Doctor Of Physical Therapy Curriculum Research Articles

An Interprofessional Team Experience—Value and Timing in a Doctor of Physical Therapy Curriculum

Introduction. Intentional interprofessional experiences (IPE) in physical therapy education are needed to address Commission on Accreditation in Physical Therapy Education criteria and ensure student readiness for practice. The purpose of this study was to compare Doctor of Physical Therapy (DPT) student perceptions of participation in an older adult interprofessional team visit (IPTV) between 3 cohorts at different points in the professional entry level curriculum. Methods. A retrospective comparison of different cohorts was possible at different time points due to curricular changes. Ninety one DPT students in 3 cohorts from 2013 to 2015 participated in the same IPTV experience format in their first, second or third year of the professional program. Doctor of Physical Therapy students were matched with students from 2 disciplines. All participated in a team and discipline-specific orientation and debriefing and completed an assessment with an older adult living in the community and a prequestionnaire/postquestionnaire. Results from postvisit surveys were examined using nonparametric statistics, and open-ended questions were coded and analyzed for themes. Responses were compared for differences across the 3 years. Results. There were significant differences across cohorts. Student reflections were positive with themes emerging across all cohorts for communication, teamwork, and learning. First-year students reported the greatest overall agreement for all learning outcome statements in comparison to the second or third cohort of students. Discussion and Conclusions. The IPTV experience provided a unique opportunity for students to work in an interprofessional team while learning about issues experienced by community dwelling older adults. The activity was ideal to provide early active community participant exposure and meet curricular objectives for communication strategies but could be used for the team-based interprofessional objectives at any stage. While student perceptions of the activity were very positive for all cohorts, this activity was valued by the first-year group more than second or third years. Timing and design of community-based IPE activities should be intentionally sequenced to meet learning objectives suitable for the stage of professional development and take into account exposure to patient care as well as other logistical and curricular sequencing to maximize learning and motivation.

The Jar of Truthiness: A Novel Class Activity to Develop Leaders With Integrity

Background and Purpose. Truthiness is a gut feeling of being true rather than being based on logic or factual evidence. This educational case report describes a novel class activity called the “Jar of Truthiness” (JoT) that aims to teach the important issues of academic and professional integrity within the affective domain. Case Description. The activity was completed in 3 different ways in physical therapist education programs at 2 institutions. Students were asked to report their incidence of cheating during a specific quiz, or overall during their time in physical therapy school, by placing anonymous responses in a jar (the JoT). Two of the activities were completed during the first year of the program, the other activity was completed during the second year of the program. Outcomes. Most students who participated in the activity reported they had cheated, and some students even reported they lied about whether they cheated. When the activity was repeated over time, the number of students admitting to cheating decreased significantly. Discussion and Conclusion. Students responded positively and were able to link academic integrity to professional integrity when the JoT activity was centered around one specific quiz and completed early in the Doctor of Physical Therapy curriculum. Students experienced negative emotions when the activity was held during the second year and when they were asked broadly about sharing information on any assessment in the program. The JoT activity facilitated class discussions about professional development and stimulated learning within the affective domain. Also, the activity appears to work best during the students' early professional formation so that it can help to frame a culture of integrity within their class cohort.

Validation of a Self-Report Clinical Decision-Making Tool Using Rasch Analysis

Introduction. No objective tools exist that assess the level and progression of clinical decision-making (CDM) skills in Doctor of Physical Therapy (DPT) students. Tools in other health professions exist but are not applicable or transferable to DPT education. The purpose of the current study is to validate an objective tool to assess DPT students' perceptions of their CDM skills across a curriculum. Methods. This is a cross-sectional, observational design study, using a convenience sample of DPT students enrolled in a DPT program. Four phases of data collection, representing four iterations of the CDM tool, are included. A self-report tool assessing CDM using a Likert scale was sent to the participants through email. Data were analyzed using Rasch analysis after each phase of data collection, which led to survey revisions and further data collection. Results. The tool demonstrated high internal consistency throughout the four phases of data collection. The tool measures one construct, CDM. The Likert scale levels discriminated well between the different ability levels on all items. The scores on the CDM tool provided known groups validation of the tool. The tool has a ceiling effect, floor effect, and is unable to differentiate CDM skills for DPT graduates who have been practicing for >1 year. Discussion. Clinical decision making is a complex, highly individualized construct. This CDM tool distinguishes the students' perceived level of CDM ability across the different class years of a DPT curriculum. The sample was one of convenience. Further research increasing the heterogeneity of the sample will assist with increasing the generalizability of the tool.

