Our mission

Why do we do all this? Find out more about the reasons below.
For all the details, you can download our project plan on the right.

Problem identification & general objective

Professional accountability, evidence based practice and autonomy of the profession are primary concerns in contemporary physical therapy (APTA 2000, Rothstein et al. 2003, Atkinson et al. 2011). As it is well-noted that clinical reasoning skills are at the heart of these concerns (Rothstein et al. 2003, Edwards et al. 2004, Higgs et al. 2011), regulatory bodies and educational institutions seek solutions to implement sound clinical reasoning frameworks into their practice guidelines and curricula. Currently, such implementation remains a major challenge due to the complexity and abstract nature of the subject (Engelbert 2011, Voigt 2011, van Egmond 2011).

Finding ways to practice case-based clinical reasoning outside clinical settings remains challenging for physical therapists and students alike. Internationally recognised frameworks of clinical reasoning appear too complex and vast in theory for students and physical therapists to deliberately employ them into their studies and practice routines.

The objective of getPTsmart.com is to create a way for teachers, students and physical therapists to engage in the teaching and learning of clinical reasoning in a contemporary, time-independent environment that serves as a link between the classroom and clinical practice.

Target group

The target group is physical therapy students in the last year of their entry level education as well as novice physical therapists. During the development of getPTsmart.com the target group is mainly represented by third year students of the European School of Physiotherapy (ESP), Amsterdam, the Netherlands.

Solution overview

Our solution to the above listed problems is to supply students, novice physical therapists and teachers with an e-learning web application, in which they can learn to apply the Hypothesis Oriented Algorithm for Clinician II (HOAC II) (Rothstein et al. 2003), a current state-of-the-art approach to clinical reasoning in physical therapy. The web application offers a time-independent, easily-accessible and stimulating environment for the users to advance their clinical reasoning skills. Several case studies in neurological physical therapy, presented in digestible chunks, form the backbone of this e-learning platform. Cases of different complexity are provided and the content of all cases is validated by expert physical therapists.

The HOAC II clinical reasoning framework represents contemporary, evidence-based physical therapy practice that incorporates the concepts of prevention, a topic receiving much attention in physical therapy (e.g. Pistorius et al. 2006), in its structure. HOAC II provides a clear structure for physical therapists to engage in conscious, process-like, systematic and effective practice as advocated by the Royal Dutch Society for Physical Therapy (KNGF) (Pistorius et al. 2006). The HOAC II has received growing interest at the Hogeschool van Amsterdam and is integrated in the re-designed European School of Physiotherapy curriculum. In addition, the HOAC II framework is used in continuous professional development programmes (de Bakker 2011).


  • American Physical Therapy Association. Vision 2020 [online]. Alexandria: American Physical Therapy Association; 2000 [last update 4/2011; cited 2011 October 19]. URL: http://www.apta.org/Vision2020.
  • Atkinson HL, Nixon-Cave K. A tool for clinical reasoning and reflection using the International Classification of Functioning, Disability and Health (ICF) framework and patient management model. Phys Ther. 2011;91:416-30.
  • de Bakker P. Professor in Physiotherapy (Hogeschool van Amsterdam, the Netherlands). Personal communication. 18 October 2011.
  • Edwards I, Jones M, Carr J, Braunack-Mayer A, Jensen G. Clinical reasoning strategies in physical therapy. Phys Ther. 2004;84:312-35.
  • Engelbert R. Director of education in Physiotherapy (Hogeschool van Amsterdam, the Netherlands). Personal communication. 6 December 2011.
  • Higgs J, Jones M. Clinical decision making and multiple problem spaces. In: Higgs J, Jones MA, Loftus S, Christensen N. Clinical reasoning in health professions. Amsterdam: Elsevier; 2008. p. 4-19.
  • Pistorius MF, Ramaekers SP, Verhoeven AL, Becht MJ, Bloo JK et al. The professional profile of the physical therapist. Amersfoort: Koninklijk Nederlands Genootschap voor Fysiotherapie (KNGF); 2006.
  • Rothstein JM, Echternach JL, Riddle DL. The Hypothesis-Oriented Algorithm for Clinicians II (HOAC II): a guide for patient management. Phys Ther. 2003;83(5):455-70.
  • van Egmond M. Professor in Physiotherapy (Hogeschool van Amsterdam, the Netherlands). Personal communication. 26 October 2011.
  • Voigt J-J. Professor in Physiotherapy (Hogeschool van Amsterdam, the Netherlands). Personal communication. 15 June 2011.