Tammy Pretorius (Peer review) - Involving people with lived experience in physiotherapy education – Research report three: Developing equal partnerships

This report is part of a series of case reports critically reflecting on the involvement of people with lived experience in a UK based physiotherapy degree programme. An initial scoping review of the literature found only two papers exploring the involvement of people with lived experience specifically in physiotherapy education. This is despite an education and training standard requiring service user and carer involvement in all approved programmes in England being in place since 2014. Our goal as a public involvement in education and research partnership, is to challenge this by showcasing a range of approaches and impacts for involving people with lived experience in physiotherapy education and to develop an empirical evidence base for this involvement so best practice can be shared and developed.

The nature of relationships between educators and people with lived experiences is well documented in literature which explores the involvement of people with lived experience in health and social care education. Issues of power, control and influence and the nature of equal and meaningful partnerships are often explored. Arnstein’s (1969) ladder of involvement and Tew et al. (2004) ladder of involvement framework, for example, seek to differentiate between different types and levels of involvement with meaningful involvement only being achieved when power is delegated. This report explores the power differences between the person with lived experience and the academic.

Peer review (Michael Rowe) - Involving people with lived experience in physiotherapy education – Research report two: Harnessing the expertise of people with lived experience

Peer review (Tammy Pretorius) - Involving people with lived experience in physiotherapy education – Research report two: Harnessing the expertise of people with lived experience

As hands-on instruction gives pupils the chance to apply the information and skills they gain while attending school to a real-world clinical setting, it may be beneficial for those participating in beginning employees physical therapy (PT) education programmes. Experiential learning is presently used in all entry-level PT programs in the form of clinical experiences; however, it has the potential to be included across the curriculum to improve student engagement as well as the application and retention of learned information. The objective of this article is to argue that there should be a greater emphasis placed on hands-on experience in physical therapy (PT) education programs that are designed for new graduates. Simulators, integrating medical experiences, volunteer work, public customer support organisations, and opportunities for professional growth are just a few of the various methods used in experiential education. The opportunity to put theoretical knowledge into practice in a setting free from criticism is very beneficial to students. Learning via experience may be especially helpful in subject preparation area when students have fewer opportunities to preparation their abilities since fewer possibilities are available. Students will be better prepared for the sort of meditative rehearsal that is necessary to make the changeover from learner to the skilled practitioner if they engage in the course of reflecting on their experiences, which is a typical activity that is conducted in combination with experiential learning.

In September 2014, the physiotherapy regulator for England and Wales (Health and Care Professions Council) introduced an education and training standard requiring service user and carer involvement in all approved programmes (HCPC 2018) including physiotherapy. Despite this, a scoping literature search on the involvement of people with lived experience in physiotherapy education and training returned only two results (Thomson and Hilton 2011, 2013), both of which pre-date the regulatory requirement. This means that there is no documented scientific literature on a client's lived experience involvement in a physiotherapy course since the introduction of this standard.

Peer review (Tammy Pretorius) - Involving people with lived experience in physiotherapy education – Research report one: Reflecting together to enhance teaching outcomes

Peer review (Michael Rowe) - Involving people with lived experience in physiotherapy education – Research report one: Reflecting together to enhance teaching outcomes

