Educational Needs for Coping with Clinical Uncertainty in Physiotherapy

Round 1

Reviewer 1 Report

I commend the authors for this topic. Well written paper. I would be useful if the authors would inquire/ address in discussion the causes of why graduated physiotherapists show a low average tolerance profile to CU, particularly unfamiliar diagnoses, treatment insecurities and the tendency to not share their uncertainty with patients- which is extremely concerning from the quality of patient care point of view.  

Author Response

Please see the attachment.

Author Response File: Author Response.pdf

Reviewer 2 Report

Education- 2461429

Thank you for the opportunity to review this paper.

Manuscript Title: “Educational Needs for Coping with Clinical uncertainty in Physiotherapy”.

Overview: The aim of this Research is twofold, on the hand, to assess the tolerance to Clinical uncertainty (CU) of physiotherapists who have just entered the labour market and, on the other hand, to identify their educational needs in terms of tolerance to CU.

General comments: This is an interesting manuscript that addresses an important area. Please see my specific comments below for more details.

Specific comments:

1.       Abstract: why the authors speak in future? “The physiotherapist will inevitably experience clinical uncertainty, as he/she will be treating a wide variety of pathologies and, in many situations, will be the first contact profesional”… It speaks of a real affirmation that exists not that it will exist, even if they are students that uncertainty already exists

2.       Introduction: In the training of Graduate in Physiotherapy, this uncertainty is not contemplated because it is about avoiding with clinical reasoning, good practice and evaluation of the patient. giving the student diagnostic and clinical tools that avoid that uncertainty. Lines 27-28… I do not agree that they are based on clinical experiences and clinical practice ALONE. 4 years of university studies, includes in addition to the Clinical part, a theoretical part that provides multiple diagnostic tools to the physiotherapy professional.

3. The keywords are absolutely fine.
4. Materials and Methods: Regarding the material and methodology I have several questions for the authors:

-          The authors do not present an approval of the corresponding Ethics Committee for the realization of this study. Why?

-          Informed consent was signed?

-          The authors consider that with a sample of 180 students of which only 31 responses have been received, is it enough to generalize these data?

-          Why was this questionnaire not sent to other university centers in your country with students in physiotherapy to get more sample?

-          A first questionnaire validated by experts was carried out before launching it to the students ...

5. I consider important a Discussion section where authors reflect on the literature published so far on this topic.

 

The sample have been students of the degree in physiotherapy which have suffered the covid19 pandemic, with its consequent confinement and modification of face-to-face learning to online, It is normal for students to show uncertainty when they have done practical online training in many cases. The main concern of students in Physiotherapy is whether they are going to find work or what postgraduate studies to do, since the training received is very good. It is a personal opinion, not to consider that a sample of 31 students from a single faculty can generalize to the set of students of a profession such as Physiotherapy.

Perhaps launching the questionnaire at the level of your country and comparing between universities with a larger sample would be much more interesting.

Thank you.

Author Response

Please see the attachment.

Author Response File: Author Response.pdf

Reviewer 3 Report

Thank you for giving me the opportunity to peer review. This study aim is assessing the tolerance to uncertainty in newly graduated physiotherapists.  

This is a very interesting paper, but I think that significant modifications to the study design are needed. The author evaluates those who graduated in 2020 and those who graduated in 2022 at the same time, but it is necessary to analyze them separately. Because there is a definite difference in experience.

In addition, there are several points that need to be verified.

Introduction

#1 There may be differences in the duties and authority of physical therapists from country to country. Is it correct to state that a physical therapist is the first health care professional in contact with a patient? Are there differences between countries?

Materials and Methods

#2 Has it passed ethics review? The participant's research consent is not fully described.

#3 This study was conducted at a Spanish university, was the questionnaire in Spanish or English?

#4  I would prefer to assess the reliability of the questionnaire.

Discussion

#5  The number of people who did not participate in the study is large, what does the author think about this? It may need to be mentioned in the limitation.

#6 The author describes the results as medium/high, but from what score is medium and from what score is high?

Author Response

Please see the attachment.

Author Response File: Author Response.pdf

Round 2

Reviewer 2 Report

Thanks to the authors for clarifying all my doubts and completing the manuscript with the contributions of the reviewers.

Reviewer 3 Report

Thank you for your corrections along with my peer review comments.

I believe you have appropriately responded to the points I mentioned.

Thank you for the peer review opportunity.