Physical Therapist Assistant Education Research Articles

The Impact of COVID-19 on Physical Therapy Clinical Education Experiences in Florida.

Full-time clinical education experiences (CEEs) constitute a significant component of entry-level physical therapy education. COVID-19 challenged clinical education throughout the country by affecting the availability of CEEs. Research suggested that the number of clinical education spots available would stay the same. By contrast, the number of students enrolling in physical therapist (PT) and physical therapist assistant (PTA) education programs continues to rise. In response to the COVID-19 pandemic, students and faculty expressed concerns about the lack of student readiness and the availability of CEEs. The purpose of this study was to examine prepandemic factors that influenced the number of CEE slots available in Florida and the impact that the COVID-19 pandemic had on slot availability. Furthermore, researchers sought to identify factors that prevented a return to prepandemic levels of CEE spot offerings and recognize solutions to overcome those barriers. Finally, the researchers aimed to pinpoint suggestions to enhance collaborations between the clinical sites and physical therapy education programs. Forty-eight site coordinators of clinical education (SCCEs) from various settings and regions in Florida completed the survey. An online survey was distributed to Florida SCCEs to ascertain their perceptions on how COVID-19 influenced clinical education. The researchers used descriptive and inferential statistics to analyze the data. Clinical instructor (CI) volunteerism was the primary determinant of CEE spots available before the COVID-19 pandemic. The number of CEE spots was reduced for both PT and PTA education programs during the COVID-19 pandemic. Although the PTA slots returned to their baseline from 2019, the PT placements remained significantly lower in 2021. Social distancing and CI availability had the most considerable impact on CEE offerings. Site coordinators of clinical education also suggested that the greatest supports needed from the academic institutions were educating students on COVID-19 prevention and providing personal protective equipment (PPE) to students for their CEEs. This article also offers suggested incentives that academic sites can provide their clinical partners, such as in-services earning continuing education units, to enhance their participation in clinical education. All clinical education stakeholders must collaborate to provide students with the required clinical educational opportunities. Academic sites should continue to provide support, training, and incentives to CIs to enhance participation from clinical education sites. Educational programs must add content about COVID-19 to their curriculum and consider providing students with PPE during their rotations to restore the number of CEEs post-COVID-19 pandemic.

The Physical Therapist Assistant Education Summit Report: Prioritized Recommendations for the Future

Background and Purpose: The APTA Academy of Education identified a need to assess the status of physical therapist assistant (PTA) education given changes in contemporary physical therapist practice and health care. In response, a task force was charged to plan a summit that would engage stakeholders in formulation of prioritized recommendations to advance PTA education. Method and Results: The Summit Planning Task Force formulated a 3-phase process: phase 1—surveys emailed to PTA education stakeholders; phase 2—four online modules that informed participants about trends in PTA education and solicited data on perceived strengths and weaknesses; and phase 3—a 2-day facilitated virtual meeting of 37 stakeholders who collaboratively developed the Summit outcomes. More than 2500 individuals contributed to data gathered from phases 1 and 2. Phase 3 participants formulated 3 comprehensive recommendations with associated goal statements, objectives, and strategies intendeds to drive future work in PTA education. Discussion and Conclusions: This report presents detailed methods by which the consensus-driven recommendations were achieved, supporting the Summit Task Force's “vision of the PTA as the educated extender that supports the future of physical therapist practice.” There was not consensus on any one direction that PTA education should take. Findings, however, support an array of flexible opportunities by which career goals of current and future PTAs may be achieved while enhancing patient care by the physical therapist/PTA team. Work to implement recommendations must be shared by all relevant stakeholders in order to move PTA education forward.

Cultural Competence and Cultural Humility: A Dialogue on Adopting a Multimodel Approach in Physical Therapist Education

Background and Purpose. Integrating the concepts of cultural humility and cultural competence into physical therapy (PT) practice may reduce health care disparities and improve patient-centered care. Although several frameworks exist for teaching physical therapist students about cultural competence and cultural humility, discussion about which framework is comprehensive enough to capture the complexity of this topic is unresolved. The purpose of this position paper was to raise awareness in physical therapist and physical therapist assistant (PTA) education about existing frameworks of cultural competence and cultural humility and present a rationale for the inclusion of both in educational approaches. Position and Rationale. This article examines the concepts of cultural competence and cultural humility, explores the differences between these 2 concepts, and provides a rationale for integrating both theoretical constructs into PT and PTA education. Discussion and Conclusion. Cultural competence and cultural humility frameworks are evolving and so should faculty member approaches to teaching this content to PT students. Contemporary pedagogy requires a focused lens through which to prepare students for incorporating cultural awareness into clinical care to avoid potential cultural mismatches. Creating a new framework that synthesizes the principles of cultural competence and cultural humility may encourage more inclusivity. Cultural pedagogy has the potential to improve the patient experience and health outcomes by empowering students to provide care that is sensitive to important patient cultural differences.

