Engagement in performing clinical physiotherapy research: Perspectives from leaders and physiotherapists

Developing an application for the UK Pre-Doctoral Clinical and Practitioner Academic Fellowship (PCAF): the collective experience of a community of physiotherapists

For physiotherapists and other healthcare professionals, developing capability and expertise in research can be challenging. However, involvement in research is beneficial at organisational and individual levels, both for clinicians and patients. One way to embark on research is to apply for a personal fellowship such as the National Institute for Health and Care Research (NIHR) Pre-Doctoral Clinical Academic Fellowship (PCAF). While the NIHR has guidance on how to complete the application form, it can be difficult to implement this guidance and understand what a competitive application looks like. As a group of physiotherapists and academic supervisors, who have applied for NIHR PCAFs, what follows is a supportive resource, to inform others who might be thinking of applying. CONTRIBUTION OF PAPER.

Therapists' Perceptions of Participating in a Large Research Study: Benefits, Challenges, and Impact on Practice

Aims: Clinician participation in research is important to expand clinical research. However, there is limited understanding of the impact of such participation. The purpose of this survey-based study was to describe school-based physical therapists' perceptions of the impact, benefits, and challenges of research participation.Methods: Participants were school-based physical therapists (n = 67) who had been research personnel in a year-long study. Participants completed a questionnaire regarding their experiences participating in the study.Results: Most therapists (59%) perceived that participating in the study improved their competency as a school-based PT a small extent. Participation impacted some therapists a moderate to a great extent in their student assessments (43%), decision-making (28%), and team collaboration (25%). Almost all therapists (96%) responded that they would participate in research again. Researchers identified three themes regarding benefits of participating in research: 1) research and promoting the growth of the profession, 2) support for and expansion of my school-based practice, and 3) reflective practitioner. Researchers identified four themes regarding challenges of participating in research: 1) administrative aspects; 2) time; 3) training; and 4) implementing the tools.Conclusions: Findings from this study support therapist participation in research, and have implications for clinicians, supervisors, and researchers.

Is there agreement between the preference of examiner and women for unidigital and bidigital vaginal palpation? A qualitative study

INTRODUCTION AND HYPOTHESIS

The International Continence Society recommends vaginal palpation as a method for assessing pelvic floor muscle (PFM) function. Our aim was to analyze the agreement between preferences of examiner and participants according to unidigital and bidigital vaginal palpation during PFM assessment. The second aim was to investigate qualitatively women's perception of vaginal palpation.

METHODS

Maximal voluntary contractions (MVCs) were requested during both types of vaginal palpation and were classified by the Modified Oxford Scale (MOS). Examiner and participants answered if they had preferences regarding vaginal palpation. Women answered qualitatively what they felt during the assessment. Cohen's linear kappa (κ) evaluated the agreement after allocation of the women with a weaker and stronger MVC and qualitative analysis was performed by transcription considering age range (18-35; 36-59; ≥60 years).

RESULTS

Agreement was almost zero for women with weaker and stronger MVC at unidigital (κ = 0.06 and κ = -0.12) and bidigital vaginal palpation (κ = 0.008 and κ = 0.005). Participants associated bidigital palpation with more perception and an easier way of contracting the PFMs. Women between 36 and 59 years associated unidigital palpation with a harder but comfortable way of contracting the PFMs. Subjects aged ≥60 years associated bidigital palpation with an uncomfortable, harder way of contracting PFM, with less space into the vagina.

CONCLUSIONS

Agreement between preferences was almost zero neither between women with a weaker and stronger PFM contraction, nor between the types of vaginal palpation. Bidigital palpation increased women's perception, made the contraction easier, and was associated with less space in the vaginal canal and less comfort.

Evidence-based practice by physiotherapists in UAE: Investigating behavior, attitudes, awareness, knowledge and barriers

