Edmund Leahy, Lucy Chipchase, Rocco Cavaleri, Felicity C Blackstock
{"title":"Does online clinical mentoring for physical therapists enhance clinical practice and patient outcomes? A randomized controlled trial.","authors":"Edmund Leahy, Lucy Chipchase, Rocco Cavaleri, Felicity C Blackstock","doi":"10.1080/10669817.2025.2481605","DOIUrl":null,"url":null,"abstract":"<p><strong>Objectives: </strong>The aim of this study was to determine whether a short-term online clinical mentoring program was more effective than asynchronous online lectures at improving physical therapists' (PT) practice and their patients' outcomes.</p><p><strong>Methods: </strong>In this randomized controlled trial, 27 PTs were randomized with allocation concealment to 6 h of online clinical mentoring sessions (experimental group) or 6-h of asynchronous online lectures (control group). The primary patient outcome was function, assessed using the Patient-Specific Functional Scale (PSFS), evaluated at baseline (initial consultation) and 4-week follow-up. Secondary patient outcomes were the Functional Rating Index (FRI) and Global Rating of Change Scale (GRC). Clinician (PT) outcomes were the 'Clinician Confidence Questionnaire for Patients with Spinal Pain' and the 'Self-Reflection Insight Scale', which were evaluated before and after the professional development interventions by blinded assessors. Linear mixed model regression analysis was used to explore differences in patient outcomes. PT outcomes were analyzed using analyses of covariance to control for any baseline differences.</p><p><strong>Results: </strong>Twenty-three PTs and 122 patients completed follow-up assessments. There were no between-group differences for any patient clinical outcomes (PSFS MD = 0.02, 95% CI -0.83, 0.79, <i>p</i> = 0.95; FRI MD = -3.01, 95% CI -10.71, 4.69, <i>p</i> = 0.42; Global Rating of Change MD = -0.08, 95% CI -1.09, 0.92, <i>p</i> = 0.86). There were also no differences between groups in terms of PTs confidence (MD = -2.17, 95% CI -9.11, 4.76, <i>p</i> = 0.52) or self-reflection insight (MD = 3.66, 95% CI -1.94, 9.27, <i>p</i> = 0.19).</p><p><strong>Conclusion: </strong>A 6-h online clinical mentoring program did not significantly influence PT confidence, self-reflection nor the outcomes of their patients when compared to 6 h of asynchronous online lectures.</p><p><strong>Impact: </strong>The results from this study may inform those designing or seeking professional development. Future online clinical mentoring should consider alternative program designs, target PTs with capacity to improve their patient outcomes, and evaluate effects on patients with chronic pain.</p><p><strong>Trial registration: </strong>ACTRN12622000123741.</p>","PeriodicalId":47319,"journal":{"name":"Journal of Manual & Manipulative Therapy","volume":" ","pages":"1-11"},"PeriodicalIF":1.6000,"publicationDate":"2025-03-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Journal of Manual & Manipulative Therapy","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.1080/10669817.2025.2481605","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q2","JCRName":"REHABILITATION","Score":null,"Total":0}
引用次数: 0
Abstract
Objectives: The aim of this study was to determine whether a short-term online clinical mentoring program was more effective than asynchronous online lectures at improving physical therapists' (PT) practice and their patients' outcomes.
Methods: In this randomized controlled trial, 27 PTs were randomized with allocation concealment to 6 h of online clinical mentoring sessions (experimental group) or 6-h of asynchronous online lectures (control group). The primary patient outcome was function, assessed using the Patient-Specific Functional Scale (PSFS), evaluated at baseline (initial consultation) and 4-week follow-up. Secondary patient outcomes were the Functional Rating Index (FRI) and Global Rating of Change Scale (GRC). Clinician (PT) outcomes were the 'Clinician Confidence Questionnaire for Patients with Spinal Pain' and the 'Self-Reflection Insight Scale', which were evaluated before and after the professional development interventions by blinded assessors. Linear mixed model regression analysis was used to explore differences in patient outcomes. PT outcomes were analyzed using analyses of covariance to control for any baseline differences.
Results: Twenty-three PTs and 122 patients completed follow-up assessments. There were no between-group differences for any patient clinical outcomes (PSFS MD = 0.02, 95% CI -0.83, 0.79, p = 0.95; FRI MD = -3.01, 95% CI -10.71, 4.69, p = 0.42; Global Rating of Change MD = -0.08, 95% CI -1.09, 0.92, p = 0.86). There were also no differences between groups in terms of PTs confidence (MD = -2.17, 95% CI -9.11, 4.76, p = 0.52) or self-reflection insight (MD = 3.66, 95% CI -1.94, 9.27, p = 0.19).
Conclusion: A 6-h online clinical mentoring program did not significantly influence PT confidence, self-reflection nor the outcomes of their patients when compared to 6 h of asynchronous online lectures.
Impact: The results from this study may inform those designing or seeking professional development. Future online clinical mentoring should consider alternative program designs, target PTs with capacity to improve their patient outcomes, and evaluate effects on patients with chronic pain.
目的：本研究的目的是确定短期在线临床指导计划在改善物理治疗师（PT）实践和患者预后方面是否比异步在线讲座更有效。方法：在本随机对照试验中，27名PTs随机分为6小时的在线临床指导课程（实验组）和6小时的异步在线讲座（对照组）。患者的主要结果是功能，使用患者特异性功能量表（PSFS）进行评估，在基线（初始咨询）和4周随访时进行评估。患者的次要结局是功能评分指数（FRI）和整体变化量表评分（GRC）。临床医生（PT）结果是“脊柱疼痛患者临床医生信心问卷”和“自我反思洞察力量表”，由盲法评估者在专业发展干预前后进行评估。采用线性混合模型回归分析探讨患者预后的差异。采用协方差分析对PT结果进行分析，以控制任何基线差异。结果：23名PTs和122名患者完成了随访评估。在任何患者临床结局方面，组间无差异(PSFS MD = 0.02, 95% CI -0.83, 0.79, p = 0.95；FRI MD = -3.01, 95% CI = -10.71, 4.69, p = 0.42；Global Rating of Change MD = -0.08, 95% CI = -1.09, 0.92, p = 0.86)。两组之间在PTs置信度（MD = -2.17, 95% CI -9.11, 4.76, p = 0.52）或自我反思洞察力（MD = 3.66, 95% CI -1.94, 9.27, p = 0.19）方面也没有差异。结论：与6小时的异步在线讲座相比，6小时的在线临床指导计划对PT的信心、自我反思和患者的预后没有显著影响。影响：本研究的结果可能会对那些正在设计或寻求专业发展的人有所启示。未来的在线临床指导应考虑其他方案设计，针对有能力改善患者预后的PTs，并评估对慢性疼痛患者的影响。试验注册号：ACTRN12622000123741。
期刊介绍：
The Journal of Manual & Manipulative Therapy is an international peer-reviewed journal dedicated to the publication of original research, case reports, and reviews of the literature that contribute to the advancement of knowledge in the field of manual therapy, clinical research, therapeutic practice, and academic training. In addition, each issue features an editorial written by the editor or a guest editor, media reviews, thesis reviews, and abstracts of current literature. Areas of interest include: •Thrust and non-thrust manipulation •Neurodynamic assessment and treatment •Diagnostic accuracy and classification •Manual therapy-related interventions •Clinical decision-making processes •Understanding clinimetrics for the clinician
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