title: Do the clinical competencies of musculoskeletal outpatient physiotherapists improve after they have participated in a bespoke in-service education programme designed around individual and service continuing professional development needs?
abstract: OBJECTIVE
  To determine whether the clinical competencies of musculoskeletal outpatient physiotherapists improve if they participate in an annual in-service education programme designed around clinical practice needs.
  
  
  METHODS
  A within-subject, without-control, experimental, pre-test post-test study.
  
  
  METHODS
  Clinical and educational facilities of Doncaster and Bassetlaw Hospitals NHS Foundation Trust and locality-based outpatient facilities. Participants were 37 specialist musculoskeletal outpatient physiotherapists (band 6 and 7), working for Doncaster and Bassetlaw Hospitals NHS Foundation Trust.
  
  
  METHODS
  Participants completed three separate modules of in-service education through an academic year, based on learning outcomes identified from observation and performance rating of their clinical competencies. Each module lasted 7 hours, with supporting clinical assistance sessions and self-directed learning time. The primary outcome measure was a (participant) performance rating (from novice to expert) of 20 clinical competencies scored by experienced clinical educators before and after completion of the in-service education programme. A secondary, qualitative outcome measure (a purpose-made, semi-structured questionnaire) given after the programme explored participants' experiences and perceptions of the in-service education programme.
  
  
  RESULTS
  Seven competencies were identified as the focus of the programme because their performance ratings were the lowest. All seven of these competencies improved following the programme. Communication scores improved by 6%, clinical reasoning by 4%, functional analysis of movement by 6%, use of research in practice by 4%, and critical appraisal of evidence by 4.6%. Performance of structural differentiation and the range of manual handling skills demonstrated were the only competencies to show a statistically significant improvement of 14.6% and 12%, respectively (p≤0.025(. Thematic analysis of the questionnaires revealed that 96% of respondents felt that their practice had changed positively over the year because of the programme.
  
  
  CONCLUSIONS
  Providing a structured and bespoke in-service education programme over an academic year may help to improve the rating of clinical competencies and give participants the perception that their clinical practice has changed because of the programme.
authors.affiliation: Physiotherapy Department, Bassetlaw District General Hospital, Worksop, UK. anthonymeaburn@nhs.net
authors.forename: Kevin
authors.initials: K
authors.lastname: Banks
authors.forename: Anthony
authors.initials: A
authors.lastname: Meaburn
authors.forename: Elaine
authors.initials: E
authors.lastname: Phelan
mesh_terms: D000553:Ambulatory Care / Q000592:standards*; D019985:Benchmarking; D002983:Clinical Competence / Q000592:standards*; D004496:Education, Continuing / Q000458:organization & administration*; D004739:England; D005246:Feedback; D006801:Humans; D009140:Musculoskeletal Diseases / Q000628:therapy*; D059825:Physical Therapists / Q000193:education*; D036301:Qualitative Research; D013222:State Medicine; D011795:Surveys and Questionnaires