Diagnostic and Procedural Imaging Curricula in Musculoskeletal Physical Therapist Residency and Fellowship Education.
Evan Othmer Nelson, Emily Claire Goetz-Sutinen, Tyler Alan James Amborn and 1 others
Most orthopedic and sports PT residency and fellowship programs teach how to read and integrate imaging results, but only 29% teach how to refer for imaging.
Programs rate graduates' ability to sign referrals as low (16-26% proficient), despite expecting them to be the ordering clinician.
Key findings
197% of programs taught integrating imaging results with clinical examination data and 94% taught incorporating results into care decisions, but only 29% taught how to directly refer patients for imaging studies.
2Programs perceived graduates as proficient in most imaging skills, but rated proficiency in signing imaging referrals as low (16-26%) and procedural ultrasound at 27%, which contradicts the majority of programs' expectation that graduates should be the ordering clinician.
397% of program facilities allowed direct access to PT services, but only 20% allowed PTs to sign diagnostic imaging referrals.
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How it was doneWhat they foundWhat it means for PTs
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What it does not show
Graduate proficiency was self-reported by programs, not measured by a standardized test. Each program defined 'proficient' independently, so the 16-26% and 27% figures are not comparable across programs. Fellowship responses were limited (17 programs) and responses were more robust for orthopedic than sports programs. The survey is anonymous and cross-sectional. It describes what programs report about their curricula, not what graduates actually do in practice. Seven residency and one fellowship surveys were abandoned, and respondents could skip any item, so some data points rest on fewer than 101 programs.
Declared interests
The authors declare no conflicts of interest and report no funding.
The easy way to misread this
Do not read the high perceived graduate proficiency as evidence that all residency and fellowship graduates can competently sign imaging referrals or perform procedural ultrasound. Programs self-reported these ratings without a standardized assessment, and the two skills with the lowest perceived proficiency (signing referrals at 16-26%, procedural ultrasound at 27%) are exactly the ones most programs did not explicitly teach.
Summarised by AI from the full paper, without a clinician reviewing it. Check it against the source before it changes what you do. Read it on PubMed →