Introduction of a psychologically informed educational intervention for pre-licensure physical therapists in a classroom setting

Abstract

Background There is an increasing need for physical therapists to address psychosocial aspects of musculoskeletal pain. Psychologically informed practice is one way to deliver this type of care through the integration of biopsychosocial interventions into patient management. An important component of psychologically informed practice is patient centered communication. However, there is little research on how to effectively implement patient centered communication into pre-licensure training for physical therapists. Methods Thirty Doctor of Physical Therapy (DPT) students took part in an educational intervention that consisted of one 4-h didactic teaching session and three 1-h experiential learning sessions. Prior to the first session, students performed an examination of a standardized patient with chronic low back pain and were assessed on psychologically informed physical therapy (PIPT) adherent behaviors via a rating scale. Students also completed the Pain Attitudes and Beliefs Scale (PABS-PT). After the last experiential session, students evaluated another standardized patient and were reassessed on PIPT adherent behaviors. Students retook the PABS-PT and qualitative data was also collected. Results After the educational intervention, students had positive changes in their pain attitudes and belief scores indicating a stronger orientation toward a psychosocial approach to patient care (p < 0.05). Additionally, after the intervention, students showed improvements in their adherence to using PIPT behaviors in their simulated patient interactions (p < 0.05). Qualitatively, students reported a high acceptability of the educational intervention with common themes indicating improved confidence with treating and communicating with complex patients. Conclusion Students had attitudes and beliefs shift towards a more psychosocial orientation and demonstrated improved PIPT behaviors in simulated patient interactions after a brief educational intervention. Future research should investigate best practices for implementation of psychologically informed physical therapy for licensed clinicians.

Remotely Delivered Psychologically Informed Mindful Movement Physical Therapy for Pain Care: A Framework for Operationalization

“…20,28,32,35,44,52 Therefore, continued exploration of optimal training for PT’s, including non-evaluative post-training fidelity checks/feedback, is important to the growth of these pain care programs. 31,73,74…”

Evaluation of a blended learning approach on stratified care for physiotherapy bachelor students

“…This training on stratified care was developed with contributions from previous research, training, consultations and practice experiences gathered by the research team members [ 23 , 24 , 33 ]. It was conceptualised using the KERN’s 6-step approach [ 34 ] and based on the idea that entry-level physiotherapists must be equipped and trained to address patients’ musculoskeletal complaints in a structured manner as demonstrated by Ballengee et al, (2020) [ 22 ].…”

“…Workshops serving as research and teaching components simultaneously complemented this by providing participants with the opportunity to critically discuss clinical experiences and perceptions. Participants could then reflect on their learning progress in relation to their clinical practice experiences and critically discuss biopsychosocial risk factors as considerations for the subsequent management of musculoskeletal conditions [ 22 , 24 ].…”

“…In combination with comprehensive early training of physiotherapists using theoretical concepts, blended learning and in-depth evaluation can have good potential to incorporate psychosocial management concepts into long-term clinical practice. This is possible since these young physiotherapists-in-training eventually evolve into full-fledged clinicians and contribute to shaping the future of physiotherapy practice [ 20 – 22 ].…”

Implementation of Psychologically Informed Physical Therapy for Low Back Pain: Where Do We Stand, Where Do We Go?

“…For pre-licensure physical therapists, Ballengee et al have proposed a training approach that is similar to the one used for practicing clinicians with an additional focus on foundational pain education and patient-centered communication. 35 This training method addresses the call for pre-licensure training to go beyond didactic content and provide more experiential training to address barriers with incorporating psychologically informed interventions. 36 , 37 The training focuses on addressing the complex nuances of behavioral-based non-pharmacologic pain treatments like building therapeutic alliance, reducing the perceived threat of pain, conceptualizing pain beliefs, and promoting self-efficacy.…”