Entry-level Physical Therapy Students Research Articles

Clinical education across the physical therapy professional continuum

The Journal of Clinical Education in Physical Therapy (JCEPT) is a peer-reviewed open-access journal that aims to develop and disseminate quality evidence related to clinical education in physical therapy. Over the first 3 years of publishing, the number of article downloads has increased quickly with 2021 downloads more than tripling the previous year. Two articles were downloaded over 200 times in just the last year. This year, JCEPT has been indexed by the Directory of Open Access Journals, and we are on track to meet our goal of PubMed Central indexing within our first 5 years. COVID-19 continues to affect society and education. In this volume, two papers explore the impact of changes imposed on physical therapy education by the ongoing COVID-19 pandemic. Many programs had to make changes to their clinical education routines due to COVID-19 restrictions and sudden limitations in clinical placements. One article explored the effect of fewer preparatory integrated clinical experiences on interpersonal communication skills and confidence in the acute care setting. Another explored the financial impact of COVID-19 on doctor of physical therapy students. JCEPT publishes scholarly work related to physical therapy education affecting any aspect of clinical practice at all levels of the professional continuum.1 The 2022 JCEPT volume, for instance, includes a model of physical therapist assistant learning in an intra-professional pro bono clinical environment with entry-level physical therapy students. For physical therapist education, articles address readiness for telehealth, the effect of integrated clinical experiences on interpersonal communication, decision making, and clinical reasoning. Post-professional topics include developing residents’ clinical reasoning and clinical instructors’ mentoring skills. Physical therapy as a profession requires a commitment to lifelong learning to ensure the profession evolves to best serve the public purpose.2 Lifelong learning is sometimes thought of as simply individual clinicians continually gaining additional knowledge and skill. Moving the profession forward, however, demands more structure.2 A more detailed formulation of lifelong learning includes activities that demonstrate the voluntary participation in professional activities that expand learning and the pursuit of opportunities to develop professionally.3 Examples within this volume include the pro bono clinics, residency training, and clinical instructors participating in simulated learning experiences within the didactic portion of physical therapy training. Advanced degrees and continuing education are also parts of the continuum for future volumes to explore.4 As the journal continues to grow, we expect to publish more papers on topics important to physical therapy clinical education in various forms. JCEPT accepts manuscript types such as original research, narrative and systematic reviews, innovative teaching methods or educational models, clinical education or clinical case reports, and critically appraised topics. Christopher Kevin Wong and Jean Fitzpatrick TimmerbergEditors in Chief

The Effect of On-Site Visits From the Physical Therapy Clinical Instructor Perspective: A Mixed-Methods Approach

Introduction and Review of the Literature. Strong academic–clinical partnerships are necessary to conduct effective, sustainable clinical education for entry-level physical therapy students. On-site visits are conducted by the entry-level physical therapist education program at affiliated clinical sites with identified clinical instructors. The purpose of this mixed-methods study was to explore the experience and impact on-site visits have on the academic–clinical partnership as perceived by physical therapy clinical instructors. Subjects. Participants were licensed physical therapists who have acted as a clinical instructor for at least 1 student from the study program. Ninety-five participants completed an anonymous survey and 14 participated in concurrent semi-structured interviews during the survey period. Methods. A concurrent, triangulation mixed-methods design was used to integrate quantitative and qualitative approaches in data analysis. A validated, novel survey was developed to assess perspectives of partnership using ordinary linear regression equations. A transcendental phenomenological approach explored perspectives of partnership after an on-site visit. The Partnership Success theoretical framework was used to define and frame the concept of partnership within this study. Results. Key findings showed that on-site visits demonstrated a statistically significant increase in perceptions of commitment among participants. On-site visits also appear to improve communication, result in stronger connections between the clinical site and physical therapist education program, and enhance resource sharing based on clinical instructor's interviews. Additionally, program alums demonstrate higher perceptions of trust and communication behaviors as compared with nonalums. Discussion and Conclusion. On-site visits are viewed favorably by clinical instructors who felt the visits positively contribute to the academic–clinical partnership and contribute to elements of the academic–clinical partnership, particularly in the area of perceived commitment. Program alums have different perceptions of partnership than nonalums.

