Facilitating Professionalism in Physical Therapy: Theoretical Foundations for The Facilitation Process

Abstract

Background and Purpose. As doctors of physical therapy achieve increased autonomy and take greater leadership in the provision of health care, a correspondingly higher level of professionalism will be expected. APTA's 2006 Education Strategic Plan, Goal 7, states, Identify and use strategies to effect behavioral change in physical therapists and student physical therapists to: ... Integrate professionalism core values into physical therapy practice. The purpose of this article is to describe how recognized behavioral theory supports The Facilitation Process described by May et al as an effective approach to the development of professionalism in both the academic and practice settings. Case Description. This article presents a case study demonstrating the development of professional behavior in Jordan, a physical therapist student, as she progressed through her academic and clinical education. Using a conceptual model that shows the relationship between Prochaska and DiClemente's11 Transtheoretical Model of Change, Bandura's12 Social Cognitive Theory, and The Facilitation Process, Jordan's case is analyzed to demonstrate how the application of the conceptual model and adult learning theory contributed to her developing professionalism. The role of academic faculty is contrasted with the role of clinical supervisors in promoting professional behavior. Outcomes. The Facilitation Process provides guidance in organizing activities and interactions that are generally present in the academic or practice setting and enhances their effectiveness in promoting behavioral change without adding responsibilities to the academic advisor or clinical supervisor. Discussion. The conceptual model presented in this article demonstrates that the elements of The Facilitation Process are consistent with 2 accepted theories of behavioral change. The case analysis demonstrates how adult learning theory can enhance the effectiveness of The Facilitation Process in effecting behavior change in adult learners. Key Words: Generic Abilities, Core Values, Professional behavior, Professionalism, Behavioral change theory. INTRODUCTION In addition to a core of cognitive knowledge and psychomotor skills, success in any profession, discipline or organization requires a repertoire of behaviors.1 In part, the 2006-2020 APTA Education Strategic Plan,2 Goal 7, states, Identify and use strategies to effect behavioral change in physical therapists and student physical therapists to: ... Integrate professionalism core values into physical therapy practice. Therefore, the question is not whether professional behavior is important, but rather how to facilitate the development of the values and abilities that demonstrate professionalism. The purpose of this article is to describe how recognized behavioral theory supports 1 model, The Facilitation Process, as an effective approach to the development of professionalism in the clinical and academic setting.3 The Facilitation Process begins with a student's initial acceptance into a professional education program and extends through staff development in the practice setting. The process is consistent with accepted theories of behavioral change and adult learning theory. This article examines how recognized theory in the areas of behavioral change and adult learning supports The Facilitation Process and demonstrates how the process is applied to an authentic case of a student developing professional behaviors. The Facilitation Process can be used to aid in the development of the 10 physical therapy-specific generic abilities4 identified by the faculty of the physical therapist education program at University of Wisconsin at Madison in 1991 or the Core Values5 identified by APTA in 2002 (Figure 1). It also supports development of any set of professional behaviors identified by a given profession, discipline, or organization. The Facilitation Process does not add responsibilities to academic faculty or clinical managers. …