The Evolution of an Integrated Advanced Regional Anatomy Course in a Doctor of Physical Therapy Curriculum

PURPOSETo describe the evolution of an integrative, clinically based advanced regional anatomy course within the second year of a Doctor of Physical Therapy (DPT) program.FOUNDATIONA model of vertical and horizontal integration, using clinically based approaches within a quarter during the second year of a DPT program, evolved over eighteen years with increased use of technology. Original methods of lectures, cadaver prosections, bony models and student presentations have evolved to include electronic examinations, diagnostic ultrasound and palpation laboratories, online sharing of surgical procedure assignments, and clinical case study and pathology discussions with cadaver prosections.DESCRIPTIONOne hundred second year DPT students participated in the newly modified 11 week course over a two year period. Clinical case study and pathology discussions with cadaver prosections, imaging lectures, and diagnostic ultrasound and palpation laboratory sessions were used. Weekly topics on body regions horizontally integrated snatomy with weekly regional topics in clinical medicine and clinical skills courses. For example, over two weeks students listened and discussed imaging of the cervical spine and shoulder girdle while handling and observing bony models, and discussed and observed variations of the brachial plexus, including a published case study, on cadaver prosections. Cervical spine and shoulder girdle structures were palpated in a lab prior to learning manual therapy skills in a clinical skills course. Students posted surgical procedure assignments about cervical disc replacement, nerve transfer for brachial plexus pathology, Bankart repair, and latissimus dorsi transfer concurrent with clinical medicine course lectures about medical approaches to cervical spine and shoulder girdle pathology. A diagnostic ultrasound laboratory session allowed students to observe anatomical structure while learning how to use the device, and a journal case study provided application of its use in physical therapy practice. Students were evaluated on their surgical procedure group assignment, competence in palpation, two electronic multiple choice and short answer examinations, and two cadaver‐based practical exams.OBSERVATIONSStudent course evaluations were positive. One hundred percent of students agreed that course assignments had instructional value, cadaver prosections were an important learning tool, and that palpation labs were effective in improving their skills. Student comments included: “By being able to actually see the structures in the lab, I learned more (than) I would have (by) just looking in a book or powerpoint”; “ the case study discussions in the lab were beneficial and contributed significantly to my learning experience in this course”; ”I thought it was very informative and useful to get back into the lab be able to see the structures again and helped facilitate learning in other courses as well particularly CS5 with hand placement”. Faculty identified improved handling skills, confidence, and competence in the concurrent clinical skills course.CONCLUSIONSEnhanced use of technology, clinical case studies, and palpation in a second year anatomy course facilitated integration within a quarter of an entry level DPT program. Maximizing integration within the curriculum may improve application of content with clinical medicine and skills courses, improve manual psychomotor skills, and enhance problem solving skills.Support or Funding InformationNone.This abstract is from the Experimental Biology 2018 Meeting. There is no full text article associated with this abstract published in The FASEB Journal.

Integrating Edema Management Into Entry-Level Doctor of Physical Therapy Curriculum: A Case Report

Background and Purpose: The Commission on Accreditation in Physical Therapy Education includes criteria for the management of edema. The purpose of this case report is to outline content and instructional guidelines for edema and lymphedema management in 2 entry-level Doctor of Physical Therapy curricula. Case Description: Teaching edema management includes both general and specific knowledge of the anatomy and physiology of the lymphatic system, an understanding of the pathophysiology of edema, and competency in traditional and innovative skills of edema management in the context of a patient management model and evidence-based practice. Northwestern University Department of Physical Therapy and Human Movement Science has a required dedicated course that combines clinical management of patients with lymphatic and integumentary dysfunction. The University of Southern California integrates edema management throughout the 3-year curriculum. Both of these programs are presented in detail. Outcomes: The Northwestern program has been presented continuously since 2003; the University of Southern California began integrative edema management in 2002 and evolved into the current model in 2005. Mean scores on the Federation of State Boards of Physical Therapy examination consistently indicate that graduates from both schools rank higher than other first-time test takers from US accredited programs in the area of cardiovascular/pulmonary and lymphatic systems. Discussion and Conclusion: This report provides objectives, methods, and references to guide an instructional course in edema management in an entry-level Doctor of Physical Therapy curriculum. Two cases of integrating edema content within a current curriculum are presented. An essential element for a successful program is the availability of academic or clinical faculty trained in lymphedema management.

