Entry-level Curriculum Research Articles

Mapping and Assessment of a Threaded Acute Care Curriculum Using Entry-Level Core Competencies Established by Academy of Acute Care Physical Therapy

The Academy of Acute Care Physical Therapy recently established core competencies for entry-level practice in acute care settings. The purpose of this article is to describe and evaluate a model that embeds the competencies throughout an entry-level curriculum, emphasizes active learning strategies, and facilitates student proficiency in clinical decision making in the acute care setting. Faculty-mapped course objectives, learning activities, and assessment methods to the competencies and identified redundancies and gaps. Student learning was assessed using a variety of activities including computerized modules and authentic simulations. The mapping process led to enhanced coordination and documentation of the competencies throughout the curriculum. Course feedback indicated high levels of student satisfaction with active and authentic learning strategies. Learning outcomes substantiated student attainment of the newly established entry-level competencies. Curricular mapping is an effective strategy to ensure that acute care competencies are embedded, reinforced, and integrated. Active and authentic learning assists students to make the transition from the classroom to the demands of acute care settings. Enhanced student self-efficacy and performance in simulated scenarios provided evidence of their attainment of clinical reasoning skills required for the complex and changing demands of the acute care environment.

'There's so much to it': the ways physiotherapy students and recent graduates experience practice.

Health science courses aim to prepare students for the demands of their chosen profession by learning ways appropriate to that profession and the contexts they will work and live in. Expectations of what students should learn become re-contextualised and translated into entry-level curriculum, with students operating as a connection between what is intended and enacted in curriculum, and required in the real world. Drawing on phenomenology, this paper explores how students understand practice-the collective, purposeful knowing, doing and being of a community-in entry-level physiotherapy programs. Ways of thinking and practising (WTP)-a framework attentive to the distinctive nature of a discipline, its values, philosophies and world-view (McCune and Hounsell in High Educ 49(3):255-289, 2005)-provides the conceptual lens. Six themes describing how students see the WTP of physiotherapy practice emerged from the analysis: discovery of new knowledge; problem solving client related contexts; adopting a systems based approach to the body; contributing to a positive therapeutic alliance; developing a sense of self and the profession; and the organisation of the workforce. The study produces knowledge about practice by focusing on physiotherapy students' experiences of disciplinary learning. Including students in educational research in this way is an approach that can help students realise their potential as part of a community of practice.

Guidelines for Contributors to AJOT.

Guidelines for Contributors to AJOT.

Teaching Evidence-Based Practice across Curricula—An Overview of a Professional Development Course for Occupational Therapy Educators

ABSTRACTA professional development course for occupational therapy educators about teaching evidence-based practice (EBP) was developed and piloted. The course was developed to promote increased awareness of resources and methods for teaching EBP that are applicable across entry-level curricula. Participants included full-time faculty (n = 7) from one entry-level occupational therapy program in the New York City area. The results of the pilot informed refinement of the course in preparation for delivery to a wider audience of educators. This paper provides a description of the course, results of the pilot, and implications for future delivery of the course.

The rehabilitation education for caregivers and patients (recap) theory and model

Background: Patient and caregiver education is recognized as a critical component of physical therapy practice and stroke rehabilitation yet the informational needs of patients with stroke and caregivers are largely unmet. A theoretical model to guide this area of practice is needed. Purpose: To develop a theory and model of “Rehabilitation Education for Caregivers and Patients” (RECAP) in the context of physical therapy and stroke rehabilitation across the post-acute care continuum, grounded in the experiences and perceptions of individuals with stroke, caregivers, and physical therapists. Methods: A qualitative study with a grounded theory approach was used. A convenience sample of 13 individuals with stroke and 12 caregivers participated in semistructured interviews. Additionally, 19 physical therapists completed pre-interview reflection activities and individual interviews and/or focus groups. Transcripts were coded and a constant comparative method was employed. Verification strategies included self-reflective memos, analytic memos, peer debriefing, and triangulation. A theory and model were derived. Results: The theory generated is: physical therapists continually assess the educational needs of individuals with stroke and caregivers, to participate in dynamic educational interactions that involve the provision of comprehensive content, at a point in time, delivered through diverse teaching methods and skilled communication. This phenomenon is influenced by characteristics of the provider (physical therapist) and receiver (individual with stroke/caregiver) of information and occurs within the context of the physical therapist’s professional responsibility, the multidisciplinary team, a complex healthcare system, and the environmental/socio-cultural context. The RECAP model depicts the relationships between the core and encompassing constructs of the theory. Conclusion(s):Educating patients and caregivers is a critical component of physical therapy practice. RECAP is the first theory andmodel developed to describe this phenomenon in the context of physical therapy and stroke rehabilitation. RECAP serves to empower, motivate, and engage individuals with stroke and their caregivers to put education into action in order to facilitate an optimal recovery and reconstruct a self-identity post-stroke. Through RECAP, physical therapists can provide individuals with stroke and caregivers with much needed education to overcome the barriers of disability and support a positive quality of life. Limitations of this work include transferability considerations regarding application offindings to other contexts, inclusion of rehabilitation settings only, and the retrospective nature of the design and subsequent impact on participant perceptions. Implications: The RECAP theory and model advances the practice of patient and caregiver education in physical therapy. This research provides a springboard to inform future research, guide RECAP in stroke physical therapy practice, design optimal educational interventions, develop training tools for entry-level curriculum and practicing clinicians, and to potentially translate to the practice of patient and caregiver education for other rehabilitation professionals and patient populations.