Inter-rater reliability of scapular dyskinesis classification in overhead athletes by entry-level physical therapy students

ABSTRACT Background Scapular dyskinesis (SD) is a dysfunction associated with shoulder pathologies in overhead athletes and its classification is highly complex, especially in entry-level physical therapy students. Objective This research aimed to determine the effect of a video training method on inter-rater reliability of physical therapy entry-level students with no clinical experience while performing SD ratings under 4-type, severity, and ‘yes or no’ criteria in overhead athletes. Methods A total of 49 overhead athletes were evaluated by video recordings in posterior view of lifting tasks. Two entry-level students without clinical experience performed SD classifications according to previously mentioned criteria on both scapula in two separate sessions, with 1 week of difference. Data analysis was conducted based on the kappa coefficient (k) and its confidence intervals (CI). Results The ‘yes or no’ criteria present better results than the 4-type and severity criteria. In addition, a better inter-rater agreement is evidenced in the second measurement compared to the first one. Furthermore, the k coefficients reach values like those achieved by experienced evaluators. Conclusion Video training settings for scapular dyskinesis rating in entry-level physical therapist students with no clinical experience allows better inter-rater reliability values.

A Comparison of Instructional Methods on Clinical Reasoning in Entry-Level Physical Therapy Students: A Pilot Study

Introduction. The primary aim of this study was to provide a comparison of the effects of 2 commonly used pedagogical approaches (paper-based case studies vs authentic patient experiences) on clinical reasoning and critical thinking of second-year entry-level physical therapy students. Current literature reveals a lack of consistency in how clinical reasoning is taught and assessed in physical therapist education. There is a need for evidence-based approaches to develop clinical reasoning in entry-level physical therapy students in the United States. Subjects. Twenty-three students in their second year of a Doctor of Physical Therapy (DPT) degree program participated in this study. Methods. Participants were randomly assigned to a control group or to receive 1 of 2 supplemental learning activities (paper-based case studies or authentic patient experiences). Outcomes measured preintervention and postintervention included the Health Science Reasoning Test with Numeracy (HSRT-N) and the Self-Assessment of Clinical Reasoning and Reflection (SACRR). Data analysis included a comparison of effect sizes of change scores between groups and correlational analysis of pretest scores and student factors. Results. Authentic patient experiences demonstrated a moderate to large effect size for improved HSRT-N scores on 5 of 8 subscales, compared with paper-based case studies. Authentic patient experiences demonstrated a moderate effect size for improved SACRR scores compared with the control group. Discussion and Conclusion. The use of authentic patient experiences may be more effective than paper-based case studies for improving critical thinking and clinical reasoning in an entry-level DPT curriculum.

The effect of real-time feedback on learning lumbar spine joint mobilization by entry-level doctor of physical therapy students: a randomized, controlled, crossover trial

ABSTRACT Objective To examine the effects of real-time, objective feedback on learning lumbar spine joint mobilization techniques by entry-level Doctor of Physical Therapy (DPT) students. Methods A randomized, controlled, crossover design was used. Twenty-four 1st Year DPT students were randomized into two groups. Group 1 (n = 12) practiced with the real-time feedback device first and then without it, while Group 2 (n = 12) practiced without the device first and then with it. Both practice periods with and without the device were 4 weeks long. Data were collected at Baseline, 5 weeks, 11 weeks, and 16 weeks. The crossover period was 5 weeks long, during which neither group practiced with or without the device. Eight force parameters were measured: R1 force; R2 force; Grade III and Grade IV mean peak force, frequency, and amplitude. Results When students practiced with the real-time feedback device, they more closely matched the reference standard for two outcomes: 1) the mean difference in R2 force between student and reference standard was better with device (38.0 ± 26.7 N) than without it (51.0 ± 38.5 N); P = .013; and 2) the mean difference in Grade III peak to peak amplitude force was also better with device (8.9 ± 9.3 N) than without it (11.8 ± 11.0); P = .026. All other force parameters improved when students practiced with the real-time feedback device, however, the differences between when they practiced without the device were not statistically significant. Discussion Real-time, objective feedback using a direct force measurement device improved learning for some aspects of lumbar spine joint mobilization by entry-level physical therapy students. Level of Evidence 2b

An Intervention Enhances Resilience in Entry-Level Physical Therapy Students: A Preliminary Randomized Controlled Trial