Effectiveness of a Clinical Reasoning Course on Willingness to Think Critically and Skills of Self-Reflection

Background and Purpose. One may possess the skills of good critical thinking but may be unwilling to use them in certain situations, and conversely one may have the habits of the mind of good critical thinking but may fail to possess the requisite skills to use them effectively. Students entering a Doctor of Physical Therapy (DPT) program are most likely already quite good at conceptualizing, analyzing, and synthesizing information. However, during a curriculum review, the faculty of a DPT program agreed that students failed to exhibit sufficient higher-order thinking required for clinical reasoning, one of the primary intended outcomes of the curriculum. The faculty members hypothesized that making the skills and attributes of clinical reasoning more explicit early in the program would help set the stage for improving students' clinical reasoning skills throughout the rest of the DPT curriculum. Case Description. A course entitled “Critical Reasoning” was created as an introduction to the habits of the mind and traits required for good critical thinking and reflective skills. The intentions of the course were to provide a framework for the development of clinical reasoning skills and to make these skills, attributes, and habits of good clinical thinking explicit. The purpose of this study was to explore the effectiveness of this Critical Reasoning course on increasing students' awareness of and willingness to think and reflect critically. Outcomes. There was a statistically significant increase from pre- to post-intervention in students' willingness to think critically as measured by the California Critical Thinking Disposition Inventory. The Self Reflection and Insight Scale also indicated improvement in students' insight into their thinking and their reflective skills. Discussion and Conclusion. It would seem that, given the statistically significant improvement in both outcome measures, the course may have had a positive effect on improving students' willingness and ability to think about their thinking. Making the habits of the mind and the skills of critical reflection explicit early in a curriculum can lead to improvements in students' willingness to think and reflect critically. However, the course's effect on students' overall clinical reasoning skills cannot be assumed without further investigation.

Genu Valgum and Arthritic Changes of the Tibiofemoral Joint in a 97 Year‐Old Female. Results of an Independent Dissection and Literature Review in a 3rd Year Anatomy Elective within a Doctor of Physical Therapy Curriculum

Introduction/ObjectiveGenu valgus alignment has been found to influence the distribution of load across the articular surfaces of the tibiofemoral (TF) joint. The malalignment alters load distribution, gait mechanics and, depending on severity, can impair functional status. The symptoms and degeneration of knee osteoarthritis (OA) are related to the disruption of the articular surfaces and are associated with significant impairment in functional ability.PurposeThis project was conducted as part of an effort to vertically integrate anatomy into the clinical curriculum of the Thomas Jefferson University Doctor of Physical Therapy Program. The objective of this study was to describe the cadaver dissection findings and to research the effect of the biomechanics of a valgus knee on lateral TF OA. Implications for physical therapy treatment were also considered.Case ReportThe subject was a 97 year‐old female with unknown cause of death, who presented with severe genu valgum in her right knee. Her contralateral knee had normal alignment and, importantly, contained a prosthesis from a total knee arthroplasty. Prior to the dissection, Q angle measurements were taken and the subject was found to have a Q angle of 24 degrees. After the skin of the thigh and leg was reflected, the quadriceps tendon was cut and the patella was reflected inferiorly to open up the joint, while preserving the lateral and medial collateral ligaments. Once in flexion, both the femoral and tibial condyles showed signs of arthritic breakdown, particularly in the lateral compartment. The lateral meniscus was absent.DiscussionThe mechanics associated with a valgus knee are increased tibial abduction and external rotation, and increased hip adduction and hip internal rotation. Statically and dynamically, these mechanics increase the articular surface pressure in the lateral compartment of the knee, which is not designed to receive the brunt of the force during gait. This mechanism predisposes the lateral meniscus to injury, which is a risk factor for OA development. Once OA has developed, the valgus knee has greater risk of lateral OA progression. Our subject had a Q angle of 24 degrees which is significantly greater than the angle of 10–15 degrees considered to be normal. Not surprisingly, the arthritic changes seen in her lateral compartment during dissection were consistent with research showing a greater incidence of lateral compartment OA in persons with genu valgum.Clinical Implications for Physical TherapistsGait training and bracing is often utilized, and has been found to be beneficial for individuals who have valgus knee alignment and OA. Gait training includes increasing activation of the gluteus medius, soleus, and hip flexors. Lateral compartment knee unloader braces have been shown to decrease pain and improve functional status associated with OA.ConclusionsThe results of our dissection support prior research regarding progression of OA and genu valgum. Non‐surgical interventions on such patients performed by physical therapists may help alleviate the symptoms of lateral compartment OA.

Evaluation of team-based learning in a doctor of physical therapy curriculum in the United States.

PurposeThe purpose of this retrospective study was to evaluate students’ academic outcomes after implementation of the team-based learning (TBL) approach in patient/client management courses in an entry-level doctor of physical therapy (DPT) curriculum. MethodsThe research design of this study involved comparing written and practical exam scores from DPT student cohorts taught with the traditional instructional methods (lecture-based) to those of students from subsequent cohorts taught using the TBL approach in two patient/client management courses: basic skills and cardiopulmonary. For this comparison, the exams used, the number of contact hours and labs, and the instructors who taught these courses remained the same during the transition between these two instructional methods (traditional vs. TBL). The average of all individual course exam scores was used for data analysis. ResultsIn both courses, there were no meaningful differences in the mean exam scores among students across years of cohorts receiving the same instructional method, which allowed clustering students from different years of cohorts in each course receiving the same instructional method into one group. For both courses, the mean exam score was significantly higher in the TBL group than in the traditional instruction group: basic skills course (P<0.001) and cardiopulmonary course (P<0.001).ConclusionStudent cohorts taught using the TBL approach academically outperformed those who received the traditional instructional method in both entry–level DPT patient/client management courses.

