Self-efficacy beliefs and confidence of rural physiotherapists to undertake specialist paediatric caseloads: a paediatric example

Rural physiotherapists are faced with unique challenges, one of which is the necessity to extend their skills and knowledge to areas that would be covered by a specialist physiotherapist in an urban setting. The effects of this on the physiotherapist's confidence and self-belief has not been studied. The present study aimed to measure the self-efficacy and confidence of rural physiotherapists who undertake service delivery in the specialist field of paediatrics. A descriptive, cross-sectional design survey was made of rural and remote physiotherapists working in north-west Queensland, Australia. Responses were coded and analysed using descriptive statistics and cross tabs to compare existing relationships among variables. Twenty-three (of 56) completed surveys were returned (41% response rate). Rural and remote physiotherapist's are likely to be sole practitioners or part of a small group of clinicians, working full time in a hospital or private practice. These physiotherapists reported less peer support than urban physiotherapists and were required to treat multiple cases across specialist areas. Physiotherapists working in such a demanding, unsupported environment have a low belief in their abilities and poor coping strategies, causing them to develop low self-efficacy. Rural physiotherapists having low self-efficacy can mean they have low levels of confidence in their ability to practise, and hold the belief that they lack the skills and attributes to practice. This could mean a conflict with professional conduct and ethical standards. Early identification of low self-efficacy gives time to review, develop and sustain strategies to help address the problems faced by the rural physiotherapist workforce, and to re-develop this workforce into one that is more stable and supportive.