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Augmented behavioral medicine competencies in physical therapy students’ clinical reasoning with a targeted curriculum: a final-semester cohort-comparison study

ABSTRACT Background Knowledge regarding the impact of curricula with behavioral medicine content and competencies (BMCC) on physical therapy (PT) students’ clinical reasoning skills is lacking. Objectives The primary objective was to compare the clinical reasoning skills, focusing on clients’ behavioral change, of entry-level PT students with or without BMCC in their curricula. The secondary objective was to compare students’ attitudes and beliefs in a biomedical and biopsychosocial practice orientation. Methods Swedish final-semester PT students (n = 151) completed the Reasoning 4 Change (R4C) instrument and the Pain Attitudes and Beliefs Scale for Physiotherapists. A blueprint was used for curricular categorization. The independent t-test was used. Results Students attending programs with BMCC curricula (n = 61) had superior scores compared with students without BMCC curricula (n = 90) in the following R4C variables, all of which were related to clinical reasoning focused on behavioral change: Knowledge, Cognition, Self-efficacy, Input from the client, Functional behavioral analysis, and Strategies for behavioral change. Students who did not receive BMCC curricula scored higher in the R4C contextual factors and reported a greater biomedical practice orientation than students receiving BMCC curricula. There was no difference in the biopsychosocial practice orientation between groups. Conclusions Our findings support the benefit of structured entry-level PT curricula with BMCC on final-semester students’ clinical reasoning skills focused on behavioral change and their level of biomedical practice orientation. Further, our findings elucidated educational opportunities to augment students’ self-efficacy and strengthen their behavioral competencies in clinical reasoning. For the generalizability of the results further research in other contexts is needed.