Exploring the physiotherapists' role in the management of blunt mechanism chest wall injury - A qualitative focus group study

Physiotherapists have a vital role in the assessment and management of patients with blunt mechanism chest wall injuries (CWI). Physiotherapy interventions focus on the prevention of both early and late complications and the promotion of functional rehabilitation. The aim of this study was to examine the experiences of physiotherapists, healthcare professional (HCP) stakeholders and patients/carers to develop deeper understanding of the role and capabilities required by physiotherapists when caring for patients with blunt mechanism CWI. Qualitative focus groups were run with physiotherapy, HCP stakeholders and patients/carers following a pre-designed topic guide. Focus groups explored participants' experience of physiotherapy care in relation to blunt mechanism chest wall injuries. Data analysis followed Braun and Clarke's Reflexive Thematic Analysis process, and the Dreyfus model of adult skill acquisition was applied as a theoretical model to support the analysis process. Seven focus groups were run with 41 participants (26 physiotherapist participants, 8 HCP stakeholder participants, and 7 patient/carer participants), between November 2024 and January 2025. Four main themes were identified from the data, including (i) Recognising clinical patterns and complexity, (ii) Applying clinical decision making to patient care, (iii) The role of experiential learning in shaping expertise, and (iv) Modelling effective interprofessional working strategies. Using these data, a framework of practice domains was formed. The results of this study will form the foundation of a new competency assessment tool that can be used by physiotherapists caring for patients with blunt mechanism chest wall injuries. These findings have provided deeper insights into the role of the physiotherapist in the management of patients with blunt mechanism chest wall injuries. The study also demonstrates the importance of clinical experience in safe clinical decision making, and the need for capabilities that are relevant for both novice and expert physiotherapy practice. [Abstract copyright: Copyright © 2025 Elsevier Ltd. All rights reserved.]