Ideal Versus Actual School-Based Physiotherapy Practice in Israel: A National Survey.

AIM: To compare actual and ideal school-based physiotherapy practice in Israel and identify barriers to implementing preferred practices. METHODS: Two anonymous national online surveys were distributed to physiotherapists working in the Israeli education system: one asking respondents to report their actual school-based practice and a second, distributed two months later, asking respondents to report their perceived ideal practice. The surveys were completed by 202 and 152 physiotherapists, respectively. The adapted School-Based Practice survey included 30 parallel items addressing evaluation, individualized education program development, service delivery, team functioning, and administrative support. Item responses were compared between the two surveys using Mann-Whitney U tests with Bonferroni correction. Open-ended responses on barriers to ideal practice were analyzed using conventional content analysis. RESULTS: Significant differences between actual and ideal practice were found in 25 of the 30 survey items. Actual practice showed lower frequencies of collaborative, consultative, and participation-oriented activities. Open-ended responses from 91 respondents were organized into five barrier categories: team dynamics, resources, administrative support, students and parents, and professional "strangeness" within school settings. CONCLUSIONS: A substantial gap exists between ideal participation-oriented models of school-based physiotherapy and everyday practice. Addressing organizational conditions and strengthening collaboration may support implementation of participation-focused services.