Comparison of Physical Therapy StudentsÕ and Physical TherapistsÕ Knowledge of Low Back Pain Clinical Practice Guidelines

Background & Purpose : Low back pain (LBP) is one of the most prevalent and expensive health care problems in the United States. Many clinical practice guidelines (CPGs) have been developed and proposed regarding the management of this patient population. A recent survey identified varied levels of understanding of CPG content related to decisions about clinical vignettes. Physical therapists with greater clinical experience were more likely to make recommendations found in CPGs and it was hypothesized that current entry level programs may not incorporate this information into their curricula. Therefore, the purpose of this study was to measure studentsÕ knowledge of recommendations for the management of patients with LBP based on contemporary guidelines. We hypothesized that physical therapy students would perform as well as physical therapists based on our curriculum.Case Description : 43 students taking a second year musculoskeletal course were studied. They completed a 2 week module on the physical therapy management of LBP. This module included content regarding the epidemiology/pathophysiology and management of patients with LBP, however an emphasis was placed on the application of theoretical frameworks and stratification based on risk, mechanism, and treatment responsiveness. This module was completed prior to the publication of the survey study described above. Tests items from the survey study were included in the regularly scheduled examination for this course. Test items included content related to imaging need, medication use, advice to stay active, and appropriate referral. To our knowledge, students were unaware of this recent publication.Outcomes : All students completed the examination. Correct responses were 67.4% for imaging need, 74.4% medication use, 58.1% for advice to stay active, and 90.7% for appropriate referral. 32.5% of students correctly answered all 4 items. The percent correct for the students were generally higher than those reported for the physical therapists (55.9, 54.7, 62.0, 92.7, and 16.6% respectively).Discussion : The findings of this case study supported our hypothesis that students would perform as well as physical therapists on questions related to the use of CPGs for patients with LBP. Students performed better on 2 out of 4 items, with a higher percentage of students answering all items correctly. Upon further review, performance on the item related to activity may have been affected by poor test item construction rather than knowledge of both groups. In addition, the findings of the previous survey study may be related to habits obtained in clinical practice rather than education, as the students performed near or above 70% on 3 out of the 4 items. These findings may not be generalized to curricula that do not include similar content. This phenomenon needs to be further studied to determine the best methods for translating evidence into practice.

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  • Control #: 2024783
  • Type: Poster
  • Event/Year: CSM2015
  • Authors: Douglas Haladay, Laura L. Swisher, Aimee B. Klein
  • Keywords: clinical practice guidelines|low back pain|entry level education

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