title: Experiences of Physical Therapists Working in the Acute Hospital Setting: Systematic Review.
abstract: BACKGROUND
  Physical therapists working in acute care hospitals require unique skills to adapt to the challenging environment and short patient length of stay. Previous literature has reported burnout of clinicians and difficulty with staff retention; however, no systematic reviews have investigated qualitative literature in the area.
  
  
  OBJECTIVE
  The purpose of this study was to investigate the experiences of physical therapists working in acute hospitals.
  
  
  METHODS
  Six databases (MEDLINE, CINAHL Plus, EMBASE, AMED, PsycINFO, and Sociological Abstracts) were searched up to and including September 30, 2015, using relevant terms.
  
  
  METHODS
  Studies in English were selected if they included physical therapists working in an acute hospital setting, used qualitative methods, and contained themes or descriptive data relating to physical therapists' experiences.
  
  
  METHODS
  Data extraction included the study authors and year, settings, participant characteristics, aims, and methods. Key themes, explanatory models/theories, and implications for policy and practice were extracted, and quality assessment was conducted. Thematic analysis was used to conduct qualitative synthesis.
  
  
  RESULTS
  Eight articles were included. Overall, study quality was high. Four main themes were identified describing factors that influence physical therapists' experience and clinical decision making: environmental/contextual factors, communication/relationships, the physical therapist as a person, and professional identity/role.
  
  
  CONCLUSIONS
  Qualitative synthesis may be difficult to replicate. The majority of articles were from North America and Australia, limiting transferability of the findings.
  
  
  CONCLUSIONS
  The identified factors, which interact to influence the experiences of acute care physical therapists, should be considered by therapists and their managers to optimize the physical therapy role in acute care. Potential strategies include promotion of interprofessional and collegial relationships, clear delineation of the physical therapy role, multidisciplinary team member education, additional support staff, and innovative models of care to address funding and staff shortages.
authors.affiliation: B. Lau, Department of Physiotherapy, School of Primary Health Care, Monash University, Frankston, Victoria, Australia.
authors.forename: Bonnie
authors.initials: B
authors.lastname: Lau
authors.affiliation: E.H. Skinner, PhD, Department of Physiotherapy, School of Primary Health Care, Monash University, Frankston, Victoria, Australia; Allied Health Research Unit, Faculty of Medicine Nursing and Health Science, Monash University; Australian Institute of Musculoskeletal Science, Western Centre for Health Research and Education, Western Health, Gordon Street, Footscray, Melbourne, Victoria 3011, Australia; and School of Physiotherapy, Faculty of Medicine Nursing and Health Sciences, The University of Melbourne, Melbourne, Victoria, Australia. drlizzieskinner@gmail.com.
authors.forename: Elizabeth H
authors.initials: EH
authors.lastname: Skinner
authors.affiliation: K. Lo, BPhysio (Hons), Department of Physiotherapy, School of Primary Health Care, Monash University.
authors.forename: Kristin
authors.initials: K
authors.lastname: Lo
authors.affiliation: M. Bearman, PhD, BSc, Health Professions Education and Educational Research (HealthPEER) Department, Monash University, Clayton, Victoria, Australia.
authors.forename: Margaret
authors.initials: M
authors.lastname: Bearman
mesh_terms: D002983:Clinical Competence; D006761:Hospitals; D006801:Humans; D059825:Physical Therapists; D024382:Professional Role