Background and Purpose. Professional (entry-level) education in physical therapy, as an enterprise distinct from, yet central to, the profession of physical therapy as a whole, has reached a level of maturity at which there is value in reviewing its development. The authors identify major elements of importance in professional education, including the nature and institutional setting of professional education programs, curriculum content and design, and characteristics of students and faculty. Major events and developments are highlighted for each major element. Methods and Materials. Information has been drawn from published materials dating from the 1910s through the end of the 20th century and from archival records maintained by individual professional education programs and professional organizations in or related to physical therapy. This information has been augmented by the authors' personal experience of professional education during the years from the 1940s through the end of the century. Summary of the Literature. Comprehensive reviews of professional education in physical therapy have been conducted at various points in time. Detailed analyses of different aspects of physical therapy education have been published throughout the 20th century. Comprehensive, but nonscholarly, histories of the profession of physical therapy, including discussions of events pertaining to professional education, also have been published, most recently in the mid 1990s. Conclusion. The article provides an overview of the history of professional education in physical therapy. Key Words: Physical therapy education. INTRODUCTION A thorough discussion of professional (entry-level) education in any field needs to address a variety of related topics, including curriculum content and format, institutional setting and program resources, faculty and student characteristics, and program standardization and accreditation. Fortunately, a number of these specific concerns are addressed in other articles in this special issue. This article, while not attempting to do complete justice to the remaining topics, will highlight the major issues and developments that occurred during the 20th century in regard to curriculum content and design, faculty and student characteristics, and institutional setting of professional education in physical therapy. Put yourself in the position of responding to the hypothetical requests for information that are interspersed throughout this article. What might you emphasize in response to each one? How might your response have varied in each circumstance? Lucy C_ Boston, Mass Dear Cousin Lucy, February 21, 1918 I was so excited to hear that you have decided to apply to be one of these new Reconstmction Aides. It sounds so thrilling! I have been thinking that maybe I could do that, too, if I could get into a training program this summer, rather than going to normal school as I had planned. Could you tell me more about it? Where would I have to go to get training, and what would it be like? I'm sorry you were not able to be home for Christmas . . . Your loving cousin, Beth The Cedars, Park City, Iowa If Beth was considering attending normal school in the fall, she almost certainly would have been much too young to become a Reconstruction Aide, the lower age limit for applicants being 25 years.2 Her cousin Lucy, if she was entering training in the Boston area, had open to her a choice of three programs that had been identified by the Office of the Surgeon General of the Army, the American School of Physical Education, the Boston School of Physical Education, and the Posse Normal School of Gymnastics.3 Another East Coast school also was identified by this time, the New Haven Normal School of Gymnastics. Later, in 1918, a new training program was instituted at Walter Reed General Hospital under the auspices of the Medical Department of the Army. …

Patient education in physical therapy is gaining attention because it can contribute to patient compliance and prevention. This article describes the development of an assessment tool for investigating patient education in physical therapy. A checklist of 65 educational activity items was constructed. The investigators tested the applicability of the checklist using 227 audiotaped treatment sessions involving patients from various private practices in the Netherlands. The 227 audiotaped sessions covered the entire period of treatment for 25 patients, each of whom participated in an average of 9 treatment sessions. The results showed that all except 1 of the 65 educational activities occurred in the 227 treatment sessions and that no educational activities occurred that could not be rated in the checklist. These findings may indicate that the checklist covers the entire range of educational activities currently applied by physical therapists. The reliability of the checklist was tested using a subsample of the treatments. The average scores for interrater and intrarater reliability, as determined by the use of the Cramer's V coefficient of association for ordinal data, were .76 and .81, respectively. The checklist can be used to investigate the current educational activities in physical therapy practice. In addition, the checklist can be used in peer review and can contribute to the development of standards for the quality of care. [Sluijs EM. A checklist to assess patient education in physical therapy practice: development and reliability.

Development of the assessment of physiotherapy practice - a standardised and validated approach to assessment of professional competence in physiotherapy

