Comparison of clinical vignettes and standardized patients as measures of physiotherapists’ activity and work recommendations in patients with non-specific low back pain

Brunner, Emanuel; Probst, Michel; Meichtry, André; Luomajoki, Hannu; Dankaerts, Wim

doi:10.1177/0269215515570499

Publication type:	Article in scientific journal
Type of review:	Peer review (publication)
Title:	Comparison of clinical vignettes and standardized patients as measures of physiotherapists’ activity and work recommendations in patients with non-specific low back pain
Authors:	Brunner, Emanuel Probst, Michel Meichtry, André Luomajoki, Hannu Dankaerts, Wim
DOI:	10.1177/0269215515570499
Published in:	Clinical Rehabilitation
Volume(Issue):	30
Issue:	1
Page(s):	85
Pages to:	94
Issue Date:	2015
Publisher / Ed. Institution:	Sage
ISSN:	0269-2155 1477-0873
Language:	English
Subjects:	Clinical vignettes; Validity; Standardized patients; Low back pain
Subject (DDC):	615.82: Physical therapy 617.5: Orthopaedic surgery
Abstract:	Objective: To validate clinical vignettes as a measure of physiotherapists’ activity and work recommendations given to patients with non-specific low back pain. Design: Validation study comparing two methods for measuring aspects of health providers’ clinical management: Clinical vignettes and unannounced visits of standardized patients (the gold standard). Setting: Outpatient physiotherapy clinics. Subjects: Physiotherapists (N = 59) who consented to see unannounced standardized patients in their clinical practice. Main measures: Clinical vignettes were used to initially measure physiotherapists’ self-reported activity and work recommendations. Subsequently, actors performing as standardized patients visited physiotherapists in their clinical practice and rated the advice given by the physiotherapist regarding activity and work. A total of 23 standardized patients were randomly scheduled to physiotherapists. Physiotherapists were blinded towards the standardized patients. To test whether standardized patients were detected, physiotherapists reported if they suspected that they had treated an actor. Results: The 23 standardized patients visited 22 different physiotherapists. Physiotherapists detected 12 out of 23 unannounced standardized patients (detection rate: 52%). The estimated agreement between the two measures was poor, for both activity and work recommendations (weighted kappa coefficients: 0.29 resp. -0.21). Conclusion: The poor concordance between clinical vignettes and standardized patients indicates the potentially limited validity of clinical vignettes as a measure of health providers’ activity and work recommendations in low back pain practice.
URI:	https://digitalcollection.zhaw.ch/handle/11475/4856
Fulltext version:	Published version
License (according to publishing contract):	Licence according to publishing contract
Departement:	School of Health Sciences
Appears in collections:	Publikationen Gesundheit

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Brunner, E., Probst, M., Meichtry, A., Luomajoki, H., & Dankaerts, W. (2015). Comparison of clinical vignettes and standardized patients as measures of physiotherapists’ activity and work recommendations in patients with non-specific low back pain. Clinical Rehabilitation, 30(1), 85–94. https://doi.org/10.1177/0269215515570499

Brunner, E. et al. (2015) ‘Comparison of clinical vignettes and standardized patients as measures of physiotherapists’ activity and work recommendations in patients with non-specific low back pain’, Clinical Rehabilitation, 30(1), pp. 85–94. Available at: https://doi.org/10.1177/0269215515570499.

E. Brunner, M. Probst, A. Meichtry, H. Luomajoki, and W. Dankaerts, “Comparison of clinical vignettes and standardized patients as measures of physiotherapists’ activity and work recommendations in patients with non-specific low back pain,” Clinical Rehabilitation, vol. 30, no. 1, pp. 85–94, 2015, doi: 10.1177/0269215515570499.

BRUNNER, Emanuel, Michel PROBST, André MEICHTRY, Hannu LUOMAJOKI und Wim DANKAERTS, 2015. Comparison of clinical vignettes and standardized patients as measures of physiotherapists’ activity and work recommendations in patients with non-specific low back pain. Clinical Rehabilitation. 2015. Bd. 30, Nr. 1, S. 85–94. DOI 10.1177/0269215515570499

Brunner, Emanuel, Michel Probst, André Meichtry, Hannu Luomajoki, and Wim Dankaerts. 2015. “Comparison of Clinical Vignettes and Standardized Patients as Measures of Physiotherapists’ Activity and Work Recommendations in Patients with Non-Specific Low Back Pain.” Clinical Rehabilitation 30 (1): 85–94. https://doi.org/10.1177/0269215515570499.

Brunner, Emanuel, et al. “Comparison of Clinical Vignettes and Standardized Patients as Measures of Physiotherapists’ Activity and Work Recommendations in Patients with Non-Specific Low Back Pain.” Clinical Rehabilitation, vol. 30, no. 1, 2015, pp. 85–94, https://doi.org/10.1177/0269215515570499.