Evidence-based practice (EBP) is an important factor determining the quality of healthcare. The field of physiotherapy is still limited by indirect access in several countries including the United Arab Emirates (UAE) which creates added pressure to justify the merit in its practitioner’s capabilities. This study explores the behavior, attitudes, awareness and knowledge towards EBP among practicing physiotherapists in the UAE. It also enquires about their perception of the barriers in the implementation of EBP. Using a questionnaire survey of 258 physiotherapists, results show that the awareness of EBP is limited to a few terms including EBP, systematic literature review, and random trials while other terms associated with scientific studies are not known well. The attitude towards EBP was found to be significantly related to the knowledge of EBP (r = 0.208) and the perception of barriers to it (r = 0.156). The EBP behavior was found positively related to its knowledge (r = 0.134) and the perception of barriers (r = 0.216). The physiotherapists prefer to use their own experience and books and research articles to apply EBP but do not consider their peers to be as worthy sources as the others. However, their attitudes towards EBP are largely positive though their perception of barriers grows with better knowledge and understanding of EBP. The barriers in the implementation of EBP are a lack of research knowledge and skills, time, support, and resources which indicate opportunities for the decision-makers to improve the adoption of EBP among these professionals. This study concluded that although physiotherapists in the UAE claim awareness about EBP, their knowledge is limited to a few key terms whereas, attention is needed to improve EBP knowledge and practice.

Experiences and attitudes toward scientific research among physiotherapists in Austria: a cross-sectional online survey

INTRODUCTION

Research is important for the development of physiotherapy practice, but several countries have a rather short history of physiotherapy as an academic profession.

PURPOSE

This study investigated physiotherapists' experiences and attitudes toward scientific research in Austria, where physiotherapists have only been qualifying at bachelor level since 2009.

METHODS

A convenience sample of 597 qualified physiotherapists completed an anonymous cross-sectional online survey.

RESULTS

Most respondents were female (n = 467, 78.2%) and in age groups between: 26-35 years (n = 149, 25.0%); 36-45 years (n = 178, 29.8%); and 46-55 years (n = 173, 29.0%). Seventeen respondents (2.8%) held doctoral degrees, and 61 (10.2%) had substantial research experience beyond undergraduate or master-level student research. More positive research attitudes were observed in participants who were male, younger, without children, had completed their physiotherapy qualification since 2009, were engaged in teaching and education, and held postgraduate degrees. Most frequently reported barriers and/or enabling factors for physiotherapy research were time, training, finances and a "critical mass" of research activity.

CONCLUSION

These findings highlight low levels of research activity among physiotherapists in Austria, despite general appreciation of the importance of research for the profession. The identified attitudinal profiles, barriers, and facilitators may inform initiatives for advancing physiotherapy research in the Austrian context.

Therapist perceptions of a rehabilitation research study in the intensive care unit: a trinational survey assessing barriers and facilitators to implementing the CYCLE pilot randomized clinical trial

Background

Rehabilitation interventions, including novel technologies such as in-bed cycling, could reduce critical illness-associated morbidity. Frontline intensive care unit (ICU) therapists often implement these interventions; however, little is known about their perceptions of engaging in clinical research evaluating these technologies.

Objective

To understand frontline therapist perceptions of barriers and facilitators to implementing a pilot randomized controlled trial (RCT) of early in-bed cycling with mechanically ventilated patients in the ICU and outcome measures (CYCLE Pilot RCT; NCT02377830).

Methods

We developed a 115-item, self-administered, electronic survey informed by 2 complementary knowledge translation (KT) models: the Capability-Opportunity-Motivation-Behaviour (COM-B) system and the Theoretical Domains Framework (TDF). We included demographics and 3 sections: Rehabilitation Practice and Research, Cycling, and Physical Outcome Measures. Each section contained items related to the COM-B system and TDF domains. Item formats included 7-point Likert-type scale questions (1 = strongly disagree, 7 = strongly agree) and free-text responses. We invited therapists (physiotherapists, occupational therapists, and therapy assistants) who participated in the international, multi-center, CYCLE Pilot RCT to complete this cross-sectional survey. We descriptively analyzed results by survey section, COM-B attribute, TDF domain, and individual question within and across sections. We identified barriers based on items with median scores < 4/7.

Results

Our response rate was 85% (45/53). Respondents were from Canada (67%), the USA (21%), and Australia (11%). The majority had a physiotherapy background (87%) and previous research experience (87%). By section, Rehabilitation Practice and Research (85%; 95% confidence interval (CI) [82%, 87%]) was higher than Cycling (77%; 95% CI [73%, 80%]) and Outcome Measures (78%; 95% CI [75%, 82%]). Across the 3 sections, Motivation was lower than Capability and Opportunity. The most common Motivation barrier was the emotion TDF domain, related to the time required to conduct cycling and outcome measures (median [1st, 3rd quartiles] 3/7 [2, 6]).

Conclusions

Frontline ICU therapists had positive perceptions of research engagement. However, we identified barriers related to Motivation, and concerns regarding time to implement the research protocol. Our results can inform specific KT strategies to engage frontline ICU therapists and optimize protocol implementation in critical care rehabilitation research.