Pediatric Physical Therapy Education Research Articles

Analysis of a model for pediatric physical therapy and clinical education via telehealth.

Analysis of a model for pediatric physical therapy and clinical education via telehealth.

Thank You All!

Please review the many names on our list of reviewers for 2022. We have a record of 283 reviewers for 2022! This reflects, in part, the increased number of manuscripts submitted. It is through the reviewers' and the editorial team's dedication and commitment to peer review that Pediatric Physical Therapy thrives! Join me in congratulating the award winners for publications in Pediatric Physical Therapy for 2022: The Toby Long Award is given each year to the author of the article deemed the best of the year. This year's recipient is Dr. Kari Kretch and team for “Learn the Signs. Act Early.”: Updates and Implications for Physical Therapists” https://journals.lww.com/pedpt/Fulltext/2022/10000/_Learn_the_Signs__Act_Early____Updates_and.2.aspx The Jeanne Fisher Award is given each year to the author of an article deemed the best of the year written while the first author was a student. This year's recipient is Dr. Diana Early and team for “The Journey: Parental Expectations and Perceptions of Therapy Services for Children with Down Syndrome” https://journals.lww.com/pedpt/Fulltext/2022/07000/The_Journey__Parental_Expectations_and_Perceptions.9.aspx Our collective thanks should go to Adrianna Castilla, Mariah Gonzalez, Lynn Kysh, and Barbara Sargent for their update to the literature on physical therapy management of congenital muscular torticollis. This effort helps keep the clinical practice guideline on torticollis informed with recent research. The Special Communication on pediatric physical therapy education authored by Marisa Birkmeier, Heather Lundeen, Jennifer Furze, James G. Moore, Lisa Dannemiller and Deborah Anderson offers evidence for best practice pediatric education for future students. My thanks for reviewers, authors and all of our readers! Linda Fetters, PhD, PT, FAPTA Editor-in-Chief Santa Barbara, CA

Excellence in Pediatric Physical Therapy Education: Recommendations and Action Items.

This special communication identifies evidence-based recommendations and offers action items to facilitate the uptake of new knowledge from the National Study of Excellence in Pediatric Physical Therapy Education (NSE-Peds). The NSE-Peds identified a conceptual framework consisting of 4 key dimensions and associated elements that dynamically interact to prepare future physical therapists to meet the needs of society. The conceptual framework serves as the Knowledge Creation component of the knowledge to action (KTA) framework, but translation into practice requires the Action Cycle, the second component of the KTA framework. Recommendations and action items provide tangible products derived from the NSE-Peds conceptual framework for application in the Action Cycle. Using the KTA framework, implementation of the recommendations at the level of the individual, program, and organization should enhance pediatric physical therapy education and ultimately physical therapy care provided to children and families.

Commentary on "Comparing Domain-Specific Self-Efficacy in Pediatric Physical Therapy Education Across Classroom-Based, Online, and Hybrid Curriculum Designs".

Commentary on "Comparing Domain-Specific Self-Efficacy in Pediatric Physical Therapy Education Across Classroom-Based, Online, and Hybrid Curriculum Designs".

Promoting Interprofessional Collaboration Among Pediatric Physical Therapy Students Through Remote Simulation

Interprofessional collaboration must be taught in healthcare curriculum to ready graduates for the clinic, however, limited evidence is available to guide pediatric physical therapy faculty in best practices. This quantitative retrospective pretest-posttest study examined collaborative competency attainment, satisfaction, and self-confidence of 84 Doctor of Physical Therapy students from four campuses of a private university. Students participated in a live, remote simulated learning experience and completed the Student Satisfaction and Self-Confidence in Learning scale and the Interprofessional Collaborative Competencies Attainment Survey–Revised. There was significant improvement in student collaborative competencies after the simulated learning experience and students were satisfied and confident in the learning experience regardless of demographics. Findings support implementation of a remote simulation for the purpose of interprofessional collaboration in pediatric physical therapy education and may relate to other fields. Future research may explore the influence of interdisciplinary, remote simulation interventions on student behavior in the clinic and patient outcomes.

