Continuing Education Courses for Orthopedic and Sports Physical Therapists in the United States Often Lack Supporting Evidence: A Review of Available Intervention Courses

Objective: The purpose of this study was to characterize the extent to which orthopedic and sports-related continuing education course descriptions approved for physical therapists in the United States taught interventions supported by evidence. Methods: A review was conducted of courses available on CEU Locker from January through December 2020, estimated to represent most courses nationally available to physical therapists. This review focused specifically on courses teaching interventions for musculoskeletal conditions in adults. Specifically, courses for orthopedic and sports populations were identified. All course information was extracted, including the intervention name, course description, and target audience. Finally, clinical practice guidelines (CPGs) and systematic reviews with at least moderate-level evidence published through May 1, 2021, were searched to determine if treatments were recommended or not recommended, or if no evidence existed. Results: The review identified 2406 available courses extracted from the database. After excluding courses that did not meet inclusion criteria, duplicates, and those with incomplete or inadequate information, the final number was 319. Most courses (52.7%, n = 168) taught interventions not supported by a CPG or systematic review. Approximately one-third of courses (34.2%, n = 109) taught interventions that were recommended by a CPG. Many courses were targeted to multiple disciplines (38.9%, n = 124), whereas 89 (27.9%) were specifically for physical therapists, physical therapist assistants, or both. The specific target was unclear for 106 (33.2%) courses. Courses usually focused on multiple body regions, and exercise was the most included intervention. Soft-skill courses were the most supported by evidence (82.9%, n = 29), whereas those teaching modalities were the least supported (30.5%, n = 29). Conclusion: Fewer than one-half of courses that focused on management of musculoskeletal disorders taught interventions supported by a CPG or systematic review, and course descriptions often misrepresented the current state of evidence. Courses required for licensure renewal might not be meeting the intended goal of keeping clinicians current with new and emerging research. Impact: Relatively few continuing education courses on orthopedic and sports-related physical therapist interventions are based on evidence provided by CPGs or systematic reviews, and some continuing education options required for physical therapists to meet annual licensure renewal requirements might not be keeping therapists current with the latest evidence. This study provides data that can facilitate candid dialog within the profession about potential solutions.