Sandstrom R, Bailey J, Dial S; Department of Physical Therapy, Creighton University, Omaha NE. rsandstr@creighton.edu.

PURPOSE: The purpose of this study was to describe differences in selection of examination items by student and graduate physical therapists for a case of hemiplegia status post stroke. BACKGROUND: The Guide to Physical Therapist Practice has been introduced to describe and standardize clinical decision making by physical therapists. A critical analysis of the Guide (Gordon and Quinn, 1999) has found that the examination items "are not ordered in a conceptual framework". Previous work from this study sample demonstrated that 15 of 36 examination items had "consensus" approval (i.e. 70% agreement on inclusion) with our neurologic physical therapist panel. SUBJECTS: The subjects for this study included 17 neurologic physical therapists from the Omaha/ Lincoln NE areas and 20 Creighton University physical therapy students who had completed their neuromuscular physical therapy coursework. METHODS: Subjects were asked to read a fictitious case scenario of a person with a left cerebrovascular accident. Subjects were asked to rate the likelihood (using a 5 point Likert scale) of incorporating each examination item from the Guide to Practice into their patient examination procedure. ANALYSIS: The difference between student and graduate physical therapist agreement with the examination items from the Guide to Practice was determined using the Chi Square test for Independence (p<.05). RESULTS: Of the 15 consensus items, students were less likely to measure motor function, neuromotor development and sensory integration and pain than the physical therapists. Students were also more likely to include 13 other examination items than the neurologic physical therapists. CONCLUSIONS: Student physical therapists include the majority of items that a consensus of graduate physical therapists would utilize when examining a patient with stroke. In addition, the students include many more items in their examination procedures than graduate physical therapists. FUNDING SOURCE: None.

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