Description of the abilities of physiotherapists in terms of diagnostic hypothesis and management decision for self-referred patients with musculoskeletal disorders in France using clinical vignettes: A cross-sectional survey.

Abstract

Background: Direct access to physiotherapy has been introduced in several countries. In France, the healthcare system is evolving towards its introduction; however, no study has described the ability of physiotherapists in this context.

Objective: To describe the ability of physiotherapists practicing in France to formulate correct diagnostic hypotheses and make appropriate management decisions using clinical vignettes.

Methods: Pre-existing validated clinical vignettes were used and integrated into a numerical questionnaire. The percentages of correct answers were calculated from the results concerning the choice of diagnostic hypothesis and the management decision, both overall and for the three different patient categories: musculoskeletal, non-critical medical, and critical medical.

Results: Four hundred eighty-two participants (1.7%) responded to the study. For the formulation of a diagnostic hypothesis, there were 43.0% (415/964), 26.6% (128/482), and 17.8% (86/482) correct answers respectively for the musculoskeletal, non-critical medical, and critical medical categories. For management decisions, there were 60.8% (586/964), 61.6% (297/482), and 85.1% (410/482) correct answers respectively for the same categories.

Conclusions: Our results related to the management decision were better than those for the diagnostic hypothesis, especially for the critical medical category. There is still room for improvement. It might be interesting to support this initial study by using more clinical vignettes validated in a French context.