Ideal Versus Actual School-Based Physiotherapy Practice in Israel: A National Survey.

Abstract

Aim To compare actual and ideal school-based physiotherapy practice in Israel and identify barriers to implementing preferred practices. Methods Two anonymous national online surveys were distributed to physiotherapists working in the Israeli education system: one asking respondents to report their actual school-based practice and a second, distributed two months later, asking respondents to report their perceived ideal practice. The surveys were completed by 202 and 152 physiotherapists, respectively. The adapted School-Based Practice survey included 30 parallel items addressing evaluation, individualized education program development, service delivery, team functioning, and administrative support. Item responses were compared between the two surveys using Mann-Whitney U tests with Bonferroni correction. Open-ended responses on barriers to ideal practice were analyzed using conventional content analysis. Results Significant differences between actual and ideal practice were found in 25 of the 30 survey items. Actual practice showed lower frequencies of collaborative, consultative, and participation-oriented activities. Open-ended responses from 91 respondents were organized into five barrier categories: team dynamics, resources, administrative support, students and parents, and professional "strangeness" within school settings. Conclusions A substantial gap exists between ideal participation-oriented models of school-based physiotherapy and everyday practice. Addressing organizational conditions and strengthening collaboration may support implementation of participation-focused services.