To explore the clinical reasoning strategies used by extended scope physiotherapists (ESPs) when assessing patients with low back pain. Extended scope physiotherapists commonly work in back pain services and their training emphasises the acquisition of clinical skills and possible diagnostic tests (including MRI) to aid clinical reasoning and diagnosis. Whilst there has been some exploration of reasoning strategies of other professional groups (notably medically qualified) to date, the clinical reasoning strategies of ESP clinicians have not been reported.Purpose of study
Background
Effective communication between healthcare professionals and patients is key to a successful consultation and is reported to affect both adherence to treatment and outcome. Despite this evidence, research on how best to open consultations is limited and the optimal way, unknown. This study seeks the opinions of physiotherapists on how to open a clinical encounter in an adult musculoskeletal outpatient setting – a topic which has relevance to all clinicians aiming to build rapport with their patients. Forty clinical encounters between physiotherapists in a primary care setting and patients with back pain were observed and audio-recorded. The clinicians' key questions inviting the patient to discuss their back pain were identified, together with a content analysis of the topics discussed prior to the conversation about their back pain. In 2012, a national survey was undertaken, approaching 34,922 physiotherapists from 3 networks on the interactive website hosted by the professional body, the Chartered Society of Physiotherapy asking participants to rank the data from clinical practice, to determine the preferred way to open a clinical encounter.Background and purpose of the study
Methods