Comparing Domain-Specific Self-Efficacy in Pediatric Physical Therapy Education Across Classroom-Based, Online, and Hybrid Curriculum Designs.

To describe the pediatric curriculum across 3 years when different instructional designs were used, quantify change in self-efficacy (SE) after completing the curriculum, and define relationships between pediatric experience, SE, and interest in future pediatric practice. Students (N = 137) were included over 3 consecutive years. Instructional design varied across cohorts: classroom-based (n = 48), online (n = 44), and hybrid (n = 45). Pediatric content hours were analyzed. Measures were the Pediatric Communication and Handling Self-Efficacy Scale, pediatric experience, and interest in future pediatric practice. Pediatric content hours met published recommendations. Significant growth in SE occurred for all cohorts, with no significant differences in SE scores based on instructional design. Experience and interest in pediatrics were significantly related to communication SE. The pediatric physical therapy curriculum delivered via classroom-based, online, or hybrid instruction can be effective in promoting pediatric-specific growth in student SE. Remote pediatric experiential learning is a feasible option for physical therapy programs with limited direct contact with children. What this adds to the evidence : When pediatric curricula meet recommended total hours of instruction, regardless of instructional method or amount of direct laboratory time with real children, pediatric-specific student SE increases. This supports the use of alternative approaches for experiential learning activities in programs with limited access and availability for direct in-person child interactions. Programs may expand integrated clinical experiences (ICE) opportunities to include telehealth when in-person ICE is limited due to distance or availability in nearby clinical settings. Online learning activities (asynchronous or synchronous) may be viable options for laboratory activities when live child volunteers are limited or unavailable. Use of multiple methods of instruction (classroom-based, online, or hybrid) can be beneficial in covering pediatric physical therapy content and improving SE. This evidence can help programs expand their options for exposing student physical therapists to pediatric practice.

Commentary on "Considering Domain-Specific Experiential Learning: Self-Efficacy in Pediatric Physical Therapy Education".

Commentary on "Considering Domain-Specific Experiential Learning: Self-Efficacy in Pediatric Physical Therapy Education".

National Study of Excellence in Pediatric Physical Therapy Education: Design, Methods, and Results.

The purposes of this study were to identify and describe the attributes of excellence and innovation in professional pediatric physical therapy education and develop a conceptual framework identifying dimensions of excellence. A multimethod case study design based on a grounded theory framework was used. Data collection included review of artifacts and field interviews (individual and focus group). A constant-comparative method for within case and across case was used for data analysis to verify and revise coding schemes, identify categories and subcategories, revise emerging themes, and develop a conceptual framework. Based on results of a predetermined grading rubric, 6 of 17 self-nominated academic sites were selected representing diverse institution types (public/private, Carnegie classification, size) and geographic locations. Pedagogical approaches and method of content delivery varied among programs; all used the essential core competencies. The core pediatric faculty member(s) were Board Certified Clinical Specialists. A conceptual framework was developed based on 4 key dimensions: Culture of Excellence, Exemplary Pediatric Faculty, Pedagogy, and Child and Family as Teacher (CFT), and 16 related elements. CFT is a unique and nonnegotiable dimension of excellence in pediatric physical therapy education, highlighting the partnership between the learner, child, family, and pediatric faculty member. CFT intersects with the other dimensions and integrates their elements (ie, faculty characteristics, contributions from the child and family, use of instructional strategies) to effectively prepare future pediatric physical therapists. Based on the pervasiveness of this dimension in teaching and learning across all programs, this may be the signature pedagogy of pediatric physical therapy education. Results of this study are important to professional physical therapist education administrators, pediatric academic faculty, and clinical educators because they represent an understanding of the attributes of excellence. The model can serve as a guide for best practice in pediatric physical therapy education.

Considering Domain-Specific Experiential Learning: Self-Efficacy in Pediatric Physical Therapy Education.

