Evaluating physiotherapy students' clinical reasoning skills on clients' activity-related behaviour and behaviour change: A comparative study in South Africa using Swedish reference data.
5 affiliations
- 1Interprofessional Education Unit, Faculty of Community and Health Sciences, University of the Western Cape, Bellville, South Africa.
- 2Department of Physiotherapy, Faculty of Community and Health Sciences, University of the Western Cape, Bellville, South Africa.
- 3Research, Innovation and Postgraduate Studies, Sol Plaatje University, Kimberley, South Africa.
- 4Division of Physiotherapy, School of Health, Care and Welfare, Mälardalen University, Västerås, Sweden.
- 5Research Development and Postgraduate Support Office, University of the Western Cape, Bellville, South Africa.
Abstract
Background
Behaviour-focused clinical reasoning is essential for effective physiotherapy practice. Physiotherapy education must equip students with competencies in psychosocial and behavioural aspects of assessment and intervention. Evidence of South African physiotherapy students' knowledge and competencies in behavioural medicine remains unexplored.Objectives
To assess behaviour-focused clinical reasoning competencies among final-year physiotherapy students at a South African university and compare these competencies with those of final-year students from two Swedish universities with integrated behavioural medicine curricula.Method
A cross-sectional comparative study design was employed. Final-year physiotherapy students (N = 38) from a South African university completed the Reasoning 4 Change (R4C) questionnaire. Swedish comparative data (N = 61) were included. Data were analysed using frequencies, percentages and independent t-tests. Cohen's d with 95% confidence intervals (CIs) was calculated.Results
The South African cohort scored significantly lower for knowledge (mean 32.6, standard deviation [s.d.] ± 5.1 vs. 35.7 ± 4.8; p = 0.003; d = -0.63), cognition (31.7 ± 6.0 vs. 34.9 ± 5.8; p = 0.012; d = -0.53), input from client (34.2 ± 6.3 vs. 38.5 ± 7.2; p = 0.003; d = -0.62), functional behaviour analysis (21.8 ± 2.6 vs. 23.8 ± 2.9; p < 0.001; d = -0.71) and strategies for behaviour change (16.2 ± 1.9 vs. 19.6 ± 3.7; p < 0.001; d = -1.07), but scored significantly higher for self-efficacy (77.8 ± 12.5 vs. 70.4 ± 12.6; p = 0.005; d = 0.59) and contextual factors (20.2 ± 2.7 vs. 14.9 ± 4.7; p < 0.001; d = 1.31).Conclusion
Explicit behavioural medicine integration within physiotherapy education may strengthen behaviour-focused clinical reasoning competencies.Clinical implications
Longitudinal integration of behavioural medicine content may strengthen students' behaviour-focused clinical reasoning, client engagement and behaviour change competencies in physiotherapy practice.
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BibTeX
@article{gamiet2026evaluating,
title = {{Evaluating physiotherapy students' clinical reasoning skills on clients' activity-related behaviour and behaviour change: A comparative study in South Africa using Swedish reference data.}},
author = {Shamila Gamiet and Farhana Karachi and José Frantz and Maria Elvén and Joliana Phillips},
journal = {The South African journal of physiotherapy},
year = {2026},
month = oct,
doi = {10.4102/sajp.v82i1.2345},
url = {https://europepmc.org/article/MED/43011161},
note = {CC BY},
}
RIS
TY - JOUR
TI - Evaluating physiotherapy students' clinical reasoning skills on clients' activity-related behaviour and behaviour change: A comparative study in South Africa using Swedish reference data.
AU - Shamila Gamiet
AU - Farhana Karachi
AU - José Frantz
AU - Maria Elvén
AU - Joliana Phillips
PY - 2026
DA - 2026/10/06
JO - The South African journal of physiotherapy
DO - 10.4102/sajp.v82i1.2345
UR - https://europepmc.org/article/MED/43011161
AB - Background Behaviour-focused clinical reasoning is essential for effective physiotherapy practice. Physiotherapy education must equip students with competencies in psychosocial and behavioural aspects of assessment and intervention. Evidence of South African physiotherapy students' knowledge and competencies in behavioural medicine remains unexplored.Objectives To assess behaviour-focused clinical reasoning competencies among final-year physiotherapy students at a South African university and compare these competencies with those of final-year students from two Swedish universities with integrated behavioural medicine curricula.Method A cross-sectional comparative study design was employed. Final-year physiotherapy students (N = 38) from a South African university completed the Reasoning 4 Change (R4C) questionnaire. Swedish comparative data (N = 61) were included. Data were analysed using frequencies, percentages and independent t-tests. Cohen's d with 95% confidence intervals (CIs) was calculated.Results The South African cohort scored significantly lower for knowledge (mean 32.6, standard deviation [s.d.] ± 5.1 vs. 35.7 ± 4.8; p = 0.003; d = -0.63), cognition (31.7 ± 6.0 vs. 34.9 ± 5.8; p = 0.012; d = -0.53), input from client (34.2 ± 6.3 vs. 38.5 ± 7.2; p = 0.003; d = -0.62), functional behaviour analysis (21.8 ± 2.6 vs. 23.8 ± 2.9; p < 0.001; d = -0.71) and strategies for behaviour change (16.2 ± 1.9 vs. 19.6 ± 3.7; p < 0.001; d = -1.07), but scored significantly higher for self-efficacy (77.8 ± 12.5 vs. 70.4 ± 12.6; p = 0.005; d = 0.59) and contextual factors (20.2 ± 2.7 vs. 14.9 ± 4.7; p < 0.001; d = 1.31).Conclusion Explicit behavioural medicine integration within physiotherapy education may strengthen behaviour-focused clinical reasoning competencies.Clinical implications Longitudinal integration of behavioural medicine content may strengthen students' behaviour-focused clinical reasoning, client engagement and behaviour change competencies in physiotherapy practice.
SN - 0379-6175
SN - 2410-8219
ER -