COVID-19 Impact on Students in Physical Therapist and Physical Therapist Assistant Education Programs in New York and New Jersey: Key Issues and Recommended Responses

Introduction. In March 2020, after the COVID-19 pandemic surged in New York City, higher education had to either halt or immediately convert to fully online education. Physical therapy program directors in New York (NY) State and New Jersey (NJ) immediately recognized a need to understand the new challenges facing students. Purpose. The purpose of this paper was to identify the challenges that students in physical therapist (PT)/physical therapist assistant (PTA) programs in NY and NJ were experiencing and how institutions could respond to those challenges. Subjects. Students enrolled in a PT or PTA program in NY or NJ; N = 934 (861 PT and 73 PTA). Methods. An online survey was distributed to PT/PTA programs in NY/NJ. The survey consisted of open-ended and closed-ended questions related to academic, financial, and nonacademic issues, transition to online learning, and how institutions could respond to student challenges. Descriptive statistics and thematic analysis were used. Results. The most important challenges that students identified were quality/quantity of hands-on experiences, lack of contact with classmates, personal physical and mental health/wellness, and affording tuition and fees. Some differences were found across geographical regions and graduating cohorts. Physical therapist and PTA student cohorts had the same top concerns. Five major themes emerged from open-ended questions: communication; safe return to campus for psychomotor skills; additional academic resources; recognition of students' financial, mental, and physical health concerns; and, financial support. Discussion and Conclusion. Students in physical therapy education in NY and NJ faced similar challenges because of COVID-19 as observed by other universities worldwide. Physical therapy education can be stressful, and these additional challenges made this time extremely difficult. The findings of this survey can be used to develop a crisis management plan for university emergencies that require program modifications.

Impact of a Self-contained Clinical Learning Space on a Physical Therapist Assistant Education Program

Background and Purpose. Immersion within practice areas or clinical education (CE) experiences are required to be both integrated within the curriculum (ie, integrated clinical education [ICE] experiences) and at the end of the curriculum (ie, terminal clinical education [TCE] experiences) for an accredited physical therapist assistant (PTA) education program. In addition, programs must meet accreditation requirements for ICE and TCE within specified clock hour (520–720) and program length limitations (five semesters). The purpose of this article was to describe one program's model for providing integrated PTA CE in a self-contained learning space and to describe the outcomes achieved in the first 2 years of operation. Method/Model Description and Evaluation. Planning, administrative approval, community fund-raising, and institutional capital budget allocation commitments took 6 years before the Nate Waters Physical Therapy Clinic (NWPTC) at Tulsa Community College, Tulsa, OK, opened in August 2014. The clinic design is based on a learning spaces framework providing students an actual clinic setting to learn and practice skills. The learning space allows students to gain clinical confidence in a comfortable, supportive learning environment, in which time restraints, high productivity requirements, and reimbursement restrictions are eliminated or minimized for the novice student. A mixed-method program evaluation assessed the 2-year performance of the self-contained clinic with two quantitative and three qualitative assessments. Outcomes. Implementation of the self-contained clinic allowed for a curriculum reduction of clinical hours from 680 to 560. The clinic generated an average of 65 visits each month with a range of 41–124 visits. No significant difference was found on the PTA students' midterm scores from the final TCE's Clinical Performance Instrument (PTA CPI, Version 1998) for the 2015 and 2016 cohorts compared with two preclinic cohorts (2013 and 2014), despite 22% less clinical time for the studied cohorts. Qualitative interviews of faculty and students showed three parallel themes and two related themes. Parallel themes in both groups included teaching in context, confidence, and communication, whereas related themes included faculty absence of concerns or complaints and student fear of failure. Students also identified an enhanced PT/PTA role formation as a benefit of the clinic. Discussion and Conclusion. Student experiences in the NWPTC are aligned to support integration of learning in the classroom. Faculty supervision in the clinic reinforces the concepts taught in didactic courses. As a self-funded, self-contained teaching clinic, NWPTC allowed faculty control on curriculum alignment and scheduling, thus allowing for a reduction in required clinical contact hours with no indication of decreased student outcomes. While CE in PTA education programs continues to be predominantly outsourced, a self-contained ICE clinic can be of value to PTA programs.

Perceived Value of Preadmission Physical Therapy Observation Hours and Their Ability to Predict Academic Performance

Introduction. Most physical therapist (PT) and physical therapist assistant (PTA) education programs require applicants to complete observation hours (ObHr) before admission. Observation hours are believed to enable the prospective PT and PTA student to gain knowledge about the profession and increase chances of success in academic programs; however, few studies have examined these relationships. The purposes of this study were to: 1) examine the relationship between the number of ObHr completed and indicators of success in a Doctor of Physical Therapy (DPT) program, 2) identify PT and PTA student opinions and perceived value of the required ObHr, including the number of hours needed to make an informed decision to pursue physical therapy as a career, and 3) identify clinical instructor (CI) opinions about the perceived value of ObHr and their impact on clinic productivity. Methods. Part 1 was a retrospective cohort study, examining data from 323 students who matriculated into a DPT program during a 6-year period (2009–2014). The relationship between admission variables (undergraduate grade point average [GPA], undergraduate math/science GPA, verbal Graduate Record Examination [GRE], quantitative GRE, age, and total ObHr) and outcome variables (National Physical Therapy Examination [NPTE] success, DPT probation status, and DPT GPA) were examined. Parts 2 and 3 focused on perceived value of ObHr gathered from surveys of PT and PTA students and CIs. Results. The number of ObHr was not a significant predictor of NPTE success, DPT probation status, or DPT GPA. Most PT (92%) and PTA (83%) students believed that ObHr positively impacted their decision to pursue physical therapy as a profession and that they needed 40–60 hours to make this decision. Most CIs (64%) do not believe that reducing ObHr opportunities would result in an increase in the number of full-time clinical experiences offered by their clinic. An overwhelming majority of the CIs (95%) believed that ObHr are meaningful for prospective students. Discussion and Conclusion. Observation hours were perceived as being valuable by both PT and PTA students and CIs. Observation hours may be useful to prospective PT students to help determine whether they pursue a career in physical therapy. However, there is no evidence that ObHr impact DPT academic performance. Physical therapist students may need fewer ObHr to confirm a career choice than what some programs currently require.