Introduction: The purpose of this study was to assess the impact of a resilience curriculum on stress levels, resilience, and protective factors, among physical therapist (PT) students during academic stress. Physical therapist students experience high levels of psychological stress during their education. Individuals with greater resilience are better equipped to handle stress. There is a lack of research examining the effect of resilience interventions in PT students. All students enrolled in an entry-level Doctor of Physical Therapy (DPT) program in Indianapolis, IN were eligible. Forty-three students volunteered to participate and all contributed preintervention and postintervention data for the study. Methods: Participants were randomly assigned to receive a resilience curriculum (n = 22) or to a wait-list control group (n = 21), with the researcher blinded to the assignment. An 8-hour resilience curriculum was delivered in 4 consecutive, 2-hour weekly sessions to the intervention group. Both the intervention and the control groups completed baseline and follow-up assessments. The control group was offered a 2-hour condensed version of the curriculum after postintervention assessments. Outcomes measured included stress, resilience, coping flexibility, optimism, emotions, social support, and illness. Results: There were significantly greater increases in resilience (P = .03) and positive emotions (P = .02) in the intervention group compared to the control group. There were no significant differences in stress, coping flexibility, negative emotions, optimism, social support, or illness symptoms. Less perceived stress, greater coping flexibility, and higher positive mood scores predicted greater baseline resilience, accounting for 56% of the variance. Discussion and Conclusion: This preliminary study demonstrates that a resilience curriculum delivered to DPT students increases resilience and positive emotions. Providing DPT students with tools to improve psychological resilience may better prepare them to meet the demands inherent in entry-level DPT educational programs.

A Pediatric Service-Learning Program in Physical Therapy Education.

The purpose of this report was to describe a pediatric service-learning program in entry-level physical therapy (PT) education in Taiwan. To meet the needs of the local community and provide preclinical service-learning experience to PT students with people with physical disability, a service-learning program of a 2-day camp for children with cerebral palsy (CP) was developed in 2012. To date, 356 entry-level PT students have participated in this program, serving 286 children and their families. Important professional attributes, identified by the World Confederation for Physical Therapy guideline, such as altruism, compassion and caring, cultural competence, personal and professional development, professional duty, social responsibility and advocacy, and teamwork, were in the reflective reports of some of the PT students. The experiences provided by this pediatric PT service-learning program appear to have the potential to foster the development of professional attributes in entry-level PT students.

Defining the Role of the Center Coordinator of Clinical Education: Identifying Responsibilities, Supports, and Challenges

Introduction. Recent changes in physical therapy (PT) education along with changes in health care delivery have placed increased demands on sites providing clinical education. The center coordinator of clinical education (CCCE) has been identified as a critical component of ensuring the quality of clinical education experiences (CEEs). Little is known about how today's CCCEs are performing this position. The purpose of this study was to identify how CCCEs define their role and associated responsibilities in current practice, how they were prepared to be a CCCE, the structure of the clinical learning environment where they work, and available supports and challenges they encounter. Methods. A total of 1,109 CCCEs, identified from the Clinical Performance Instrument, responded to an online anonymous survey. Results. Respondents indicated that many of the CCCE's responsibilities as defined by the American Physical Therapy Association (APTA) 1 are not being performed by all. Most CCCEs schedule students, meet with them while at their site, provide an orientation, monitor novice clinical instructor's (CI's), and assist in crisis intervention when a student is not meeting expectations. Most CCCEs report not having adequate time within their workday for those tasks. Fewer than half of the respondents were given support to attend professional development activities related to clinical education, had a job description provided, or had their role acknowledged on their facility's career ladder. Most CCCEs indicated that they had not been mentored but those who had, found it valuable. Fifty-two percent belong to the APTA, 5.5% were education section members, and 17% of respondents were members of a clinical education consortium. A vast majority of CCCEs requested support in providing crisis management when the student is not meeting expectations, as well as mentoring novice and experienced CI's. Respondents also noted that the best avenue to provide that support would be self-paced online modules. Discussion and Conclusion. There is considerable variability in the way individuals define and perform the role of CCCE. The structure of the clinical learning environment likely impacts the quality of the learning experiences offered, as well as the willingness of the staff to participate in clinical education. Many resources for the CCCE are provided through professional organizations. The results of this study indicate that many respondents are not members of such organizations and may not have access. Integral to the success of clinical education is the need for our profession, clinical facility administration, and clinical education consortia to value and support the vital role of the CCCE as a leader in providing CEEs that culminate in entry-level PT students.

