Physiotherapy new graduate self-efficacy and readiness to engage in pain assessment and management: A mixed-methods study

Introduction: The competent assessment and management of pain is a requirement of all new graduate physiotherapists, however the readiness of new graduates in this area of practice is unknown. Understanding self-efficacy and readiness of new graduates is important in informing curricula. Methods: A sequential mixed-methods design was used. On completion of their professional education, new graduate physiotherapists completed a survey (n = 150, 90.9% response rate) measuring their self-efficacy for established competencies for pain assessment and management. Six months later, a randomised sample of respondents (n = 15) participated in a semi-structured interview to further explore self-efficacy and readiness for practice. Results: Competency items with the highest self-efficacy scores were Demonstrate empathic and compassionate communication and Assess patient preferences. The item with the lowest self-efficacy score was Differentiate physical dependence, substance use disorder, misuse, tolerance, addiction and nonadherence and how these affect pain and function. Six themes emerged from the semi-structured interviews: (1) understanding and explaining pain, (2) striving for patient-centred practice, (3) incomplete mastery of outcome measures, (4) chronic pain management is challenging (5) facing patient conflict and complexity and (6) direct mastery is most influential. Conclusions: New graduate physiotherapists demonstrated high self-efficacy for engaging in patient-centred practice but low self-efficacy for using pain outcome measures, managing chronic pain and substance use. The interview findings corroborated these results and highlighted the role of direct practice for pain assessment and management, self-efficacy and readiness for practice. Identifying the implications for improving professional pain curricula and new graduate workplace support in these domains are recommended