Predicting Academic and Licensure Examination Success Among Physical Therapist Assistant Students

Introduction. Identifying and admitting students most likely to succeed is key to physical therapist assistant (PTA) student and program success. However, there is currently no information available regarding admission criteria outcomes among PTA students. The purpose of this research was to examine quantitative PTA program admission criteria and their ability to predict student academic and National Physical Therapy Examination (NPTE) success. Methods. All CAPTE-accredited PTA programs were asked to return data for each student admitted to the program since 2009 including those who graduated, were dismissed, or left the program. Data on 2809 PTA students from 31 programs in 24 states were used for this research. Predictor variables included prerequisite course grades, overall prerequisite GPA, and standardized test scores. Outcome variables included dichotomized academic success (academic difficulty/no academic difficulty) based on research by Utzman et al and ultimate NPTE status (pass/fail). Binary logistic regression with multiple models was used for data analysis. Results. A&P I grade (academic: odds ratio = 1.44, P = .0005; NPTE: odds ratio = 1.72, P = .007), overall prerequisite GPA (academic: odds ratio = 2.02, P = .0005; NPTE: odds ratio = 2.14, P = .0005), and TEAS total score (academic: odds ratio = 1.05, P = .0005; NPTE: odds ratio = 1.06, P = .006) were the only significant predictors of both academic and NPTE success. For both outcomes, A&P I, GPA, and TEAS remained the significant predictors regardless of the program type (public/private/for-profit), students' sex, and students' ethnicity. Discussion and Conclusion. When establishing the PTA program admission criteria, A&P I grade, overall prerequisite GPA, and TEAS total score offer predictive values for both academic and NPTE success regardless of the program type, students' sex, and students' ethnicity. These scores should be important contributors to admission decisions for PTA education.

Recent Graduates’ Perceptions of the Impact of a 1-Month International Service Learning Experience in Kenya During Their Physical Therapist Assistant Education

INTRODUCTIONThe use of international service learning (ISL) by health professions educators, including those in physical therapy, can facilitate the development of attributes to serve a global society through the provision of health care services to communities around the world.1-9 The American Physical Therapy Association strongly promotes the engagement of the profession in improving the health and quality of life of people in a global society.10 Attributes including advocacy, health promotion, social responsibility, communication, cultural competence, and citizenship are all professional practice expectations cited in the standards and required elements documents from the Commission on Accreditation in Physical Therapy Education. Both physical therapist and physical therapist assistant (PTA) graduates are required to show competence in serving others with respect regardless of cultural difierences.11-12 The Commission on Accreditation in Physical Therapy Education specifically expects PTA graduates to identify, respect, and act with consideration for patients'/clients' difierences, values, preferences, and expressed needs in all workrelated activities 11(f27) and to participate in professional and community organizations that provide opportunities for volunteerism, advocacy, andleadership.11(P37) Although approximately 43% of entry-level PT education programs in the United States and Canada have some form of ISL or other international volunteer service as part of the curriculum, there is no evidence that this same type of experience exists within PTA education programs.13In general, service learning has been defined as learning experiences that combine community service with specific learning objectives that emphasize preparation before the experience, reflection by the participant, and reciprocity of benefit for the person being served and the person who is serving.14 Pechak and Thompson specifically defined ISL as a structured learning experience where students accompanied by faculty travel to different countries and immerse themselves in a culture different than their own.15(f71)REVIEW OF LITERATUREMany health-related education programs, including occupational therapy, social work, dental hygiene, nursing, physician assistant, and medicine programs, have included ISL and have examined how the experiences influenced the development of the skills, attitudes, and awareness needed by graduates to deliver culturally competent care. The benefits of ISL in these programs were associated with improvements in cultural awareness and understanding, cross-cultural communication skills, the ability to work with people from different cultures, open-mindedness, and an appreciation for community and civic engagement.2-7,8-16-19 Other benefits included the development of cultural appreciation and sensitivity, improved clinical reasoning and leadership skills, increased confidence, and the ability to advocate for the profession and patients.16-18,20,21 Long-term benefits for nurses included a new appreciation for life, a broader view of the profession, and improved confidence and effectiveness as practitioners when working with diverse populations.22Researchers who studied the impact of ISL on physical therapist students found similar professional, emotional, and cultural changes. Both short- and long-term benefits were reported. From a professional perspective, researchers identified short-term improvements in adaptability, critical thinking, collaboration with peers, development of professional identity and role formation, leadership, communication skills, and confidence as a clinician.8,23-26 Short-term emotional changes in physical therapist students were found by Hayward and Charrette,23 who reported statistically significant positive changes in the emotional resilience category of the Cross Cultural Adaptability Inventory.27 Multiple researchers reported improvements in components of cultural competence, such as cultural readiness, ease of acknowledging and accepting diverse populations, expanded worldviews, appreciation for global issues, heightened sensitivity to others' cultural values and differences, and motivation to make culture a primary concern in future practice. …

Integrating Safe Patient Handling Into Physical Therapist Education: Reducing the Incidence of Physical Therapist Injury and Improving Patient Outcomes