Variability exists in pediatric training in physical therapy programs. Little is known about educator implementation of curriculum recommendations. Few options exist for evaluating student outcomes following pediatric instruction. The purposes of this study are to describe the pediatric curriculum of a physical therapy program, quantify changes in self-efficacy following pediatric instruction, and define relationships between self-efficacy, prior experience, and interest in future pediatric practice. A prospective cohort study included 48 students. Measures were pediatric content hours, the Pediatric Communication and Handling Self-Efficacy Scale, prior experience, and self-reported interest in future pediatric practice. Pediatric content hours followed published recommendations. There was a significant increase in self-efficacy after pediatric instruction. Prior experience and interest in future pediatric practice were significantly related to self-efficacy. Our results indicate that physical therapy programs reaching the recommended content hours for pediatric instruction support growth in student communication and handling self-efficacy.

Development of a Grading Rubric to Assess Learning in Pediatric Physical Therapy Education.

The purpose of this perspective article is to describe the development and potential use of a grading rubric to assess pediatric psychomotor and clinical reasoning skills in professional pediatric physical therapist students. Feedback from focus groups made up of pediatric physical therapy educators informed development of the rubric. In addition, preliminary reliability and feasibility of the rubric were evaluated using videotaped student performance on a related pediatric case. Pilot data suggest a range of reliability between slight and moderate across the components of the rubric. Both the case and the rubric are included as appendices, and recommendations are provided for implementation and for future research.

Educational Research Priorities for Pediatric Physical Therapy: A Consensus Study.

This study engaged stakeholders internal and external to pediatric physical therapy education in a consensus exercise toward determining and refining priorities and considerations for educational research for pediatric physical therapy. The Delphi method was used to survey 54 physical therapists from 5 stakeholder groups drawn from experts in the field of physical therapy education and from Academy of Pediatric Physical Therapy members invested in educational leadership, research, and/or pediatric physical therapy clinical and residency education. A 4-round survey process revealed 12 educational research priorities and 13 educational research considerations that reached 80% consensus, with clear and consistent top ranking of 4 of these priorities and 4 considerations across all stakeholder groups. As the Academy of Pediatric Physical Therapy continues to develop and advance its capacity and support for educational research, knowledge of these priorities and considerations might be used to guide an educational research agenda.

Moving Toward Excellence in Pediatric Physical Therapy Education: A Scoping Review.

The purpose of this scoping review was to identify and map current evidence that underpins excellence in pediatric physical therapy education. An extensive review was conducted of literature published over a 27-year period regarding pediatric physical therapy/medical/allied health education. Thirty articles were reviewed and analyzed. Articles were classified as levels of evidence 4 to 7. Three major overarching concepts emerged: faculty characteristics, curriculum, and pedagogy. Few published studies with methodological rigor exist on this topic. More research and higher quality studies are needed to identify exemplar programs, curriculum, and pedagogy. The key concepts identified in this review will help inform the definition of excellence, as it is perceived through the lens of pediatric physical therapy educators, clinicians, and students.

Commentary on "Moving Toward Excellence in Pediatric Physical Therapy Education: A Scoping Review".

“How could I apply this information?” The results of this scoping review provide thought-provoking insight into the state of current physical therapy (PT) education to prepare future physical therapists to work with children and their families. The evidence from this review indicates that the level of expertise and pediatric content in entry-level programs has increased over the past 27 years. However, concerns persist as to whether current students are being adequately prepared. The pursuit of excellence is dynamic, and a collaborative process among researchers, educators, and clinicians is recommended. Researchers with expertise in educational research design are needed to implement higher levels of research to explore unanswered questions about the characteristics of faculty who teach pediatric content, effective curriculum practices, and insights into how students learn most effectively driven through active partnerships with pediatric PT educators, clinicians, and students. Seeking information from current pediatric physical therapists and their employers may help inform the effectiveness of education approaches. “How should I be mindful when applying the information?” The central theme of this study is excellence, and the authors remind the readers that the pursuit of excellence includes consideration of culture, context, and values for all stakeholders. Remarkably, the initial intent of the authors was to complete a systematic review but due to the lack of rigor in existing studies, a scoping review was performed. The reader should be mindful that APTA and the Academy of Pediatric Physical Therapy play a vital role in this pursuit toward excellence (summits, conferences, guidelines, published resources, etc). While the focus of this review is entry-level PT education, the conclusions apply to residencies, fellowships, and continuing education for pediatric physical therapists. Barriers to education reform must address practicality issues, limitations of time within a full generalist entry-level program, limitations of access to children and families for learning, and the rising costs of tuition. Elizabeth T. Kennedy, PT, PhD, PCS Department of Physical Therapy Department of Developmental-Behavioral Pediatrics University of South Alabama Mobile, Alabama Sheree Chapman York, PT, DPT, PCS Children's Hospital of Alabama Birmingham, Alabama

