Summary Background Grit, resilience and a growth mindset are personal traits conducive to optimal learning and clinical readiness. These are important traits to consider with regards to whether a student thrives or struggles in challenging situations. Research with medical, nursing and pharmacy students demonstrates correlations of these traits with positive well‐being and academic success. No research has investigated the traits of resilience, grit and mindset type together in health professional students to explore whether they are related, and none have focused on physiotherapy students. Methods Cross‐sectional study of final‐year physiotherapy students (n = 134) aiming to describe the levels of these personal traits and to determine whether they are related to each other or demographic factors. Results A proportion of physiotherapy students have low levels of resilience (25%), low academic resilience (19%) and low levels of grittiness (13%). Grit and resilience were positively related (p < 0.001). A smaller fraction of students had a fixed mindset in relation to intelligence (7%) and talent (10%). Having a mental health condition or disability and the number of hours spent in paid employment were related to personal traits. Discussion This is the first study to document empirical evidence of physiotherapy students’ levels of grit, resilience and mindset type with a significant proportion of students having low levels of these attributes. Results have implications for clinical educators and universities seeking to improve student well‐being in order to facilitate effective learning. Institutions need to consider best‐practice approaches to managing and supporting these students to foster well‐being for effective learning.

Objective To (1) review the effect of pelvic floor (PF) symptoms (urinary incontinence [UI], pelvic organ prolapse, and anal incontinence) on exercise participation in women, and (2) explore PF symptoms as a barrier to exercising. Design Mixed-methods systematic review with meta-analysis. Literature Search Eight databases were systematically searched up to September 2020. Study Selection Criteria We included full-text, peer-reviewed observational, experimental, or qualitative studies in adult, community-dwelling women with PF symptoms. Outcomes included the participant-reported effect on exercise or the perception of PF symptoms as an exercise barrier. Study quality was assessed using a modified version of the Mixed Methods Appraisal Tool. Data Synthesis Meta-analysis was performed where possible. Deductive and inductive content analysis was used to synthesize qualitative data. The Grading of Recommendations Assessment, Development and Evaluation (GRADE) framework and the GRADE-Confidence in the Evidence from Reviews of Qualitative research (CERQual) guided interpretation of the certainty of evidence. Results Thirty-three studies were included. In 47% (95% confidence interval [CI]: 37%, 56%; I2 = 98.6%) of women with past, current, or fear of PF symptoms, UI symptoms adversely affected exercise participation (21 studies, n = 14 836 women). Thirty-nine percent (95% CI: 22%, 57%; I2 = 93.0%; 6 studies, n = 426) reported a moderate or great effect on exercise. Pelvic organ prolapse affected exercise for 28% of women (95% CI: 24%, 33%; I2 = 0.0%; 2 studies, n = 406). There were no quantitative studies of anal incontinence. Conclusion For 1 in 2 women, UI symptoms negatively affect exercise participation. Half of women with UI reported either stopping or modifying exercise due to their symptoms. Limited data on pelvic organ prolapse also demonstrated adverse exercise effect. J Orthop Sports Phys Ther 2021;51(7):345–361. Epub 10 May 2021. doi:10.2519/jospt.2021.10200

Objective Following graduation from professional education, the development of clinical expertise requires career-long participation in learning activities. The purpose of this study was to evaluate which learning activities enhanced physical therapist practice. Methods Eight databases were searched for studies published from inception through December 2018. Articles reporting quantitative data evaluating the effectiveness of learning activities completed by qualified physical therapists were included. Study characteristics and results were extracted from the 26 randomized controlled trials that met the inclusion criteria. Clinician (knowledge, affective attributes, and behavior) and patient-related outcomes were extracted. Results There was limited evidence that professional development courses improved physical therapist knowledge. There was low-level evidence that peer assessment and feedback were more effective than case discussion at improving knowledge (standardized mean difference = 0.35, 95% CI = 0.09–0.62). Results were inconsistent for the effect of learning activities on affective attributes. Courses with active learning components appeared more effective at changing physical therapist behavior. The completion of courses by physical therapists did not improve patient outcomes; however, the addition of a mentored patient interaction appeared impactful. Conclusion Current evidence suggests active approaches, such as peer assessment and mentored patient interactions, should be used when designing learning activities for physical therapists. Further high-quality research focused on evaluating the impact of active learning interventions on physical therapist practice and patient outcomes is now needed. Impact This study is a first step in determining which learning activities enhance clinical expertise and practice would enable the physical therapy profession to make informed decisions about the allocation of professional development resources.

Objective Post-professional physical therapy expertise requires career-long participation in learning activities. Understanding physical therapists’ lived experience of learning activities provides novel insight into how best to enhance physical therapist practice from the perspective of the learner. The purpose of this study was to explore qualified physical therapists’ experiences, beliefs, and perspectives with regard to learning activities and professional development. Methods Eight databases were searched for studies published from inception through December 2018. Study selection included mixed-methods and qualitative studies exploring physical therapists’ experiences, perspectives, beliefs, and attitudes. Thematic synthesis was performed, and the GRADE-Confidence in the Evidence from Reviews of Qualitative research was used to assess the level of confidence in the findings. A total 41 studies with 719 participants were included. Results The key findings include physical therapists’ perceptions that worthwhile post-professional learning requires more than attendance at professional development courses. Physical therapists perceived that worthwhile learning requires connection with others and being “taken out of one’s comfort zone.” Sufficient time and accessible, trustworthy resources were also valued. Conclusions Moderate- to low-level evidence suggests that the choice of professional development activities and education design for qualified physical therapists should consider the inclusion of connected activities, activities that take participants out of comfort zones, time to practice, and trustworthy resources that are easily accessible. Future research should evaluate the effectiveness of learning activities encompassing these factors, prioritizing those that minimize the barriers of time and distance. Impact This study adds to the profession’s understanding of physical therapists’ lived experience of learning activities, providing novel insight into how best to enhance physical therapist practice from the perspective of the learner.