Background and Purpose: There is an increasing focus on physical therapy specialization through postprofessional residency and/or fellowship training. Scant evidence exists that evaluates the influence of postprofessional education on patient outcomes. The purpose of this study was to compare the outcomes of patients with musculoskeletal impairments between physical therapists who have completed a residency or fellowship program and therapists who have not completed either. Methods: A retrospective chohort design was conducted using data from a survey and an existing commercial database. Physical therapsts using the database were surveyed to determine what level of education they completed. Musculoskeletal outcome data for 25,843 patients treated by these physical therapists was extracted from the database for the timeframe of June 2012-June 2013. Data were analyzed with ANCOVA to identify differences between groups in the functional status change, number of visits, duration of care, and efficiency. Logistic regression was used to determine the odds of achieving various magnitudes of improvement between groups. Results: Patients treated by physical therapists who completed residency or fellowship training demonstrated significantly greater improvement in their functions fellowship-trained group had significantly fewer visits than the residency trained group but no the group without training. The fellowship trained group and the group without training had significantly shorter episode durations than the residency trained group. Physical therapists who had completed a fellowship program had significantly greater efficiency, defined as change per visit, than the other groups. Patients ere 40% more likely to achieve outcomes 4-5 times greater than MCID values when they were treated by a physical therapist with fellowship training. Discussion & Conclusion: The data analyzed in this observational study demonstrate that physical therapists with fellowship training may achieve greater outcomes for patients with musculoskeletal impairments. There may be a benefit from postprofessional fellowship training that positively influences patient outcomes. No definitive conclusions about residency or fellowship training can be made due to the observational nature of this study.
