Developing biopsychosocial competence in musculoskeletal pain care: Australian physiotherapy educators' perspectives.

Abstract

Importance A biopsychosocial approach serves as an important paradigm underpinning musculoskeletal pain education training. Understanding how educators teach this approach in their training may provide insights on how to improve the clinical translation and adoption of a biopsychosocial model in musculoskeletal pain care. Objective This primary qualitative study explored physiotherapy educators' perspectives on translating the biopsychosocial approach to pain care from knowing ('what') to doing (the 'how' of clinical adoption). Methods Semi-structured interviews were conducted with 18 purposively-sampled, experienced physiotherapy pain educators from across Australia. Data were analyzed using reflexive thematic analysis. Results Eighteen experienced physiotherapy educators participated from nine Australian universities. Five themes (with nine subthemes) were identified, collectively referred to as 'levers to biopsychosocial translation'. These themes were: (1) Considerations for teaching across different physiotherapy health workforce training levels; (2) Theoretical models of pain that underpin and scaffold biopsychosocial training ('what' to teach); (3) Developing biopsychosocial competencies and skills ('how' to teach); (4) Learning enablers, reinforcement strategies, and educational resources; and (5) Supporting clinical adoption. Conclusion This study identified data-driven 'translation levers' (specific tools, structures and processes) perceived by experienced educators as supporting biopsychosocial competence and facilitating clinical adoption in musculoskeletal pain care. These findings offer educators a potential translation framework to support effective biopsychosocial educational and clinical translation and adoption across the learning continuum. The identified resources as educational training supports - to strengthen clinical competence in the biopsychosocial approach to musculoskeletal pain care.