Diagnostic and Procedural Imaging Curricula in Musculoskeletal Physical Therapist Residency and Fellowship Education

BACKGROUND AND PURPOSE: Educational standards require physical therapy (PT) orthopedic and sports residency and fellowship curricula to include diagnostic imaging instruction. Prior research found that clinicians with advanced training through post-professional education had the requisite diagnostic imaging knowledge and skills. Curricular design or graduate proficiency in diagnostic imaging has not been investigated. The purpose of this study was to assess diagnostic and procedural imaging curricula, instructional methods, and graduate expertise in orthopedic and sports physical therapy residency and fellowship programs. METHODS: A 42-item electronic survey was distributed to all American Board of Physical Therapy Residency & Fellowship Education (ABPTRFE) orthopedic and sports programs. Content categories included (1) program characteristics, (2) diagnostic imaging curriculum, (3) instructional methods, (4) self-reported graduate proficiency, and (5) perception that direct referral for diagnostic imaging is within the scope of PT practice. RESULTS: Survey responses from 101 programs (84 residency; 17 fellowship) represent 67 orthopedic and 34 sports PT programs. Curricula include radiography (n = 90), magnetic resonance imaging (88), computed tomography (77), bone scintigraphy (55), and ultrasound (60). Eighty-two (97%) curricula instruct how to integrate imaging results with other clinical data and 80 (94%) how to incorporate imaging results into clinical decisions. Twenty-five (29.4%) taught how to directly refer patients for imaging studies. Curricula include diverse educational methods, resources, and assessment techniques. Programs perceived graduates were proficient in all requisite diagnostic imaging skills, but the lowest perceived proficiency was referring to imaging studies. DISCUSSION: Imaging curricula are widely included in post-professional orthopedic and sports PT programs. Learning experiences embedded in the clinical setting are well positioned to provide meaningful training for appropriate imaging utilization.