Rehabilitation of the Upper Extremity after Stroke: Current Practice As a Guide for Curriculum

Stroke is the leading cause of disability in the United States and a top diagnosis for occupational therapy (OT) services among neurological conditions. Academic programs teach OT students neurological frames of reference (FORs) to provide a foundation for future practice. To meet accreditation standards, entry-level curricula must reflect current practice and evidence-based interventions. A survey of OT practitioners working in upper extremity stroke rehabilitation was conducted to investigate current clinical practice in a variety of treatment settings. Survey questions probed the use of motor rehabilitation techniques exclusive to one of six neurological FORs: Brunnstrom, Constraint-induced Movement Therapy, Neurodevelopmental Treatment, Proprioceptive Neuromuscular Facilitation, Rood, and Task-Oriented. Responses from 167 OT professionals indicated interventions representing all six FORs are currently being utilized in stroke rehabilitation. Techniques from the Task-Oriented and Neurodevelopmental Treatment approaches were used most frequently; however, the Rood–based techniques were used much less than interventions from the other FORs. No single neurological approach was found to dominate practice regardless of the number of years of experience in stroke rehabilitation or years since graduation from an entry-level program. A majority of participants appear to employ techniques from multiple approaches frequently, suggesting contemporary OT practice in upper extremity stroke rehabilitation is eclectic in nature.

Exploration of spirituality in doctor of physical therapy students and graduate students in non-health disciplines

Background/Aims: The purpose of this study was to explore spirituality in doctor of physical therapy (DPT) students, and to compare these findings with graduate students from other disciplines outside healthcare. An additional purpose was to determine DPT student attitudes towards spirituality and its relevance to their profession. Methods: A brief survey was administered including the 16-item Daily Spiritual Experiences Scale (DSES). Findings: A total of 65 DPT students and a total of 132 non-healthcare graduate students completed the survey. Age did not show a statistically significant relationship (r=.051, P>.05) to spirituality in our subjects and was therefore excluded from further analysis. A 2-way, between-subjects ANOVA was performed to test for differences in spirituality scores between the sexes and between the two student groups. There was a significant main effect for sex [F(1,173) =8.771, P=.004]. There was no significant main effect for Academic Major group (P>.05). There were no significant interactions (P>.05). The vast majority of physical therapy students indicated that physical therapists should be concerned with the spiritual health of their clients (81.5%), and that their education should include exposure to spiritual health issues (78.5%). Conclusions: Spirituality in DPT students does not differ significantly from non-healthcare graduate students. DPT students, however, do have high levels of daily spiritual experiences, believe spirituality is important to the profession, and desire training in this area. Physical therapy educational programmes may want to consider expanding this component of the entry-level curriculum.

Clinical Instructors' Perspectives

This study explored clinical instructors' perspectives regarding specific aspects of pediatric content that should be included in the curricula of entry-level physical therapist education programs. This mixed methods sequential explanatory study was conducted using 2 groups of participants. The survey-only group consisted of 278 participants who anonymously completed a Web-based survey. The mixed-data group consisted of 9 purposively selected participants who completed the Web-based survey and participated in a one-on-one qualitative interview that explored their survey responses. Participants provided recommendations pertaining to the depth and breadth of pediatric content in entry-level curricula. A diagram was created to depict the participants' perspectives on how pediatric content in the entry-level curricula should be structured. Clinical instructors offer valuable insights that can be used to guide entry-level curricular content in pediatrics. The results of this study may assist physical therapist faculty in preparing students for entry-level practice in pediatrics.

