Physiotherapy Assessment and Clinical Reasoning: Interview, Outcome Measures, Differential Diagnosis and Goal Setting
What the exam tests
Patient interview, outcome measures, differential diagnosis, and goal setting; whether you can justify clinical decisions.
Core rules and concepts
- Interview: history, red flags, irritability, 24-hour behaviour, and functional impact; use open questions first, then closed questions.
- Outcome measures: valid, reliable, and responsive. Know MCID examples such as the Oswestry Disability Index, DASH, and Berg Balance Scale; use condition-specific and patient-reported measures.
- ICF: impairment, activity, and participation; goals should be SMART and patient-centred.
- Differential diagnosis: screen cervical, visceral, and systemic causes before treating locally; reassess after intervention.
Worked example
A patient has shoulder pain, night pain, and tingling in the hand. Reasoning: screen cervical radiculopathy and red flags before treating the shoulder. If neurological signs are present, adjust testing and refer. Do not anchor on rotator cuff disease.
Traps that cost marks
Anchoring on the first diagnosis; using non-validated measures; writing vague goals; ignoring patient priorities; failing to reassess after treatment.