The skills, knowledge and attributes needed as a first-contact physiotherapist in musculoskeletal healthcare

Musculoskeletal Care. 2019 Jun;17(2):253-260. doi: 10.1002/msc.1401. Epub 2019 Apr 17.


Objectives: The provision of musculoskeletal assessment and pathway management by physiotherapists in primary care is an expanding innovation within the UK National Health Service. This new model of care is challenging physiotherapists to work in new ways, and so an understanding of these roles is timely and wil contribute to the growing knowledge regarding these practitioners and their impact.

Methods: This qualitative study aimed to improve the understanding of the clinical practice of first-contact clinicians in musculoskeletal healthcare. The study used a think-aloud method to explore eight clinicians' views via a stage 1 semi-structured interview process. This was followed by a stage 2 focus group involving physiotherapists and a general practitioner trainer. A thematic analysis then followed, which involved the researcher and a research colleague coding the data and subsequently developing themes.

Results: The themes identified were: medical assessment and systems knowledge; speed of thought in an uncertain environment; breadth of knowledge; people and communication skills; common sense/simplify; and responsibility and experience.

Conclusions: The identified themes should help to underpin the competence, capability and training requirements for these new roles, and should be considered when developing new services utilizing first-contact primary care physiotherapy practice.

Keywords: clinical reasoning; physiotherapy; primary care.

MeSH terms

  • Clinical Competence
  • Humans
  • Musculoskeletal Diseases / rehabilitation*
  • Physical Therapists / standards*
  • Qualitative Research