Linking the Essential Core Competencies to Pediatric Content in an Entry-Level Physical Therapy Education Curriculum: A Case Report

Background and Purpose. In 2012, the Section on Pediatrics (SoP) established five Essential Core Competencies in Entry-Level Pediatric Physical Therapy Education representing the expected pediatric knowledge base, skills, and abilities of all graduating physical therapist (PT) students. To facilitate the integration of the Core Competencies within curricula and to achieve intended academic objectives, educators need tools to connect or “link” specific didactic content to each of the five Core Competencies and their associated subcriteria. The purpose of the current case report was to introduce a novel systematic approach using linking rules to demonstrate comprehensive inclusion of Essential Core Competencies within professional (entry-level) PT education programs. Case Description. Course descriptions and objectives within the curriculum of an accredited entry-level physical therapy professional program were reviewed for pediatric content. Two investigators independently assigned pediatric curriculum content to the 5 Essential Core Competencies using 10 linking rules. A third investigator was used to establish a consensus during the linking process. Frequencies and percentages representing the inclusion of each of the competencies and their associated subcriteria were calculated. Percent agreement and Cohen's kappa (κ) between the two independent investigators were calculated to evaluate the interrater reliability of the linking process. Outcomes. One hundred sixty-five (17%) of the 976 course objectives within the entry-level physical therapy professional program contained pediatric content. All 5 of the Essential Core Competencies were represented at varying degrees: human development (17%), age-appropriate patient/client management (51%), family-centered care for all patient/client and family interactions (6%), health promotion and safety (12%), and legislation, policy, and systems (7%). The remaining objectives (7%) were considered either General Pediatric Content or Not Covered by the Core Competencies, or Not Definable. The linking process had substantial interrater reliability (κ = 0.76; standard error = 0.09; 95% confidence interval = 0.60–0.93) between the two independent investigators. Discussion and Conclusion. A systematic approach to linking pediatric curriculum content to the Essential Core Competencies was introduced and applied using an integrated professional (entry-level) physical therapy education program. Such reliable systematic processes support best educational practice by confirming that all relevant pediatric content is preserved throughout an integrated physical therapy curriculum and ensures that PT students are provided with the essential knowledge base, skills, and abilities needed to successfully work with children. Future research should apply the linking strategies to nonintegrated physical therapy curricula, programs in other geographic regions, and content outside of pediatrics.

Stepping OUT in Educational Research: Pediatric Physical Therapy Education has Learned to Walk