BACKGROUND AND PURPOSESafe patient handling (SPH) programs were introduced in the United States in the late 1990s by the American Nurses Association (ANA) to combat work-related musculoskeletal disorders (WMSDs) by incorporating a combination of education, technology, and policies to help guide health care workers to safely and effectively move patients with impaired mobility.1 SPH programs and policies adopted by nursing relate primarily to patient transport. Physical therapists (PTs) should consider SPH programs both for safe patient transport and as a therapeutic tool. The focus of this position paper is on the incorporation of SPH programs in PT education. While this content applies to physical therapist assistant (PTA) education as well, it is not explicitly addressed in this position paper.The American Physical Therapy Association (APTA) supports the use of SPH programs in physical therapy practice and adopted a position in 2012 regarding the roles of PTs and PTAs in SPH.2 The position reinforces that PTs and PTAs should be the leaders in multidisciplinary health care teams in modeling the appropriate use of SPH. Both the ANA and APTA have advocated for implementing SPH programs to help tackle the vast number of debilitating and sometimes career-ending musculoskeletal injuries that occur among health care professionals when performing manual mobility activities.1,2 When manual patient handling techniques such as transfers, bed mobility, and gait are deemed risky, these programs advocate the ergonomic strategy of using equipment to assist with patient handling.The United States has been slow to implement policies regulating SPH. Since 2003, there have only been 11 states that have enacted SPH regulations to help enforce the use of technology to mobilize patients.3 The Occupational Safety and Health Administration (OSHA) has issued recommendations for SPH programs to establish policies which guide facilities in obtaining appropriate equipment, training staff, collecting data, and evaluating the effectiveness of the program.2,4 Some facilities develop formal policies in attempts to reduce worker injuries. These policies can include guidelines to ensure appropriate equipment is available to workers as well as train workers in the safe use of the equipment.5,6 In physical therapy practice, SPH equipment includes, but is not limited to, floor and ceiling mechanical lifts, sit to stand lifts, overhead track and harness systems, and body weight supported treadmill training.While there is little information regarding the efficacy of SPH programs in physical therapy practice, the implementation of SPH programs has been shown to be very effective in improving safety for patients and health care professionals in a variety of situations and settings. The ANA provides a summary of literature related to multiple health care disciplines and reports that SPH programs have increased job satisfaction, decreased worker compensation claims, decreased employee turnover, and reduced the incidence of health care worker injuries by up to 95%.* Li et al7 reported reductions in injury rates, lost workdays due to injuries, worker compensation, and musculoskeletal complaints after utilization of SPH devices. The health care workers also reported increased job satisfaction.5 Yassi et al8 reported that a healthier environment emerged as the equipment decreased fatigue of workers, improved comfort with patient handling tasks, and increased the perception of safety among staff. These findings are consistent with a systematic review conducted by Tuller et al,9 which concluded that there is moderate evidence that SPH programs improve musculoskeletal health of providers and decrease the incidence of staff WMSDs. Collins et al10 proposed a mechanism for injury reduction through use of SPH equipment. They demonstrated that mechanical lifts reduced compressive forces to the spine of skilled nursing facility personnel by 60%, removed two-thirds of lifting demand per transfer, and increased perceptions of comfort and security by patients when compared to being manually transferred. …

Institutional and Program Factors Predict Physical Therapist Assistant Program Graduation Rate and Licensure Examination Pass Rate

Background and Purpose. Physical therapist assistant (PTA) education experienced a 34% increase in the overall number of accredited and developing programs from 2007 to 2012. While PTA programs have primarily been housed in not-for-profit institutions, 60% of developing PTA programs in 2014 were housed in for-profit institutions. In light of these changes, purposes of this study were to: (a) identify institutional and program factors related to graduation rate and licensure pass rate in PTA education programs and (b) determine whether institutional and program factors were predictive of successful graduate outcomes. Subjects: Deidentified data from the 274 PTA programs in the United States that had graduates in 2012 were utilized. This study was part of a larger investigation that also included physical therapist (PT) programs. Methods. Spearman rank correlation coefficients were calculated to examine relationships among selected predictor variables and outcome variables of graduation rates, first-time licensure pass rates, and 3-year ultimate pass rates. Prediction models were developed using stepwise regression analyses for variables that demonstrated significant correlations. Additional analyses were conducted to provide clarity on the characteristics of the variable institutional status (for-profit or not-for-profit). Results. Nonparametric analyses revealed significant weak correlations with PTA graduation rate for 3 variables. The percentage of program weeks in full-time clinical education was positively associated with graduation rate, while complete program length and total operating expenses per graduate were negatively associated. Predictors of graduation rate were total operating expenses per graduate and percentage of full-time clinical education. For-profit institutional status and number of cohorts per year demonstrated weak to fair significant negative correlations with licensure pass rates (ultimate and first-time). The single predictor of first-time and ultimate pass rates, a negative predictor, was for-profit institutional status. Discussion and Conclusion. Our findings identified clear distinctions between factors related to graduation rates and factors related to licensure pass rates. Programs with a greater percentage of program weeks consisting of full-time clinical experiences had higher graduation rates. The optimal percentage of program time devoted to clinical education has not previously been investigated and warrants further study. Programs in for-profit institutions had lower licensure pass rates than programs in not-for-profit institutions. This finding was consistent with the literature in higher education and merits further investigation since the majority of developing PTA programs is housed in for-profit institutions. The results of this study may inform stakeholders in PTA education, including program faculty, administrators, students, the Commission on Accreditation in Physical Therapy Education (CAPTE), and the public.

