Thank you for submitting this article. Overall your article addresses a potentially interesting topic, however there are some areas in which I think the article would benefit from some significant revision, particularly in relation to establishing the relevance and rationale of the research question.
The article has a clear overall structure and is organised appropriately for this type of study. However the key issue that I struggled with was understanding the premise for your research project in relation to how clinical skill was being evaluated using the study methodology. In order to provide sufficient explanation of the problem and demonstrate the relevance of your research it would be helpful to clarify and provide evidence to support what skilled performance of the weight shift task looks like and how your chosen outcome measures can therefore demonstrate differences in skill between groups of participants. It is not inherently clear to me that greater or lesser displacement of COP or ground reaction force during this task would be associated with different levels of clinical skill. My presumption would be that when looking to support a patient to shift weight, that either too much movement of the COP or conversely not enough would both be less effective (and potentially less safe), and that skilled clinicians may be more likely to adapt the amount and direction of weight shift in response to an individual patient. Establishing the rationale for using these measures as a proxy for clinical skill in your introduction is necessary to link the background that you present to your study methodology in order to show that this was an appropriate research design to answer your question.
In addition I would question the definition of novice and experienced clinicians used in the study given that all clinicians had over 5 years practice experience. The definition of experience as over 11 years needed justification as this appeared arbitrary. This distinction needs to be more clearly based on a theoretical framework for expertise development linked to this skill.
The methods are clearly described and repeatable, including appropriate justification and selection of statistical analysis. Results are clearly presented. However the interpretation and analysis of results is unclear when these are discussed in the context of skill development and expertise. This relates back to the need to establish the premise for using these measures as a proxy for skill performance. The difference between institutions is not clearly relevant. The sample size is too small to draw any firm conclusions from as to the relevance of this finding and more data relating to training or other variables would be needed to support the assertion that any difference may be associated with educational differences between institutions.
The study conclusions are not clearly related to the findings. I wasn’t clear whether the implication was that using this methodology to quantify weight shift had potential utility in physiotherapy education, but this is not supported by the study findings.
Bearing in mind these overall comments, please find below further comments relating to each section:
This provides a concise overview. It would benefit from more clearly stating the research aims and briefly establishing why the methodology is appropriate to answer the question as discussed above, which would also help focus the conclusions.
The introduction provides some broad background, but as discussed above, does not currently provide sufficient clarity on the research objectives or rationale for the methodology as a means to achieve them. This section would benefit from greater use of literature in developing the rationale for the study including considering a theoretical framework of development of expertise to explain why greater expertise may result in different application of the practical skill, and to provide a link to physiotherapy education to justify why understanding differences in skill performance between different groups of clinicians may be relevant to physiotherapy educational practice.
The methods themselves are clearly described and repeatable. The participant demographic information should come at the start of the results section rather than in the methods. There could be an argument for using correlational statistical analysis to see whether years of experience changes the degree of weight shift rather than comparison of means given the arbitrary cut-off between novice and experienced clinician.
The results are clearly presented. The tables would benefit from including which differences are significant and the level of significance. Some of the wording to describe groups could be reviewed for clarity – eg “at each year of experience” suggests that the groups are more stratified than they are.
In line with the previous recommendations, clearer establishment of why your data is a useful proxy for clinical skill in the introduction would help to support your discussion. Currently the discussion is based on your perceptions of the findings and does not place your findings in the context of other literature. Relating your findings to theoretical frameworks of skill development and other empirical findings of skill development will strengthen the critical analysis of your results. In addition, considering the strengths and limitations of your own study methodology in this section would add critical appraisal and help to consider more specific implications for future research.
The concluding paragraph does not currently clearly relate to the study aims and objectives. Having a clearer rationale for how your study is attempting to answer the it’s questions in the introduction will allow you to draw your discussion together towards addressing those aims. More specific implications for practice and future research, that consider the validity of your findings will strengthen this section.
Thank you again for submitting this article. I would be interested to see a future iteration of it and happy to continue the discourse.[jetpack-related-posts]