Maddigan Kaitlyn, Davis Chris, Saville Brendan, Nishimura Kathryn, Van Bussel Jennifer, Tawiah Andrews K, Kowalski Katie L, Rushton Alison B
School of Physical Therapy, Faculty of Health Sciences, Western University, London, Ontario, Canada.
Fowler Kennedy Sport Medicine Clinic, 3M Centre, Western University, London, Ontario, Canada.
PLoS One. 2025 May 12;20(5):e0322626. doi: 10.1371/journal.pone.0322626. eCollection 2025.
Advanced Practice Physiotherapy (APP) is a higher level of practice grounded in 4 pillars: clinical practice, leadership, education and research. A critical step toward successful integration and sustainability of APP in healthcare systems is understanding the educational pathway to APP.
This systematic mixed studies review is reported in accordance with PRISMA and pre-registered (PROSPERO: CRD42024499563). 8 databases plus the grey literature were searched. 2 independent reviewers determined eligibility, extracted data, assessed quality (QuADS) and determined the overall confidence in the cumulative evidence (GRADE-CERQual).
81 studies (18 qualitative, 17 mixed methods, 46 quantitative) were included in a data based convergent qualitative synthesis. 6 distinct post-licensure educational pathways were described and evaluated: Masters level education, residency and fellowship programs, accredited area of practice education, mentorship, multiple encounter courses and single encounter courses.
There is a high level of confidence (GRADE-CERQual) in the finding that Masters level education consistently resulted in all 4 pillars demonstrated by the physiotherapist. Masters level education appears to be the optimal pathway to APP.
高级实践物理治疗（APP）是基于四个支柱的更高水平的实践：临床实践、领导力、教育和研究。APP在医疗保健系统中成功整合和可持续发展的关键一步是了解APP的教育途径。
1）描述物理治疗师为提升其实践水平而参与的执照后教育途径。2）评估物理治疗师在完成执照后教育途径后对APP支柱的展示情况。
本系统混合研究综述按照PRISMA报告并预先注册（PROSPERO：CRD42024499563）。检索了8个数据库以及灰色文献。2名独立评审员确定入选资格、提取数据、评估质量（QuADS）并确定对累积证据的总体信心（GRADE-CERQual）。
81项研究（18项定性研究、17项混合方法研究、46项定量研究）纳入基于数据的收敛性定性综合分析。描述并评估了6种不同的执照后教育途径：硕士水平教育、住院医师和研究员项目、认可的实践领域教育、指导、多次接触课程和单次接触课程。
对于硕士水平教育始终能使物理治疗师展示所有4个支柱这一发现，有很高的信心（GRADE-CERQual）。硕士水平教育似乎是通往APP的最佳途径。