Leadership Retention in Physical Therapy Education Programs

Background and Purpose. Program leadership is a key to achieving program outcomes and meeting the program’s mission. The Commission on Accreditation in Physical Therapy Education (CAPTE) requires that programs have qualified and effective academic administrators. In recent years, CAPTE has noted a high rate of attrition among academic administrator positions for physical therapist (PT) and physical therapist assistant (PTA) education programs. Therefore, a survey was developed to help identify the reasons program directors were leaving their administrative positions. Subjects. The survey was sent to individuals who had vacated positions as directors of PT or PTA education programs during the 3-year time period from 2008 to 2011. Seventy-nine individuals returned surveys for a response rate of 59%. Methods. The survey was developed by the members of CAPTE’s Central Panel. Members of the other 2 panels (PT and PTA) reviewed the survey for clarity and face validity. The survey was sent electronically to former program directors. Survey items included demographic information, institutional classification, years of academic experience, and reasons for leaving an administrative position. Results. Individuals who had directed PT programs comprised 58% of the sample versus 41% who had directed PTA programs (1% directed both). The most frequently cited reasons for leaving administrative positions included: (1) a perceived lack of resources or support from university administration or some type of internal conflict; (2) excessively high/demanding workloads; (3) inadequate compensation; (4) promotion to a higher administrative position; and (5) inability to hire or retain adequate faculty to operate the program. A greater proportion of PT program directors had prior academic experience compared to PTA program directors. Program directors who had at least 5 years of prior academic experience stayed in their administrative positions longer. Individuals who were hired to direct developing programs were less likely to have had prior academic experience than those who were hired to direct established programs, especially in PTA education. Retention was higher at public and nonprofit private institutions compared to proprietary institutions. Discussion and Conclusion. To enhance retention of program administrators, institutions should consider structuring a development program to support program directors; such a program could include formal or informal mentoring, networking with experienced colleagues in similar positions, and regular communication with supervising administrators (deans and/or chairs). Because most PT and PTA program directors enter their administrative positions without any formal management training, continuing education courses or workshops on topics such as strategic and long-term planning, fiscal and personnel management, and accreditation issues may be particularly beneficial. Prospective program directors may also benefit from exploring the institutional expectations of an administrative position prior to accepting such a position.

Building the Physical Therapy Workforce for an Aging America

BACKGROUND AND PURPOSEA landmark Institute of Medicine (IOM) Report in 2008, Retooling for an Aging America: Building the Healthcare Workforce,1 provided a discouraging assessment of the readiness of the health care workforce to meet the needs of the rapidly growing older adult population and stressed the critical need to enhance educational preparation in geriatrics. The IOM report examined workforce data and educational preparation across the spectrum of health disciplines, concluding that (1) the health care workforce in general is inadequately prepared to deliver effective and efficient health care services to older adults, and (2) the numbers of health care practitioners choosing to specialize in geriatrics is critically insufficient to meet the needs of the population.This is not the first call for greater emphasis on geriatrics in health professional education. This need was widely discussed in the late 1970s and early 1980s.2,3 The IOM's 1978 report 'Aging and Medical Education4 focused on the changing demographics and the need to better prepare clinicians for these changes. The implementation of geriatric education centers (GECs)5 by the US Public Health service in 1983 was spurred by the recognition of this growing and unmet need for better preparation of health care practitioners in geriatrics.In 1990, the APTA's Department of Accreditation, recognizing the critical need for enhanced geriatric content, received an Administration on Aging grant to support a project aimed at enhancing the aging-related content and learning experiences in physical therapist (PT) and physical therapist assistant (PTA) education programs. A survey was conducted, resource manual produced, and a cadre of physical therapy professionals with advanced knowledge in geriatrics were trained as onsite reviewers for the accreditation of PT and PTA academic programs.Despite the effort of many over the years, the gap between the need for and the existence of a well-prepared workforce remains large. A crisis is now upon us. Older adults are currently the predominant group using the health care system. Older adults access the health care system at 3 times the rate of other age groups, have longer hospital stays, have more office visits, and spend more money on health care than other age groups.6 Given our population demographics, this growth will continue for at least the next several decades. A workforce well prepared to deliver quality health services in a resource-efficient and clinically effective manner is essential to meet the health care needs of the population. Quality health care for older adults will not be achieved through the services of specialists alone. All health professionals must have a solid preparation in the management of older adults, and students seeking entry to health professions programs should recognize that the majority of them will regularly work with older adults.The patient demographics within physical therapy mirror other health professions. In the 2011 Analysis of Practice for the Physical Therapy Profession: Entry-Level Physical Therapists7 commissioned by the Federation of State Boards of Physical Therapy, a large and representative sample of PTs reported the percentage of their typical caseload by age bracket (18 or younger, 19-65, 66 or older). The summary data indicated that, on average, 47% of patients managed by PTs are 66 years of age or older. This compares to 37% of patients between 19-65 and 13% of patients 18 years or younger. The parallel document for the PTA, the Analysis of Practice for the Physical Therapy Profession: Entry-Level Physical Therapist Assistants,8 reports that, on average, 63.6% of the patients treated by PTAs are 66 years of age or older, 28.8% are between the ages of 19-65, and 5.5% are 18 years of age or younger. Thus, the older adult constitutes an even higher percentage of the PTAs caseload.Bardach and Rowles9 reported on the contemporary status of geriatric education across 7 health care disciplines, including physical therapy. …

Development of Geriatric Curricular Content Within a Physical Therapist Assistant Education Program