It is our pleasure introduce special series of articles that will appear in each of the next 3 issues of this journal highlighting key areas of educational research specific pediatric physical therapy education. The purpose of this special series, as stated in the initial call for proposals in 2014, is to focus on identifying the curricular elements and instructional changes that will be necessary ensure the provision of high quality physical therapy services for pediatric patients and adults with lifelong developmental disabilities. To this end, we found it was both necessary enhance our collective understanding of best practice in pediatric physical therapy education and share that more broadly with the physical therapy education community. While the literature on the scholarship of teaching and learning (SoTL) in physical therapy education continues expand in both breadth and depth, the variability of educational practices relative the education of pediatric physical therapy knowledge, skills, and abilities is highly variable across professional physical therapy curriculum. In fact, many of the concerns first identified in 1993 by Cherry and Knutson1 and by Martin2 regarding the limited amount of time spent and the variability in teaching pediatric content as part of the entry-level physical therapy curriculum are still unresolved. More recently, pediatric physical therapy educators have begun strive towards more systematic approach the SoTL using an increasingly broader array of educational research methods answer some of these same questions. To this end, the special series will expand the current literature base.The happenstance of several separate, yet overlapping, key events led this special series. The words and actions of Journal of Physical Therapy Education coeditors, Hack and Gwyer, have demonstrated their support for publishing special series highlight specific topic. In addition, and perhaps more notable, has been the encouragement of the coeditors, through editorials and their own contributions the literature, acknowledging that research of physical therapy education needs be supported by evidence and sound methodology.3-4 In her 2011 McMillan lecture, Dr Jensen spoke directly the need for educational research that will provide evidence on best practices in physical therapist education.5 And more recently, Jensen et al proposed a compelling rationale for building much needed foundation for education research in physical therapy6 The foundations for our work on this series began around the same time.This special series is one of several key outcomes from the first (2012) Pediatric Education Summit sponsored by the Section on Pediatrics (now known as the Academy on Pediatric Physical Therapy, or APPT). This was in part result of the findings of Schreiber et al, as they identified that variability across educational practices among professional physical therapy education programs had not changed much from 1993 compared with their 2010 survey.7 The Education Summit brought together 20 individuals affiliated with pediatric physical therapy education (academic and clinical components), and together, they reached consensus on 5 essential core competencies in pediatric physical therapy education: (1) Human Development, (2) Age-Appropriate Patient/Client Management, (3) Family-centered Care, (4) Health Promotion and Safety, and (5) Legislation, Policy and Systems.8 (Readers who are not familiar with the competencies are encouraged review that work before delving into this special series.) Several additional manuscripts stemmed from that first Summit,9-10 and the formation of the Academic and Clinical Educator (ACE) Special Interest Group (SIG) of the APPT was also born. These efforts helped better describe expectations of pediatric physical therapy education, while both academicians and clinicians tried better understand the best ways teach pediatric physical therapy in the classroom, lab, and clinic. …

PEDIATRIC EDUCATION SPECIAL SERIES: Use of Academic-Community Partnerships in Teaching Pediatric Physical Therapy

BACKGROUND AND PURPOSEInteractive and clinically integrated teaching has long been used and advocated as beneficial component of entry-level pediatric physical therapist (PT) education.1-5 Community-based experiential learning experiences draw from models of clinically integrated teaching2 and from the scholarship of engagement and practice.6-8 These opportunities enabled students to become actively involved in authentic experiences in the community, which have been found to increase students' self-awareness, understanding of community, and their impact on others, as well as bringing about professional transformation.9 Such experiences also helped to reinforce material introduced in the didactic component of an entry-level pediatric physical therapy course (examination, evaluation, and intervention), allowed students to experience real-world examples of topics and issues addressed in the didactic component of the course (family-centered care, lifespan transitions, participation-based physical therapy, and community-based physical therapy services), and prepared students for further clinical experience with children and adults with pediatric-onset disabilities.2,8The purposes of this paper are to (1) describe an academic-community partnership comprised of 5 components within pediatric physical therapy course, and (2) discuss implementation of the academic-community partnership across 2 different student cohorts.Case DescriptionOur program of academic-community partnerships (Figure 1) was initially developed for Doctor of Physical Therapy (DPT) capstone research project with 2 PT students in 2012. The program was subsequently modified and utilized in conjunction with newly developed 2-credit pediatric physical therapy course in 2013. The program was used with this pediatric physical therapy course in 2013 with 55 final-year PT students and in 2014 with 68 students. Use of this program helped address multiple learning objectives for the pediatric physical therapy courseThis academic-community partnership program consists of 5 components: (1) experiential learning, (2) topic/issue selection, (3) literature review, (4) development of an evidence-based project, and (5) research utilization. The goals of this academic-community partnership program are to (1) provide opportunities for active student learning through experiential learning with practicing clinicians, (2) promote student and clinician evidence-based practice utilizing clinical expertise, patient/client values and circumstances, and available research, and (3) promote research utilization amongst students and practicing clinicians.Experiential learning. Small groups of 2 to 5 PT students were paired with local pediatric PTs from variety of practice settings. Schreiber et al describe experiential learning within pediatric physical therapy education as a form of practice-based education that provides exposures and opportunities for students to explore the work, roles, and identities they will encounter as future profession als. It is learning by doing, and occurs within relevant setting.5(p357) Practice settings utilized in this course during 2013 and 2014 included private homes (for early intervention services; 4 sites); public and private preschool, elementary, middle, and high schools (8 sites); inpatient rehabilitation (1 site); and outpatient facilities (6 sites).The experiential learning components of this program were adapted from existing models of community partnerships10,13 and interactive and clinically integrated teaching.1,3,4,5 Students completed total of 3 experiential learning visits for total time of approximately 6 hours. During these visits, students and clinicians were asked to focus on an overview of the child(ren) receiving services, the particular setting in which the child was being seen, examination and evaluation, and intervention. While it was preferred for students to have the opportunity to have hands-on experiences in their pediatric setting, given the nature of and considerations specific to each individual setting, students in some sites were encouraged to actively participate through handson work with pediatric patients/clients while other sites were not able to permit this type of interaction. …

