Physiotherapy educators’ perceptions of physiotherapists’ competencies and continuing education in the practice of musculoskeletal physiotherapy direct access

Introduction: The aim of direct access (DA) physiotherapy practice in Finland is the treatment of musculoskeletal (MSK) conditions by physiotherapists who have completed continuing DA education. It is difficult to pinpoint the competencies of DA physiotherapists as their roles and scope of practice varies. Purpose: The present study aimed to explore the competencies and education of DA physiotherapists through the perceptions of DA educators. Methods: Data were collected through individual semi-structured interviews of eleven Finnish physiotherapy educators who described their perceptions of DA physiotherapists' competencies and their continuing DA education. The interviews were recorded and transcribed verbatim and then examined using a reflexive thematic analysis. Results: Two main themes were formulated on the basis of the data, conveying the educators' perceptions. The first theme, Interaction as grounds for meaningful clinical reasoning, had two subthemes: Meaningful encounter and Rationally and safely locating the core of the client's problem. The second theme, Continuing professional development in an expert role, had four subthemes: Continuous learning, Self-reflection, Deep understanding and Taking responsibility for one's own expertise. Conclusion: The present study revealed how DA educators perceive the competencies of DA physiotherapists. The findings highlight the perceived significance of the physiotherapists' interaction with the client as a ground for meaningful clinical reasoning, and their responsibility for their own continuing professional self-development.