughout the research process to answer complex research questions. MMR designs align with the guiding frameworks of patient-centered care and social determinants of health by effectively examining the role of contextual factors and human experiences in influencing health and rehabilitation outcomes. Reporting standards and critical appraisal tools ensure the quality and transparency of the research process. MMR standards exist; yet, there is a need for reporting guidelines and an appraisal tool that meets field standards, is applicable across rehabilitation fields of study, and can accommodate the range of possibilities for combining research approaches and methods. METHODS: Mixed Methods Reporting in Rehabilitation & Health Sciences (MMR-RHS) was developed using a systematic consensus-building process in accordance with published guidance and was preregistered with the Enhancing the Quality and Transparency of Health Research Network. MMR-RHS evolved through a sequence of steps, including extensive literature review, expert consultation, stakeholder feedback, pilot testing, and tool refinement. RESULTS: MMR-RHS consists of 20 criteria that align with field standards for rigor and transparency, with an emphasis on integration throughout the research process, a key component of MMR. CONCLUSIONS: A systematic process was utilized to develop the reporting standards and an appraisal tool for MMR in rehabilitation and health science. The tool is comprehensive, includes a set of criteria grounded in MMR literature, and is flexible for application to a range of MMR designs commonly seen in rehabilitation research. IMPACT: The MMR-RHS may improve the quality and transparency of MMR by supporting investigators, authors, reviewers, and editors during project development, manuscript preparation, and critical review. The tool may assist readers in critical appraisal, knowledge translation, and application of published MMR findings. Ultimately, the MMR-RHS may help legitimize mixed methods in rehabilitation and health research, an important step toward understanding the complexities of health care, patient outcomes, and evolving societal health needs.

Students' perspectives of core value development in a modified problem-based learning program.

Physical therapy educational programs are tasked to develop core values in their students as the foundation of professionalism. Problem-based learning (PBL) is an approach that intends to enrich exploration of issues in clinical decision making, understand how patient care is supported by other aspects of professional practice, and develop examination, intervention and communication skills. This qualitative study aimed to understand, interpret, and describe doctoral physical therapy students' perspectives of core value development in a modified PBL program. Twenty-seven of 49 students from a single class participated in the study at the time of graduation. Phenomenological methods via semi-structured focus group interviews were used to foster an in-depth understanding of students' experiences. Interviews were thematically organized by the constant comparison method and several strategies were used to establish trustworthiness. Eleven emerging themes represented the adjustment to PBL and essence of core value development from the students' perspective. An additional overarching theme "transformation" was also identified as students described a process of "transformation" from student to professional, supported by the curricular elements of the modified PBL process. These findings inform faculty on educational methods and curricular strategies, which may enhance the development of professional core values, regardless of curricular format.

Development of the Clinical Teaching Effectiveness Questionnaire in the United States.

PURPOSE: The purpose of this study was to develop a valid measure for assessing clinical teaching effectiveness within the field of physical therapy. METHODS: The Clinical Teaching Effectiveness Questionnaire (CTEQ) was developed via a 4-stage process, including (1) initial content development, (2) content analysis with 8 clinical instructors with over 5 years of clinical teaching experience, (3) pilot testing with 205 clinical instructors from 2 universities in the Northeast of the United States, and (4) psychometric evaluation, including principal component analysis. RESULTS: The scale development process resulted in a 30-item questionnaire with 4 sections that relate to clinical teaching: learning experiences, learning environment, communication, and evaluation. CONCLUSION: The CTEQ provides a preliminary valid measure for assessing clinical teaching effectiveness in physical therapy practice.