RESULTS Knowledge translation interventions appear to have result ed in a positive change in physiotherapist beliefs , attitudes , skills and guideline awareness .
However , no consistent improvement in clinical practice , patient and economic outcomes were observed .
AND IMPLICATION OF KEY FINDINGS The intensity and type of knowledge translation intervention seem to have an effect on practice change .
BACKGROUND Many physiotherapists underuse evidence -based practice guidelines or recommendations when treating patients with musculoskeletal disorders , yet synthesis of knowledge translation interventions used within the field of physiotherapy fails to offer clear conclusions to guide the implementation of clinical practice guidelines .
OBJECTIVES To evaluate the effectiveness of various  knowledge translation interventions used to implement changes in the practice of current physiotherapists treating common musculoskeletal issues .
An Innovative Peer Assessment Approach to Enhance Guideline Adherence in Physical Therapy: Single-Masked, Cluster-Randomized Controlled Trial
Background Clinical practice guidelines ( CPGs ) are not readily implemented in clinical practice . One of the impeding factors is that physical therapists do not hold realistic perceptions of their adherence to CPGs . Peer assessment ( PA ) is an implementation strategy that aims at improving guideline adherence by enhancing reflective practice , awareness of professional performance , and attainment of personal goals . Objective The purpose of this study was to compare the effectiveness of PA with the usual case discussion ( CD ) strategy on adherence to CPGs for physical therapist management of upper extremity complaints . Design A single-masked , cluster-r and omized controlled trial with pretest-posttest design was conducted . Intervention Twenty communities of practice ( n=149 physical therapists ) were r and omly assigned to groups receiving PA or CD , with both interventions consisting of 4 sessions over 6 months . Both PA and CD groups worked on identical clinical cases relevant to the guidelines . Peer assessment focused on individual performance observed and evaluated by peers ; CD focused on discussion . Outcomes Guideline adherence was measured with clinical vignettes , reflective practice was measured with the Self-Reflection and Insight Scale ( SRIS ) , awareness of performance was measured via the correlation between perceived and assessed improvement , and attainment of personal goals was measured with written commitments to change . Results The PA groups improved more on guideline adherence compared with the CD groups ( effect=22.52 ; 95 % confidence interval [ 95 % CI]=2.38 , 42.66 ; P=.03 ) . The SRIS scores did not differ between PA and CD groups . Awareness of performance was greater for the PA groups ( r=.36 ) than for the CD groups ( r=.08 ) ( effect=14.73 ; 95 % CI=2.78 , 26.68 ; P=.01 ) . The PA strategy was more effective than the CD strategy in attaining personal goals ( effect=0.50 ; 95 % CI=0.04 , 0.96 ; P=.03 ) . Limitations Limited validity of clinical vignettes as a proxy measure of clinical practice was a limitation of the study . Conclusions  Peer assessment  was more effective than CD in improving adherence to CPGs . Personal feedback may have contributed to its effectiveness . Future research should address the role of the group coach
RESULTS Knowledge translation interventions appear to have result ed in a positive change in physiotherapist beliefs , attitudes , skills and guideline awareness .
However , no consistent improvement in clinical practice , patient and economic outcomes were observed .
AND IMPLICATION OF KEY FINDINGS The intensity and type of knowledge translation intervention seem to have an effect on practice change .
BACKGROUND Many physiotherapists underuse evidence -based practice guidelines or recommendations when treating patients with musculoskeletal disorders , yet synthesis of knowledge translation interventions used within the field of physiotherapy fails to offer clear conclusions to guide the implementation of clinical practice guidelines .
OBJECTIVES To evaluate the effectiveness of various  knowledge translation interventions used to implement changes in the practice of current physiotherapists treating common musculoskeletal issues .