A cross-sectional survey examines diagnostic reasoning differences among physical therapists based on training level, suggesting training improves outcomes.
OBJECTIVE: To examine the differences in diagnostic clinical reasoning among physical therapists with varying levels of post-professional training using the Script Concordance Test (SCT), while investigating associations between participant demographics and the most recent American Physical Therapy Association (APTA) cervical spine clinical practice guideline (CPG) use. DESIGN: Cross-sectional survey. METHODS: A one-way ANOVA with post-hoc Bonferroni analysis compared SCT mean scores across three cervical spine cases, and binary logistic regression identified associations between demographic variables. RESULTS: One hundred thirty-one participants completed the survey. A one-way ANOVA revealed a small-to-moderate effect with fellowship-trained clinicians scoring higher than those without advanced training ( p=.01, 95% CI −2.04, −0.27). Board-Certified Orthopedic Clinical Specialists (OCS) did not differ significantly from either the fellowship-trained group ( p=.40, 95% CI −1.89, 0.44) or those without advanced training ( p=.89, 95% CI −1.37, 0.54). CONCLUSION: Fellowship-trained clinicians demonstrated superior diagnostic reasoning regarding the cervical spine case vignettes compared to clinicians with no post-professional training.
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Schumacher et al. (2026) studied this question.
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