All ETDs from UAB

Advisory Committee Chair

Cecilia Graham

Advisory Committee Members

David M Morris

Diane Clark

Diane U Jette

Kathleen T Foley

Document Type

Dissertation

Date of Award

2012

Degree Name by School

Doctor of Science in Physical Therapy (DScPT) School of Health Professions

Abstract

SCREENING FOR MEDICAL REFERRAL: DETERMINING VARIABLES THAT INFLUENCE ACCURACY HEATHER E. MOUNT DOCTOR OF SCIENCE IN PHYSICAL THERAPY ABSTRACT Background: Screening for medical referral is essential to autonomous practice; however, no studies have examined the medical screening abilities of physical therapists in various settings. Objective: The purpose of this study was to determine if physical therapists in various practice settings could appropriately screen for medical referral, given brief clinical vignettes. Methods: A Delphi study was performed to enhance the content validity of the vignettes. After reviewing the vignettes, survey participants determined if they would provide intervention, provide intervention and refer, or refer before intervention. For each category of cases, the percentage of participants who made correct decisions for 100% of cases and the mean score was calculated. To determine which variables were associated with correct decisions in each category, 4 sets of logistic regressions were performed. Results: A random sample of APTA members (n=214) completed the survey. Participants were able to make correct management decisions greater than 90% of the time in traditional and non-critical medical cases. Participants in outpatient settings were 2 times as likely to make correct decisions in critical medical and traditional cases. Participants with more than 30 years experience were 6 times as likely to make correct decisions in non-critical medical cases. Limitations: Generalizability of the results may be limited by the brief nature of the vignettes, lack of 100% consensus in the Delphi study, and the relatively low sample size. Conclusions: Despite the variety of cases presented spanning different settings, participants made correct management decisions for 84% of the cases. Screening for medical referral is vital in all practice settings and further research is needed to investigate knowledge and practice patterns related to medical screening. Keywords: physical therapy, medical screening, decision making

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