Development and Validation of a Self-Efficacy Scale for Clinical Reasoning in Physical Therapists

Background and Purpose. Contemporary physical therapist (PT) practice assigns greater responsibility, accountability, and autonomy to the PT than ever before. Achieving accuracy in clinical reasoning is more complex and is associated with greater risk. Self-efficacy contributes, positively or negatively, to clinical reasoning. At present there is no tool for measuring self-efficacy in clinical reasoning among PTs or PT students. The purpose of this study was to develop and present a PTspecific self-efficacy scale for measuring clinical reasoning among students. Methods. The 5-item Physical Therapist Self-Efficacy (PTSE) scale was developed with model indicators available in the literature and expert opinion related to expectations in clinical reasoning. Seventy-one students enrolled in the 3-year Doctor of Physical Therapy degree program at Marymount University, Arlington, Virginia, completed both the New General Self-Efficacy scale and the PTSE scale described in this study. Results. An initial factor analysis revealed that 2 independent component factors accounted for 95.6% of the variance in the data, namely, general self-efficacy and PT self-efficacy. A planned comparisons analysis of variance demonstrated that increases in PT self-efficacy among students across years of enrollment in the Doctor of Physical Therapy curriculum were statistically significant (F = 22.134; df = 2; P = .000). Discussion and Conclusion. The evidence in this study supports the initial validation of the newly developed PTSE scale for measuring self-efficacy in clinical reasoning among PT students, with potential application for practicing PTs. physical therapist self-efficacy is developmental, that is, responsive to environmental inputs such as educational experiences. Changes in perceived general self-efficacy that were observed in this study may be related to the homogeneity associated with the academic environment.

Opportunities and Challenges in The Use of an External Interprofessional Reviewing Body in a Curricular Review Process in a Doctor of Physical Therapy Curriculum

Purpose: The purpose of this article is to describe the opportunities and challenges of a curricular review process in an entry-level doctor of physical therapy geriatric curriculum. The curricular review process utilized an external interprofessional reviewing body, in conjunction with an established internal curricular reviewing body, to determine inclusion of Essential Competencies in order to prepare students for best clinical practice in the care of the older adult. Method: The methodology of our curricular review process included both internal and external reviewing bodies but the intent of this article is to highlight how the review process was implemented including an external interprofessional reviewing body. The internal reviewing body involved two faculty members with expertise in geriatrics, the Program Curriculum Committee members, and the faculty members within the entry-level doctor of physical therapy program. The external reviewing body was comprised of the 2012-2014 members of the Faculty Development Collaborative Program in Geriatrics (FDCPG), a national interprofessional learning community representing multiple disciplines involved in the care of older adults. Results: The outcomes of including an external interprofessional reviewing body in the geriatric curricular review process were: the FDCPG justified the need for the review of the Essential Competencies, deemed their role as important in healthcare education, and reported a greater understanding of the role of physical therapists as part of an interprofessional healthcare team. The Program Curriculum Committee created a policy for consideration of other published competencies, including a recommendation for “other necessary consultation” based on our use of an external reviewing body, noting its value. The outcomes of the overall curricular review process included: 53/61 Essential Competencies were identified as already in the curriculum and the remaining 8/61 Essential Competencies were added. Conclusions and Recommendations: The addition of an external interprofessional reviewing body to an already established internal reviewing body within the geriatric curricular review process in an entry-level doctor of physical therapy program produced a curriculum that will hopefully prepare students for best clinical practice in the care of the older adult. This comprehensive curricular review process involved opportunities and challenges yet still can be used across multiple disciplines, across multiple curricular structures, and is in line with the current state of healthcare practice.

Student perceptions and understanding of client-therapist interactions within the inpatient acute care environment: qualitative study.

Physical therapists practicing in inpatient acute care settings in the United States work in a 21st century health care system that requires professional competence in clinical reasoning and decision making. For doctor of physical therapy (DPT) students, the development of confidence in the patient evaluation and the professional skills necessary for managing the inpatient environment can be challenging. The study's purpose was to understand whether the early exposure of students to inpatient settings informed their understanding of the thought processes and actions of experienced clinicians during client interactions. A qualitative design was used. Thirty-three DPT students working in inpatient settings were recruited from 15 unique inpatient hospital (acute care and rehabilitation) facilities with a convenience sampling technique. Reflective data were collected for 1 month with clinician-facilitated discussion boards. Four themes emerged: environment, communication, evaluation, and client-therapist interaction. The themes informed a conceptual model depicting the observation by DPT students of factors that influenced interactions between clients and experienced clinicians in inpatient settings. Reflection on the what, the how, and the why that informed clinical decisions enabled students to recognize the situated nature of evaluation and treatment approaches. The use of a sample from 1 year of a DPT program at one university reduced the generalizability of the results. Limited research has examined student perceptions of the interactions of experienced clinicians with clients in inpatient acute care settings. More research is needed to understand the impact of exposing students to the thoughts and actions of therapists working in such settings earlier within DPT curricula.

