What are the experiences of therapists using the online Back Skills Training and implementing it within clinical practice?

Introduction: The purpose of the present study was to explore the experiences of physiotherapists using the online Back Skills Training (i-BeST). The aim of the this programme was to enable clinicians to facilitate group-based treatment based on a cognitive behavioural (CB) approach to the treatment of lower back pain (LBP).

Methods: A qualitative, exploratory approach was chosen. Seven physiotherapists were interviewed. Participants were asked broad, open-ended questions in order to explore: (a) their experiences with the training; (b) the online method; and (c) the implementation of BeST into clinical practice. The interviews were transcribed and analysed manually using interpretive phenomenological analysis.

Results: Four main themes were identified following the analysis: (a) Flexibility but lack of interactivity; (b) CB approach is a new way of working; (c) Facilitating group work after i-BeST training; and (d) The need for managerial support. The flexibility of the online tool was perceived as a major advantage. However, lack of interactivity was identified by most participants as the biggest challenge. Participants found the online tool to be acceptable for attaining knowledge but not adequate for developing skills. After completing BeST, participants reported the application of key principles of the CB approach within routine physiotherapeutic practice, but were reluctant to refer into the group-based treatment programme. Coordination of implementation of the group-based treatment programme throughout a large trust was perceived as necessary, including sufficient staff training for all clinicians.

Conclusions: I-Best can be implemented within everyday clinical settings but should be enhanced with additional face-to-face support mechanisms to improve effectiveness.