The First Physical Therapy Summit on Global Health: Implications and Recommendations for the 21st century

The First Physical Therapy Summit on Global Health was convened at the 2007 World Confederation for Physical Therapy (WCPT) Congress to vision practice in the 21st century and, in turn, entry-level education and research, as informed by epidemiological indicators, and consistent with evidence-based noninvasive interventions, the hallmark of physical therapy. The Summit and its findings were informed by WHO data and validated through national databases of the countries of the five WCPT regions. The health priorities based on mortality were examined in relation to proportions of physical therapists practicing in the areas of regional priorities and of the curricula in entry-level programs. As a validation check and to contextualize the findings, input from members of the 800 Summit participants was integrated and international consultants refined the recommendations. Lifestyle-related conditions (ischemic heart disease, smoking-related conditions, hypertension, stroke, cancer, and diabetes) were leading causes of premature death across regions. Contemporary definitions of physical therapy support that the profession has a leading role in preventing, reversing, as well as managing lifestyle-related conditions. The proportions of practitioners practicing primarily in these priority areas and of the entry-level curricula based on these priorities were low. The proportions of practitioners in priority areas and entry-level curricula devoted to lifestyle-related conditions warrant being better aligned with the prevalence of these conditions across regions in the 21st century. A focus on clinical competencies associated with effective health education and health behavior change formulates the basis for The Second Physical Therapy Summit on Global Health.

A national study of the availability and use of electrophysical agents by Australian physiotherapists

Electrophysical agents (EPAs) are a core part of physiotherapy practice and entry level education. With the increase in the number of EPAs over time, their availability and use in contemporary physiotherapy practice is an important consideration when determining entry level curricula. Thus, the aim of the study was to ascertain the current availability and usage of EPAs in Australian physiotherapy practice. A purpose-designed questionnaire was mailed to all registered physiotherapists in Australia. A response rate of 27% was obtained (n=3,538). Nonresponder analyses indicated that the results were representative of the total population of Australian physiotherapists. Over 70% of respondents had access to ultrasound, cold packs/ice, heat packs, electrical stimulation for sensory stimulation, and interferential therapy. Two main groups of EPAs were used relatively frequently. The first group was used daily or monthly by 60% of respondents (ultrasound, hot packs, and cold packs/ice), and a second group (electromyographic and pressure biofeedback, interferential therapy, and electrical stimulation for sensory stimulation) was used on a daily or monthly basis by between 30% and 45% of the sample. A group of EPAs, including ultraviolet light, microwave, and shortwave diathermy, was not used by over 90% of the sample. The study has provided contemporary national data on EPA availability and use in Australia.

Teaching graphics with the openGL shading language

A long-standing difficulty in the development of introductory courses in computer graphics is balancing the educational necessity of ensuring mastery of fundamental graphical concepts with the highly desirable goal of exciting and inspiring students to further study by enabling them to produce visually interesting programming projects. Recently, we have developed a modified curriculum predicated on the extensive integration of the OpenGL Shading Language with a more traditional pedagogical approach. We utilized this curriculum in the quarter-long, upper-division introductory graphics course taught in the Department of Computer Science at the University of California, Santa Cruz. Our experience indicates that making shading an integral part of the entry-level curriculum inculcates students with a comprehensive understanding of the algorithms and mathematical concepts that underlie modern graphical systems, while simultaneously equipping them with the tools necessary to produce complex projects with state-of-the-art technology.

Clinical evaluation of support surfaces: a review

The recent editorial by Laakso and colleagues argued that there was sufficient evidence to justify the continued inclusion of electrophysical agents as a major study area within entry-level curricula. They stated that “despite the barriers, there are some positive, high quality systematic reviews supporting the use of electrophysical agents…”. In support of this assertion, they cited a Cochrane review (Flemming and Cullum 2002a). My view is that the citation of this review to support their assertion is quite misleading because it seems contrary to the reviewers’ conclusions.

A new approach to teaching feedback

The Control and Dynamical Systems (CDS) Department at the California Institute of Technology (Caltech) has revised its entry-level curriculum in dynamics, feedback, and control with the goals of updating the subject matter to include modern tools and making control tools accessible to a nontraditional audience. One of the approaches made was to divide the introductory control theory class into two tracks, with a conceptual track geared toward students who need only a conceptual overview of control tools and an analytical track providing a more detailed mathematical treatment of feedback. The conceptual track, CDS 101, which is mainly discussed in the paper, is intended for advanced students in science and engineering who can benefit from an overview of control techniques but who might not have the need for the mathematical depth underlying the material. Special attention is paid to ensuring that the course is accessible to students from biological, physical, and information sciences, using examples from these domains to illustrate concepts. The goal of the course is to enable students to use the principles and tools of feedback in their research activities.

