Enhancing Screening Competencies in Bachelor Degree Education

NCT07484295 | Active Not Recruiting DMC

• 1 other identifier: PMU-EK_2025-0027
• Study Type: interventional
• Target: 400
• Locations: 1 country
• Sites: 1

Brief Summary

Background Physiotherapists are increasingly expected to act as first-contact practitioners in many healthcare systems. With the growing expansion of direct access to physiotherapy services, clinicians must be able to identify serious medical conditions that require referral to a physician rather than physiotherapeutic treatment. These conditions are commonly described as "Red Flags." Red flag screening refers to the clinical process of identifying signs and symptoms that may indicate serious underlying pathology such as malignancy, fracture, infection, neurological compromise, or cardiovascular disease. Failure to recognize these conditions may delay appropriate medical care and can pose a significant risk to patient safety. Despite the growing responsibility of physiotherapists in primary care settings, research suggests that screening competencies among physiotherapy students and early-career clinicians may vary considerably depending on the structure and emphasis of educational programs. Many physiotherapy curricula still primarily focus on musculoskeletal management, while structured training in clinical screening and differential decision-making remains inconsistently implemented. In response to these developments, international professional organizations such as the International Federation of Orthopaedic Manipulative Physical Therapists (IFOMPT) have published clinical frameworks and recommendations emphasizing the importance of systematic screening in physiotherapy practice. However, empirical research investigating how screening competencies can be effectively developed and assessed during undergraduate physiotherapy education remains limited. This gap in the literature represents an important challenge for physiotherapy education and patient safety. The overarching goal of this PhD project is therefore to investigate whether digitally standardized, video-based training and assessment approaches can improve red flag screening competencies among physiotherapy bachelor students.

Conditions

Education, Health

Outcome Measures

Primary Outcomes (2)

• Red Flag Screening

  Primary Outcome Measure Accuracy of Red Flag Identification The primary outcome of the study is the accuracy with which physiotherapy students identify potentially serious medical conditions (Red Flags) when evaluating standardized video-based clinical cases. Participants are required to classify each case into predefined clinical decision categories: medically critical condition requiring immediate referral, non-critical condition suitable for physiotherapy treatment, or trial treatment with monitoring. Accuracy is determined by comparing student responses with expert-defined reference classifications developed prior to the study. The outcome will be quantified as the percentage of correct classifications across all presented cases.

  18 weeks

• Red Flag Screening

  Primary Outcome Measure Accuracy of Red Flag Identification The primary outcome of the study is the accuracy with which physiotherapy students identify potentially serious medical conditions (Red Flags) when evaluating standardized video-based clinical cases. Participants are required to classify each case into predefined clinical decision categories: medically critical condition requiring immediate referral, non-critical condition suitable for physiotherapy treatment, or trial treatment with monitoring. Accuracy is determined by comparing student responses with expert-defined reference classifications developed prior to the study. The outcome will be quantified as the percentage of correct classifications across all presented cases.

  16 weeks

Study Arms (2)

Enhancing screening competencies in physiotherapy education

EXPERIMENTAL

Project Structure The doctoral project consists of two complementary research phases. Phase 1: Multicentric Randomized Longitudinal Study The first phase of the project focuses on the quantitative evaluation of screening competencies among physiotherapy students. Study Design This phase is designed as a multicentric randomized longitudinal study conducted across several universities offering physiotherapy bachelor programs. Participating students evaluate standardized video-based clinical cases that simulate typical patient presentations in physiotherapy practice. The videos represent realistic clinical encounters including patient history, symptom presentation, and elements of physical examination. Students are required to classify each case according to clinical urgency using predefined decision categories

Diagnostic Test: Project Structure The doctoral project consists of two complementary research phases. Phase 1: Multicentric Randomized Longitudinal Study The first phase of the project focuses on the quantitative eva

