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Abstract

Rural physiotherapists may need to extend their skills to address the lack of allied health service provision in rural areas but will do so based on their perceived self-efficacy. This narrative review aims to understand self-efficacy amongst rural physiotherapists and contributing factors to self-efficacy, especially in the specialised area of paediatrics.Method: A search of the literature was undertaken to understand the self-efficacy of rural physiotherapists who are expected to undertake specialist paediatric cases. Databases searched included CINAHL, PEDro, Informit, Proquest, PubMed, and Ovid. Articles were assessed for quality in accordance with the National Health and Medical Research Council (NHMRC) evidence ranking system. Using this search strategy and inclusion criteria, a total of forty five articles were found and included in the narrative review. Results: Self-efficacy, a person’s judgement of their capabilities, is a key component in performance, accomplishments, and positive well-being. If the rural physiotherapist has low self-efficacy in their work practices, then physiotherapy specialisation or advance practice may not be considered an achievable career option. However, the caseload of the rural physiotherapist is vast and demanding, spanning across many boundaries and scopes including paediatrics, which has been defined as an area of specialisation within physiotherapy. The work practices of the rural physiotherapist’s are often challenged by the complexities of rural area’s and an unstructured, poorly supportive workforce, thus giving cause for the recognition of rural physiotherapy as a specialist branch of physiotherapy practice. Yet, the majority of the evidence base surrounding this topic has been developed through opinion pieces and observational studies which were rated as level IV evidence. At present, the lack of higher level evidence allowed readers to make assumptions based on opinions and descriptive studies. Conclusion: If the current workforce and structure leads to low self-efficacy in the rural physiotherapy population, this in turn could lead to impaired confidence in the ability to practice as a physiotherapist as well as result in the development of poor coping strategies. Early identification of the self-efficacy beliefs within this cohort will allow the development and evaluation of strategies to help address those issues identified as challenges in rural areas. There is a definite need for stronger, higher levels of evidence on this topic in order to develop more accurate definitions of the work practices and working environments of the rural physiotherapists. Additional higher level research is needed to better understand the self-efficacy of rural physiotherapists and possible contributing factors for low self-efficacy. Higher level research will also establish true clinical implications of low self-efficacy amongst the rural physiotherapist population.

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