Studies, experience, and reflection on the promotion of standardized outcome measures in physical therapy

The use of standardized self-report questionnaires to measure outcome has been promoted in physical therapy (PT) for two decades but has not been widely adopted. Knowledge translation literature has disclosed complex and multidimensional factors associated with practice change in healthcare. Specific barriers and facilitators need to be disclosed to tailor KT interventions. The dissertation is framed with the Ottawa Model for Research Use. Chapter Two describes a comprehensive literature review of interventions to facilitate development of reflective abilities by clinicians, to use reflection to change specific practice abilities, and to implement outcomes measures in healthcare settings. Chapter Three describes a review of Canadian regulatory and professional documents regarding elements of PT practice. Examination and diagnosis elements were represented while prognosis and outcome evaluation were less prevalent. Systematic integration of these latter elements into practice is recommended. Chapter Four describes a statistical evaluation of outcome data collected by a motivated physical therapist and insights she gained from her experience. The evaluation offered an interpretation of data partitioned into meaningful subsets. The clinician’s reflection on her experience provides insight to changes she made in her practice. Chapter Five describes the development of a clinical decision-making model to integrate PT practice elements with the components of the International Classification of Functioning, Disability, and Health. Chapter Six describes a preliminary survey and interview on practices and attitudes towards outcome measurement, and barriers and facilitators to the use of self-report questionnaires to measure outcome. Despite the small sample, insight was gained on some limitations of a scale to measure attitude towards outcome measurement and reported barriers. Chapter 7 provides a summary and synthesis of the findings, and reflections on my experience. Studies on interventions to promote changes in clinical decision-making through adoption of outcome measures in healthcare are sparse. Reflection is one cognitive process that can influence decision-making, but the extent to which these cognitive processes can change is unclear. The meaning of outcome must be understood from the clinician’s perspective and integrated into clinical practice. The Ottawa Model of Research Use functions as a framework to guide planning and redirection of implementation studies.Medicine, Faculty ofGraduat