Cognitive-Affective Learning in Physical Therapy Education: From Implicit to Explicit

Abstract

Background and Purpose. Practice expectations that describe the knowledge, skills, and behaviors defining the performance of physical therapists encompass the cognitive, psychomotor, and affective learning domains. As in virtually all disciplines in higher education, learning in the affective domain pertains for the most part in the implicit curriculum of physical therapist education. However, no one would argue that the focus on the cognitive domain alone without addressing the affective domain is sufficient to meet today's professional practice expectations. The objectives of this paper are: (1) to define the cognitive affective relationship, (2) to describe the significance of affect in intellectual inquiry, and (3) to suggest enhanced focus on cognitiveaffective learning into physical therapist professional education. Position and Rationale. Although recognized as an essential and integral part of becoming a health care professional, physical therapist student development in the affective domain remains part of the implicit curriculum. Physical therapist education should be grounded in all domains of learning—affective, cognitive, and psychomotor—with physical therapy care and core abilities developed in parallel and feeding off of each other. Teaching practices should nurture student development in the affective learning domain without over-romanticizing the emotional and reducing disciplinary content to secondary stature. A commitment to do so will require having explicit program goals, course objectives, and graduate outcomes specifically related to the affective domain, with serious consideration of how to evaluate students with regard to the affective domain. Discussion and Conclusion. If physical therapist educators believe that the affective domain is a critical component of the curriculum, affective objectives need to be explicit and integrated throughout the curriculum. From a curricular point of view, faculty buyin, decreased traditional lecture time in favor of more active-learning time, faculty and student development, increased resources, and solid clinical community support are essential elements to facilitate the transition.