Enhancing Screening Competencies in Bachelor Degree Education

Background Physiotherapists are increasingly expected to act as first-contact practitioners in many healthcare systems. With the growing expansion of direct access to physiotherapy services, clinicians must be able to identify serious medical conditions that require referral to a physician rather than physiotherapeutic treatment. These conditions are commonly described as "Red Flags." Red flag screening refers to the clinical process of identifying signs and symptoms that may indicate serious underlying pathology such as malignancy, fracture, infection, neurological compromise, or cardiovascular disease. Failure to recognize these conditions may delay appropriate medical care and can pose a significant risk to patient safety. Despite the growing responsibility of physiotherapists in primary care settings, research suggests that screening competencies among physiotherapy students and early-career clinicians may vary considerably depending on the structure and emphasis of educational programs. Many physiotherapy curricula still primarily focus on musculoskeletal management, while structured training in clinical screening and differential decision-making remains inconsistently implemented. In response to these developments, international professional organizations such as the International Federation of Orthopaedic Manipulative Physical Therapists (IFOMPT) have published clinical frameworks and recommendations emphasizing the importance of systematic screening in physiotherapy practice. However, empirical research investigating how screening competencies can be effectively developed and assessed during undergraduate physiotherapy education remains limited. This gap in the literature represents an important challenge for physiotherapy education and patient safety. The overarching goal of this PhD project is therefore to investigate whether digitally standardized, video-based training and assessment approaches can improve red flag screening competencies among physiotherapy bachelor students.