Background and Purpose. The number of older adults within the population of the United States (US) will increase dramatically within the next several decades, and a significant number of these older individuals will require physical therapy services. There is a concern that physical therapists (PTs) and physical therapist assistants (PTAs) will not be adequately prepared to deliver the best possible care to these older adults and those that are prepared will be few in number. Data suggests that PTAs may be more involved than PTs in the day-to-day care of the older adult, especially in skilled nursing facilities. There is little guidance on geriatric content within PT and PTA education programs, and research shows variability in depth of content and approach to geriatric education within physical therapy education programs. Few programs appear to offer dedicated units of geriatric instruction, with most integrating geriatric content across the curriculum. There does not appear to be similar research of PTA programs, but it can be assumed that geriatric content is delivered in similar ways in PTA programs. The purpose of this case report is to describe one approach to geriatric education for the PTA that offers a dedicated unit of instruction on aging and physical therapy for the older adult. Case Description. The PTA program of a small urban community college undertook a complete program review that resulted in a revision to the sequence of courses within the program and a critical look at the content of each course. As part of this review the geriatric unit that had been in existence since 2000, was moved from the first to the second year of the program. This move allowed for greater focus on geriatric specific content and less time spent on instruction in basic skills, which had been the case when the course was offered in the first year. The course was also sequenced in the program in such a way to prepare students for the first full-time clinical education experience. Outcomes. Student reports supported the changes and recognized that the content in the geriatric unit built on previous knowledge and provided a greater understanding of the many issues faced by the older adult. Feedback from clinical instructors has also been supportive of the changes made in the program, although it is not clear whether these changes are directly related to the enhanced geriatric content or to changes made to the program as a whole. Discussion and Conclusion. Although the data is limited, it does suggest that a dedicated unit of instruction in geriatric physical therapy, placed appropriately within a PTA program, not only serves to prepare students to be more successful during clinical education, but also increases awareness of older people in society and the role that physical therapy can play in health, wellness, disease, and at the end of life.

Factors Influencing Physical Therapist Assistant Licensure Examination Success

Background and Purpose. While there is considerable research regarding the predictability of various admission criteria and cognitive and noncognitive variables on licensure examination pass rates and other outcome measures in physical therapy and other health and nursing programs, minimal published attention has been given to these issues in physical therapist assistant programs. The purpose of this retrospective study was to examine the relationship between scores on the national licensure examination for physical therapist assistants (NPTE-PTA) and anatomy and physiology grades (A&P), grade point average in physical therapist assistant coursework (PTA GPA), and scores on the Physical Therapist Assistant Clinical Performance Instrument (PTA CPI). Subjects. Data of 72 students from the years 2003-2005 were collected from 7 New England-based physical therapist assistant programs (all 2-year academic institutions) and from the Federation of State Boards of Physical Therapy (FSBPT). Methods. Bivariate correlation values were examined among the variables, including PTA GPA, PTA CPI scores, A&P grades, and NPTE-PTA scores. Linear regression was explored to determine the predictive value of the independent variables in accounting for variance in NPTE-PTA score. Results. The correlation coefficient between PTA GPA and licensure examination scores (r = .48) was stronger than the previously reported values of between (r = .317 and .367). Discussion and Conclusion. PTA GPA was the best predictor for success on the NPTE-PTA based on higher examination scores. Likewise, this study also confirmed that CPI scores did not predict success on the licensure examination. While A&P grades appear to be valid with a positive, though weak, correlation-they are far less predictive for licensure examination scores than PTA-GPA. A predictive formula for licensure examination success has been proposed. Key Words: Academic administration, Higher education, Evaluation research, Student outcomes. BACKGROUND AND PURPOSE The physical therapist assistant (PTA) has been recognized by the American Physical Therapy Association (APTA) since 1964 as a paraprofessional in the field of physical therapy1 APTA subsequently authorized the training of PTAs at its 1967 Annual Conference.1 The majority of physical therapist assistant education programs are offered in community colleges, consist of approximately 2 years of academic and clinical education, and result in an associate's degree. In order to practice, a PTA must graduate from an accredited educational program. The Commission on Accreditation in Physical Therapy Education (CAPTE) is responsible for accrediting both physical therapist and physical therapist assistant education programs. Educational institutions provide annual data and outcome measures to CAPTE as part of the accreditation process.2 The range of outcome measures examined by CAPTE is similar for both physical therapist and physical therapist assistant education programs, and include graduation rates, licensure examination pass rates, and employment rates at 6 months post-graduation. In addition to graduation from a CAPTEaccredited educational program, 42 jurisdictions also require a passing score on a criterion-referenced licensing examination constructed and administered by the Federation of State Boards of Physical Therapy (FSBPT).3 The FSBPT assists licensing jurisdictions by identifying and promoting uniformity in physical therapy regulatory practices and standards. The same minimum passing score (600) for the Physical Therapist Assistant National Physical Therapy Examination (NPTE-PTA) is required in all of these jurisdictions. CAPTE requires that programs in such jurisdictions demonstrate an NPTE-PTA ultimate passing rate that averages at least 80% for the most recent 3 years.2 Ultimate passing rate is determined by the number of candidates who pass the exam, regardless of the number of attempts required. …

Physical Agents: Theory and Practice, ed 2

Behrens BJ, Michlovitz SL. Philadelphia, PA 19103, FA Davis Co, 2005, paperback, 274 pp, illus, ISBN: 0-8036-1134-X, $ 44.95. The purpose of Physical Agents: Theory and Practice is to provide a textbook for teaching thermal, mechanical, and electrical modalities. The first edition was intended for physical therapist assistant students; however, this newer edition would work well for students in either physical therapist or physical therapist assistant education programs. The book contains 4 sections. The first section, “The Concept of Adjunctive Therapies,” provides background information necessary for the effective use of physical agents. Chapter 1 presents concise information about the physiology, assessment, and theories of pain and information about the process of soft tissue repair. Chapter 2 is titled “Patient Responses to Therapeutic Interventions.” One of the strengths of this book is the underlying concept of this …

Comparison of the Use of Service Learning, Volunteer, and Pro Bono Activities in Physical Therapy Curricula

