L’implantation de pratiques avancées en physiothérapie au Québec : une étude qualitative de la représentation des défis collaboratifs et législatifs en contexte clinique
Bibliographic record
Abstract
In the context of the ongoing reform of the Health and Social Services system in Quebec, advanced practice models in physiotherapy are generating increasing interest as a potential solution to issues related to healthcare accessibility. These practices generally refer to expanded roles assumed by experienced physiotherapists that go beyond the traditional scope of practice. They may include, among other things, the diagnosis and triage of musculoskeletal disorders, greater autonomy in clinical decision-making, and, in specific contexts, the right to prescribe certain diagnostic tests. This thesis aims to better understand the collaborative and legislative challenges associated with the implementation of these care models, from the perspective of clinicians and researchers in the field. Although these models are promising, the challenges surrounding their implementation in Quebec remain not well documented. This research was conducted using a qualitative approach, through semi-structured interviews with five researchers and six clinicians working in advanced practice physiotherapy. Regarding collaborative challenges, the study revealed that there is little resistance from other healthcare professionals toward the integration of advanced practice in physiotherapy. However, these models appear to receive less support from physiotherapists not working in advanced practice. The vision of the role physiotherapists should play remains a subject of debate within the profession. From a legislative standpoint, the lack of recognition by third-party payers of diagnoses made by advanced practice physiotherapists is considered a major barrier. The regulatory framework surrounding the prescription of X-rays by physiotherapists was also identified by participants as one of the main legislative obstacles. Finally, the study revealed that funding for advanced practice models in physiotherapy represents a significant challenge. In summary, this project shed light on the collaborative and legislative challenges specific to the Quebec context, while also proposing ideas for improvement.
Fetched live from OpenAlex and de-inverted. Abstracts are not stored in this database: the inverted indexes are 8.6 GB of the frame’s 9.3 GB of text, and the host has 13 GB free.
How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.019 | 0.022 |
| Meta-epidemiology (narrow) | 0.000 | 0.001 |
| Meta-epidemiology (broad) | 0.001 | 0.001 |
| Bibliometrics | 0.002 | 0.003 |
| Science and technology studies | 0.018 | 0.015 |
| Scholarly communication | 0.008 | 0.004 |
| Open science | 0.003 | 0.004 |
| Research integrity | 0.003 | 0.004 |
| Insufficient payload (model declined to judge) | 0.005 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".