Physiotherapy students' perceptions of how the Cervical Framework influences their clinical reasoning: A qualitative single case study of a Canadian university

Abstract

Background

Neck pain and headaches are highly prevalent, often presenting a challenge for physiotherapists when considering differential diagnoses. For guidance, the International Federation of Manual and Musculoskeletal Physical Therapists (IFOMPT) created the International IFOMPT Cervical Framework. Its purpose is to improve clinical reasoning through various functional objectives and design principles. Although the Cervical Framework supports clinical reasoning among physiotherapy students, how this is achieved is unexplored.

Objectives

1. To explore physiotherapy students’ perceptions of how the Cervical Framework’s functional objectives influence their clinical reasoning.

2. To explore physiotherapy students’ perceptions of how the Cervical Framework’s design principles influence their clinical reasoning.

Design

Qualitative, constructivist, exploratory, single-case study.

Method

Semi-structured interviews of physiotherapy students enrolled in one of three educational programs at one university were conducted. Directed qualitative content analysis informed by the Cervical Frameworks’ functional objectives and design principles was used to interpret data.

Findings

From eighteen participants, meaningful data were found for all functional objectives, with particular value when informing clinical reasoning during assessment and improving understanding of risk. Students showed mixed perceived value in informing clinical reasoning during treatment and facilitating patient-centred practice. Physiotherapy students’ perceptions of the Cervical Framework align with most of its design principles, especially its informative, simple, and non-prescriptive nature. Students also perceived the Cervical Framework as long and this may have affected engagement.

Conclusion

Physiotherapy students in this case study perceive the Cervical Framework to influence their clinical reasoning by achieving its functional objectives and by successfully adhering to its design principles.