Interesting, my suggestion would be:

A complex system approach where probabilistic (Bayes), prognostic and pragmatic approaches are evaluated, when and where they take place in which phase. Or take the Sackett approach: pattern recognition, hypothetico deductive, algorhythm and complete history taking variables.

Evaluate in which phase which technique takes place and see what emerges.

Dear Sander,

Thanks for your suggestion.

Best wishes,

Rob Oostendorp.

Dear Sir

What is your mean from collecting data? In other word what was the topic or your objective?

Dear Ghodratollah and followers,

In this study we will test the following hypotheses:

. it is expected that there will be a decline since 2000 in the use of physical therapy modalities and massage therapy and a rise in the use 'explanation, education and advice' and 'cognitive-based exercise therapy' caused by the introduction of the guidelines-based recommendations by the Royal Dutch Association of Physiotherapy;

. it is expected that the clinical reasoning process is since 2000 more consistent with the biopsychosocial model because of changes in the general management, including physiotherapy management, of patients with WAD.

If you have any discussion, please let us know.

Best wishes, also on behalf of the projectgroup,

Rob Oostendorp.

Hi Rob

An interesting topic of research, indeed. Given that the guidelines/recommendations are informed by an expert panel, and provided that the steps are described/defined, I wonder whether the script concordance test can be used as a measure of clinical reasoning.

Also, it will be interesting to find out whether there are differences within the sample. For example, time of graduation and the possible time it takes for participants to be familiar with and adopt amended guidelines, particularly when clinical habits/preferences have been shaped over time and the clinic and its processes have been set up accordingly.

Kind regards,

Adrian

Dear Adrian,

Thank you for your suggestion. I don't know the script concordance test. Do you have a reference? So I can look at the possibility to use this test. Thank you in advance.

We have a lot of interesting study objects, not only on the level of quality of physiotherapy care but also on the level of therapists and practices.

The first object is to measure the quality of care on patients with WAD.

All the best for you in Australia with good memories of your last visit to the Netherlands.

Best wishes,

Rob Oostendorp.

Dear Rob

Indeed, it was great meeting. I am planning again and will email you soon and hope it suits to meet again.

Script concordance has been used in the medical literature but I haven't found any evidence in the physiotherapy literature, although applicability will be the same. Useful papers are:

https://www.ncbi.nlm.nih.gov/pubmed/24979174

https://www.ncbi.nlm.nih.gov//22005350

https://hms.harvard.edu/sites/default/files/assets/Sites/Academy/files/Nouh-ScriptConcordanceTest.pdfhttps://www.ncbi.nlm.nih.gov/pubmed/24979174 https://www.ncbi.nlm.nih.gov//22005350

https://hms.harvard.edu/sites/default/files/assets/Sites/Academy/files/Nouh-ScriptConcordanceTest.pdf

I hope that this is useful.

Kind regards,

Adrian

Dear Adrian,

Thank you very much for your references. However, I have a problem with reference 2 and reference 3. If I link the references, I don't have any result. Please, control the link and send me again.

Thank you in advance and best wishes,

Rob O.

Sorry Rob. It looks like some of the hyperlinks where bunched together when pasting them into my response, and some where double. I hope that this works better.

https://www.ncbi.nlm.nih.gov/pubmed/22005350

https://hms.harvard.edu/sites/default/files/assets/Sites/Academy/files/Nouh-ScriptConcordanceTest.pdf

https://www.ncbi.nlm.nih.gov/pubmed/24979174

Kind regards,

Adrian

Adria, thank you again for the links. It is now OK.

Rob O.

We have used the DTI and SCT in research involving musculoskeletal physiotherapists to evaluate changes in clinical reasoning as part of a longitudinal study. The work has not yet been published, but we do have experience of developing a SCT for msk physios given it had only previously been used in other professional groups. DTI and SCT offer different quantitative methods to ‘measure’ clinical reasoning.

Hi Nicola

Once it is published, would you be able to make us aware of it? I am sure it will be interesting read. Many thanks.

Kind regards,

Adrian

Of course.....

Kind regards

Nicola

Dear Nicola,

Thanks for your answer and suggestion. It is very nice that you have already experience of developing a SCT for musculoskeletal physiotherapists. I have read the article of Humbert and Miech (2014). If you want, I can send you a copy of their paper.

We have now engaged in the analysis based on quality indicators. The first draft is ready and now I am busy to prepare the second draft for submission.

It It is very pleasant to have contact with colleagues like you on the same subject. We keep in touch.

With best wishes form The Netherlands,

Rob Oostendorp.

Thank you for your message. Likewise, it is nice to share common interests, especially in an important area like CR evaluation for msk physiotherapy.

I look forward to seeing your work evolve and we too will hopefully have our work published in the next few months.

Best wishes from Birmingham

Nicola