Thank you for the opportunity to review this article reporting on the findings of a survey of digital confidence, experience and motivation among physiotherapists in the United Kingdom. The article is clearly written and succinct, and presents a useful contribution to understanding the readiness of the physiotherapy profession to incorporate digital technologies into physiotherapy practice in meaningful ways in one jurisdiction (UK).
There are a few grammatical issues to be addressed, but the article accomplishes its stated goals in its current form. One point I was left wondering about was the broader implications of the digital transformation of health care on a profession that so prominently incorporates touch. To what extent will the digital transformation affect physiotherapy practice? What would be a “good” amount of digital transformation in physiotherapy? How would that vary by practice setting? For example, it’s like that an inpatient rehabilitation physiotherapist would have less need for virtual visit technology than would an outpatient musculoskeletal physiotherapist. Addressing this point could strengthen the sophistication of the discussion section. I would suggest that the digital transformation will have a more substantial effect on certain practice settings, but that physiotherapists will need to enhance their digital literacy across care settings in order to remain attuned to an increasingly digitizing system.
The abstract reports levels of confidence in using digital devices on a numeric scale, but does not present anchors to help the reader understand the results. For example, “moderate-high levels of confidence in the use of digital devices (7.6 ±1.77)”.
Paragraph 1 uses semicolons in ways that are not grammatically correct. This occurs at locations throughout the manuscript. I would suggest reviewing the correct uses of semicolons and then doing a search and find within the document to correct their uses.
In paragraph 1 there are no end brackets on the title of Topol review.
Could this section be referred to as “participants”? The term “subjects” comes across as outdated.
Which allied health professional designations were included in the sample? I see this information is provided in the results section, but this is also a methodological decision. Why were these designations included?
What is “professional banding” and “Agenda for Change Band”? As a reviewer not located in the United Kingdom, I’m not sure what these refer to.
Do the authors have a sense for why physiotherapists are so prominently represented in the final sample? Does that respondent profile match the distribution of these health human resources across the UK?
Could table 2 please include percentages of respondents in each category? That would make it much easier to contextualize the number provided in each cell.
I also think it might be easier to interpret for the read if Table 1 was present with the first three columns of results being all those pertaining to physiotherapists, and the final three columns of results being all those pertaining to AHPs.
Regarding Figure 4c, communication via Whatsapp, was it clarified in the survey that this question refers to communication about work, as opposed to only while at work? Is communicating about patient care via Whatsapp compliant with relevant health information policy in the UK?
The discussion section is built around “Two competency areas are deemed vital components of digital competency by the guiding literature both in UK and abroad”, identified in this case as machine learning/AI and health informatics. However, these do not strike me as a reviewer as the most fundamental elements of digital competency for clinical practice. Instead, a much more basic digital literacy seems to be the most fundamental competency to establish, enabling providers to acquire and learn to use digital applications across devices (laptops, phones, other digital interfaces). If the author would like to structure the discussion around ML/AI and health informatics, I think that is completely fine! I would just like to see further justification as to why that decision is made, as opposed to focusing on the more basic skills related to digital literacy.
The discussion section states: “The development of training standards in radiology for AI/ML is in the nascent stages. In both the USA and UK, standards require training radiologists to understand basics of imaging informatics (e.g. data privacy, post-processing imaging) (American Board of Radiology (2019). However, syllabi do not explicitly include AI/ML within the curriculum.”
However, it is very likely that syllabi are now including AI/ML across professional programs. As a reviewer I can say that this is certainly true in both faculties of public health and medicine at the University of Toronto. Please remove the final sentence in that paragraph regarding syllabi.
Please provide a sub-heading titled “Conclusion” prior to the final paragraph.