BACKGROUND AND PURPOSESimulation is an established method for building knowledge and ensuring competence in the aviation industry and military training.1 Health care simulation has been widely adopted in medical and nursing education with simulated experiences emerging in program accreditation requirements. Simulation is growing in use for health care staff development, including using simulations in the providers' practice environment. Physical therapy education has a long tradition of simulations, using standardized patients and role playing.25 Interprofessional and mannequinbased simulation in physical therapy education is a growing in popularity.68 Research in health care simulation consistently reveals the importance of sound debriefing strategies to realize the desired learning objectives.9,10In part, health care simulation has been driven by the increasing sensitivity and attention to inherent risk to patients posed by novice and inexperienced health care providers. Clinical training of physical therapy students is challenged by declining availability of clinical educational experiences and stipulations requiring close supervision of students.11,12 Clinical education cannot be scripted to present the range of situations that prompt the safe execution of skills and decision-making that a physical therapist (PT) must possess. Simulation can introduce the high risk/low frequency clinical events or highly sensitive patient interactions that have low tolerance for error within a learning experience that does not impose risk to actual patients. Furthermore, simulation allows feedback and repetition of events to achieve mastery. This practice can be aided by temporal manipulation of the experience with use of pause to think, rewind to a critical point, or a do-over following a suboptimal performance. Within clinical practice, simulation can also be a risk management strategy to revisit a breakdown of care, evaluate a near miss event, or rehearse a new workflow process.13 Simulation is particularly useful for developing team functioning.14Growing use of simulation in physical therapy education and professional development calls for an evidence-based approach. Best simulation practices require experiences purposely designed to expose the learner's frameworks, the cognitive foundation that directs clinical decisions and actions.15 Research in health care simulation has established essential conditions to create an effective learning environment. Simulation in medical education has demonstrated the importance of supporting realism, using prompts, effectively using confederates, and scripting key elements of the simulation. The key piece to participant learning is postsimulation debriefing, methods that serve to uncover and shape decision frame works. Ideally, a simulation is purposefully designed to expose any decision errors or performance gaps, which can then lend to fruitful debriefing. Various debriefing tools that have been developed and researched can be translated to physical therapy simulation. Evidenced-based simulation and debriefing strategies have the potential to sharpen skills and transform the learner's decision frameworks, which leads to durable improvements in clinical knowledge and competency.The purpose of this perspective is to justify the integration of simulation in physical therapy education and professional development. Simulation grounded in an evidence-based, pedagogical approach is a powerful learning tool independent of the technology available. The perspective will offer strategies, tools, and scripts that physical therapy educators can apply to their own simulations, leading to positive learning outcomes and replacing traditional instructional methods. Furthermore, simulation can support professional development for practicing PTs.POSITIONDespite its recognized value, the pedagogy and learning theory that supports simulation and debriefing is often overshadowed by simulation technology. …

The Journal of Clinical Education in Physical Therapy (JCEPT) mission emphasizes facilitating development of and disseminating evidence related to clinical education in physical therapy. Our distinguished editorial board members continue to provide guidance as we develop, while representing various clinical specialties, research interests, and roles in physical therapy education. The coronavirus (COVID) pandemic has posed serious challenges for everyone including personal health and financial crises, educational adaptation to online learning, and professional research challenges. Interest in JCEPT has continued to grow, nevertheless. Submissions and published papers for the 2021 volume have doubled. As an open-access journal, JCEPT is developing an international reach; papers last year were downloaded about 1,000 times with >15% of users located beyond the United States. In the current volume, we look forward to papers with timely topics: impact of integrated clinical experiences on physical therapy student clinical performance, student mental health during clinical education, competency of clinical instructors, entry level caseload expectations during terminal clinical experiences, and student physical therapist burnout and grit during terminal clinical education experiences. Many of the opportunities and challenges we face along the continuum of learning is not unique to physical therapy. In an effort to integrate the views of other professions, we are pleased to publish our first resident case study in our Inter-Professional Corner. Physical therapy education programs create learning experiences in a controlled environment to approximate authentic clinical situations. There is, however, no substitute for clinical education where learners apply knowledge and skills in real clinical practice. Clinical instructors (CIs) are the primary educators during entry level Doctor of Physical Therapy (DPT) clinical education experiences which account for approximately one third of the DPT curriculum.1 While typical characteristics and qualities of CIs have been identified,2–4 there is wide variation in the quality of clinical education that DPT students experience. One reason for variations in clinical education quality appears to be CIs clinical teaching skills.2 The National Study of Excellence and Innovation in Physical Therapy Education has suggested the establishment of a standard comprehensive, longitudinal approach for performance-based learning outcomes across the learner continuum.5 Competencies, or characteristics of an individual, are an example of a defined outcome. In the current volume, Bilyeu et al. describe a path to the stepwise development of competencies for CIs to help prepare them to teach. This information can help develop personalized professional development for CIs that could reduce the variation in clinical teaching. The increase in new and expanding DPT programs has increased demand for clinical education placements. Bayliss introduces a re-designed clinical education curricular model that emphasizes in-class patient experiences along with integrated clinical experiences as an alternate solution to meet this growing challenge. In addition, increased productivity pressures add to the challenges of CIs and students. Sherman et al. examine expected student caseloads across and within clinical settings, while Kish et al. explore student burnout and grit within clinical settings. Finally, Eubanks et al. explores the experiences of the Director of Clinical Education (DCE) that often expand beyond the recommended roles6 to include supporting the student during mental health challenges.7 The growth of JCEPT has been exciting to see and we look forward to developing further as other manuscripts progress through the publication pathway. JCEPT accepts original research, narrative and systematic reviews, innovative teaching methods or educational models relevant to clinical training, clinical education or clinical case reports, and exceptional critically appraised topics all of which can address any element of physical therapy education related to clinical practice. Christopher Kevin Wong and Jean Fitzpatrick TimmerbergEditors in Chief

