Review - Digital confidence, experience and motivation in physiotherapists: A UK-wide survey

Article: Digital confidence, experience and motivation in physiotherapists: A UK-wide survey
Article status: accepted
Author: Simone Titus
Review date: 6 October 2020
DOI: 10.14426/opj/20201006

Peer review (Simone Titus) – Digital Confidence, experience and motivation in physiotherapist: A UK-wide survey

Dear Editor,

Thank you for the opportunity to review this paper entitled: ‘Digital Confidence, experience and motivation in physiotherapist: A UK-wide survey’

This paper offers valuable insights into the digital literacies, confidence and experiences of physiotherapists and other allied health professionals (AHP’s).


Aim– I am not sure whether the information in brackets is needed as this does not appear to be a comparative study, as the paper is more descriptive in nature (besides the t-test).

Methods: Please expand the methods to state that it is a quantitative study. Was this a cross-sectional design?

The conclusion in the abstract does not fully align with the results showed in both the abstract and in the body of the paper. Just a short succinct conclusion as it (explicitly)relates to digital confidence, experience and motivation of physiotherapists would be sufficient.

The practical implications should include some of the core constructs of the paper (I.e confidence, motivation, digital confidence). It is unclear how learning is linked. If it is about health data analytics, then perhaps this should be made more overt.


Good introduction which demonstrates the niche area and the gap in our understanding and the rationale for this paper. Improving digital skills may facilitate and boost staff competence and focus.

the title of the tool review closed caption “” and a comma

Methodology– there is some information missing in terms of design. Be specific about it being quantitative and also cross-sectional (if that is what you have used). The methods also indicate that a t-test was conducted, you do not discuss this t-test results.

I am not sure whether I have missed something-  Under the procedure, it states that survey responses were 143, yet the results response rate indicates 282 responses with 279 complete responses.


The computed scores in Table 1 requires some context as it relates to the instrument. Whilst this is a 5-point Likert Scale, it would be useful to add an Annexure for the instrument used so that one can make some inferences about the items in each of the scales. Reporting of the mean and SD should be written in a more conventional manner.

The link between this study and TOPOL review is insightful in terms f the results and findings, given that this speaks to the clinical skills required in the digital age as it relates to digital literacy, transformation. It is unclear from the explanation of whether these figures are raw scores. Would be useful to indicate this in the table as an (n) as a  very minor addition.

The headings of the figures could be changed. Avoid using the direct questions as headings or words such as frequency as these are statistical terms for analysis. Figures 3 (a, b, c and d) follows one another without explanations in between to orientate the reader. Whilst having about 2 tables of the same (eg 3a and 3b) following one another with a summarised explanation as it offers an explanation and comparison of Physiotherapists and other AHP’s for the same scale. The same for Fig’s 4- It is a string of figures and as a reviewer, I kept having to scroll up for the explanation (which may require some more detailed explanation).

Kolachalama and Garg (2018) suggest that concerning AI/ML, curricula should aim for literacy, rather than proficiency; focusing on developing conceptual knowledge to assist clinical practice. Physiotherapy education could follow, by embedding technological knowledge relevant to patient care into workforce development strategies.’- I found that this is useful for practical implications as it demonstrates some of the conceptual and requisite knowledge which clinicians may require and therefore would need to be included in a curriculum.


Do not repeat the results in the discussion section- only discuss the findings. This being said, there are some very interesting findings in this study which could potentially have a good impact on the physiotherapy curriculum. It is somewhat clear from the discussion that much work is needed in areas where there is a lack of knowledge with regard to the use of more recent developments in the health sectors, such as machine learning/AI and informatics. Whilst the author offers recommendation in the discussion about these areas, it does require a discussion explicitly about these based on the findings of the study before a recommendation could be offered. the author does this, using the results. I recommend removing the results and having a discussion about it. Then, when one considers the ‘poor knowledge’ scores as it relates to ML and informatics, one would question how this impacts on digital confidence and motivation. Therefore, it may be useful to cross-reference some of your findings by way of your discussion.


One Reply to “Peer review (Simone Titus) – Digital Confidence, experience and motivation in physiotherapist: A UK-wide survey”

  1. Author’s response to reviewer 1
    Dear Dr Titus, Thank you for taking the time to respond to this manuscript. I apologies for the delay in completing these modifications in light of the COVID-19 pandemic and the subsequent alteration in my work schedule. I have found your feedback insightful, constructive and helpful to improve the manuscript. I will respond to individual points of feedback below. Changes have subsequently been made to the manuscript in light of these comments.
    AIM: You comment on the statement in parenthesis that this is not a comparative study. Whilst the focus of the study is not a deep comparison of two groups as per a RCT, the results of the survey for physiotherapists are juxtaposed with those for the wider group of AHPs. Details of comparison are minimal in light of there being no statistical significance between the groups (physiotherapists vs AHPs). I have removed the word “comparison” and switch to “juxtaposed” for clarity.
    METHODS: You ask whether this is cross-sectional and advise to add that it is quantitative. The study is certainly both quantitative and cross-sectional. This has been added.
    CONCLUSION: You advise that the conclusion does not full align with the results shown in the abstract/ body of the paper. The final conclusion sentence has been modified to be more representative of the paper’s results/ conclusions.
    PRACTICAL IMPLICATIONS: You suggest that the implications should include mention of the core constructs of the paper to show how confidence, motivation and competence can be linked to learning. This is very well stated, and we have added two additional implication points to make this clearer.
    BODY: INTRODUCTION: You highlight a grammatical mistake on line 5-6 which has been rectified.
    BODY: METHODS: You rightly suggest we should include mention of the quantitative/ cross sectional design, which has been included. The results of the T-test are included in Table 1, and a comment of “no statistical significance” being found is included in the original manuscript. A query is also raised regarding the number of responses. The original manuscript states that there were 282 responses from the AHP wide group, with 279 completed responses. The results section describes how 126 of these responses were from physiotherapists. The number 143 is used to describe the duration of the survey period.
    BODY: RESULTS: The description of the three questions taken from the previous Timmus paper were not adequate in the original manuscript. You request further context related to the instrument to understand the scores in Table 1. Clarity has been provided in the Methods section regarding the questions in Table 1 in that the items are based upon a 10 point numerical rating scale. This has also been added to the caption for table 1. The convention for reporting mean (SD) has been modified as per We have also added the n=per group.
    You made a comment regarding the naming of the Figures, specifically to avoid using questions as headings. We would like to present the figures as shown in the original manuscript. The questions are presented to demonstrate to which questions the results are linked. Captions are provided to summarise the Figures as per normal convention. A further comment was made regarding the use of the word “frequency”. Changes have been made to Figures to reflect this comment.
    You made a comment regarding the flow of the Figures. Prior to peer review the manuscript was presented with numbered figures grouped together in a 2×2/ 4×4 matrix (e.g. 3a,b,c and d). The editorial team requested the provision of larger images for ease of the reader on the platform. It would be the author’s preference to not split the position of the text to break up the images, and they have been designed to be presented together.
    Your comment regarding the paragraph starting with “Kolachalama and Garg (2018) suggest that…” is appreciated.
    BODY: DISCUSSION: You made a pertinent comment regarding the repetition of results in the discussion. This comment has been taken on board and the discussion has been re-written with this feedback in mind. This has led to a more discursive elaboration of points, with allusion to the findings of the survey without repetition.
    I very much appreciate you taking the time to review and feedback on the manuscript. I hope the changes made have been satisfactory. Changes to the manuscript will be published imminently.

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