Integrating Spanish language training across a Doctor of Physical Therapy curriculum: a case report of one program's evolving model.

As the Hispanic population continues to expand in the United States, health professionals increasingly may encounter people who speak Spanish and have limited English proficiency. Responding to these changes, various health profession educators have incorporated Spanish language training into their curricula. Of 12 doctor of physical therapy (DPT) programs identified as including elective or required Spanish courses, the program at The University of Texas at El Paso is the only one integrating required Spanish language training across the curriculum. The purpose of this case report is to describe the development, implementation, and preliminary outcomes of the evolving educational model at The University of Texas at El Paso. The University of Texas at El Paso is situated immediately across the border from Mexico. Responding to the large population with limited English proficiency in the community, faculty began to integrate required Spanish language training during a transition from a master-level to a DPT curriculum. The Spanish language curriculum pillar includes a Spanish medical terminology course, language learning opportunities threaded throughout the clinical courses, clinical education courses, and service-learning. Forty-five DPT students have completed the curriculum. Assessment methods were limited for early cohorts. Clinically relevant Spanish verbal proficiency was assessed with a practical examination in the Spanish course, a clinical instructor-rated instrument, and student feedback. Preliminary data suggested that the model is improving Spanish language proficiency. The model still is evolving. Spanish language learning opportunities in the curriculum are being expanded. Also, problems with the clinical outcome measure have been recognized. Better definition of intended outcomes and validation of a revised tool are needed. This report should promote opportunities for collaboration with others who are interested in linguistic competence.

Outcomes Related to a Multimodal Human Anatomy Course With Decreased Cadaver Dissection in a Doctor of Physical Therapy Curriculum

BACKGROUND AND PURPOSECadaver dissection historically has been an indispensable component of teaching and learning human anatomy for most health care professionals, including physical therapists.1'5 More recently, the effectiveness and efficiency of using cadavers has been studied and challenged.1,6 Cost and time have been cited as reasons for decreasing the use of human cadavers in courses.2,3,6 Also, the development and implementation of computer-assisted (CA) and web-based (WB) information technologies have challenged the traditional notion that cadaver dissection is essential for learning, understanding, and applying anatomy in clinical practice.3,7,8 Studies have demonstrated that use of CA and WB are reasonable and viable components of, or alternatives to, traditional cadaver dissection in human anatomy courses.6,9Recent studies provide evidence that learning human anatomy is not adversely affected by the use of CA and WB information technology.9'13 However, challenges still remain with regard to providing cost- and time-efficient anatomy content without compromising optimal standards for learning outcomes.1 There may be no single pedagogy for teaching anatomy that is maximally efficient for all health care disciplines. Physical therapists utilize visual assessment, surface anatomy, and palpation skills when examining patients, and may not need as much time in the cadaver lab as might be the case in other health care disciplines in order to learn clinically relevant anatomy.6 The purposes of this study were to: (1) describe changes to a traditional human gross anatomy course, specifically the use of WB video dissections and reduced time in actual cadaver dissection lab; (2) describe and assess student impressions of the curriculum; and (3) compare, assess, and discuss student outcomes related to changes to the human anatomy course in the entry-level Doctor of Physical Therapy (DPT) degree program at the University of Alabama at Birmingham (UAB).Method/Model Description and EvaluationFifty first-year physical therapist students were enrolled in the Human Gross Anatomy course in the Department of Physical Therapy. Forty-four students consented to participate in the study. Students were quasi-randomly assigned to lab groups of 5 students each at the beginning of the semester. During the semester, students viewed online video dissections14 on the Internet (www.youtube.com) for each region of the body studied. Four regions were studied during the semester: abdominal, spine, upper extremity, and lower extremity. Within each region, specific skeletal, muscular, articular, vascular, and neural components were identified and discussed. The course included a general description of the abdominal cavity's visceral components, emphasizing somatic representation of referred pain during surface anatomy labs. (Anatomy of the neck/head, thoracic cavity, and pelvic cavity is covered in the second semester of the curriculum, with 2 groups attending dissection sessions each week over an 8-week period.) The 4-credit hour course consisted of 1-hour lecture sessions, followed by 2-hour palpation/surface anatomy labs, 1-hour video dissection sessions, and cadaver dissection labs distributed over the 15 weeks of the semester. During the semester, each lab group participated in two, 3-hour cadaver dissection labs with the course instructor. Two 5-student groups were in the dissection lab for each session, with 1 cadaver per group. There was a total of 10 dissection sessions.All students participated in the online video dissection labs.14 There was a total of 10 video dissection sessions during the semester. Students viewed the assigned dissection video within their lab groups for approximately 20 minutes. The groups returned to class and viewed the dissection videos a second time with intermittent narration and more indepth discussion with the course instructor, each session totaling 50 minutes.The palpation/surface anatomy labs were 2-hour sessions immediately following each lecture session. …