BackgroundAdvances in health professions education increasingly emphasize the use of digital technologies to enhance student engagement and support diverse learning needs. In physiotherapy training, particularly in technically complex subjects like electrotherapy, conventional instruction may fall short in fostering active learning and knowledge retention. Game-based platforms such as Ren’Py offer an opportunity to integrate interactive, scenario-based learning into the curriculum. This study aimed to assess the impact of Ren’Py-based digital materials on learning outcomes by comparing conventional, digital, and hybrid teaching models in an undergraduate electrotherapy course.MethodsThis single-blind, three-arm randomized controlled trial was conducted between October-December 2024 at the Department of Physiotherapy and Rehabilitation. Eighty second-year physiotherapy students who had not previously taken the course were randomly assigned via computerized sequence to one of three groups: Conventional Education Group (CEG, n = 23), Digital Education Group (DEG, n = 29), or Conventional and Digital Education Group (CaDEG, n = 28). Instructional delivery included theoretical and practical sessions, followed by theoretical and practical exams. Outcomes included exam scores, the Cognitive Load Scale, the Attitude Scale Towards the Physiotherapy Profession, and the Educational Materials Motivation Survey. The data were analyzed using SPSS 27.0 package program. The parametric ANOVA test was used for normally distributed data, and the nonparametric Kruskal-Wallis test was used for nonnormally distributed data. Post-hoc analyses were performed using the Bonferroni test for normally distributed data and the Dunn-Bonferroni test for non-normally distributed data. A p < 0.05 level of significance was accepted for all findings.ResultsTheoretical exam scores were similar between groups (CI(95%) = 0.00 to 0.07; p = 0.616), but practical exam scores were significantly different (CI(95%) = 0.03 to 0.30; p < 0.001); both CEG and CaDEG performed better than DEG (CI(95%) = 2.22 to 18.01, p = 0.007 and CI(95%)=-18.51 to -3.52, p = 0.002, respectively). In ASTPP scores, no significant difference was observed between the groups in pre-training, post-training, post-pre-training differences, and in within-group comparisons in any of the CEG, DEG and CaDEG groups (CI(95%) = 130.13 to 136.16, p = 0.858; CI(95%) = 131.91 to 137.08, p = 0.511; CI(95%)=-1.27 to 3.97, p = 0.852; CI(95%)=-4.59 to 3.63, p = 0.987; CI(95%)=-7.31 to 5.10, p = 0.335; CI(95%)=-5.22 to 0.57, p = 0.075, respectively). Cognitive load was significantly higher in the CEG group compared to DEG and CaDEG (CI(95%)=-2.04 to 0.09, p = 0.020; CI(95%)=-0.01 to 2.11, p = 0.016, respectively). IMMS scores were significantly higher in the CaDEG group than in CEG (CI(95%) = 1.77 to 30.32, p = 0.022).ConclusionFace-to-face and hybrid models were more effective than digital-only instruction for developing practical skills in physiotherapy education. The hybrid model also reduced cognitive load and increased motivation. These findings suggest that integrating tools like Ren’Py into conventional instruction may enhance learning when used as a complement. Further studies with larger samples and extended durations are recommended.Trial registrationThis study was retrospectively registered on ClinicalTrials.gov (NCT07274839).Supplementary InformationThe online version contains supplementary material available at 10.1186/s12909-025-08474-z.