Student Perception of Preparedness for Clinical Management of Adults With Lifelong Disability Using a Standardized Patient Assessment

Background and Purpose. A need exists to increase entry-level Doctor of Physical Therapy student exposure to adults with lifelong disability using novel educational methods. The purpose of this project was to determine whether student perception of preparedness with the knowledge, skills, and attitudes required for the management of lifelong disability was enhanced by the use of a standardized patient (SP) assessment experience with actors trained as adults with cerebral palsy (CP). Method/Model Description and Evaluation. An SP case about a young adult with CP was developed, and an assessment was implemented by a team of faculty members in a neuromuscular management track. Entry-level physical therapy students in their fifth of 7 semesters completed a survey about their perception of preparedness in the 3 learning domains at 3 time points, before (time 1) and after (time 2) the SP assessment and after a 10-week clinical education experience (time 3). Outcomes. Fifty-one students completed a series of 3 surveys. There was no change in student perception of preparation with the knowledge required for physical therapist management of an adult with CP at the 3 time points. Student perception of preparation with skills was increased significantly at time 2 and was maintained at time 3. Student perception of preparation with attitudes was also significantly increased at time 2, but returned to original levels at time 3. Discussion and Conclusion. Use of an SP experience was an educational assessment method that resulted in enhanced student perception of preparedness with the skills and attitudes necessary to work with adults with CP. Physical therapy programs may consider this method to address the need for creative educational strategies to address physical therapist management of lifelong disability.

UMFlint-Nigeria distance transition DPT collaboration – changing physical therapists education and practice in a resource limited country

Background: The Nigeria Society of Physiotherapy and the Medical Rehabilitation Therapists (Registration) Board of Nigeria have set in motion efforts to upgrade baccalaureate entry-level programs in Nigerian Universities to a Doctor of Physical therapy (DPT) entry-level degree. The processes involved in getting approval from various Nigerian Government agencies to commence entry-level DPT will take a few years. An interim strategy to upgrade physical therapists’ (PT) education and practice in Nigeria to the doctoral level, led to a distance transitional DPT (tDPT) collaboration between the University of Michigan-Flint (UMFlint) and Nigeria. The first cohort of the UMFlint-Nigeria tDPT program matriculated in fall 2011 for the 24-months long curriculum. Purpose: This preliminary report identifies factors and challenges related to the successful implementation of a distance tDPT program between a resource rich and a resource limited country. Methods: Matriculation and graduation data of the UMFlint-Nigeria tDPT program were collected. Other collected data include feedback (written, via email) and telephone oral interviews gathered from: (1) matriculated students as they progress through the tDPT curriculum; (2) graduates of the tDPT program; and (3) a handful of employers or current clinical supervisors of matriculated students and tDPT graduates. Factors and challenges contributing to successful program completion were identified. Results: Since Spring 2011, over 50 practicing Nigerian PTs applied for placement in the tDPT program, of which 35 were granted admission (70% acceptance rate). Fourteen of these PTs have graduated with DPT degrees as of fall 2014. Five students required academic remediation, one was dismissed for poor academic performance, while others are still at various stages of completion. Graduates affirmed that the quality of their practice in Nigeria have been positively impacted and noticed by PT colleagues. Graduates reported that theynow receive a higher rate of referrals fromphysicians who noticed better patient outcomes following completion of their DPT degrees. Graduates have also been identified as better clinical instructors to entry-level physical therapy students; and are more competitive for faculty positions in a new/developing PT entry-level education program in Nigeria. Themost impactful tDPT courses included: Systems Review andClinical DecisionMaking (includingDifferential Diagnosis), Evidence-Based Practice Patterns, and Medical Imaging. Factors which ensured success included dedication of UMFlint professors, IT Support, administrative assistance and guidance throughout the program. Challenges included yearly increasing tuition costs at the UMFlint; poor Internet infrastructure, constantly interrupted electricity supply in Nigeria, security challenges and civil unrest in some parts of Nigeria where students reside. Conclusion(s):A collaborative distance tDPT program is already changing education and clinical practice in Nigeria, one physical therapist at a time. Program cost was identified by graduates and current students as themost impactful factor determining ability to complete the tDPT program. Security, Internet and electricity infrastructural challenges in Nigeria were the next most impactful factors. Implications: Distance tDPT program has the ability to change the level of education, clinical practice and quality of physical therapy patient care and outcomes in a resource limited country, if some factors and challenges identified in this preliminary report can be managed.

Physical Therapy Case Files: Orthopaedics

Physical Therapy Case Files: Orthopaedics

Review of: Fundamentals of the Physical Therapy Examination, by Stacie Fruth

INTRODUCTION Stacie Fruth, PT, DSci, OCS, is a physical therapist who teaches in the School of Physical Therapy at the University of Indianapolis. She also has degrees in Kinesiology and Exercise Science. She developed this textbook for entry-level physical therapy students to learn the basic foundation of an initial examination. Fundamentals of the Physical Therapy Examination is organized into two major parts.

