Development of domain-specific epistemological beliefs of physiotherapists: a longitudinal study

BACKGROUND: Epistemological beliefs (EBs) and therapeutic health concepts are two important factors of influence that affect how healthcare professionals process treatment-relevant information. A previous investigation compared physiotherapy students’ EBs and therapeutic health concepts with those of professionals in a cross-sectional study. That study design, however, did not allow for any conclusions about the temporal development of these concepts. This shortcoming has been addressed in the study presented here, which aimed to assess that temporal development. METHODS: In a longitudinal study, physiotherapists filled in a questionnaire that measured their personal EBs about physiotherapy and about medicine, as well as their biomedical and biopsychosocial therapeutic health concepts. The participants were first examined during their medical training (December 2011). The follow-up measure was about 3 years later when the participants had become professional physiotherapists (January 2015). The development of their EBs was examined using paired sample t-tests and Wilcoxon signed-rank test. RESULTS: The analysis was based on 41 participants who filled in the questionnaire at both time points and were working as physiotherapists at the time of the second measurement. There was a development of physiotherapy-related and a development of medicine-related EBs: Physiotherapy-related as well as medicine-related EBs were more sophisticated when physiotherapists had already entered the working world than during their physiotherapy training. Due to psychometric problems of the scales, the development of their therapeutic health concepts could not be analyzed. CONCLUSIONS: EBs are an important factor for (lifelong) learning. Physiotherapy-related and medicine-related EBs developed similarly in both domains. This is an indication that the temporal development of EBs is an expression of professionalization of healthcare personnel in their occupational field. The findings demonstrate that the development of EBs is not completed at the end of vocational training; it appears to be a development that continues even after the transition to professional life.