Screening for medical referral is essential to physical therapist practice; however, no studies have examined medical screening across physical therapy practice settings. The purpose of this study was to determine if physical therapists in a variety of practice settings, given brief clinical vignettes, would screen for medical referral in a similar manner. The Delphi Technique was implemented to establish content validity, although only 2 vignettes reached 100% consensus by the expert panel. After reviewing the vignettes, physical therapist subjects determined if they would provide intervention, provide intervention and refer, or refer before intervention. To determine which variables were associated with identified appropriate decisions in each category, 4 sets of logistic regressions were performed. A random sample of APTA members in targeted sections (n=214) completed the survey. Physical therapists with more than 23 years experience were 7 times more likely to make similar management decisions in noncritical vignettes then those with 11 years or less. Half of the participants practiced in outpatient practice settings. In critical medical vignettes, 86% of physical therapists made similar decisions. Physical therapists in this study made identified appropriate management decisions for 90% of the vignettes. Board certification, practice setting and highest earned degree were not found to be statistically significant. It is imperative not only to ensure that the client is appropriate for physical therapy intervention, but it is also vital to recognize and identify signs and symptoms that warrant evaluation by other health care providers.

Author Bio(s)

Heather E. Mount, PT, DSc, OCS, cert MDT is an associate professor in the College of Health Sciences at Alabama State University in Montgomery, Alabama. She is also a licensed Physical Therapist in the state of Alabama.

Dr. Cecilia Graham was Associate Professor and Director of the Doctor of Science in Physical Therapy Program in the Department of Physical Therapy at The University of Alabama at Birmingham at the time this study was conducted.

Dr. Diane Clark, PT, DSc, MBA is the Program Director and Associate Professor in the School of Health Professions at the University of Alabama Birmingham. She is also a licensed Physical Therapist.

Dr. Davis Morris is the Interim Chair of the Department of Physical Therapy Program and Professor in the School of Health Professions at the University of Alabama Birmingham. He is also a licensed Physical Therapist.

Dr. Kathleen Foley, PhD, OTR/L is Associate Professor and Research Coordinator at the North Atlanta Campus at Brenau University as well as a licensed Occupational Therapist.




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