We are honored to write our first editorial as co-editors of the Journal of Physical Therapy Education (JOPTE) for the spring 2011 issue as we approach the 25th anniversary of JOPTE. The first issue of JOPTE was published in winter 1987, with Winifred Mauser as the first editor. Otto D. Payton served as editor from 1988 to 1996; Susan Deusinger was editor from 1997 to 2000; and Elizabeth Mostrom served as editor from 2001 to 2003. We wish to acknowledge our most recent editor, Judith L. Stoecker, who served JOPTE as editor from 2004 to 2010, with her associate editor, Wendy Rheault. Judith led the editorial board for over 6 years, pursuing excellence in the quality of the manuscripts published in JOPTE. Her vision was to promote educational scholarship for the profession by making JOPTE the premier publication for physical therapy education researchers and academic and clinical faculty. She valued the process of becoming an author and led the editorial board in producing yearly author workshops for academic and clinical faculty new to the process of writing for publication. Judith personally coached many authors through the peer review process to publication in the JOPTE. She mined the aspirations of the editorial board in a strategic planning process that stretched us to envision big goals for JOPTE. One of these goals was the transition from paper submissions to electronic submissions, which led to our ScholarOne contract. Every aspect of production of JOPTE is en-hanced immeasurably by this achievement, and we now have a process for submission and review of manuscripts that sets us on par with other peer-reviewed journals in our profession. Judith and Wendy and their capable assistant Pam Burke have contributed innumerable hours of time with the support of their home institution, Rosalind Franklin University, which we also acknowledge. As research colleagues at 2 different institutions, we have worked together for over 2 decades and have found our 6 months onthe-job training since July 2010 to be exciting and demanding. We look forward to our work with an outstanding board of associate editors, a dedicated and experienced reviewer pool, and a growing number of authors. This is an exciting and challenging time for physical therapy education. As educators, we do not lack for substantive questions for which we desire answers; they keep us awake at night! Faculty and academic leadership shortages, funding education endeavors in physical therapy academic and clinical settings, identifying new pedagogies that suit a new generation of learners, and global and national health concerns. These are but a few of the topics that interest our community. Our previous editors have set us on a path to become the best resource for evidence-based educational practice, and we hope to continue in this direction. The newly published Research Agenda for the profession1 includes a section of 10 targeted research goals in the area of education/professional development as well as sections on health services research/policy and workforce. We hope this new agenda both validates our need for evidence for our educational practices and spurs education researchers to tackle these issues. It is our goal to continue the development of JOTPE as a strong voice for physical therapy education. We plan to build on the strengths that our predecessors have bequeathed us in seeking out, developing, and publishing work that moves the profession of physical therapy forward. We also want to provide a venue for conversation about the important issues facing physical therapy education. As an example of this goal, we have invited commentary on a very new aspect of our professional landscape—the creation, within APTA, of the Academic Council. This council, a representative body for physical therapist education programs, came into existence in the fall of 2010 and is now beginning to develop its leadership structure and goals. The Academic Council has now replaced what was formally the Academic Administrators Special-Interest Group of the Education Section. We have invited 2 individuals to write perspective papers for this issue related to this new organization. Leslie Portney, the newly elected president of the Academic Council provides the reader with a bit of history of the formation of the organization and a glimpse of the aspirations of this group of academic leaders in physical therapist education. Susan Deusinger, also newly elected to the Board of Directors of the Academic Council, provides a perspective on the impact of this change in organizational structure for our community; reflecting on both opportunities and risks of this new venture. We hope to see many other such perspectives on topics of importance to physical therapy education in JOPTE as we go forward. We look forward to seeing and hearing your responses to the actions we will take over the next few years to bring JOPTE to its full maturity. Next year will be our 25th anniversary. What a wonderful milestone we will celebrate together!