Exploring the Impact of Post-professional Training on Diagnostic Clinical Reasoning Using the Script Concordance Test...

OBJECTIVE: To examine the differences in diagnostic clinical reasoning among physical therapists with varying levels of post-professional training using the Script Concordance Test (SCT), while investigating associations between participant demographics and the most recent American Physical Therapy Association cervical spine clinical practice guideline use. DESIGN: Cross-sectional survey. METHODS: A 1-way analysis of variance (ANOVA) with post hoc Bonferroni analysis compared SCT mean scores across 3 cervical spine cases, and binary logistic regression identified associations between demographic variables. RESULTS: One hundred thirty-one participants completed the survey. A 1-way ANOVA revealed a small-to-moderate effect, with fellowship-trained clinicians scoring higher than those without advanced training (P = .01; 95% confidence interval [CI]: -2.04, -0.27). Board-certified Orthopedic Clinical Specialists did not differ significantly from either the fellowship-trained group (P = .40; 95% CI: -1.89, 0.44) or those without advanced training (P = .89; 95% CI: -1.37, 0.54). CONCLUSION: Fellowship-trained clinicians demonstrated superior diagnostic reasoning regarding the cervical spine case vignettes compared to clinicians with no post-professional training. JOSPT Open 2026;4(2):239-246. Epub 25 March 2026. doi:10.2519/josptopen.2026.0200.