Introducing Palliative Care into Entry-Level Physical Therapy Education

There is a paucity of information related to teaching palliative care to entry-level physical therapy students. The aim of this study was to evaluate the impact of an undergraduate course in palliative care on the preparedness of entry-level physical therapy students to practice within the palliative care setting. Participants were all entry-level undergraduate students enrolled in the third year of a 4-year undergraduate degree. All students enrolled in the course, "Physiotherapy Through Lifestages" took part in the learning modules relating to the care of patients undergoing palliative care. A survey instrument was used in the study, a modified version of an existing unpublished written questionnaire previously used to evaluate palliative care education in other allied health professions. Participation in the course resulted in an increase in self-rated knowledge and confidence for working in the palliative care setting for entry-level physical therapy students and is considered to provide a useful ongoing resource for the presentation of this topic material. Although the impact of the delivery of this education module may be considered successful in this regard, it would appear that some of the underlying attitudes and emotional responses to this area of physiotherapy practice were less easily influenced. Further research is required to understand the influences on emotional preparedness of students to undertake this area of study and practice and to determine the optimal stage of study for delivery of this content.

A Comparative Analysis Of Computer-Assisted Instruction And Traditional Lecture Instruction For Administration And Management Topics In Physical Therapy Education

Technological advancements and competition in student recruitment have challenged educational institutions to expand upon traditional teaching methods in order to attract, engage and retain students. One strategy to meet this shift from educator-directed teaching to student-centered learning is greater computer utilization as an integral aspect of the learning environment. The purpose of the present study was to assess the effectiveness of utilizing Computer-Assisted Instruction (CAI) to teach administration and management content in Physical Therapy (PT) education. It was hypothesized that CAI is equally effective for assimilation of information when compared to traditional lecture instruction (TLI). The sample consisted of third-year entry-level PT students enrolled in an Administration and Management course. Thirty-three of forty students who met the inclusion criteria consented to participate. Both the Mercy College and Seton Hall University IRB boards approved the project and all students signed informed consents. Participants were randomly assigned to the control (TLI, n=16) or experimental (CAI, n=17) group. Each participant completed a pretest on the material to be covered and a demographic survey to assess grade point average (GPA), gender, age and computer literacy. Students then attended the course in the designated medium and took a post-test at the end of the semester. There were no significant differences between the two groups for GPA, age or gender. Both groups showed significant improvement from pretest to post-test (51.5±12.7 to 80.6±7.8; p<0.001), and (52.0±9.5 to 85.1±6.1; p<0.001), respectively. No significant difference was found between the groups for baseline knowledge (52.0±9.5 vs. 51.5±12.7; p=0.905), final exam scores (80.6±7.8 vs. 85.1±6.1; p=0.073) or final course grades (90.2±3.0 vs. 90.5±3.1; p=0.763). The hypotheses that CAI is equally effective for assimilation and retention of information presented in a professional management and administration PT class, when compared to TLI, was supported. Areas for further analysis include examining student satisfaction levels, work efficiency and long-term retention of material. With both teaching methods found to be equally effective, educators can utilize CAI to promote a student-centered experience for the high tech learners of today. Hiring faculty from remote locations to fill positions for which candidates are unavailable locally, and allowing instructors to teach multiple sections of the same course at different geographic campuses, is also possible with CAI. Additionally, if the instructor or student is absent or a lecture is not finished in the classroom, the material can be placed online. This new evidence supports the use of CAI in teaching administration and management material to PT students, providing institutions of higher learning with an alternative teaching strategy to meet the needs of today’s students.

Health and Wellness in Entry-level Physical Therapy Students: Are Measures of Stress, Anxiety, and Academic Performance Related?

Purpose: This study investigated the relationship among measures of stress, anxiety, and academic performance in entry-level doctor of physical therapy (DPT) students during the didactic portion of their curriculum. Methods: The State-Trait Anxiety Inventory, yielding separate state anxiety (SAS) and trait anxiety (TAS) scores, and the Perceived Stress Scale (PSS14) were completed by 163 (117 females, 46 males) students from 3 professional DPT programs. Undergraduate grade point average (UGPA) and the physical therapy education grade point average (DPTGPA) were obtained from program personnel. Results: SAS, TAS, and PSS14 scores for females were significantly higher than for males (p < 0.05). The mean SAS and TAS scores for all subjects exceeded norms for working adults of similar age. PSS14 scores for all subjects were higher than normative values for age, and for students. Moderate to high correlations (r5 =0.602-0.705) were found among the measures of stress and anxiety, but low correlations were found between these measures and the academic performance measures. In separate regression analyses by sex, TAS scores explained between 48.7% to 61.1% of the variability in PSS14. Conclusion: Stress and anxiety measures are related and higher in entry-level DPT students than age and gender matched peers. These measures are not strongly associated with, nor can they be predicted, by measures of academic performance.

