Clean Communication in ConEd

By Ryan Fogel,

The Value Of Clear Communication With Patients Cannot Be Overstated

A day in the life of a physical therapist is usually quite fast paced, with busy schedules that involve treating several patients at different stages of their visit simultaneously, filling out reports, responding to calls and emails, and handling any other unexpected events that may arise. With the task of managing each of these responsibilities and maintaining an efficient practice, in some cases there may be unfortunate trade-offs that could potentially affect the quality of care being provided to patients. But this pitfall should be avoided at all costs, and patients’ wellbeing should always be the top priority.

The course of care is a multidimensional process for patients, and whether they experience a positive outcome is influenced by both direct and indirect factors. While it’s crucial that all patients undergo treatment programs that are evidence based and inclusive of the most appropriate interventions for their diagnosis, their treatment success is also largely contingent on less obvious factors, particularly the patient-therapist relationship.

How physical therapists interact with their patients is fundamental to the therapeutic process, and a strong and healthy relationship can have a significant impact on how patients perceive their care and how they react to treatment. Many patients—and therapists—believe that having clear communication is a key component of the therapy experience, and that neglecting this objective can negatively impact the course of care.

Identifying the core themes important to patient-therapist interactions
Research has supported this concept, including one systematic review and meta-analysis that investigated patients’ and therapists’ perceptions on the most important factors that influence patient-therapist interactions. From the 13 studies reviewed, four themes were identified as crucial to these interactions:

  1. Physical therapist interpersonal and communication skills
  2. Physical therapist practical skills
  3. Individualized patient-centered care
  4. Organizational and environmental factors

For the first theme on interpersonal and communication skills, both patients and therapists agreed that active listening was one of the most important qualities of a physical therapist and that it could foster a bond between the two parties. Other key qualities included empathy, friendliness, encouragement, confidence, and nonverbal communication such as physical contact and paying attention to body language. Together, having these good communication and interpersonal skills were perceived as vitally important to interaction, treatment success, and satisfaction.

In another study conducted by a physical therapist, patients with chronic low back pain underwent one of four combinations of a real or sham intervention and either an enhanced or limited interaction with the physical therapist. Results showed that although patients who had an enhanced interaction and the real treatment experienced the best outcomes, those who had an enhanced interaction and a sham treatment reported the next greatest improvement in pain intensity and threshold, which were better than the group that received actual treatment and limited interaction. The group that received limited interaction and a sham treatment reported the least change. These findings further support the importance of a positive patient interaction with their therapist.

At Applied Continuing Education (ACE), we understand the value of clear patient-therapist communication and have imbued that into our physical therapy continuing education courses. In addition to providing instruction on weight management and shoulder pain and dysfunction in our two courses, we prioritize educating our participants on how to discuss these issues with patients in a transparent, friendly, and empathic manner. This especially applies to our weight management course, as it covers a sensitive topic that some patients may be apprehensive to discuss. Therefore, we walk participants through the best approach to take on this subject and how to carefully discuss personal matters.

If you’re interested in learning more about our courses, the ACE website or contact us at 781-229-8011 or

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Evidence Based ConEd

By Ryan Fogel,

Physical Therapy Continuing Education Courses Should Be Based On Evidence
To Provide The Greatest Value To Participating Therapists

Physical therapy continuing education is one of the most integral facets of the practice. Although it is a requirement in most states for retaining one’s license, physical therapists should view continuing education as an ongoing learning opportunity that allows them to keep up with the continuously changing and evolving landscape to provide the best clinical care possible to patients.

Therefore, continuing education should be of the highest standard, possessing qualities that ensure the courses are worth the physical therapists’ time and money. Perhaps chief among these qualities is that physical therapy continuing education instructs on methods, techniques, and interventions that are based on the most current evidence and clinical guidelines. Yet it’s not guaranteed that all continuing education courses for physical therapists is strictly evidence based, which may degrade the value of these courses and leave therapists searching for those that do.

Grading the current continuing education landscap
With this in mind, a study was conducted to determine how many physical therapy continuing education courses taught interventions that were supported by evidence. To accomplish this, researchers conducted a systematic assessment of all publicly available data for orthopedic and sports physical therapy continuing education courses available in the U.S. in 2020. To be included, courses needed to provide education specifically about an intervention designed to treat a musculoskeletal disorder in adult populations, while courses not focused on specific interventions were excluded.

A hierarchy was used to grade the interventions being taught in identified courses, and an intervention was deemed “evidence based” if it either aligned with relevant clinical practice guidelines or a systematic review that supported it with at least moderate level evidence. Any conflicts between guidelines and systematic reviews were resolved primarily by favoring the most recent guideline or systematic review.

More than half of courses were not evidence based
The systematic assessment identified 319 courses that were eligible for inclusion in the final review, with most of these courses (78.7%) teaching only one category of intervention and 16.9% teaching two categories of interventions. More than half of the courses reviewed (52.7%) taught interventions that were not supported by a clinical practice guideline or systematic review. In addition, interventions that were not recommended by a clinical practice guideline (65.8%) were rarely supported by a systematic review (20.0%). Courses that taught interventions categorized as modalities were the least likely to be supported by evidence (30.5%), while those teaching soft skills were the most likely to be supported (82.9%)

These findings are disconcerting, as they reveal that about 1 in 2 physical therapy continuing education courses provides instructions on interventions that are not supported by the latest evidence. This trend can have numerous downstream effects, as physical therapists often rely more on continuing education than published research articles to shape their practice patterns. Therefore, patients could potentially be undergoing unsupported interventions in their course of care, which could prevent them from receiving the greatest benefits from treatment.

Applied Continuing Education (ACE) a continuing education company firmly committed to offering courses that are based on the latest evidence, ensuring that the physical therapists who complete our courses will be providing the highest standard of care to their patients for the conditions we cover. We currently offer two courses (“Weight Management for Rehab Patients: Crucial Skills for PTs and OTs to Help Patients with Weight Management” and “Shoulder Pain and Dysfunction: Effective Therapy for the Treatment of Common Shoulder Disorders,” both of which are built on a strong base of research. For more information, explore the ACE website or contact us at 781-229-8011 or

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