Development of a Musculoskeletal Imaging Competency Examination for Physical Therapists

Tory Burley
Lori T. Brody
William G. Boissonnault
Michael Ross, Daemen College



The number of physical therapists with imaging ordering privileges is increasing; however, a known level of competency and knowledge is generally lacking within the profession, as is a method to determine practitioner competency. The purpose of this study is to develop a valid and reliable musculoskeletal (MSK) imaging competency examination for physical therapists. Methods

This 3-round Delphi method study utilized experts to reach consensus on examination content and development. Round 1 was completed by 37 experts. The last 2 rounds were completed by 35 experts. Experts rated questions on a 5-point Likert rating scale of importance (1 = not at all important, 5 = very important). Consensus was achieved with an a priori decision of (1) > 75% agreement of the expert panel rating and ≥ 4 on the Likert scale, and (2) ≥ .90 on Cronbach alpha and intraclass correlation coefficients (ICCs). Experts recommended a passing score of 75%. The examination was subsequently reviewed by a panel of 5 radiologists. Results

The Delphi Mmethod and radiologist panel review resulted in the 151-question Burley Readiness Examination (BRE) for MSK Imaging Competency. Interrater agreement and internal consistency of the Delphi panel were excellent, with an average ICC and Cronbach alpha of .928 and .950, respectively. Conclusions

The BRE is a tool that has the potential to demonstrate practitioners’ level of baseline competency with MSK imaging. Further testing among physical therapists will provide further validation and reliability of the examination. Impact

The use and application of diagnostic imaging is becoming more widespread in physical therapist practice throughout the United States. The BRE could potentially have broader implications for health care utilization and cost in the area of MSK imaging.