Effects of Restructuring a Neuroscience Curriculum in a Physical Therapist Education Program

Background and Purpose. This study investigated (1) whether restructuring of the neuroscience curriculum to reduce basic neuroscience credit hours to allow additional credit hours in applied neuroscience would improve students’ knowledge of basic neuroscience and neurology course sequence outcomes, and (2) whether integration of basic neuroscience into a regional cadaver anatomy course would improve student attitudes toward neuroscience topics and improve retention of basic neuroscience knowledge. Participants. A survey instrument and a neuroscience knowledge-retention test (KRT) were developed and administered to 5 sequential cohorts of physical therapist students. Methods. The first 2 cohorts (nonintegratedcourse group) took a 6-credit-hour regional anatomy course in their first semester and a 3-credit-hour basic neuroscience course in their second semester. The second 3 cohorts (the integrated-course group) took a 6-credit-hour combined regional anatomy and basic neuroscience course in their first semester, followed by a 2-credit-hour applied neuroscience course in their second semester. Outcomes. Overall GPA performance in subsequent neurology sequence courses improved with the revised neuroscience curriculum. Student attitudes to neuroscience improved markedly in the second cohort of students prior to course integration. No further improvement in attitudes occurred after course integration. These findings suggest that the first cohort by chance had more students with negative attitudes toward neuroscience. Mean KRT scores were not statistically different after the shift in student attitudes or after course integration (P > .87, P > .35). When data from all cohorts were combined, analysis of student attitudes and demographics revealed that students who reported enjoyment in learning basic neuroscience topics had on average statistically higher KRT scores (52% versus 46%, P < .007). Discussion and Conclusion. Student performance in courses in the neurology course sequence improved and retention of basic neuroscience knowledge remained constant following a shift of 2 credits from basic neuroscience to applied neuroscience courses within the Doctor of Physical Therapy curriculum. Integration of the anatomy and basic neuroscience courses did not impact student attitudes toward basic neuroscience. Those students who enjoyed learning basic neuroscience performed better on the KRT than those students who reported less enjoyment in learning neuroscience content.

Fostering the development of effective person-centered healthcare communication skills: An interprofessional shared learning model

To describe the implementation of an interprofessional shared learning model designed to promote the development of person-centered healthcare communication skills. Master of social work (MSW) and doctor of physical therapy (DPT) degree students. The model used evidence-based principles of effective healthcare communication and shared learning methods; it was aligned with student learning outcomes contained in MSW and DPT curricula. Students engaged in 3 learning sessions over 2 days. Sessions involved interactive reflective learning, simulated role-modeling with peer assessment, and context-specific practice of communication skills. The perspective of patients/clients was included in each learning activity. Activities were evaluated through narrative feedback. Students valued opportunities to learn directly from each other and from healthcare consumers. Important insights and directions for future interprofessional learning experiences were gleaned from model implementation. The interprofessional shared learning model shows promise as an effective method for developing person-centered communication skills.

An Integrative, Longitudinal Case-Based Learning Model as a Curriculum Strategy to Enhance Teaching and Learning

