Clinician's Commentary on Farrell et al.(1).

Abstract

Clinically based anatomy is a foundational science for musculoskeletal (MSK) physiotherapists. Best practices are based on informed treatment strategies that rely heavily on an extensive and up-to-date knowledge of MSK anatomy. The results of this novel study by Farrell and colleagues,1 which investigated the use of clinical anatomy resources by outpatient physiotherapists, are important in identifying the extent of self-directed learning that is taking place in this area after graduation. The finding that more experienced physiotherapists used resources significantly less frequently than their less experienced colleagues can be interpreted in many ways. Perhaps more experienced physiotherapists do not see a need for further clinical anatomy education and view anatomy as a “textbook science,” to be studied from textbooks rather than from the research literature. On the opposite end of the spectrum, it may be that current clinical literature, including relevant basic science studies, is relatively inaccessible as a result of high subscription rates. Open-access papers are readily available, but obtaining articles from many specialty-specific journals requires access to a library that subscribes to these journals or purchasing or renting articles from the publisher. This can be costly, as students' library privileges are terminated on graduation. Canada, unlike Australia (where Farrell and colleagues practise), does not have a “statewide health department online resource portal,” which may further limit the number of physiotherapists who can access online library resources. Encouraging students to become lifelong learners is an important goal of professional programmes. Farrell and colleagues state that “clinical reasoning demands a thorough understanding of the appropriate clinical subject matter,” but the results of their study suggest that gaining deeper insight into pathology-specific MSK anatomy may not be a high priority for some practitioners. Clinical anatomy is a living and evolving science, and all practitioners should therefore strive to keep abreast of the current literature, with a view to integrating the findings into their clinical practice. Textbooks are useful references, but the research literature provides the key to advance evidence-based practice. I congratulate the authors on their excellent study exploring physiotherapists' behaviour and attitudes toward clinical anatomy. Their findings support the development of better resources with greater accessibility to the physical therapy community, enabling lifelong learning and the integration of research findings into clinical practice.