1. Intervention Group - Structured Red Flag Screening Training Participants assigned to the interven

EXPERIMENTAL

1. Intervention Group - Structured Red Flag Screening Training Participants assigned to the intervention group receive a targeted educational program designed to enhance red flag screening competencies. The intervention consists of a blended learning format combining face-to-face teaching sessions and online modules, focusing on systematic patient screening, structured history taking, and clinical reasoning in the identification of potentially serious medical conditions. Students work with standardized video-based clinical cases that simulate real physiotherapy consultations and require classification of clinical urgency and referral decisions. The training emphasizes application of international screening frameworks and case-based decision making. Participants complete both baseline and post-intervention assessments using new standardized video cases. 2. Control Group - Standard Curriculum Participants assigned to the control group continue with the regular physiotherapy bachelor cur

Diagnostic Test: Project Structure The doctoral project consists of two complementary research phases. Phase 1: Multicentric Randomized Longitudinal Study The first phase of the project focuses on the quantitative eva

Interventions

Project Structure The doctoral project consists of two complementary research phases. Phase 1: Multicentric Randomized Longitudinal Study The first phase of the project focuses on the quantitative eva DIAGNOSTIC_TEST

The intervention is distinguished by the use of digitally standardized, video-based clinical cases that simulate authentic physiotherapy consultations from patient history to elements of clinical examination. Unlike traditional educational interventions that rely mainly on lectures or written case studies, this approach exposes students to dynamic clinical scenarios requiring real-time clinical reasoning and triage decisions. A further distinguishing feature is the integration of training and competency assessment within the same structured digital framework, enabling objective benchmarking across institutions. The intervention also combines face-to-face teaching, online learning modules, and case-based decision training, creating a blended-learning environment specifically designed to strengthen red flag screening skills. Additionally, the project links quantitative competency testing with a qualitative investigation of expert reasoning processes, allowing the educational intervention

1. Intervention Group - Structured Red Flag Screening Training Participants assigned to the interven; Enhancing screening competencies in physiotherapy education

Eligibility Criteria

• Sex: all
• Healthy Volunteers: Yes
• Age Groups: Child (0-17), Adult (18-64), Older Adult (65+)

You may qualify if:

• Enrollment in a Bachelor-level physiotherapy program at one of the participating universities.
• Students currently in the clinical phase of their education (e.g., semesters 3-6), when foundational knowledge in musculoskeletal assessment and clinical reasoning has already been introduced.
• Ability to understand and complete video-based clinical case assessments in the language used for the study.
• Provision of written informed consent to participate in the study. Willingness to complete both baseline and follow-up assessments within the study period.

You may not qualify if:

• Participants will be excluded from the study if any of the following criteria apply:
• Students in early semesters who have not yet received basic training in clinical assessment and musculoskeletal physiotherapy.
• Students who have previously completed advanced external training specifically focused on red flag screening or differential diagnosis, which could bias baseline competency levels.
• Inability to complete the online video-based assessments due to technical limitations or language barriers.
• Failure to provide informed consent. Incomplete participation in the baseline assessment, making comparison with post-intervention outcomes impossible.

Sponsors & Collaborators

• Rudolf Knipp: lead

Study Sites (1)

Paracelsus medical university

Salzburg, 5020, Austria

Location

MeSH Terms

Conditions

Health Education

Condition Hierarchy (Ancestors)

Adherence Interventions; Medication Adherence; Patient Compliance; Patient Acceptance of Health Care; Treatment Adherence and Compliance; Health Behavior; Behavior

Study Design

• Study Type: interventional
• Phase: not applicable
• Allocation: RANDOMIZED
• Masking: SINGLE
• Who Masked: PARTICIPANT
• Purpose: PREVENTION
• Intervention Model: CROSSOVER
• Sponsor Type: OTHER
• Responsible Party: SPONSOR INVESTIGATOR
• PI Title: PhDr, MSc

Study Record Dates

• First Submitted: March 16, 2026
• First Posted: March 20, 2026
• Study Start: November 5, 2025
• Primary Completion: August 1, 2026
• Study Completion: August 1, 2026
• Last Updated: March 20, 2026

Record last verified: 2026-03

Locations

AU (1)