Experiential Learning With Children: An Essential Component of Professional Physical Therapy Education.

The Section on Pediatrics of the American Physical Therapy Association has developed a number of resources to support and improve the consistency of professional pediatric physical therapy education, including a set of core competencies that all graduates must attain. The purpose of this article is to advocate for the inclusion of experiential learning activities with children, including children with participation restrictions, as a necessary component to achieve the core competencies. Experiential learning is a form of practice-based education that provides exposures and opportunities for students to explore the work, roles, and identities they will encounter as future professionals. Experiential learning is learning by doing, and occurs within a relevant setting. Six representative curricular exemplars are presented to provide readers with a variety of suggestions for development and integration of experiential learning. Recommendations for future research are provided and 4 key recommendations are provided.

Perspectives on Pediatric Physical Therapy Education

The Section on Pediatrics convened an Education Summit in July 2012 to examine, discuss, and respond to documented inconsistencies and challenges in teaching pediatric physical therapy content in entry-level professional education programs. This lecture was designed to provide attendees with the history of pediatric physical therapy education, stemming from the author's early involvement with the Section on Pediatrics and as a long-standing academician. The limited literature on pediatric physical therapy education was reviewed and used to highlight the continued variability across programs. The challenge was presented to build upon attendees' scholarship of teaching and learning. These remarks were designed to help understand the growth and development in pediatric physical therapy education over the past 40 years and to encourage others to use what has been learned to build a stronger foundation for the future.

Essential Competencies in Entry-Level Pediatric Physical Therapy Education

The Section on Pediatrics (SoP) convened an Education Summit in July 2012 to examine, discuss, and respond to documented inconsistencies and challenges in teaching pediatric physical therapy (PT) content in entry-level professional education programs. Despite previous attempts by the SoP to provide guidance around teaching pediatric PT, variability continued to be extensive across programs. This article presents the core competencies developed out of the Summit to inform pediatric content in the entry-level PT curriculum. In addition, the core competencies were linked to teaching strategies, learning activities, assessment outcomes, and curricular structures. Consensus was reached on 5 core competencies that represent a knowledge base essential to all graduates of PT programs. In contrast to prior SoP documents, these competencies were specifically designed to focus on knowledge and skills unique to pediatric practice but essential for all graduates of accredited entry-level PT education programs. For more insights from the authors, see Supplemental Digital Content 1, at http://links.lww.com/PPT/A50.

A Description of Professional Pediatric Physical Therapy Education

The purpose of this work was to reexamine the status of professional pediatric physical therapy education in the United States. A task force designed a 16-item survey and contacted representatives from all professional physical therapy programs. Surveys were gathered from 151 programs for a return rate of 75%. Much variability exists across programs in total number of hours devoted to pediatrics (range, 35-210 hours). In addition, almost 60% of respondents indicated that the individual responsible for delivering the pediatric content will be retiring within the next 15 years. These results describe current pediatric professional education and provide numerous opportunities and challenges for the development of optimal professional pediatric education.