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 .
Effectiveness of Peer Assessment for Implementing a Dutch Physical Therapy Low Back Pain Guideline: Cluster Randomized Controlled Trial
Background Clinical practice guidelines are considered important instruments to improve quality of care . However , success is dependent on adherence , which may be improved using peer assessment , a strategy in which professionals assess performance of their peers in a simulated setting . Objective The aim of this study was to determine whether peer assessment is more effective than case-based discussion s to improve knowledge and guideline -consistent clinical reasoning in the Dutch physical therapy guideline for low back pain ( LBP ) . Design A cluster r and omized controlled trial was conducted . Setting and Participants Ten communities of practice ( CoPs ) of physical therapists were cluster r and omized ( N=90 ) : 6 CoPs in the peer- assessment group ( n=49 ) and 4 CoPs in the case-based discussion group ( control group ) ( n=41 ) . Intervention Both groups participated in 4 educational sessions and used clinical patient cases . The peer- assessment group reflected on performed LBP management in different roles . The control group used structured discussion s. Measurements Outcomes were assessed at baseline and at 6 months . The primary outcome measure was knowledge and guideline -consistent reasoning , measured with 12 performance indicators using 4 vignettes with specific guideline -related patient profiles . For each participant , the total score was calculated by adding up the percentage scores ( 0–100 ) per vignette , divided by 4 . The secondary outcome measure was reflective practice , as measured by the Self-Reflection and Insight Scale ( 20–100 ) . Results Vignettes were completed by 78 participants ( 87 % ) . Multilevel analysis showed an increase in guideline -consistent clinical reasoning of 8.4 % in the  peer- assessment group , whereas the control group showed a decline of 0.1 % ( estimated group difference=8.7 % , 95 % confidence interval=3.9 to 13.4 ) . No group differences were found on self-reflection . Limitations The small sample size , a short-term follow-up , and the use of vignettes as a proxy for behavior were limitations of the study . Conclusions Peer assessment leads to an increase in knowledge and guideline -consistent clinical reasoning
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 .