The role of play in pediatric occupational therapy.

This study examined the roles that play occupies within current occupational therapy practice with preschoolers. Two hundred twenty-four pediatric occupational therapists completed mail questionnaires designed to ascertain how they use play in their practice, their knowledge and use of play assessments, and potential constraints on their use of play. Although respondents indicated that play was important in motivating children and frequently used play as a treatment modality or reinforcer, they less frequently assessed play behaviors or wrote treatment goals and objectives related to play. Differences were found between school-based and non-school-based respondents regarding the discipline or model that addresses play in the work setting, the use of play assessments, and constraints that limit the use of play in the work setting. The results suggest a need for increasing the emphasis on play in entry-level curricula and continuing education, improving clinician access to valid and reliable play assessments, and completing studies designed to examine the use and efficacy of play in occupational therapy intervention.

A curriculum based on systems theory.

This paper describes an entry-level curriculum based on systems theory that was designed to promote integrated thinking and a shared image of practice among all of the members of an educational community that included students, faculty, and clinicians. Initiated in 1983, the program integrates occupational therapy theory, critical thinking, and knowledge about person-environmental transactions with traditional medical, biological, psychological, and sociological course work to create a unique educational experience. The curriculum model is based on a spiral learning process that encourages integrated thinking. Furthermore, all concepts are systematically tied to the occupation core, the central theme of the program. Fieldwork is used to reinforce ideas presented in the classroom and features discrete learning experiences where students demonstrate their integration of knowledge and skills. In an evaluation of the program, responses from 78 clinician, 51 alumni, and 132 student questionnaires; feedback from 132 fieldwork supervisors; and longitudinal data from 33 alumni confirmed that graduates are critical thinkers who appreciate the diverse needs of clients while demonstrating an appreciation for the curative effect of meaningful, goal-directed activities.

Negotiation Skills in the Entry-level Curriculum. Price C (presenter); University of Louisville, 423 Deerfield Lane, Louisville, KY 40207.

Negotiation Skills in the Entry-level Curriculum. Price C (presenter); University of Louisville, 423 Deerfield Lane, Louisville, KY 40207.

A Survey of Technology Education in Entry-Level Curricula: Quantity, Quality, and Barriers

A Survey of Technology Education in Entry-Level Curricula: Quantity, Quality, and Barriers

Educating Entry-Level Occupational Therapy Students in Gerontology

The need for gerontic occupational therapists is increasing as the number of elders increases. The practice of including gerontologic content in occupational therapy entry-level curricula is relatively new. This article provides a rationale for including gerontologic content in entry-level occupational therapy curricula and presents the results of a brief survey conducted in November 1990 of all accredited and developing entry-level professional occupational therapy programs in the United States. Seventy-one percent of the entry-level programs responded. All of the responding programs included some gerontologic content in their curricula, and 82% of the responding programs indicated that the amount of gerontologic content in the required curriculum had increased in the past 5 years. Other gerontologic elements examined were courses offered and topics included in entry-level curricula, textbooks used, and gerontic fieldwork requirements.

Preparation of Entry-level Students for Future Roles as Clinical Instructors

In the clinical rotation sites affiliated with Indiana University, physical therapists commonly assume the position of clinical instructor within a year of entry into the profession. Most entry-level curricula do not incorporate instruction in the skills necessary to become an effective clinical instructor. This article discusses the 5-year evolution of an entry-level course designed to provide knowledge on the development of a clinical education program and the roles and responsibilities of clinical educators. The format and resources utilized to develop this body of knowledge regarding clinical instruction are presented so that other programs can adopt such a segment into their own curriculum.

Joint mobilization education and clinical use in the United States.

Joint mobilization in the physical therapy evaluation and treatment of patients with synovial joint dysfunction has come into general use only within the past decade. The purposes of this study were 1) to collect survey data regarding the education of physical therapists in mobilization techniques, 2) to examine quantitative changes in entry-level curricula from 1970 to 1986, and 3) to examine basic and continuing education opportunities and determine whether physical therapists are making use of these opportunities. Using chi-square analysis, significant changes (p less than or equal to .01) were found in the number of entry-level programs offering instruction in joint mobilization techniques and in the interest in initiating or expanding relevant course work. In the survey of practicing physical therapists, the increase in the number of therapists who have had instruction in mobilization techniques was also found to be significant (p less than or equal to .01). These results would seem to indicate that mobilization techniques are becoming more widely used by physical therapists to treat joint dysfunction and that entry-level physical therapy education programs are making an attempt to prepare students by expanding curricula.