Background and Purpose. Indiana University faculty and students developed a multi-generational case family series as a tool for implementing the Integrated Longitudinal Case-Based Learning (ILCBL) model supporting the achievement of program objectives. The purposes of this paper are to present the development of the Indiana University Doctor of Physical Therapy Family Tree as a tool for the application of the ILCBL model and to discuss preliminary findings evaluating the model's effectiveness. Method/Model Description and Evaluation. The Indiana University Doctor of Physical Therapy Family Tree: An Integrated Case Series, comprised of 37 interrelated cases spanning 4 generations, was co-created by faculty and students to serve as a tool to enhance teaching and learning. ILCBL is a novel perspective on casebased learning. Its aim is to facilitate the development of student problem-solving and clinical decision-making skills, as well as cultural and ethical competence in preparation for clinical practice. Outcomes. Outcome measures included student course surveys (n = 89/102; 87.25% response rate) and clinical discussion forum comments (n = 69/69; 100% response rate). Student survey results were supportive of the ILCBL model, citing benefits in problem solving, critical thinking, and clinical preparation; however, a desire for more consistent use was indicated. Clinical discussion forum comments reflected the longitudinal value of ILCBL in translating classroom knowledge into clinical application. Faculty comments also highlighted the efficiency and effectiveness of the ILCBL model. Discussion and Conclusions. The ILCBL model successfully supports course and program objectives. The case family series is an effective and efficient means for implementation of the ILCBL model. The most promising aspect of ILCBL is students' perspective of its longitudinal value in fostering critical thinking skills and cultural and ethical sensitivity. Future developments will focus on more consistent and integrated applications of the case family series towards expansion of the ILCBL concept. Key Words: Teaching methods, Critical thinking, Case-based learning, Curricular strategy. BACKGROUND AND PURPOSE In 2003, in its first year of a newly designed Doctor of Physical Therapy curriculum, Indiana University (IU) was presented an opportune moment to foster faculty collaboration toward a comprehensive education model. The goal was to implement the Integrated Longitudinal Case-Based Learning (ILCBL) model with the goals of decreasing course isolation, facilitating effective learning, and increasing efficiency. A pedagogical instrument, The Indiana University Doctor of Physical Therapy Family Tree: An Integrated Case Series, was constructed connecting the mission, vision, and curricular threads with the hope of facilitating learning across the curriculum. The IU physical therapy curriculum is derived from an analysis of current practice standards articulated in the American Physical Therapy Association's (APTA) Guide to Physical Therapist Practice1 and the Normative Model of Physical Therapist Professional Education,2 as well as from disablement3 and clinical decision-making models.46 Integration of these various resources has led to a progressive curricular design where basic science forms a knowledge base from which applied sciences build. The goal is to prepare new clinicians to think critically and to problem solve for all types of patient conditions. While the structure of the curriculum lends itself to the development of these skills, creating educational experiences that draw these components together can be challenging. Consequently, implementing pedagogical approaches within the classroom that foster applied learning becomes essential. The literature describes several different strategies to promote effective clinical reasoning, including problem-based learning (PBL),'8 case-based learning (CBL),911 and standardized patient simulations (SPS). …

Use of a Community Volunteer Program to Develop Value for Patient-centered Care in Physical Therapist Professional Education

Background and Purpose. When the Physical Therapy Program at the University of Colorado's School of Medicine transitioned from a 2-year master's degree program to a 3-year Doctor of Physical Therapy (DPT) program in 2004, the faculty took the opportunity to rethink the program's philosophy and employ innovative instructional methods to reinforce key curricular components. As part of this new curriculum, the Community Volunteer Program (CVP) was established to enhance experiential learning and emphasize a patient-centered care philosophy. The purposes of this paper are to: (1) describe the CVP and its intentions as an educational strategy to reinforce our philosophy of patient-centered care; (2) share student feedback on the program, based on survey results; and (3) discuss future directions for the CVP experience as a component of physical therapist professional education. Method/Model Description and Evaluation. The CVP pairs students with community volunteers who have a selfidentified physical disability. Each student follows his or her volunteer throughout the 3-year curriculum and learns about life with a disability directly from the volunteer's and family's perspectives and experiences. Course assignments help to guide students in their interactions and provide opportunities for reflection and guided learning. An online survey was conducted with 3 student cohorts each at the midpoint of their 3-year program to assess their perceptions of the CVP. Outcomes. The survey response rates for students in the graduating classes of 2007, 2008, and 2009 were 92%, 76%, and 67%, respectively. Overall, survey results were positive and indicated that the CVP enhanced student learning in the intended focus areas related to patient-centered care and contributed to the students' professional growth. Discussion and Conclusion. Results from this survey have been used to assist in program planning and to insure the experience is effective for students. The CVP has enhanced our DPT curriculum through tangible experiences and interactions with individuals in our community who have disabilities. Physical therapist professional education programs may want to consider this model to augment student learning.

Administration and Management Skills Needed by Physical Therapist Graduates in 2010: A National Survey

Administration and management (A and M) skills are essential to physical therapist practice. This study identified which A and M skills will be most critical for future Doctor of Physical Therapy (DPT) graduates to possess upon entry into clinical practice. Using a 7-point scale, 435 randomly selected American Physical Therapy Association members (physical therapists) rated 121 A and M skills based on expectation of the level of independence required by a new DPT graduate. No differences among respondents based on role, work setting, or experience were found, so the data were combined for factor analyses, producing 16 A and M skill groups. The most independence was expected in skills related to self-management, compliance with rules, ethical behavior, and insurance coding. Skills requiring the most assistance were marketing and strategic planning, financial analysis and budgeting, and environmental assessment. This study has identified the level of independence for the A and M skills needed by new DPT graduates, provided empirical evidence suggesting which A and M skills should be included in DPT curricula, and suggested a pattern of A and M skill acquisition that applies first to the new therapist and the patient, then to the organization, and finally to the health care environment.