Background and Purpose. Service to others considered an important attribute of a professional and incorporated into the Guide to Physical Therapist Practice and accreditation criteria. However, little known about the extent of the use of service activities within physical therapist (PT) and physical therapist assistant (PTA) education programs. The purposes of this study were to determine the use of three forms of community-based learning (CBL), service learning (SL), extracurricular volunteer activity (V), and pro bono services (PB) within PT and PTA curricula and to offer a comparison between the two curricula. Methods. Survey questionnaires were sent to the program administrators of all accredited PT programs, requesting information about the use of SL, V, and PB experiences within their curricula. A slightly modified version of this survey instrument was sent to the program administrators of all accredited PTA programs, soliciting similar information. Both survey instruments requested demographic and activity-specific information. Responses were tabulated for each group and then combined to compare between groups. Results. The response rates were 48% and 47% for the PT and PTA programs, respectively. Within the last 7 years, 77% of the PT programs and 61% of the PTA programs had used at least one of the three types of service activities. Of the respondents, 50 PT programs and 38 PTA programs were currently using SL in their curricula. The most frequent goals for incorporating SL were student learning and community benefit for both types of programs. Discussion and Conclusion. Half of those responding to this survey incorporate some form of CBL within their curriculum, and many programs that do not currently include SL are planning to add SL. Service learning and PB services are offered more frequently in PT programs than in PTA programs. This study suggests that physical therapy education increasingly incorporating service opportunities. Key Words: Physical therapy education, Pro bono learning, Service learning, Volunteerism. INTRODUCTION Service emphasized in many fields of professional education, including the health care professions. Altruism considered an extremely important attribute of a physical therapist (PT) and a physical therapist assistant (PTA), as noted in the professional practice guidelines and educational models.1-3 In addition, the accreditation standards for PT and PTA education identify the importance of developing these professional qualities in the educational setting.4 However, the extent of its integration into physical therapy education not known.5 The purpose of this study was to determine the use of three types of community-based learning (CBL)-service learning (SL), extracurricular volunteer activity (V), and pro bono services (PB)-within curricula throughout the United States and to offer a comparison between the two curricula. Service learning a form of experiential education in which students engage in activities that address human and community needs, together with structured opportunities intentionally designed to promote student learning and development.6 Academic credit awarded for learning, in contrast to service hours rendered while volunteering. Service learning aims to provide a reciprocal benefit for the student and the community, whereas extracurricular volunteer activity, according to Furco, is the engagement of individuals in activities where the primary emphasis in the service [emphasis added] being provided and the primary intended beneficiary clearly the service recipient.7(p4) Pro bono services, incorporated into some PT and PTA education programs, provide professional services at no fee or at a reduced fee to people of limited financial means.2,7 Pro bono services are not necessarily linked to academic course objectives or structured reflective opportunities, as required in SL. The following research questions were examined in this study: (1) How many PT and PTA programs are using service activities? …

Needs Assessment of Faculty and Program Directors in Physical Therapist Assistant Education Programs: Implications for Development

Background and Purpose. Declining enrollments and more stringent evaluative criteria for accreditation have had a substantial impact on the faculty and program directors of physical therapist assistant education programs. This survey was conducted to determine the perceived job-related needs of faculty and program directors in physical therapist assistant education programs, their workload, and preferences for faculty development activities. Subjects. A preliminary questionnaire was sent to the directors of the published list of 261 accredited physical therapist assistant education programs. Based on the responses, 414 full-time faculty tvere identified as subjects. Methods. Needs assessment instruments that addressed the areas of teaching, scholarship, and administration were mailed to the subjects. Usable survey questionnaires were returned by 340 individuals (82% response rate). Results. Respondents expressed extensive needs in all 26 items rated. When categorized, they were ranked as scholarship, administration, and then teaching. Respondents to shift their workload from teaching to scholarship, and they ranked workshops and personal assessments highest for faculty development activities. Discussion and Conclusions. The findings of this study indicate that faculty and program directors in physical therapist assistant education programs have extensive perceived needs in their academic roles, especially in the area of scholarship. Workloads and faculty development activities should he designed for this target audience to provide opportunities to address these areas. Key Words: Faculty development, Needs assessment, Physical therapist assistant education. INTRODUCTION Recent actions by the federal government, the Commission on Accreditation in Physical Therapy Education (CAPTE), and the American Physical Therapy Association (Al1TA) have resulted in a climate of profound change for physical therapist assistant (ITA) education programs. For example, the Balanced Budget Act of 1997 and subsequent rulings of the Centers for Medicare and Medicaid (CMS, formerly known as the Health Care Financing Administration) limited the reimbursement for physical therapy services. Private health insurance companies likewise restricted reimbursement and frequency of visits for physical therapy services. This had an immediate negative impact on the employment of PTAs and secondary impact of unprecedented decreased enrollment and subsequent termination of academic programs.1,2 New Evaluative Criteria for Accreditation of Education Programs for the Preparation of Physical Therapist Assistants (Evaluative Criteria)3 were adopted by CAPTE in 2000 and took effect on January 1, 2002. The Evaluative Criteria identified a requisite number of core faculty (2) and minimum characteristics for program directors (master's degree). This caused extensive concern for many PTA program directors who might not be able to secure the resources necessary to maintain an accredited status for the program. Finally, transition to the doctoral degree as the professional-level degree for physical therapists (PTs) has fostered more discussion on the education level for the FIA. In response to these and other factors, the APTA House of Delegates (HOD) charged APTA in 2001 to collaborate with the National Assembly of Physical Therapist Assistants and conduct a study of the preferred future rote of the physical therapist assistant (PTA) including education level, scope of work within physical therapy, employment, and potential market factors.4(p31) while the results of this study due in 2003 will provide long-term planning for the clinical role and academic preparation of the PTA, dicy will not address the immediate impact of diese forces on the faculty and program directors of the PTA education programs. If change Is on the horizon for these individuals, effective faculty development activities must be provided to ensure appropriate performance levels. …