Comparison of Three Teaching Methods for Learning Spinal Manipulation Skill: A Pilot Study

The purpose of this study was to determine the difference in how a spinal manipulation skill was acquired and retained using one of three learning methods. Twenty-three physical therapy students were divided into three groups. All received training in a spinal manipulation technique. Group 1 (n=8) was trained by an instructor, who gave delayed verbal feedback. Group 2 (n=8) received training via videotape observation. Group 3 (n= 7) was trained by an instructor and given concurrent verbal feedback. The students were then asked to train 10 minutes per day for one week, after which time they were tested. The students were then required to refrain from practice and to return one week later for retention testing. No difference was demonstrated in acquisition of the motor skill between the three teaching methods. A one way ANOVA of the difference of score (Trial 1 – Trial 2) revealed significant differences (p<.05) between groups, and post hoc Tukey follow-up revealed greater differences in the scores for Groups 1 and 2 than Group 3. The three methods of teaching spinal manipulation (video training, delayed feedback, or concurrent feedback) appeared no different in acquiring skill initially. However, the concurrent feedback received by Group 3 appeared to improve retention of spinal manipulation skills. Teaching entry-level physical therapy students complex motor tasks like spinal manipulation may best be accomplished when concurrent feedback is given.

Behaviors of Entry-level Physical Therapy Students That Alert Clinical Instructors to Unsafe and Ineffective Student Performance

Northwestern University Medical School, Programs in Physical Therapy, Chicago, Ill. This work was supported by a grant from the Chicagoland Clinical Educators Forum.

Clinical Performance of Physical Therapy Students in Traditional and Problem-based Curricula

This retrospective study examined the effect of problem-based learning (PBL) on the clinical performance of entry-level physical therapy students at Simmons College. Students had participated in either a lecture-based curriculum or a combination of traditional and PBL approaches. Ratings for 50 items representing critical thinking, self-directed learning, and collaboration on final performance evaluations for three full-time clinical experiences were examined. Chi-square analyses were used to determine curricular effects on evaluation scores. These analyses revealed eight instances of curricular effects. Three of the four effects in favor of the PBL approach were in the area of self-directed learning during the first experience. The four effects in favor of the traditional approach crossed all categories during the first and second experiences. The limitations of the curricular design and performance evaluations included the number of PBL courses in the curriculum; problems with clarity, sensitivity, and application of the performance evaluation tool; and variability in the characteristics of the clinical experiences.

Curriculum to Prepare Diagnosticians in Physical Therapy

The changing nature of health care and the expanding knowledge about diagnoses made by physical therapists require education programs to update their curricula continually. This article describes a curriculum that prepares entry-level physical therapy students to be diagnosticians. The curriculum is characterized by (1) immediate introduction of students to their roles as diagnosticians, (2) instruction in impairment-based diagnostic systems, (3) teaching diagnostic process through instruction in content, and (4) a systematic increase in the complexity of learning. An outline of the four-semester curriculum is provided with brief descriptions of the teaching methods used. Instruments that guide students to make judgments about diagnosis are provided. Examples are given of the classification schemes and diagnoses used for patients with medical-surgical, musculoskeletal, neurological, and cardiopulmonary problems. Preliminary evidence is provided of the extent to which graduates report using the diagnostic skills they have learned, and suggestions are made for encouraging increased usage. Collaborative research is needed to develop further the content on diagnosis in physical therapy.

Management of the Disabled: A Three-Part Curriculum Design to Promote Community Reintegration

The purpose of this article is to describe a three-part curriculum plan to provide entry-level physical therapy students with a comprehensive approach to the management of individuals with physical disabilities. With increasing numbers of elderly and disabled persons living in the community, it is important for physical therapists to provide simple, cost-effective recommendations for this population based on accurate functional assessments. This instructional model involves a sequential design in which students develop assessment and functional management skills that encourage maximal home and community reintegration of patients with a chronic disability. Student response to this design has been very positive.