Community Experiential Learning Opportunities In the Drexel University Professional Doctor of Physical Therapy Program

Background and Purpose. Community experiential learning opportunities culminating in service learning activities provide Doctor of Physical Therapy (DPT) students with knowledge and skills that enhance their understanding of patient-centered care in the context of the patient's environment (community, home, family, and individual). Students who engage in community experiential learning opportunities interact with patients in the real world. These students may strengthen their problem-solving and clinical skills and learn to be flexible as they address reallife issues that affect health outcomes for their patients. Method/Model Description and Evaluation. The purpose of this brief report is to describe a model that integrates community experiential learning opportunities and service learning activities by threading the experiences across a DPT curriculum. The goal at Drexel University is to provide students with opportunities that match their developing knowledge base and clinical skills. Through community experiences provided in 3 phases, students are able to gradually gain mastery and confidence in community-based health care. Outcomes. Course evaluations, reflection reports, and focus group discussions indicate that students value community-based learning experiences. These experiences enrich professional development and personal growth. Furthermore, the activities help students understand patients' life situations, an understanding that in turn may improve patient-centered care and help build respectful relationships between patients and future health care professionals. Discussion and Conclusion. Partnership building among clinical and public health care professionals, community health care providers, and faculty is essential for the future development of these student experiences. Key Words: Doctor of Physical Therapy curriculum, Community experiences, Service learning, Student learning. Drexel University, a large urban university, prepares students for professional roles and encourages them to become responsible citizens through activities that meet community needs.1 The University's mission statement embodies this belief: To serve its students and society through comprehensive, integrated academic offerings enhanced by technology, cooperative education and clinical practice in an urban setting.1 This mission is exemplified in the mandatory service learning experience for all undergraduates that is conducted through the University's Center for Civic Engagement. The Civic Engagement program expands on the University's long-standing commitment to the community and to experiential learning. This program provides students with a variety of experiences that are rich in cultural, social, and ethnic diversity.2 The College of Nursing and Health Professions (CNHP) at Drexel University houses 7 academic programs for the education of health care professionals. The Programs in Physical Therapy and Rehabilitation Sciences in the CNHP offer a professional Doctor of Physical Therapy (DPT) degree and postprofessional physical therapy education. The mission statement for the professional DPT program reflects the values and priorities of both Drexel University and the CNHP: 'To educate doctors of physical therapy, to meet current and future health care needs and challenges through a learning environment that promotes academic excellence, evidence based practice, and a diversity of clinical experiences. Drexel University strives to graduate innovative and caring practitioners who possess a sense of civic and professional responsibility and value lifelong learning.3 Community experiential learning opportunities were designed by faculty members with interest and experience in community service and service learning and embedded throughout the professional DPT curriculum. Experiential learning is sometimes referred to as incidental or informal learning and includes concepts in adult learning, such as self-directed learning, lifelong learning, working knowledge, practical intelligence, and situated learning. …

The Varied-Integrative-Progressive (VIP) Model for Anatomy Instruction in Physical Therapist Education

Background and Purpose. When Chapman University converted from its Master of Physical Therapy (MPT) degree to a Doctor of Physical Therapy curriculum, the faculty evaluated the components of the MPT anatomy courses, examined the relevant standards and recommendations for physical therapist education, reviewed the published literature on anatomy instruction, consulted with other experts in the field, and solicited input from students and graduates to develop our current model for anatomy instruction, the Varied-Integrative-Progressive (VIP) model. The article reviews the literature pertaining to anatomy instruction, describes the VIP model, and presents outcome data pertaining to the model. Method/Model Description and Evaluation. The VIP model for teaching anatomy content is an example of evidencebased pedagogy that is based upon findings in the published literature; expert opinion; and student outcomes, perceptions, and preferences. This model draws upon a variety of teaching approaches: The content is integrated throughout the curriculum both horizontally and vertically, and the complexity of learning progresses within semesters and across the curriculum. As a result, students are able to learn clinical anatomy and develop their abilities to become self-directed, lifelong learners. We evaluated student perspectives of the VIP model through anonymous surveys. In addition, we examine licensure examination performance and other learning outcomes and cost comparisons. Outcomes. Of the components of the multimodal VIP model, students rated most highly the use of human cadavers, particularly performing dissection and carrying out individual capstone projects. Students also greatly value the integration of clinical applications and crosscurricular content and the incorporation of surface/living anatomy exercises into the coursework. Discussion and Conclusion. The VIP model is an evidence-based, multimodal, progressive model for anatomy instruction that emphasizes clinical applications and includes a 2-course series with human cadaveric prosections and dissection. The dissection course is taught between fulltime internships to optimize clinical relevance and reinforce learning.