Physical Therapist Assistant Education Over the Decades

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The History of Physical Therapy Education in the United States

emphasis of this special issue is on the history of physical therapist education; one manuscript, however, specifically illustrates the history of physical therapist assistant education. All of the authors describe the early days of physical therapy in the United and the external and internal influences that make physical therapist practice and education what it is today. As you read this issue, you will be impressed by the way societal and political factors, along with the continual evolution of disease, have affected physical therapist practice. Over the years, the manner in which physical therapy professionals dress, talk, and relate to patients has changed markedly. Surges or resurgences of certain diseases have impacted the profession, as has the political arena, from payment structures to the domination by physicians of our profession in the early days. key elements of our profession include practice, teaching, and research. transformations in physical therapy education and practice were very difficult to capture in short manuscripts. authors have provided you with a tour of critical past events. Physical therapy practice has evolved from being prescriptive, with physicians telling physical therapists exactly what to do, to physical therapists practicing independently. proposed national Medicare regulations for payment for direct-access services substantiates how far this profession has come; this issue is discussed by Marilyn Moffat, PT, PhD, CSCS, FAPTA, in The History of Physical Therapy Practice in the United States and by John L Echternach, PT, RdD, HCS, FAITA, in his article The Political and Social Issues That Have Shaped Physical Therapy Education over the Decades. Education has also changed from being prescriptive to evidence-based over the last 80 years, as illustrated by Elizabeth H Littell, PT, PhD, and Geneva Richard Johnson, PT, PhD, FAPTA, in their article Professional Entry Education in Physical Therapy during the 20th Century. At one time, when a teacher entered the room all of the students had to stand up in deference to the instructor. Those days are long gone! Students now expect excellence and challenge their instructors, which would not have been accepted in the early days of physical therapy education. Clinical instruction has also changed with the evolution of the profession. With entry-level doctoral education, identifying and developing superb clinical instructors (CIs) is a challenge. Issues such as finding talented CIs to mentor students continue to be a concern, as does the number of clinical placement sites. Jan Gwyer, PT, PhD, and colleagues, in The History of Clinical Education in Physical Therapy in the United States, describe critical issues that have shaped clinical education. evolution of the Doctorate in Physical Therapy (DPT) has recently been a catalyst for change in the profession. Schools across the county have followed the Creighton University faculty in offering a DPT degree. Creighton University faculty's decision to train doctorally prepared clinicians was controversial, widely discussed, and criticized. They believed in their goal and persevered. Sidney J Stohs, PhD, FASAHP, FACN, CNS, FATS, and colleagues explain the steps in the evolution of the first physical therapist doctoral program in their paper, Initiating Clinical Doctoral Education in Physical Therapy: case of Creighton University. …

History of Accreditation in Physical Therapy Education

The authors review the recognition of physical therapy education programs from 1928 to the present and describe the chronological activities that led to the accreditation process as we know it today. The history, current practice, and the broader national accreditation environment in which the Commission on Accreditation in Physical Therapy Education (CAPTE) must operate are explained. The evolution of the standards used in making accreditation decisions in physical therapist professional education is described along with the changes in the arenas of education and practice that have influenced the accreditation process. Possible and probable changes for the future are proposed. Key Words: Accreditation, History, Physical therapy, Educational standards. INTRODUCTION In 2003, the year after the Commission on Accreditation in Physical Therapy Education (CAPTE) celebrated its 25th year of national recognition as an accrediting agency, a 1977 quote from Rosemary Scully, PT, EdD, which predated CAPTE's initial recognition, is still quite applicable to the profession: Physical Therapy has an ancient history, a proud past, an exciting present, and a challenging future. Education for physical therapy practice has been built on a strong foundation and with resourcefulness and wisdom it should be able to meet the demands of the present and the challenges of the future.1(p159) This article will explore the history of accreditation in physical therapy and the evolution of the standards used in making accreditation decisions in physical therapist professional education. It will describe the changes in the arenas of education and practice that have influenced the accreditation process and the national environmental influences with which each nationally recognized accreditation agency must deal. The work of CAPTE also includes the activities of accreditation related to physical therapist assistant education programs. However, this article will not compare the evolution of the criteria related to those programs nor the changes within the practices of physical therapists that have clearly led to changes in the work done by physical therapist assistants. HISTORY-THE EARLY YEARS Education programs for the preparation of physical therapists have been recognized in some manner since 1928. The American Physical Therapy Association (APTA) first published a list of approved programs in the June 1928 issue of The Physiotherapy Review and continued to publish such a list through 1933. Little is known about the process used to approve programs, but the standards by which they were measured are well documented in the Minimum Standard for Schools of Physical Therapy.2 In 1933, because APTA lucked the financial and human resources needed to manage the accreditation effort, APTA requested and received agreement from the American Medical Association's Council on Medical Education and Hospitals (AMA/CME) to become involved in accreditation and recognition of programs in physical therapy.3 During 1934 and 1935, no additional programs were granted approval, nor was approval withdrawn by either organization. The AMA/CME inspected and approved13 programs in physical therapy using as its standards for approval the Essentials of an Acceptable School for Physical Therapy Technicians.4 An annual list of approved programs was published in the Journal of the American Medical Association beginning August 29, 1936. From 1936 to 1956, the AMA was solely responsible for accreditation activities, though AMA staff did submit a report on each program to the APTA Executive Committee prior the AMA/CME action.5 The Essentials of an Acceptable School of Physical Therapy6 was developed and adopted in December 1949 in collaboration and cooperation with the Council on Physical Medicine and Rehabilitation, APTA, and the AMA Council on Medical Education and Hospitals. COLLABORATION AND CHANGE Although documented evidence is difficult to find, it is rumored that in the mid 1950s the AMA approached APTA and requested that its members become involved in a collaborative accreditation effort. …